Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: EC:2.1.1.69 (BMT)
 2,655 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report 11 years experience with a modified version of a chemotherapy programme in use at the MRC Leukaemia Unit from 1982 to 1984, supplemented by allogeneic bone marrow transplantation in first relapse or second or later remission from 1985. 79 consecutive patients aged 15-60 years with newly diagnosed acute lymphoblastic leukaemia (ALL) were given induction chemotherapy. This included a standard DAT course (daunorubicin, cytarabine and thioguanine) applied as in acute myelogenous leukaemia approximately midway in the induction programme. A 3-year rotating maintenance programme consisted of combinations of cytotoxic drugs used in the induction therapy. CNS prophylaxis did not include CNS irradiation. Allogeneic BMT was not performed in first remission. The overall complete remission (CR) rate was 82% (65/79). 26 patients relapsed (seven first in the CNS). Seven patients underwent allogeneic BMT of whom six are alive and well with a mean observation time of 32 months (range 4-99 months) after transplantation. Three patients died in first CR. Estimated 5- and 8-year overall survival was 51% (95% confidence interval (CI) 39-63) and 47% (CI 33-61). For patients who reached CR, the corresponding figures were 63% (CI 50-76) and 57% (CI 41-73). Estimated disease-free survival in the remitters was 54% (CI 40-68) at 5 years and 44% (CI 28-60) at 8 years. Patient age below 25 years and white cell count below 15 x 10(9)/l at presentation were both found to improve the chance of overall survival.
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PMID:Estimated 8-year survival of more than 40% in a population-based study of 79 adult patients with acute lymphoblastic leukaemia. 780 61

Previous studies of PBPC BMR have found evidence supporting its safety, feasibility, and efficacy when used in a wide range of patients. Although the optimal regimen for mobilization remains a focus of debate, data from the use of combinations of chemotherapy and cytokines suggest that there is more rapid white cell and platelet engraftment than with BMT, which leads to decreased transfusion requirements and, possibly, reduced patient care costs. Recent advances in the field include allogeneic PBPC BMR, negative selection of tumor cells to reduce contamination, and positive selection of CD34+ cells. These new strategies are anticipated to enhance the therapeutic effectiveness of PBPC BMR while minimizing toxicity. Still, the ultimate comparison of PBSC BMR and medullary BMT will depend on the results of well-designed, randomized, controlled clinical trials with long-term outcome analysis. However, the refinement and improvement of mobilization and collection techniques for PBPC BMR continue to add to the armamentarium of current therapeutic approaches for cancer and related nonmalignant conditions and will enable future strategies for ex vivo expansion of progenitor cells and use in gene transfer studies.
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PMID:Peripheral blood progenitor cells for marrow reconstitution: mobilization and collection strategies. 870 52