29 results on '"GOLDSTONE"'
Search Results
2. Anogenital Human Papillomavirus (HPV) Infection, Seroprevalence, and Risk Factors for HPV Seropositivity Among Sexually Active Men Enrolled in a Global HPV Vaccine Trial.
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Tota, Joseph E, Giuliano, Anna R, Goldstone, Stephen E, Dubin, Brady, Saah, Alfred, Luxembourg, Alain, Velicer, Christine, and Palefsky, Joel M
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EPIDEMIOLOGY of sexually transmitted diseases ,SEXUALLY transmitted disease risk factors ,RESEARCH ,SEROPREVALENCE ,MEN'S health ,CONFIDENCE intervals ,PAPILLOMAVIRUS diseases ,HUMAN papillomavirus vaccines ,VIRUS diseases ,DISEASE prevalence ,ANAL diseases ,MEN who have sex with men ,ODDS ratio ,SEXUAL partners ,DISEASE risk factors - Abstract
Background In men, the incidence of human papillomavirus (HPV)–related cancer is rising, but data regarding male HPV infection and seroprevalence are available from only a few countries. Methods This analysis of a global HPV vaccine trial evaluated baseline data from 1399 human immunodeficiency virus–negative heterosexual men (HM) and men who have sex with men (MSM). Key objectives included assessment of HPV prevalence and risk factors for seropositivity to 9-valent HPV (9vHPV) vaccine types (6, 11, 16, 18, 31, 33, 45, 52, and 58), and concordance between seropositivity and prevalent HPV type. Results Overall, 455 of 3463 HM (13.1%) and 228 of 602 MSM (37.9%) were HPV DNA positive for any 9vHPV vaccine type at baseline. Infection prevalence and seroprevalence (≥1 9vHPV vaccine type) were 13.2% and 8.1%, respectively, among 333 HM from Europe, and 37.9% and 29.9%, respectively, among 335 MSM from Europe or North America. Among men with baseline infection, MSM had higher seroprevalence for concordant HPV types (39.5% vs 10.8% in HM). The seropositivity risk (irrespective of baseline infection status) was higher among MSM versus HM (age-adjusted odds ratio, 3.0 [95% confidence interval, 2.4–6.4]). Among MSM, statistically significant seropositivity risk factors included younger age at sexual debut, higher number of receptive anal sex partners, and less frequent condom use. No factors assessed were associated with seropositivity in HM. Conclusions Higher proportions of MSM than HM were HPV DNA positive and seropositive, and concordance between HPV DNA positivity and seropositivity, a potential marker of true infection versus carriage, was higher in MSM. Most MSM and HM were seronegative for all 9vHPV vaccine types, suggesting the potential benefit of catch-up vaccination after sexual debut. Clinical Trials Registration. NCT00090285. [ABSTRACT FROM AUTHOR]
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- 2022
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3. Review of evidence on health aspects of air pollution - REVIHAAP Project.
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Goldstone, Mark E.
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PHYSIOLOGICAL effects of air pollution , *ENVIRONMENTAL policy , *GOVERNMENT policy on air pollution , *PARTICULATE matter , *NITROGEN dioxide - Abstract
The article offers information on a technical report on the review of evidence on health aspects of air pollution (REVIHAAP) project that analyzes some of the questions related to European policies on air pollution and addresses health aspects these policies. Topics include health evidence on the role of fractions of particulate matter (PM); ozone metrics that can be used for health impact assessment; and most relevant exposure period for a short-term limit value for nitrogen dioxide.
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- 2015
4. The Origins of Western Superiority: A comment on Modes of Meta-History and Duchesne's Indo-Europeans Article.
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Goldstone, Jack A.
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INDO-Europeans , *LITERATURE , *RENAISSANCE , *SCIENTIFIC Revolution , *INDUSTRIALIZATION , *EIGHTEENTH century , *HISTORY , *MANNERS & customs - Abstract
The article focuses on the origins of the western superiority based from the Indo-European literature of author Ricardo Duchesne. It says that Duchesne emphasized that the society of Europe was unique. It states that several factors, which include European exploration, Renaissance, and the Scientific Revolution have reflected and demonstrates the Indo-European social culture. It adds that the key economy and culture of European society caused industrialization in 18th century.
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- 2013
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5. Capitalist Origins, the Advent of Modernity, and Coherent Explanation: A Response to Joseph M. Bryant.
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Goldstone, Jack A.
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EAST-West divide , *HISTORY of economic development , *HISTORY of industrialization , *MODERNIZATION (Social science) , *HISTORY ,ECONOMIC conditions in Europe - Abstract
This article discusses the analysis of global economic development during the last thousand years provided by the historian Joseph M. Bryant. Bryant maintains that the West changed institutionally around 1500 and began the process of modernization and industrialization. The author responds from the perspective of the so-called California School, which maintains that economic and social differences between Europe and the rest of the world do not emerge until after 1700 and even then they originated in Great Britain rather than the West as a whole. Econometric data, forensic anthropological records and narrative accounts of the economies of Europe and Asia between 1500 and 1850 are considered.
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- 2008
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6. EUROPE VS. ASIA: MISSING DATA AND MISCONCEPTIONS.
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Goldstone, Jack A.
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ECONOMICS - Abstract
Focuses on the economy of Europe and Asia. Labor productivity growth in European agriculture; History of agricultural productivity.
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- 2003
7. Abdominal CT and the Euratom Directive.
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Dixon, Adrian K. and Goldstone, Karen E.
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APPENDICITIS ,APPENDIX diseases ,IONIZING radiation ,TOMOGRAPHY ,LEGISLATION - Abstract
Legislation about the use of ionising radiation within Europe is being more strictly defined. Since the introduction of the Euratom Directive, each member state is obliged to check that the Directive is being implemented and that referrals are appropriate. Against this background there is also increasing concern about the relatively high radiation dose associated with CT. This article explores these issues and considers one practical example, namely the investigation of appendicitis. [ABSTRACT FROM AUTHOR]
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- 2002
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8. The Rise of the West—or Not? A Revision to Socio-economic History.
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Goldstone, Jack A.
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SOCIOECONOMICS , *ECONOMIC history , *SOCIAL history , *INDUSTRIALIZATION , *DEMOCRACY - Abstract
The debate over the "Rise of the West" has generally been over which factor or factors— cultural, geoographic, or material—in European history led Europe to diverge from the World's pre-industrial civilizations. This article aims to shift the terms of the debate by arguing that there were no causal factors that made Europe's industrialization inevitable or even likely. Rather, most of Europe would not and could not move toward industrialization any more than China or India or Japan. Rather, a very accidental combination of events in the late seventeenth century placed England on a peculiar path, leading to industrialization and constitutional democracy. These accidents included the compromise between the Anglican Church and Dissenters, and between Crown and Parliament, in the settlements of 1689; the adoption of Newtonian science as part of the cosmology of the Anglican Church and its spread to craftsmen and entrepreneurs throughout Britain; and the opportunity to apply the idea of the vacuum and mechanics to solve a particular technical problem: pumping water out of deep mine shafts in or near coal mines. Without these particular accidents of history, there is no reason to believe that Europe would have ever been more advanced than the leading Asian civilizations of the eighteenth and nineteenth centuries. [ABSTRACT FROM AUTHOR]
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- 2000
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9. CAPITALIST ORIGINS OF THE ENGLISH REVOLUTION: Chasing a Chimera.
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Goldstone, Jack A.
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REVOLUTIONS , *CAPITALISM , *COAL mining , *EUROPEAN history - Abstract
The search for the capitalist origins of the English Revolution has an undeniable appeal. The long sixteenth century from 1500 to 1640 saw the spread of enclosures, the expansion of commercial agriculture and overseas trade, the rapid growth of coal mining and shipping, the birth of joint-stock companies for overseas commerce, and culminated in the Revolution. Presumably these events must be closely related. Moreover, the English Revolution was only one of many attacks on European monarchs throughout the early and mid-1600s constituting a "general crisis" of the seventeenth century. By tying the English Revolution to the early stirrings of capitalism, and framing the other anti-monarchal rebellions of the seventeenth century as similarly motivated, albeit lesser, conflicts, one links England's Revolution to contemporaneous events on the continent, thus allowing to view early seventeenth century European history as an integrated whole. Yet belief in the capitalist origins of the English Revolution has proved surprisingly difficult to reconcile with the results of historical research.
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- 1983
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10. A New Historical Materialism.
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Goldstone, Jack A.
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POPULATION ,BAPTISM ,DEMOGRAPHY - Abstract
This article discusses the book "The Population History of England 1541-1871. A Reconstruction," by E.A. Wrigley and R.S. Schofield. Until recently, Europe's demographic history was known only through vague estimates of national populations at widely separated points in time, plus a limited number of often contradictory local studies. A demographic history of a major European nation, over a significant time span, simply did not exist. But Wrigley and Schofield's effort details England's demographic history from the Renaissance through the Industrial Revolution. The key data sources used in the book are records of baptisms, marriages, and burials in 404 English parishes, parishes selected not for their sampling virtues-randomness and representativeness were not part of the process-but for the completeness of their records. Estimates to deal with missing data, underregistration of births and deaths, regional weighting, and the impact of London on national totals are all developed and incorporated into the final results. Briefly, their technique is back projection. The authors use the parish records of baptisms and burials to estimate annual national totals of births and deaths.
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- 1983
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11. Hematopoietic stem cell transplantation for DLBCL: a report from the European Society for Blood and Marrow Transplantation on more than 40,000 patients over 32 years.
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Berning P, Fekom M, Ngoya M, Goldstone AH, Dreger P, Montoto S, Finel H, Shumilov E, Chevallier P, Blaise D, Strüssmann T, Carpenter B, Forcade E, Castilla-Llorente C, Trneny M, Ghesquieres H, Capria S, Thieblemont C, Blau IW, Meijer E, Broers AEC, Huynh A, Caillot D, Rösler W, Nguyen Quoc S, Bittenbring J, Nagler A, Galimard JE, Glass B, Sureda A, and Schmitz N
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- Humans, Middle Aged, Male, Female, Adult, Aged, Europe epidemiology, Adolescent, Young Adult, Transplantation Conditioning methods, Transplantation, Homologous, Transplantation, Autologous, Hematopoietic Stem Cell Transplantation methods, Lymphoma, Large B-Cell, Diffuse therapy, Lymphoma, Large B-Cell, Diffuse mortality
- Abstract
Autologous(auto-) and allogeneic(allo-) hematopoietic stem cell transplantation (HSCT) are key treatments for relapsed/refractory diffuse large B-cell lymphoma (DLBCL), although their roles are challenged by CAR-T-cells and other immunotherapies. We examined the transplantation trends and outcomes for DLBCL patients undergoing auto-/allo-HSCT between 1990 and 2021 reported to EBMT. Over this period, 41,148 patients underwent auto-HSCT, peaking at 1911 cases in 2016, while allo-HSCT saw a maximum of 294 cases in 2018. The recent decline in transplants corresponds to increased CAR-T treatments (1117 cases in 2021). Median age for auto-HSCT rose from 42 (1990-1994) to 58 years (2015-2021), with peripheral blood becoming the primary stem cell source post-1994. Allo-HSCT median age increased from 36 (1990-1994) to 54 (2015-2021) years, with mobilized blood as the primary source post-1998 and reduced intensity conditioning post-2000. Unrelated and mismatched allo-HSCT accounted for 50% and 19% of allo-HSCT in 2015-2021. Three-year overall survival (OS) after auto-HSCT improved from 56% (1990-1994) to 70% (2015-2021), p < 0.001, with a decrease in relapse incidence (RI) from 49% to 38%, while non-relapse mortality (NRM) remained unchanged (4%). After allo-HSCT, 3-year-OS increased from 33% (1990-1999) to 46% (2015-2021) (p < 0.001); 3-year RI remained at 39% and 1-year-NRM decreased to 19% (p < 0.001). Our data reflect advancements over 32 years and >40,000 transplants, providing insights for evaluating emerging DLBCL therapies., (© 2024. The Author(s).)
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- 2024
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12. Scalable and robust SARS-CoV-2 testing in an academic center.
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Aitken J, Ambrose K, Barrell S, Beale R, Bineva-Todd G, Biswas D, Byrne R, Caidan S, Cherepanov P, Churchward L, Clark G, Crawford M, Cubitt L, Dearing V, Earl C, Edwards A, Ekin C, Fidanis E, Gaiba A, Gamblin S, Gandhi S, Goldman J, Goldstone R, Grant PR, Greco M, Heaney J, Hindmarsh S, Houlihan CF, Howell M, Hubank M, Hughes D, Instrell R, Jackson D, Jamal-Hanjani M, Jiang M, Johnson M, Jones L, Kanu N, Kassiotis G, Kirk S, Kjaer S, Levett A, Levett L, Levi M, Lu WT, MacRae JI, Matthews J, McCoy LE, Moore C, Moore D, Nastouli E, Nicod J, Nightingale L, Olsen J, O'Reilly N, Pabari A, Papayannopoulos V, Patel N, Peat N, Pollitt M, Ratcliffe P, Reis e Sousa C, Rosa A, Rosenthal R, Roustan C, Rowan A, Shin GY, Snell DM, Song OR, Spyer MJ, Strange A, Swanton C, Turner JMA, Turner M, Wack A, Walker PA, Ward S, Wong WK, Wright J, and Wu M
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- Academies and Institutes, COVID-19 Testing, Coronavirus Infections diagnosis, Europe, Humans, Reverse Transcriptase Polymerase Chain Reaction, United Kingdom, Clinical Laboratory Techniques, Medical Laboratory Science organization & administration
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- 2020
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13. Remote wireless vital signs monitoring on the ward for early detection of deteriorating patients: A case series.
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Posthuma LM, Downey C, Visscher MJ, Ghazali DA, Joshi M, Ashrafian H, Khan S, Darzi A, Goldstone J, and Preckel B
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- Aged, Aged, 80 and over, Early Diagnosis, Europe, Female, Hospitals, Humans, Male, Middle Aged, Monitoring, Physiologic methods, Remote Sensing Technology methods, Vital Signs physiology, Wearable Electronic Devices
- Abstract
Introduction: Remote wireless monitoring is a new technology that allows the continuous recording of ward patients' vital signs, supporting nurses by measuring vital signs frequently and accurately. A case series is presented to illustrate how these systems might contribute to improved patient surveillance., Methods and Results: Five hospitals in three European countries installed a remote wireless vital signs monitoring system on medical or surgical wards. Heart rate, respiratory rate and temperature were measured by the system every 2 min. Four cases of (paroxysmal) atrial fibrillation are presented, two cases of sepsis and one case each of pyrexia, cardiogenic pulmonary edema and pulmonary embolisms. All cases show that the remote monitoring system revealed the first signs of ventilatory and circulatory deterioration before a change in the trends of the respective values became obvious by manual vital signs measurement., Discussion: This case series illustrates that a wireless remote vital signs monitoring system on medical and surgical wards has the potential to reduce time to detect deteriorating patients., (Copyright © 2020. Published by Elsevier Ltd.)
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- 2020
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14. Prevalence of and risk factors for human papillomavirus (HPV) infection among HIV-seronegative men who have sex with men.
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Goldstone S, Palefsky JM, Giuliano AR, Moreira ED Jr, Aranda C, Jessen H, Hillman RJ, Ferris DG, Coutlee F, Liaw KL, Marshall JB, Zhang X, Vuocolo S, Barr E, Haupt RM, Guris D, and Garner EI
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- Adolescent, Adult, Anal Canal virology, Antibodies, Viral blood, Anus Diseases virology, Australia, DNA, Viral genetics, DNA, Viral isolation & purification, Europe, Genital Diseases, Male virology, Humans, Latin America, Male, Papillomaviridae classification, Papillomaviridae genetics, Papillomavirus Infections virology, Penis virology, Perineum virology, Prevalence, Risk Factors, Scrotum virology, Young Adult, Anus Diseases epidemiology, Genital Diseases, Male epidemiology, Homosexuality, Male, Papillomaviridae isolation & purification, Papillomavirus Infections epidemiology
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Background: We examined the baseline prevalence of penile, scrotal, perineal/perianal, and intra-anal human papillomavirus (HPV) infection in human immunodeficiency virus (HIV)-seronegative men who have sex with men (MSM)., Methods: Data were analyzed from 602 MSM aged 16-27 years with ≤ 5 lifetime sexual partners. Serum samples were tested for antibodies to HPV6/11/16/18. Swab samples were collected separately from several anogenital areas for detection of HPV6/11/16/18/31/33/35/39/45/51/52/56/58/59 DNA., Results: The prevalence of any tested HPV type was 18.5% at the penis, 17.1% at the scrotum, 33.0% at the perineal/perianal region, 42.4% in the anal canal, and 48.0% at any site. Overall, 415 MSM (69.7%) were negative to HPV 6, 11, 16, and 18 at enrollment by both serology and DNA detection. Men residing in Europe and Latin America had significantly increased risk of HPV infection at external genital sites and the anal canal compared to men from Australia. Tobacco use and greater number of lifetime sexual partners was associated with higher HPV infection prevalence., Conclusions: The prevalence of HPV infection is high among young sexually active MSM, with the anal canal being the most common site of infection. Lifetime number of sexual partners was the most important modifiable risk factor for anogenital HPV infection.
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- 2011
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15. The logistic EuroSCORE.
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Roques F, Michel P, Goldstone AR, and Nashef SA
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- Europe, Humans, Risk Factors, Thoracic Surgical Procedures, Coronary Disease surgery, Risk Assessment
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- 2003
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16. An EBMT registry matched study of allogeneic stem cell transplants for lymphoma: allogeneic transplantation is associated with a lower relapse rate but a higher procedure-related mortality rate than autologous transplantation.
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Peniket AJ, Ruiz de Elvira MC, Taghipour G, Cordonnier C, Gluckman E, de Witte T, Santini G, Blaise D, Greinix H, Ferrant A, Cornelissen J, Schmitz N, and Goldstone AH
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- Adolescent, Adult, Aged, Bone Marrow pathology, Burkitt Lymphoma mortality, Burkitt Lymphoma therapy, Child, Child, Preschool, Europe, Female, Hodgkin Disease mortality, Hodgkin Disease therapy, Humans, Lymphoma classification, Lymphoma mortality, Lymphoma pathology, Lymphoma, Non-Hodgkin mortality, Lymphoma, Non-Hodgkin therapy, Male, Middle Aged, Neoplasm Staging, Recurrence, Treatment Outcome, Lymphoma therapy, Registries, Stem Cell Transplantation methods, Transplantation, Autologous adverse effects, Transplantation, Homologous adverse effects
- Abstract
The role of allogeneic bone marrow transplantation in lymphoma remains uncertain. We have analyzed 1185 allogeneic transplants for lymphoma reported to the EBMT registry between 1982 and 1998 and compared the results with those of 14687 autologous procedures performed over the same period. Patients receiving allogeneic transplants were subdivided according to histology: low-grade non-Hodgkin's lymphoma (NHL) 231 patients; intermediate-grade NHL 147 patients; high-grade NHL 255 patients; lymphoblastic NHL 314 patients; Burkitt's lymphoma 71 patients; and Hodgkin's disease 167 patients. These patients received allogeneic transplants as their first transplant procedure. Actuarial overall survival (OS) at 4 years from transplantation was: low-grade NHL 51.1%; intermediate-grade NHL 38.3%; high-grade NHL 41.2%; lymphoblastic lymphoma 42.0% years; Burkitt's lymphoma 37.1%; and Hodgkin's disease 24.7% years. These outcomes are relatively poor because of the high procedure-related mortality associated with these procedures, particularly in patients with Hodgkin's disease (51.7% actuarial procedure-related mortality at 4 years). Multivariate analysis showed that for all lymphomas apart from Hodgkin's disease, status at transplantation significantly affected outcome. A matched analysis was performed: for all categories of lymphoma, OS was better for autologous than for allogeneic transplantation. Relapse rate was better in the allogeneic group for low-, intermediate- and high-grade, and lymphoblastic NHL. It was equivalent for Burkitt's lymphoma and worse in the allogeneic group for Hodgkin's disease. Allogeneic transplantation appears to be superior to autologous procedures in terms of producing a lower relapse rate. The toxicity of allogeneic procedures must however be reduced before this translates into an improvement in OS.
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- 2003
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17. Alpha-interferon maintenance treatment is associated with improved survival after high-dose treatment and autologous stem cell transplantation in patients with multiple myeloma: a retrospective registry study from the European Group for Blood and Marrow Transplantation (EBMT).
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Björkstrand B, Svensson H, Goldschmidt H, Ljungman P, Apperley J, Mandelli F, Marcus R, Boogaerts M, Alegre A, Remes K, Cornelissen JJ, Bladé J, Lenhoff S, Iriondo A, Carlson K, Volin L, Littlewood T, Goldstone AH, San Miguel J, Schattenberg A, and Gahrton G
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- Adolescent, Adult, Aged, Case-Control Studies, Disease-Free Survival, Europe, Female, Hematopoietic Stem Cell Transplantation mortality, Humans, Male, Middle Aged, Multiple Myeloma mortality, Registries, Retrospective Studies, Survival Rate, Transplantation, Autologous methods, Transplantation, Autologous mortality, Hematopoietic Stem Cell Transplantation methods, Interferon-alpha administration & dosage, Multiple Myeloma therapy
- Abstract
The purpose of this study was to evaluate the effect of alpha-IFN maintenance treatment after autologous stem cell transplantation (ASCT) for multiple myeloma in a retrospective registry analysis. 473 patients with multiple myeloma who received IFN maintenance treatment ASCT were compared with 419 patients who did not receive IFN-treatment. Patients who were evaluable for response and in complete or partial remission at 6 months after ASCT were eligible, after excluding patients with graft failure. Cox proportional hazards assumptions were checked and handled by stratification. The prognostic variables unevenly distributed between the two groups were statistically corrected for in the Cox analysis. 391 patients reached complete remission (CR) after ASCT (203 in the IFN group and 188 in the no-IFN group) and 501 were in partial remission (PR, IFN 270, no-IFN 231). Overall survival (OS) and progression-free survival (PFS) were significantly better in the IFN-group (OS, 78 vs 47 months, P = 0.007, and PFS, 29 vs 20 months, P = 0.006, respectively). The difference in OS and PFS was most strongly pronounced in the PR patients. 209 patients have died (IFN, 84; no-IFN, 125). Progressive myeloma was the cause of death in 94% of the IFN-treated patients and in 83% of the no-IFN group (P = NS). Thus, IFN maintenance treatment after ASCT was associated with better OS and PFS. Treatment seemed to be most beneficial in patients who did not achieve CR. The difference in median survival was as long as 2.5 years, and although part of this difference is attributable to differences in other prognostic factors, it might justify possible differences in quality-of-life due to adverse effects of interferon treatment.
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- 2001
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18. Secondary leukaemia and myelodysplasia after autografting for lymphoma: results from the EBMT. EBMT Lymphoma and Late Effects Working Parties. European Group for Blood and Marrow Transplantation.
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Milligan DW, Ruiz De Elvira MC, Kolb HJ, Goldstone AH, Meloni G, Rohatiner AZ, Colombat P, and Schmitz N
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- Adolescent, Adult, Bone Marrow Transplantation methods, Child, Europe epidemiology, Female, Humans, Male, Middle Aged, Multivariate Analysis, Recurrence, Risk Factors, Survival Analysis, Transplantation, Autologous, Bone Marrow Transplantation statistics & numerical data, Leukemia therapy, Leukemia, Myeloid epidemiology, Myelodysplastic Syndromes epidemiology
- Abstract
Between 1978 and 1996 more than 7500 lymphoma transplants have been reported to the European Bone Marrow Transplantation (EBMT) Lymphoma Registry. This has been examined to establish the incidence of secondary leukaemia and myelodysplasia and to relate this to possible prognostic factors. 131 centres representing 4998 patients responded to a questionnaire. This identified 66 patients with post transplant myelodysplastic syndrome (MDS)/acute myeloid leukaemia (AML). The actuarial risk for MDS/AML at 5 years post-transplant (+/-95% CI) was 4.6% (3.1-6.8) for Hodgkin's disease and 3.0% (2.0-4. 3) for non-Hodgkin's lymphoma. Multivariate analysis for all patients demonstrated an effect of age at transplant, radiotherapy at conditioning, number of transplants and interval between diagnosis and transplant as risk factors. For patients with NHL, grade of histology was important (low grade > intermediate or high-grade); for Hodgkin's disease, female sex was identified as a risk factor. These findings suggest that the incidence of MDS/AML may not be greater following an autograft than after conventional chemotherapy.
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- 1999
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19. High-dose chemotherapy with autologous bone marrow rescue in children with poor-risk Burkitt's lymphoma: a report from the European Lymphoma Bone Marrow Transplantation Registry.
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Ladenstein R, Pearce R, Hartmann O, Patte C, Goldstone T, and Philip T
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- Antineoplastic Agents administration & dosage, Child, Child, Preschool, Combined Modality Therapy, Europe, Female, Humans, Infant, Male, Outcome Assessment, Health Care, Prognosis, Registries, Salvage Therapy, Transplantation Conditioning, Antineoplastic Agents therapeutic use, Bone Marrow Transplantation, Burkitt Lymphoma therapy
- Abstract
To evaluate the role of high-dose chemotherapy (HDC) followed by autologous bone marrow transplantation (ABMT) in children with poor-prognosis Burkitt's lymphoma, the European Lymphoma BMT registry was critically reviewed. Between February 1979 and July 1991, a selected group of 89 children (78 boys and 11 girls) were considered as ABMT candidates in 12 European cancer centers for the following reasons: poor initial response (PIR) to first-line chemotherapy in 28 patients, primary refractory disease (PRD) in nine patients, sensitive relapse (SR) in 38 patients, and resistant relapse (RR) in 14 patients. The median age at ABMT was 8.2 years (range, 2.8 to 16.2 years). Thus, this report reflects data for patients surviving the salvage attempt deemed appropriate for HDC/ABMT and who then actually underwent the transplant procedure. The median follow-up period after HDC/ABMT was 4.3 years (range, 2 to 12 years). The prognosis was dismal for PRD patients and those with RR, ie, all patients died within 1 year. The 5-year event-free survival (EFS) was 56.6% (P < .0001) for patients in partial remission (PR) and 48.7% (P = .002) for patients with SR. The toxic death rate was 11.1%. Continuous complete remissions (CRs) in 39.4% of these otherwise incurable children highlight the fact that HDC/ABMT was an effective complementary procedure after conventional-dose chemotherapy protocols used during the given period. In addition, these data show that patients with PRD or RR clearly had no advantage from this aggressive and cost-intensive procedure. It has to be considered that the need for HDC/ABMT has greatly diminished in parallel with the improvement in survival using the modern intensive pulsed CCT of current protocols. To further rescue patients failing to respond to modern protocols, new approaches appear necessary, ie, combinations of HDC with antibody-targeted therapy plus allogeneic BMT for the additional benefits of the potential graft-versus-lymphoma effect.
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- 1997
20. Role of a second transplant in the management of poor-prognosis lymphomas: a report from the European Blood and Bone Marrow Registry.
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Vandenberghe E, Pearce R, Taghipour G, Fouillard L, and Goldstone AH
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- Adolescent, Adult, Child, Europe, Female, Humans, Lymphoma drug therapy, Male, Middle Aged, Prognosis, Registries, Reoperation, Survival Analysis, Treatment Outcome, Antineoplastic Combined Chemotherapy Protocols adverse effects, Bone Marrow Transplantation, Hematopoiesis drug effects, Hematopoietic Stem Cell Transplantation, Lymphoma surgery
- Abstract
Purpose: Treatment of selected patients with poor-prognosis lymphomas with high-dose chemotherapy and marrow or peripheral stem-cell rescue improves prognosis. A second course of myeloablative chemotherapy has been given to some patients, but few data are available on the indications, morbidity, and overall survival associated with this approach. This study was undertaken to evaluate morbidity and identify subgroups of patients who may benefit from a second transplant., Patients and Methods: Thirty-four patients with lymphoma given two cycles of myeloablative chemotherapy and entered onto the European Blood and Bone Marrow Transplant (EBMT) registry between 1982 and 1995 were included in this study: Hodgkin's disease (HD), n = 12; intermediate/high-grade non-Hodgkin's lymphoma (HG-NHL), n = 17; and low-grade non-Hodgkin's lymphoma (LG-NHL), n = 5. The reason for second transplant, status at transplant, conditioning regimen, morbidity, and both progression-free survival (PFS) and overall survival (OS) were assessed., Results: The second procedure was performed for the following reasons: (1) elective double procedure in four patients, (2) relapse after first transplant in 20, (3) partial remission (PR) after first transplant in eight, and (4) refractory disease after first transplant in two. The OS rate at 2 years for patients who underwent two transplants (estimated from the date of second transplant) was 49%, with a median follow-up time of 44 months. The OS rate at 2 years by histologic subtype was as follows; HD, 50%; HG-NHL, 60%; and LG-NHL, 0%. Seven of 15 patients with HD or HG-NHL who relapsed after they had achieved a posttransplant complete remission (CR) remain in CR 13 to 36 months after the second transplant, compared with two of 10 patients in CR (at 6 and 19 months after second transplant) who achieved a PR or had refractory disease after the first transplant. There were eight deaths (24%) before 3 months, of which three (9%) were transplant-related and the remainder due to persistent disease. Three late toxic deaths occurred: two of cardiovascular disease and one of secondary leukemia., Conclusion: Selected patients with HD and HG-NHL whose disease recurs after one transplant may benefit from a second transplant. Patients with refractory disease and LG-NHL did not benefit from a second transplant.
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- 1997
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21. Peripheral-blood stem-cell transplantation versus autologous bone marrow transplantation in Hodgkin's and non-Hodgkin's lymphomas: a new matched-pair analysis of the European Group for Blood and Marrow Transplantation Registry Data. Lymphoma Working Party of the European Group for Blood and Marrow Transplantation.
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Majolino I, Pearce R, Taghipour G, and Goldstone AH
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- Adult, Case-Control Studies, Disease-Free Survival, Europe, Female, Humans, Male, Matched-Pair Analysis, Middle Aged, Multivariate Analysis, Prognosis, Registries, Survival Analysis, Transplantation, Autologous, Treatment Outcome, Bone Marrow Transplantation, Hematopoietic Stem Cell Transplantation, Hodgkin Disease therapy, Lymphoma, Non-Hodgkin therapy
- Abstract
Purpose: To address the question of short-term and long-term advantages of peripheral-blood stem-cell transplantation (PBSCT) over autologous bone marrow transplantation (ABMT), we have reviewed the data of 3,214 patients with lymphoma, 2,859 undergoing ABMT, and 355 undergoing PBSCT., Patients and Methods: Analysis of prognostic factors for progression-free survival (PFS) was conducted separately for non-Hodgkin's lymphoma (NHL) (N = 1,915) and Hodgkin's disease (HD) (N = 1,299). In multivariate analysis, the relevant factors were status at transplant for NHL and sex, size of largest mass at transplant, status at transplant, and conditioning regimen for HD. The pair analysis was carried out by matching NHL and HD patients separately by their prognostic factors. Additionally, NHL patients were matched for histology, whereas both HD and NHL patients were matched for date of transplant. With this method, 454 patients were matched in the NHL group and 256 were matched in the HD group., Results: The overall survival (OS) and PFS unexpectedy were better for ABMT versus PBSCT patients in the HD group (OS, 65.3% at 4 years for ABMT v 52.7% for PBSCT; P = .0198). There was no difference in OS or PFS in the NHL group (OS, 56.6% at 4 years for ABMT v 52.7% for PBSCT; P = .4148). The overall relapse or progression rate at 4 years for NHL was 42% after ABMT and 49.2% after PBSCT (P = .1220); for HD, it was 40% and 58.6%, respectively (P = .0164). Transplant-related mortality was lower, but not significantly, with PBSCT: 7.0% for ABMT versus 3.5% for PBSCT in NHL (P = .1356) and 7% for ABMT versus 4.7% for PBSCT in HD (P = .6056). Hematologic recovery occurred faster significantly with PBSCT irrespective of disease., Conclusion: This study confirms the advantage of PBSCT in terms of hematopoietic reconstitution, but it fails to show any superiority in the long term. Poorer results for both progression free and overall survival observed in HD patients who are receiving PBSCT are unexplained and should be confirmed with randomized studies.
- Published
- 1997
- Full Text
- View/download PDF
22. The European Group for Blood and Marrow Transplantation (EBMT): a report from the president and the chairmen of the working parties.
- Author
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Gratwohl A, Gorin C, Apperley J, Goldstone A, Rosti G, Bacigalupo A, Gluckman E, Fischer A, Ljungman P, Kolb HJ, and Niethammer D
- Subjects
- Adult, Anemia, Aplastic therapy, Child, Clinical Trials as Topic, Communicable Diseases therapy, Europe, Humans, Leukemia therapy, Lymphoma therapy, Neoplasms therapy, Transplantation Immunology, Bone Marrow Transplantation trends, Hematopoietic Stem Cell Transplantation trends
- Published
- 1996
23. Retrospective evaluation of autologous bone marrow transplantation vs allogeneic bone marrow transplantation from an HLA identical related donor in acute myelocytic leukemia. A study of the European Cooperative Group for Blood and Marrow Transplantation (EBMT).
- Author
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Gorin NC, Labopin M, Fouillard L, Meloni G, Frassoni F, Iriondo A, Brunet Mauri S, Goldstone AH, Harousseau JL, Reiffers J, Esperou-Bourdeau H, and Gluckman E
- Subjects
- Acute Disease, Adult, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Bone Marrow Transplantation mortality, Child, Combined Modality Therapy, Disease-Free Survival, Europe epidemiology, Female, Histocompatibility, Humans, Leukemia, Myeloid drug therapy, Leukemia, Myeloid mortality, Male, Middle Aged, Prognosis, Registries, Remission Induction, Retrospective Studies, Treatment Outcome, Bone Marrow Transplantation statistics & numerical data, Leukemia, Myeloid therapy, Transplantation, Autologous, Transplantation, Homologous
- Abstract
We analyzed retrospectively data from 1696 patients with AML transplanted in Europe from January 1987 to December 1992 and reported to the acute leukemia EBMT registry. Groups of patients were analyzed according to age (adults and children) and status at transplant (first remission = CR1; second remission = CR2). (1) 1114 adult patients were transplanted in CR1; 516 received an allograft; 598 received an autograft. Following alloBMT, the transplant-related mortality (TRM) was significantly higher (27 vs 13%, P < 10(-4)), the relapse incidence (RI) lower (25 vs 52%, P < 10(-4)) and the leukemia-free survival (LFS) better (55 vs 42%, P = 0.006). Favorable prognostic factors for alloBMT were a FAB type other than M4-M5, a donor-recipient combination excluding a female donor to a male recipient, and a younger age. Favorable prognostic factors for ABMT were a younger age of the patients at time of transplant, the AML3 FAB type, and a longer interval from CR1 to ABMT. (2) 288 adult patients were transplanted in CR2: 98 received an allograft; 190 received an autograft. The TRM was higher following allogeneic BMT (32 vs 20%, P = 0.02) and the RI lower (42 vs 63%, P = 0.001). The LFS was not significantly different (alloBMT: 39%; ABMT: 30%, P = 0.22). (3) 242 children were transplanted in CR1; 129 received an allograft; 113 received an autograft. Following alloBMT, the RI was lower (25 + 5 vs 48 + 6%, P < 10(-4)), and the LFS better (68 vs 47%, P = 0.002). The use of TBI was a favorable prognostic factor in allografted patients with a lower RI and a better LFS. (4) The number of children transplanted in CR2 was too small for a comparative analysis. These results confirm that both allogeneic and autologous BMT are suitable curative approaches for AML. They favor the use of an HLA identical related allogeneic transplant when available, especially in younger patients, over ABMT with unpurged marrow. The role of purging in ABMT could not be addressed in this study.
- Published
- 1996
24. Allogeneic bone marrow transplant is not better than autologous transplant for patients with relapsed Hodgkin's disease. European Group for Blood and Bone Marrow Transplantation.
- Author
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Milpied N, Fielding AK, Pearce RM, Ernst P, and Goldstone AH
- Subjects
- Adolescent, Adult, Case-Control Studies, Europe, Female, Graft vs Host Disease, Humans, Male, Middle Aged, Probability, Proportional Hazards Models, Survival Analysis, Transplantation, Autologous, Transplantation, Homologous, Treatment Outcome, Bone Marrow Transplantation methods, Hodgkin Disease therapy
- Abstract
Purpose: To compare the results achieved with myeloablative therapy followed by either allogeneic bone marrow transplantation (alloBMT) or autologous bone marrow transplantation (ABMT) for patients with Hodgkin's disease (HD)., Patients and Methods: Of more than 1,200 patients with HD reported to the European Bone Marrow Transplantation (EBMT) registry, 49 underwent alloBMT. Of these, 45 with sufficient data were matched to 45 patients who underwent ABMT. The matching criteria were sex, age at time of transplantation, stage of disease at diagnosis, bone marrow involvement at diagnosis and at transplantation, year of transplantation, disease status at time of transplantation, time from diagnosis to transplantation, and conditioning regimen with or without total-body irradiation (TBI)., Results: The 4-year actuarial probabilities of survival, progression-free survival (PFS), relapse, and non-relapse mortality were 25%, 15%, 61%, and 48% and 37%, 24%, 61%, and 27% after alloBMT and ABMT, respectively. The toxic death rate at 4 years was significantly higher for alloBMT patients (P = .04). For patients with sensitive disease at the time of transplantation, the 4-year actuarial probability of survival was 30% after alloBMT and 64% after ABMT (P = .007). This difference is mainly due to a higher transplant-related mortality rate after alloBMT (65% v 12%, P = .005). Acute graft-versus-host disease (aGVHD) > or = grade II was associated with a significantly lower risk of relapse, but also with a lower overall survival (OS) rate., Conclusion: Based on this study, alloBMT from a human leukocyte antigen (HLA)-identical sibling donor does not appear to offer any advantage when compared with ABMT. A graft-versus-Hodgkin effect is associated with > or = grade II aGVHD, but its positive effect on relapse is largely offset by its toxicity. In most circumstances, alloBMT cannot be recommended for patients with HD.
- Published
- 1996
- Full Text
- View/download PDF
25. Autologous bone marrow transplantation for first remission acute myeloblastic leukemia in patients older than 50 years: a retrospective analysis of the European Bone Marrow Transplant Group.
- Author
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Cahn JY, Labopin M, Mandelli F, Goldstone AH, Eberhardt K, Reiffers J, Ferrant A, Franklin I, Hervé P, and Gratwohl A
- Subjects
- Acute Disease, Age Factors, Aged, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Bone Marrow Purging, Cause of Death, Cohort Studies, Combined Modality Therapy, Europe, Feasibility Studies, Female, Hematopoietic Stem Cell Transplantation, Humans, Leukemia, Myeloid drug therapy, Leukemia, Myeloid mortality, Male, Middle Aged, Multivariate Analysis, Remission Induction, Retrospective Studies, Risk Factors, Survival Analysis, Treatment Outcome, Whole-Body Irradiation, Bone Marrow Transplantation, Leukemia, Myeloid therapy
- Abstract
High-dose chemotherapy, with or without radiotherapy, followed by autologous stem-cell rescue is used increasingly for the intensification of first remission in acute myeloblastic leukemia (AML). However, these treatments have been limited to young patients due to the increased risks of regimen-related toxicities and mortality with age. Several investigators have recently published the upper age limit for autologous bone marrow transplant (ABMT) in AML because of encouraging results. The results of ABMT for AML were studied in 111 patients > or = 50 years of age intensified in first remission. Median age at transplant was 53 years (range, 50 to 63 years). Fifty patients were conditioned with total body irradiation and 61 with polychemotherapy: 23 with busulfancyclophosphamide, 11 with the University College Hospital (UCH; London, UK) regimen, 6 with BAVC, and 21 with various other treatments. Marrow was purged in only 11 cases. Results were compared with 786 ABMTs performed for AML in patients between 16 and 49 years of age (median, 35 years). For AML in first remission, the probability of leukemia-free survival (LFS) at 4 years was 34% +/- 5% for patients aged 50 years or more and 43% +/- 2% for patients less than 50 years of age (P = .004), with a survival probability of 35% +/- 6% and 48% +/- 2%, respectively (P = .004). The probability of relapse was not significantly different between the two groups (52% +/- 7% v 50% +/- 2%), but transplant-related mortality was significantly higher in the older age group (28% +/- 5% v 14% +/- 2%; P < .0001) and mainly due to infectious complications. In a multivariate analysis, age less than 50 years was a favorable risk factor for LFS, treatment-related mortality (TRM), and survival but not for relapse incidence. These data suggest that ABMT should be considered in older AML patients.
- Published
- 1995
26. The tribulation of trials: a summary of carotid surgery, 1993.
- Author
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Goldstone J
- Subjects
- Carotid Stenosis surgery, Cerebrovascular Disorders prevention & control, Europe, Humans, Multicenter Studies as Topic, North America, Randomized Controlled Trials as Topic, United States, United States Department of Veterans Affairs, Clinical Trials as Topic, Endarterectomy, Carotid
- Published
- 1994
27. Cytomegalovirus interstitial pneumonia in autologous bone marrow transplant recipients. Infectious Disease Working Party of the European Group for Bone Marrow Transplantation.
- Author
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Ljungman P, Biron P, Bosi A, Cahn JY, Goldstone AH, Gorin NC, Link H, Messina C, Michallet M, and Richard C
- Subjects
- Adolescent, Adult, Child, Child, Preschool, Europe epidemiology, Foscarnet therapeutic use, Ganciclovir therapeutic use, Humans, Immunoglobulins, Intravenous therapeutic use, Incidence, Lung Diseases, Interstitial epidemiology, Lung Diseases, Interstitial microbiology, Middle Aged, Retrospective Studies, Surveys and Questionnaires, Survival Analysis, Bone Marrow Transplantation adverse effects, Cytomegalovirus Infections drug therapy, Lung Diseases, Interstitial etiology
- Abstract
CMV pneumonia is rare following ABMT. No information has been presented concerning risk factors or outcome of antiviral therapy. Information concerning CMV pneumonia after ABMT was collected from bone marrow transplant centers in Europe. Twenty-one patients who fulfilled the diagnostic criteria of CMV pneumonia were reported. Eighteen of these patients were reported from centers who also reported the total number of ABMT performed. The CMV pneumonia frequency among 2252 reported ABMT patients was 0.8%, and this varied from 0% to 8.6% between different centers. Survival for > 30 days from diagnosis of pneumonia was 43%. Three patients suffered relapses, which were fatal, giving a total survival of 28%. Patients treated with or without TBI had a survival of 18% and 50%, respectively. Among patients given ganciclovir or foscarnet with or without intravenous immune globulin, survival at 30 days was 50% and total survival 28%. There was no difference in survival with or without the addition of intravenous immune globulin. CMV pneumonia is an infrequent but serious complication of ABMT.
- Published
- 1994
28. Comparison of peripheral blood stem-cell and autologous bone marrow transplantation for lymphoma patients: a case-controlled analysis of the EBMT Registry data. Lymphoma Working Party of the EBMT.
- Author
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Liberti G, Pearce R, Taghipour G, Majolino I, and Goldstone AH
- Subjects
- Adolescent, Adult, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Case-Control Studies, Child, Combined Modality Therapy, Europe epidemiology, Female, Humans, Lymphoma drug therapy, Lymphoma mortality, Lymphoma radiotherapy, Lymphoma surgery, Male, Middle Aged, Prognosis, Proportional Hazards Models, Registries, Survival Analysis, Treatment Outcome, Whole-Body Irradiation, Blood Component Transfusion statistics & numerical data, Blood Transfusion, Autologous statistics & numerical data, Bone Marrow Transplantation statistics & numerical data, Hematopoietic Stem Cell Transplantation, Lymphoma therapy
- Abstract
A case-controlled analysis was performed to assess the effect of stem-cell source on autograft in a group of patients with malignant lymphoma reported to the European Bone Marrow Transplant Group (EBMT). The study was performed matching 83 patients autografted with peripheral blood stem cells (PBSC) with 83 autologous bone marrow transplantation (ABMT) patients. The case-matching was carried out following selection of the main prognostic factors for progression-free survival by multivariate analysis. The progression-free survival was similar in both types of transplants (38.5% PBSCT vs. 36.4% ABMT). The overall relapse and progression rate for the PBSCT was 51.2% compared with 50.1% for the ABMT patients. The differences were not significant statistically. The transplant-related mortality was 6% for both groups. The neutrophil and leucocyte recovery occurred faster in the peripheral blood stem-cell transplantation (PBSCT); the platelet recovery was not significant. A higher number of interstitial pneumonitis and fungal infection episodes were observed in the ABMT group. In conclusion, in these closely matched groups, there is no difference in PFS between patients undergoing PBSCT and those undergoing ABMT. However, the patients autografted with PBSC have a more rapid engraftment and a lower toxicity.
- Published
- 1994
- Full Text
- View/download PDF
29. Autologous bone marrow transplantation for acute myelocytic leukemia in first remission: a European survey of the role of marrow purging.
- Author
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Gorin NC, Aegerter P, Auvert B, Meloni G, Goldstone AH, Burnett A, Carella A, Korbling M, Herve P, and Maraninchi D
- Subjects
- Adolescent, Adult, Aged, Antineoplastic Agents pharmacology, Bone Marrow drug effects, Bone Marrow physiology, Child, Child, Preschool, Cyclophosphamide analogs & derivatives, Cyclophosphamide pharmacology, Europe, Female, Humans, Infant, Leukemia, Myeloid, Acute epidemiology, Leukemia, Myeloid, Acute mortality, Male, Middle Aged, Recurrence, Remission, Spontaneous, Bone Marrow Transplantation physiology, Leukemia, Myeloid, Acute surgery, Transplantation, Autologous physiology
- Abstract
We analyzed data from 263 patients with acute myelocytic leukemia (AML) autografted in first remission (CR) during the period from January, 1982 to January, 1987 at one of 34 centers in the European Bone Marrow Transplant Group. The median age of patients was 30 years (range, 1 to 65). The median interval between achieving CR and autografting was 5 months (range, 1 to 23). Of the 263 patients, 131 patients received cytoreductive regimens that included total body irradiation (TBI); the remainder received various combinations of cytotoxic drugs. Sixty-nine patients received autologous marrow purged in vitro with mafosfamide, and 194 received unpurged marrow. The median follow-up was 28 months (range, 12 to 97). For patients with standard risk AML in CR1 autografted after TBI (n = 107), the leukemia-free survival (LFS) was higher, and the probability of relapse was lower in recipients of purged than of unpurged marrow (63% versus 34%, P = .05 and 23% versus 55%, relative risk 0.34, P = .005, respectively). The superior results of purging were most obvious in patients autografted within 6 months of achieving CR (probability of relapse, 20% versus 61%, P = .01). Patients with longer intervals between CR and autografting had higher LFS and lower probability of relapse than those autografted early in CR (intervals greater than 9 months, 7 to 9 months, 4 to 7 months, and less than or equal to 3 months: LFS = 56%, 40%, 35%, 27%, P = .007, probability of relapse = 25%, 56%, 59%, 67%, P = .005; respectively). We conclude that marrow purging with mafosfamide may be valuable for patients autografted early in first CR.
- Published
- 1990
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