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5. No benefit from adding GM-CSF to induction chemotherapy in transforming myelodysplastic syndromes: better outcome in patients with less proliferative disease

Author

Hast, R, Hellström-Lindberg, E, Ohm, L, Björkholm, M, Celsing, F, Dahl, I-M, Dybedal, I, Gahrton, G, Lindberg, G, Lerner, R, Linder, O, Löfvenberg, E, Nilsson-Ehle, H, Paul, C, Samuelsson, J, Tangen, J-M, Tidefelt, U, Turesson, I, Wahlin, A, Wallvik, J, Winquist, I, Öberg, G, and Bernell, P

Published
2003
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13. Marrow versus peripheral blood for geno-identical allogeneic stem cell transplantation in acute myelocytic leukemia: Influence of dose and stem cell source shows better outcome with rich marrow

Author

Gorin N.C., Labopin M., Rocha V., Arcese W., Beksac M., Gluckman E., Ringden O., Ruutu T., Reiffers J., Bandini G., Falda M., Zikos P., Willemze R., Frassoni F., Abecasis M., Abráhamová J., Afanassiev B.V., Aglietta M., Alabdulaaly A., Aleinikova O., Paolo Alessandrino E., Al Shemmari S.H., Amadori D., Amadori S., Amos T., Andolina M., Andreesen R., Angelucci E., Anhuf J., Arnold R., Arpaci F., Attal M., Azevedo W., Azim H.A., Baccarani M., Bacigalupo A., Barbui T., Bargetzi M., Barnard D.L., Bartsch H.H., Baruchel A., Battista C., Bay J.-O., Bayik M., Bazarbachi A., Beguin Y., López J.L.B., Benedek I., Benedetti F., Bengala C., Berrebi A., Besalduch J., Biesma D., Biron P., Björkholm M., Blaise D., Blesing N.E., Boasson M., Bobev D., Boccadoro M., Bolaman Z., Boogaerts M.A., Bordessoule D., Bosi A., Aida B.S., Bourhis J.H., Bourikas G., Bowen D.T., Bregni M., Bries G., Brinch L., Brittain D., Bron D., Brune M., Bullorsky E.O., Bunjes D., Burdach S., Burnett A.K., Buzyn A., Caballero D., Cagirgan S., Cahn J.-Y., Canepa C.O., Cao A., Carella A.M., Carrera F.D., Carret A.-S., Cascinu S., Castel V., Caswell M., Cavanna L., Cetto G.L., Chapuis B., Chasty R., Chen Y.-C., Chisesi T., Chopra R., Chybicka A., Clark R.E., Colombat P., Colovic M.D., Constenla-Figueiras M., Contreras M., Contu L., Cordonnier C., Cornelissen J.J., Cornish J., Coser P., Costa N., Coze C., Craddock C., Crown J., Culligan D.J., Danova M., Darbyshire P.J., Davies J.M., de Bock R., de Pablos Gallego J.M., De Prijck B., de Revel T., De Rossi G., De Souza C.A., Deb G., Degos L., Demuynck H., Dervenoulas I., Di Bartolomeo P., Di Renzo N., Diaz M.A., Diehl V., Diez-Martin J.L., Dincer S., Giorgio D., Dmoszynska A., Doelken G., Peter P.D., Dulley F., Easow J., Ebell W., Efremidis A., Ehninger G., Eichler H., Eimermacher H., Enno A., Errazquin L., Aguado J.E., Everaus H., Fagioli F., Fanin R., Fassas A., Fasth A., Faulkner L.B., Fauser A.A., Feldman L., Feremans W., Ferhanoglu B., Fernández M.N., Fernández-Ranada J.M., Ferrant A., Ferrara F., Finke J., Fischer A., Fischer J., Fitzsimons T., Floristan F., Forjaz de Lacerda J.M.F., Fossati-Bellani F., Fosser V., Franklin I., Freund M., Frickhofen N., Gabbas A., Gadner H., Gallamini A., Galvin M.C., López J.G., García-Conde J., Gaska T., Gastl G., Gedikoglu G., Ghavamzadeh A., Gianni A., Gibson B.E., Gil J.L., Gilleece M.H., Gisselbrecht C., Glass B., Gmür J., Göbel U., Goldman J.M., Goldstone A.H., San Miguel J.D.G., González-López M.-A., Grafakos S., Gramatzki M., Grañena A., Gratecos N., Gratwohl A., Greinix H.T., Gugliotta L., Guilhot F., Guimaraes J.E., Gülbas Z., Gulyuz O., Gurman G., Gutierrez M.M., Haas R., Hamladji R.-M., Hamon M.D., Hansen N.E., Harhalakis N., Harousseau J.L., Hartenstein R., Hartmann C.O., Hausmaninger H., Haznedar R., Heit W., Hellmann A., Herrmann R.P., Hertenstein B., Hess U., Hinterberger W., Ho A.D., Hoelzer D., Holowiecki J., Horst H.-A., Hossfeld D.K., Huebsch L., Hunter A.E., Iacopino P., Iannitto E., Indrák K., Iriondo A., Izzi T., Jackson G.L., Jacobs P., Jacobsen N., Janvier M., Jebavy L., Joensuu H., Joerg S., Jones F.G.C., Jouet J.P., Joyner M.V., Juliusson G., Jürgens H., Kalayoglu-Besisik S., Kalman N., Kalmanti M., Kansoy S., Kansu E., Kanz L., Karianakis G., Kernéis Y., Khalifeh O., Khomenko V., Kienast J., Killick S., Kirchner H.H., Klingebiel T., Knauf W., Koenigsmann M., Koistinen P., Koivunen E., Kolb H.-J., Kolbe K., Koller E., Komarnicki M., Koscielniak E., Kovacsovics T., Kowalczyk J.R., Koza V., Kozak T., Kugler J., Kuliczkowski K., Kvaloy S., Labar B., Laciura P., Palacios J.J.L., Lakota J., Lambertenghi D.G., Lange A., Lanza F., Isasti R.L., Lauria F., Le Moine F., Leblond V., Lelli G., Lenhoff S., Leon L.A., Leoncini-Franscini L., Leone G., Leoni P., Levis A., Leyvraz S., Liberati M., Link H., Linkesch W., Liso V., Lisukov I.A., Littlewood T., Ljungman P., Locatelli F., Losonczy H., Lotz J.-P., Ludwig H., Lukac J., Lutz D., Macchia P., Madrigal A., Maiolino A., Majolino I., Eloy-García J.M., Malesevic M., Mandelli F., Marc A., Marcus R., Marianska B., Markuljak I., Marsh J.C.W., Martelli M.F., Marti Tutusaus J.M., Martin S., Martin M., Martinelli G., Martínez-Rubio A.M., Martoni A., Maschan A., Maschmeyer G., Masszi T., Mazza P., McCann S., Meier C.R., Messina C., Mettivier V., Metzner B., Michallet M., Michieli M., Michon J., Milligan D.W., Milone J.H., Giuseppe G.M., Minigo H., Mistrik M., Moicean A.D., Monfardini S., Montserrat E., Moraleda Jimenez J.M., Morales-Lazaro A., Morandi S., Morra E., Mufti G.J., Musso M., Nagler A., Nalli G., Naparstek E., Narni F., Nenadov-Beck M., Neubauer A., Newland A.C., Niederwieser D., Niethammer D., Noens L.A., Nousiainen T., Novik A., Novitzky N., Occhini D., Odriozolas J., Ojanguren J.M., O’meara A., Onat H., Orchard K., Ortega J.J., Osieka R., Ossenkoppele G.J., Othman B., Ovali E., Ozcebe O.I., Ozerkan K., Ozturk A., Papatryfonos A., Parker J.E., Pastore M., Patrone F., Patton N., Pejin D., Peñarrubia M.J., Equiza E.P., Peschel C., Pession A., Pigaditou A., Pignon B., Pihkala U., Pimentel P., Pitini V., Podoltseva E., Pogliani E.M., Anna A.P., Porta F., Potter M., Powles R., Prentice G.H., Pretnar J., Ptushkin V., Quarta G., Reiter A., Remes K., Reykdal S., Santasusana J.M.R., Rifón J., Rio B., Rizzoli V., Robak T., Robinson A.J., Rodeghiero F., Rodríguez Fernández J.M., Rombos Y., Romeril K.R., Rosenmayr A., Rossi J.F., Rosti G., Rotoli B., Rowe J.M., Russell N.H., Ryzhak O., Rzepecki P., Saglio G., Salwender H., Samonigg H., Santoro A., Sanz M.A., Sayer H.G., Scanni A., Schaafsma M.R., Schaefer U.W., Schanz U., Schattenberg A., Schey S.A.M., Schlimok G., Schmoll H.-J., Schots R., Schouten H., Schwarer A.P., Schwerdtfeger R., Scimè R., Segel E., Seger R., Selleslag D., Serban M., Shamaa S., Shaw P.J., Siegert W., Siena S., Sierra J., Simonsson B., Singer C.R.J., Sirchia G., Skotnicki A.B., Slavin S., Snowden J., Sotto J.J., Tanyeli A., Tedeschi L., Tidefelt U., Tissot J.-D., Tobler A., Tomas J.F., Torres J.P., Torres G.A., Touraine J.-L., Trneny M., Uderzo C., Unal E., Unal A., Undar L., Urban C., Van den Berg H., van Marwijk K.M., Vellenga E., Venturini M., Verdonck L.F., Veys P., Vilardell J., Vinante O., Visani G., Vitek A., Vivancos P., Volpe E., Vora A., Vorlicek J., Vowels M., Vujic D., Wachowiak J., Wagner T., Wahlin A., Walewski J., Wandt H., Weissinger F., Wijermans P.W., Wiktor-Jedrzejczak W., Will A.M., Woell E., Wörmann B., Yaniv I., Yesilipek M.A., Yilmaz U., Yong A., Zachée P., Zambelli A., Zander A.R., Zintl F., Zoumbos N.C., Çukurova Üniversitesi, Maltepe Üniversitesi, and Ege Üniversitesi

Subjects
Myeloid, Male, Pathology, Time Factors, Graft vs Host Disease, Biochemistry, Gastroenterology, Blood cell, Bone Marrow, Child, Bone Marrow Transplantation, Leukemia, Remission Induction, Hematology, Middle Aged, Prognosis, Leukemia, Myeloid, Acute, ComputingMilieux_MANAGEMENTOFCOMPUTINGANDINFORMATIONSYSTEMS, medicine.anatomical_structure, Treatment Outcome, Child, Preschool, Female, Stem cell, InformationSystems_MISCELLANEOUS, Homologous, Adult, medicine.medical_specialty, Adolescent, Immunology, Acute, Disease-Free Survival, Internal medicine, medicine, Transplantation, Homologous, Humans, Preschool, Aged, Transplantation, business.industry, ComputerSystemsOrganization_COMPUTER-COMMUNICATIONNETWORKS, Cell Biology, medicine.disease, Peripheral blood, Histocompatibility, Multivariate Analysis, Stem Cell Transplantation, ComputingMethodologies_PATTERNRECOGNITION, Myelocytic leukemia, Bone marrow, business, Settore MED/15 - Malattie del Sangue
Abstract

PubMed ID: 12829583, Several studies have compared bone marrow (BM) and peripheral blood (PB) as stem cell sources in patients receiving allografts, but the cell doses infused have not been considered, especially for BM. Using the ALWP/EBMT registry, we retrospectively studied 881 adult patients with acute myelocytic leukemia (AML), who received a non-T-depleted allogeneic BM (n = 515) or mobilized PB (n = 366) standard transplant, in first remission (CR1), from an HLA-identical sibling, over a 5-year period from January 1994. The BM cell dose ranged from 0.17 to 29 × 10 8 /kg with a median of 2.7 × 10 8 /kg. The PB cell dose ranged from 0.02 to 77 × 10 8 /kg with a median of 9.3 × 10 8 /kg. The median dose for patients receiving BM (2.7 × 10 8 /kg) gave the greatest discrimination. In multivariate analyses, high-dose BM compared to PB was associated with lower transplant-related mortality (RR = 0.61; 95% CI, 0.39-0.98; P = .04), better leukemia-free survival (RR = 0.65; 95% CI, 0.46-0.91; P = .013), and better overall survival (RR = 0.64; 95% CI, 0.44-0. 92; P = .016). The present study in patients with AML receiving allografts in first remission indicates a better outcome with BM as compared to PB, when the dose of BM infused is rich. © 2003 by The American Society of Hematology.

Published
2003

14. Marrow versus peripheral blood for geno-identical allogeneic stem cell transplantation in acute myelocytic leukemia: Influence of dose and stem cell source shows better outcome with rich marrow

Author

Gorin, N.C. Labopin, M. Rocha, V. Arcese, W. Beksac, M. Gluckman, E. Ringden, O. Ruutu, T. Reiffers, J. Bandini, G. Falda, M. Zikos, P. Willemze, R. Frassoni, F. Abecasis, M. Abráhamová, J. Afanassiev, B.V. Aglietta, M. Alabdulaaly, A. Aleinikova, O. Paolo Alessandrino, E. Al Shemmari, S.H. Amadori, D. Amadori, S. Amos, T. Andolina, M. Andreesen, R. Angelucci, E. Anhuf, J. Arnold, R. Arpaci, F. Attal, M. Azevedo, W. Azim, H.A. Baccarani, M. Bacigalupo, A. Barbui, T. Bargetzi, M. Barnard, D.L. Bartsch, H.H. Baruchel, A. Battista, C. Bay, J.-O. Bayik, M. Bazarbachi, A. Beguin, Y. López, J.L.B. Benedek, I. Benedetti, F. Bengala, C. Berrebi, A. Besalduch, J. Biesma, D. Biron, P. Björkholm, M. Blaise, D. Blesing, N.E. Boasson, M. Bobev, D. Boccadoro, M. Bolaman, Z. Boogaerts, M.A. Bordessoule, D. Bosi, A. Aida, B.S. Bourhis, J.H. Bourikas, G. Bowen, D.T. Bregni, M. Bries, G. Brinch, L. Brittain, D. Bron, D. Brune, M. Bullorsky, E.O. Bunjes, D. Burdach, S. Burnett, A.K. Buzyn, A. Caballero, D. Cagirgan, S. Cahn, J.-Y. Canepa, C.O. Cao, A. Carella, A.M. Carrera, F.D. Carret, A.-S. Cascinu, S. Castel, V. Caswell, M. Cavanna, L. Cetto, G.L. Chapuis, B. Chasty, R. Chen, Y.-C. Chisesi, T. Chopra, R. Chybicka, A. Clark, R.E. Colombat, P. Colovic, M.D. Constenla-Figueiras, M. Contreras, M. Contu, L. Cordonnier, C. Cornelissen, J.J. Cornish, J. Coser, P. Costa, N. Coze, C. Craddock, C. Crown, J. Culligan, D.J. Danova, M. Darbyshire, P.J. Davies, J.M. de Bock, R. de Pablos Gallego, J.M. De Prijck, B. de Revel, T. De Rossi, G. De Souza, C.A. Deb, G. Degos, L. Demuynck, H. Dervenoulas, I. Di Bartolomeo, P. Di Renzo, N. Diaz, M.A. Diehl, V. Diez-Martin, J.L. Dincer, S. Giorgio, D. Dmoszynska, A. Doelken, G. Peter, P.D. Dulley, F. Easow, J. Ebell, W. Efremidis, A. Ehninger, G. Eichler, H. Eimermacher, H. Enno, A. Errazquin, L. Aguado, J.E. Everaus, H. Fagioli, F. Fanin, R. Fassas, A. Fasth, A. Faulkner, L.B. Fauser, A.A. Feldman, L. Feremans, W. Ferhanoglu, B. Fernández, M.N. Fernández-Ranada, J.M. Ferrant, A. Ferrara, F. Finke, J. Fischer, A. Fischer, J. Fitzsimons, T. Floristan, F. Forjaz de Lacerda, J.M.F. Fossati-Bellani, F. Fosser, V. Franklin, I. Freund, M. Frickhofen, N. Gabbas, A. Gadner, H. Gallamini, A. Galvin, M.C. López, J.G. García-Conde, J. Gaska, T. Gastl, G. Gedikoglu, G. Ghavamzadeh, A. Gianni, A. Gibson, B.E. Gil, J.L. Gilleece, M.H. Gisselbrecht, C. Glass, B. Gmür, J. Göbel, U. Goldman, J.M. Goldstone, A.H. San Miguel, J.D.G. González-López, M.-A. Grafakos, S. Gramatzki, M. Grañena, A. Gratecos, N. Gratwohl, A. Greinix, H.T. Gugliotta, L. Guilhot, F. Guimaraes, J.E. Gülbas, Z. Gulyuz, O. Gurman, G. Gutierrez, M.M. Haas, R. Hamladji, R.-M. Hamon, M.D. Hansen, N.E. Harhalakis, N. Harousseau, J.L. Hartenstein, R. Hartmann, C.O. Hausmaninger, H. Haznedar, R. Heit, W. Hellmann, A. Herrmann, R.P. Hertenstein, B. Hess, U. Hinterberger, W. Ho, A.D. Hoelzer, D. Holowiecki, J. Horst, H.-A. Hossfeld, D.K. Huebsch, L. Hunter, A.E. Iacopino, P. Iannitto, E. Indrák, K. Iriondo, A. Izzi, T. Jackson, G.L. Jacobs, P. Jacobsen, N. Janvier, M. Jebavy, L. Joensuu, H. Joerg, S. Jones, F.G.C. Jouet, J.P. Joyner, M.V. Juliusson, G. Jürgens, H. Kalayoglu-Besisik, S. Kalman, N. Kalmanti, M. Kansoy, S. Kansu, E. Kanz, L. Karianakis, G. Kernéis, Y. Khalifeh, O. Khomenko, V. Kienast, J. Killick, S. Kirchner, H.H. Klingebiel, T. Knauf, W. Koenigsmann, M. Koistinen, P. Koivunen, E. Kolb, H.-J. Kolbe, K. Koller, E. Komarnicki, M. Koscielniak, E. Kovacsovics, T. Kowalczyk, J.R. Koza, V. Kozak, T. Kugler, J. Kuliczkowski, K. Kvaloy, S. Labar, B. Laciura, P. Palacios, J.J.L. Lakota, J. Lambertenghi, D.G. Lange, A. Lanza, F. Isasti, R.L. Lauria, F. Le Moine, F. Leblond, V. Lelli, G. Lenhoff, S. Leon, L.A. Leoncini-Franscini, L. Leone, G. Leoni, P. Levis, A. Leyvraz, S. Liberati, M. Link, H. Linkesch, W. Liso, V. Lisukov, I.A. Littlewood, T. Ljungman, P. Locatelli, F. Losonczy, H. Lotz, J.-P. Ludwig, H. Lukac, J. Lutz, D. Macchia, P. Madrigal, A. Maiolino, A. Majolino, I. Eloy-García, J.M. Malesevic, M. Mandelli, F. Marc, A. Marcus, R. Marianska, B. Markuljak, I. Marsh, J.C.W. Martelli, M.F. Marti Tutusaus, J.M. Martin, S. Martin, M. Martinelli, G. Martínez-Rubio, A.M. Martoni, A. Maschan, A. Maschmeyer, G. Masszi, T. Mazza, P. McCann, S. Meier, C.R. Messina, C. Mettivier, V. Metzner, B. Michallet, M. Michieli, M. Michon, J. Milligan, D.W. Milone, J.H. Giuseppe, G.M. Minigo, H. Mistrik, M. Moicean, A.D. Monfardini, S. Montserrat, E. Moraleda Jimenez, J.M. Morales-Lazaro, A. Morandi, S. Morra, E. Mufti, G.J. Musso, M. Nagler, A. Nalli, G. Naparstek, E. Narni, F. Nenadov-Beck, M. Neubauer, A. Newland, A.C. Niederwieser, D. Niethammer, D. Noens, L.A. Nousiainen, T. Novik, A. Novitzky, N. Occhini, D. Odriozolas, J. Ojanguren, J.M. O’meara, A. Onat, H. Orchard, K. Ortega, J.J. Osieka, R. Ossenkoppele, G.J. Othman, B. Ovali, E. Ozcebe, O.I. Ozerkan, K. Ozturk, A. Papatryfonos, A. Parker, J.E. Pastore, M. Patrone, F. Patton, N. Pejin, D. Peñarrubia, M.J. Equiza, E.P. Peschel, C. Pession, A. Pigaditou, A. Pignon, B. Pihkala, U. Pimentel, P. Pitini, V. Podoltseva, E. Pogliani, E.M. Anna, A.P. Porta, F. Potter, M. Powles, R. Prentice, G.H. Pretnar, J. Ptushkin, V. Quarta, G. Reiter, A. Remes, K. Reykdal, S. Santasusana, J.M.R. Rifón, J. Rio, B. Rizzoli, V. Robak, T. Robinson, A.J. Rodeghiero, F. Rodríguez Fernández, J.M. Rombos, Y. Romeril, K.R. Rosenmayr, A. Rossi, J.F. Rosti, G. Rotoli, B. Rowe, J.M. Russell, N.H. Ryzhak, O. Rzepecki, P. Saglio, G. Salwender, H. Samonigg, H. Santoro, A. Sanz, M.A. Sayer, H.G. Scanni, A. Schaafsma, M.R. Schaefer, U.W. Schanz, U. Schattenberg, A. Schey, S.A.M. Schlimok, G. Schmoll, H.-J. Schots, R. Schouten, H. Schwarer, A.P. Schwerdtfeger, R. Scimè, R. Segel, E. Seger, R. Selleslag, D. Serban, M. Shamaa, S. Shaw, P.J. Siegert, W. Siena, S. Sierra, J. Simonsson, B. Singer, C.R.J. Sirchia, G. Skotnicki, A.B. Slavin, S. Snowden, J. Sotto, J.J. Tanyeli, A. Tedeschi, L. Tidefelt, U. Tissot, J.-D. Tobler, A. Tomas, J.F. Torres, J.P. Torres, G.A. Touraine, J.-L. Trneny, M. Uderzo, C. Unal, E. Unal, A. Undar, L. Urban, C. Van den Berg, H. van Marwijk, K.M. Vellenga, E. Venturini, M. Verdonck, L.F. Veys, P. Vilardell, J. Vinante, O. Visani, G. Vitek, A. Vivancos, P. Volpe, E. Vora, A. Vorlicek, J. Vowels, M. Vujic, D. Wachowiak, J. Wagner, T. Wahlin, A. Walewski, J. Wandt, H. Weissinger, F. Wijermans, P.W. Wiktor-Jedrzejczak, W. Will, A.M. Woell, E. Wörmann, B. Yaniv, I. Yesilipek, M.A. Yilmaz, U. Yong, A. Zachée, P. Zambelli, A. Zander, A.R. Zintl, F. Zoumbos, N.C. The Acute Leukemia Working Party (ALWP) of the European Cooperative Group for Blood Marrow Transplantation (EBMT)

Abstract

Several studies have compared bone marrow (BM) and peripheral blood (PB) as stem cell sources in patients receiving allografts, but the cell doses infused have not been considered, especially for BM. Using the ALWP/EBMT registry, we retrospectively studied 881 adult patients with acute myelocytic leukemia (AML), who received a non-T-depleted allogeneic BM (n = 515) or mobilized PB (n = 366) standard transplant, in first remission (CR1), from an HLA-identical sibling, over a 5-year period from January 1994. The BM cell dose ranged from 0.17 to 29 × 108/kg with a median of 2.7 × 108/kg. The PB cell dose ranged from 0.02 to 77 × 10 8/kg with a median of 9.3 × 108/kg. The median dose for patients receiving BM (2.7 × 108/kg) gave the greatest discrimination. In multivariate analyses, high-dose BM compared to PB was associated with lower transplant-related mortality (RR = 0.61; 95% CI, 0.39-0.98; P = .04), better leukemia-free survival (RR = 0.65; 95% CI, 0.46-0.91; P = .013), and better overall survival (RR = 0.64; 95% CI, 0.44-0. 92; P = .016). The present study in patients with AML receiving allografts in first remission indicates a better outcome with BM as compared to PB, when the dose of BM infused is rich. © 2003 by The American Society of Hematology.

Published
2003

15. Continuing high early death rate in acute promyelocytic leukemia : a population-based report from the Swedish Adult Acute Leukemia Registry

Author

Lehmann, Sören, Ravn, S, Carlsson, L, Antunovic, P, Deneberg, S, Möllgård, L, Rangert Derolf, Å, Stockelberg, D, Tidefelt, U, Wahlin, Anders, Wennström, L, Högberg, M, Juliusson, G, Lehmann, Sören, Ravn, S, Carlsson, L, Antunovic, P, Deneberg, S, Möllgård, L, Rangert Derolf, Å, Stockelberg, D, Tidefelt, U, Wahlin, Anders, Wennström, L, Högberg, M, and Juliusson, G

Abstract

Our knowledge about acute promyelocytic leukemia (APL) patients is mainly based on data from clinical trials, whereas population-based information is scarce. We studied APL patients diagnosed between 1997 and 2006 in the population-based Swedish Adult Acute Leukemia Registry. Of a total of 3897 acute leukemia cases, 3205 (82%) had non-APL acute myeloid leukemia (AML) and 105 (2.7%) had APL. The incidence of APL was 0.145 per 100 000 inhabitants per year. The median age at the time of diagnosis was 54 years; 62% were female and 38% male. Among younger APL patients, female sex predominated (89% of patients <40 years). Of the 105 APL patients, 30 (29%) died within 30 days (that is, early death (ED)) (median 4 days) and 28 (26%) within 14 days from diagnosis. In all, 41% of the EDs were due to hemorrhage; 35% of ED patients never received all-trans-retinoic acid treatment. ED rates increased with age but more clearly with poor performance status. ED was also associated with high white blood cells, lactate dehydrogenase, creatinine, C-reactive protein and low platelet count. Of non-ED patients, 97% achieved complete remission of which 16% subsequently relapsed. In total, 62% are still alive at 6.4 years median follow-up. We conclude that ED rates remain very high in an unselected APL population.

Published
2011
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16. Superior long-term survival with a high rate of allogeneic stem cell transplantation in AML (non-APL) patients below 60 years of age in BONE MARROW TRANSPLANTATION, vol 45, issue , pp S9-S10

Author

Juliusson, G, Wahlin, A, Stockelberg, D, Mollgard, L, Brune, M, Antunovic, Petar, Lehmann, S, Tidefelt, U, Lazarevic, V, Rangert Derolf, A, Hoglund, M, Juliusson, G, Wahlin, A, Stockelberg, D, Mollgard, L, Brune, M, Antunovic, Petar, Lehmann, S, Tidefelt, U, Lazarevic, V, Rangert Derolf, A, and Hoglund, M

Abstract

n/a

Published
2010

17. Granulocyte-macrophage colony-stimulating factor to increase efficacy ofmitoxantrone, etoposide and cytarabine in previously untreated elderlypatients with acute myeloid leukaemia: a Swedish multicentre randomizedtrial.

Author

Lofgren, C, Paul, C, Astrom, M, Hast, R, Hedenius, M, Lerner, R, Liliemark, J, Nilsson, I, Rodjer, S, Simonsson, B, Stockelberg, D, Tidefelt, U, Bjorkholm, M, Lofgren, C, Paul, C, Astrom, M, Hast, R, Hedenius, M, Lerner, R, Liliemark, J, Nilsson, I, Rodjer, S, Simonsson, B, Stockelberg, D, Tidefelt, U, and Bjorkholm, M

Published
2004

19. No benefit from adding GM-CSF to induction chemotherapy in transformingmyelodysplastic syndromes: better outcome in patients with lessproliferative disease.

Author

Hast, R, Hellstrom-Lindberg, E, Ohm, L, Bjorkholm, M, Celsing, F, Dahl, IM, Dybedal, I, Gahrton, G, Lindberg, G, Lerner, R, Linder, O, Lofvenberg, Eva, Nilsson-Ehle, H, Paul, C, Samuelsson, J, Tangen, JM, Tidefelt, U, Turesson, Ingela, Wahlin, A, Wallvik, J, Winquist, I, Oberg, G, Bernell, P, Hast, R, Hellstrom-Lindberg, E, Ohm, L, Bjorkholm, M, Celsing, F, Dahl, IM, Dybedal, I, Gahrton, G, Lindberg, G, Lerner, R, Linder, O, Lofvenberg, Eva, Nilsson-Ehle, H, Paul, C, Samuelsson, J, Tangen, JM, Tidefelt, U, Turesson, Ingela, Wahlin, A, Wallvik, J, Winquist, I, Oberg, G, and Bernell, P

Published
2003

21. A phase I/II study of the MDR modulator Valspodar (PSC 833) combined withdaunorubicin and cytarabine in patients with relapsed and primaryrefractory acute myeloid leukemia.

Author

Gruber, A, Bjorkholm, M, Brinch, L, Evensen, S, Gustavsson, B, Hedenus, M, Juliusson, G, Lofvenberg, E, Nesthus, I, Simonsson, B, Sjo, M, Stenke, L, Tangen, JM, Tidefelt, U, Uden, AM, Paul, C, Liliemark, J, Gruber, A, Bjorkholm, M, Brinch, L, Evensen, S, Gustavsson, B, Hedenus, M, Juliusson, G, Lofvenberg, E, Nesthus, I, Simonsson, B, Sjo, M, Stenke, L, Tangen, JM, Tidefelt, U, Uden, AM, Paul, C, and Liliemark, J

Published
2003

22. A phase I/II study of the MDR modulator Valspodar (PSC 833) combined with daunorubicin and cytarabine in patients with relapsed and primary refractory acute myeloid leukemia

Author

Gruber, A, Björkholm, M, Brinch, L, Evensen, S, Gustavsson, B, Hedenus, M, Juliusson, Gunnar, Lofvenberg, E, Nesthus, I, Simonsson, B, Sjö, M, Stenke, L, Tangen, JM, Tidefelt, U, Uden, AM, Paul, C, Liliemark, J, Gruber, A, Björkholm, M, Brinch, L, Evensen, S, Gustavsson, B, Hedenus, M, Juliusson, Gunnar, Lofvenberg, E, Nesthus, I, Simonsson, B, Sjö, M, Stenke, L, Tangen, JM, Tidefelt, U, Uden, AM, Paul, C, and Liliemark, J

Abstract

The cyclosporine analog Valspodar (PSC 833, Novartis Pharma) is a strong inhibitor of the mdr1 gene product p-glycoprotein (pgp). A phase I/II study was conducted in order to evaluate if addition of Valspodar to treatment with daunorubicin and cytarabine, given to patients with primary refractory or relapsed acute myeloid leukemia, could increase the complete remission rate. Fifty-three patients were treated in cohorts of three to six patients. Twelve patients reached a complete remission in bone marrow, five of whom also normalized their peripheral blood values. Three patients experienced treatment-related deaths from pneumonia, liver failure and cerebral hemorrhage, respectively. It is concluded that Valspodar 10mg/kg per 24h in combination with daunorubicin 45mg/m2 for 3 days and cytarabine 1g/m2 twice daily for 4 days is tolerable in this heavily pre-treated group of patients. Due to the moderate treatment results, the phase II part of the study was ended prematurely. The modulation of only pgp did not give an obvious improvement of the treatment results in this group of patients. ⌐ 2002 Elsevier Science Ltd. All rights reserved.

Published
2003
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23. Long-term follow-up of patients >or=60 yr old with acute myeloid leukaemiatreated with intensive chemotherapy.

Author

Oberg, G, Killander, A, Bjoreman, M, Gahrton, G, Grimfors, G, Gruber, A, Hast, R, Lerner, R, Liliemark, J, Mattson, S, Paul, C, Simonsson, B, Stalfelt, AM, Stenke, L, Tidefelt, U, Uden, AM, Bjorkholm, M, Oberg, G, Killander, A, Bjoreman, M, Gahrton, G, Grimfors, G, Gruber, A, Hast, R, Lerner, R, Liliemark, J, Mattson, S, Paul, C, Simonsson, B, Stalfelt, AM, Stenke, L, Tidefelt, U, Uden, AM, and Bjorkholm, M

Published
2002

24. High-dose cytarabine in upfront therapy for adult patients with acutelymphoblastic leukaemia.

Author

Hallbook, H, Simonsson, B, Ahlgren, T, Bjorkholm, M, Carneskog, J, Grimfors, G, Hast, R, Karlsson, K, Kimby, E, Lerner, R, Linder, O, Linderholm, M, Lofvenberg, E, Malm, C, Nilsson, PG, Paul, C, Stenke, L, Stockelberg, D, Tidefelt, U, Turesson, I, Uden-Blome, AM, Vilen, L, Wahlin, A, Winquist, I, Smedmyr, B, Hallbook, H, Simonsson, B, Ahlgren, T, Bjorkholm, M, Carneskog, J, Grimfors, G, Hast, R, Karlsson, K, Kimby, E, Lerner, R, Linder, O, Linderholm, M, Lofvenberg, E, Malm, C, Nilsson, PG, Paul, C, Stenke, L, Stockelberg, D, Tidefelt, U, Turesson, I, Uden-Blome, AM, Vilen, L, Wahlin, A, Winquist, I, and Smedmyr, B

Published
2002

27. P-glycoprotein inhibitor valspodar (PSC 833) increases the intracellular concentrations of Deunorubicin in vivo in patients with P-glycoprotein-positive acute myeloid leukemia.

Author

Tidefelt, U, Liliemark, J, Gruber, A, Sundman-Engberg, B, Juliusson, Gunnar, Stenke, L, Elmhorn-Rosenborg, A, Möllgård, L, Lehman, S, Xu, D, Covelli, A, Gustavsson, B, Paul, C, Liliemark, E, Tidefelt, U, Liliemark, J, Gruber, A, Sundman-Engberg, B, Juliusson, Gunnar, Stenke, L, Elmhorn-Rosenborg, A, Möllgård, L, Lehman, S, Xu, D, Covelli, A, Gustavsson, B, Paul, C, and Liliemark, E

Published
2000

29. Etoposide accumulation of AML cells is affected by PSC 833 in vivo and in vitro.

Author

Liliemark, E, Wang, Y, Tidefelt, U, Paul, C, Gruber, A, Juliusson, Gunnar, Stenke, Lilian, Frostvik-Stolt, M, Zhou, R, Sundman-Engberg, B, Gustavsson, B, Pfister, C, Liliemark, J, Liliemark, E, Wang, Y, Tidefelt, U, Paul, C, Gruber, A, Juliusson, Gunnar, Stenke, Lilian, Frostvik-Stolt, M, Zhou, R, Sundman-Engberg, B, Gustavsson, B, Pfister, C, and Liliemark, J

Published
1999

31. Outcome for patients with leukemia, multiple myeloma and lymphoma who relapse after high dose therapy and autologous stem cell support

Author

Johnsen, H E, Bjorkstrand, B, Carlson, K, Gruber, A, Blystad, A, Fast, A, Boesen, A M, Bjorkholm, M, Sallerfors, B, Ruutu, T, Carneskog, J, Malm, A, Geisler, C, Lehtinen, M, Schroder, H, Brinch, L, Remes, K, Tidefelt, U, Heilman, C, Hornsten, P, Thorling, K, Daugaard, G, Johnsen, H E, Bjorkstrand, B, Carlson, K, Gruber, A, Blystad, A, Fast, A, Boesen, A M, Bjorkholm, M, Sallerfors, B, Ruutu, T, Carneskog, J, Malm, A, Geisler, C, Lehtinen, M, Schroder, H, Brinch, L, Remes, K, Tidefelt, U, Heilman, C, Hornsten, P, Thorling, K, and Daugaard, G

Published
1996

32. Mitoxantrone, etopside and ara-C vs doxorubicin-DNA, ara-C, thioguanine, voncristine and prednisolone in the treatment of patients with acute myelocytic leukemia. A randomized comparison.

Author

Bjorkholm, M, Liliemark, J, Gahrton, G, Grimfors, G, Gruber, A, Hast, R, Juliusson, G, Jarnmark, M, Killander, A, Kimby, E, Lerner, R, Ljungman, P, Lonnqvist, B, Palmblad, J, Paul, C, Pettersson, C, Simonsson, B, Stalfelt, A-M, Stenke, L, Sundstrom, C, Tidefelt, U, Uden, A-M, Oberg, G, Ost, Å, Bjorkholm, M, Liliemark, J, Gahrton, G, Grimfors, G, Gruber, A, Hast, R, Juliusson, G, Jarnmark, M, Killander, A, Kimby, E, Lerner, R, Ljungman, P, Lonnqvist, B, Palmblad, J, Paul, C, Pettersson, C, Simonsson, B, Stalfelt, A-M, Stenke, L, Sundstrom, C, Tidefelt, U, Uden, A-M, Oberg, G, and Ost, Å

Published
1995

33. Outcome for Patients with Leukemia, Multiple Myeloma and Lymphoma who Relapse After High Dose Therapy and Autologous Stem Cell Support

Author

Johnsen, H. E., primary, Björkstrand, B., additional, Carlson, K., additional, Gruber, A., additional, Blystad, A., additional, Fast, A., additional, Boesen, A. M., additional, Björkholm, M., additional, Sallerfors, B., additional, Ruutu, T., additional, Carneskog, J., additional, Malm, A., additional, Geisler, C., additional, Lehtinen, M., additional, Schrøder, H., additional, Brinch, L., additional, Remes, K., additional, Tidefelt, U., additional, Heilmanns, C., additional, Hörnsten, P., additional, Thorling, K., additional, and Daugaard, G., additional

Published
1996
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34. A Randomized Comparison of Doxorubicin and Doxorubicin-DNA in the Treatment of Acute NonLymphoblastic Leukemia

Author

Paul, C., primary, Tidefelt, U., additional, Gahrton, G., additional, Björkholm, M., additional, Järnmark, M., additional, Killander, A., additional, Kimby, E., additional, Liliemark, J., additional, Lindeberg, A., additional, Lindquist, R., additional, Lockner, D., additional, Lönnqvist, B., additional, Mellstedt, H., additional, Merk, K., additional, Palmblad, J., additional, Peterson, C., additional, Simonsson, B., additional, Stalfelt, A.-M., additional, Sundström, C., additional, Wadman, B., additional, Wedelin, C., additional, Udén, A. M., additional, Öberg, G., additional, and öst, Å., additional

Published
1991
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35. research paper Granulocyte-macrophage colony-stimulating factor to increase efficacy of mitoxantrone, etoposide and cytarabine in previously untreated elderly patients with acute myeloid leukaemia: a Swedish multicentre randomized trial.

Author

Löfgren, C., Paul, C., Aström, M., Hast, R., Hedenius, M., Lerner, R., Liliemark, J., Nilsson, I., Rödjer, S., Simonsson, B., Stockelberg, D., Tidefelt, U., and Björkholm, M.

Subjects
GRANULOCYTE-macrophage colony-stimulating factor, MITOXANTRONE hydrochloride, ETOPOSIDE, MYELOID leukemia, LEUCOCYTES, COLONY-stimulating factors (Physiology), PATIENTS
Abstract

A total of 110 patients, aged 64 years or over, with de novo acute myeloid leukaemia (AML) and white blood cell counts <50 × 109/l were treated with 3 d of cytarabine 1 g/m2 twice daily, mitoxantrone 12 mg/m2 and etoposide 200 mg/m2, randomized with or without the addition of granulocyte-macrophage colony-stimulating factor (GM-CSF) 200 μg/m2. The primary aim was to evaluate the effect of GM-CSF on the remission rate. Secondary aims included comparison of duration of remission, survival and infectious complications and the impact of maintenance therapy with thioguanine. Complete remission (CR) was achieved by 64% of patients without GM-CSF, and by 65% of patients who received GM-CSF, the median remission duration was 13 vs. 6 months, the median overall survival (OS) was 14 vs. 9 months, the mean time to neutrophil recovery was 25 vs. 17 d ( P = 0·03) and the number of positive blood cultures was 46 vs. 39 ( P = 0·05) respectively. The impact of thioguanine remains unanswered since only 30 patients remained in CR after consolidation therapy. We conclude that induction therapy is feasible with acceptable toxicity in elderly patients with AML, albeit with a high relapse rate and short OS. GM-CSF prior to, and in combination with, induction treatment reduced the time to neutrophil recovery and the number of neutropenic septicaemia cases but did not improve the OS of AML in the elderly. [ABSTRACT FROM AUTHOR]

Published
2004
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36. Treatment, long-term outcome and prognostic variables in 214 unselected AML patients in Sweden.

Author

Åström, M, Bodin, L, Nilsson, I, and Tidefelt, U

Subjects
ACUTE myeloid leukemia, PATIENTS
Abstract

With the aim of describing an unselected series of acute myeloid leukaemias (AML) in adults, patients diagnosed 1987-1992 in the &Oouml;rebro region of central Sweden were reviewed by investigating hospital records. By utilizing: (1) The Swedish Cancer Registry, (2) The Cause of Death Registry, (3) listings of pathology bone marrow reports and (4) listings of inpatient discharge diagnoses, we attempted to find all patients. Among secondary AML, only blast-crises of CML were excluded. A total of 214 cases of AML with a median age of 69.5 years were verified corresponding to a mean yearly incidence in adults of 5.4/100 000. Of all patients, 56% had received 'high-dose' induction treatment, 28% 'low-dose' treatment and 16% no cytostatic treatment. Median survival for all patients was 5.8 months and the probability of survival at 5 years was 9.3%. The 120 'high-dose' treated patients had a total CR rate of 67%, median CR duration 10.1 months and median survival 11.4 months. Age, LDH and kidney function were found to be independent prognostic variables for survival. The inclusion of patients unreferred from district hospitals makes this study unique as an example of unselected AML. [ABSTRACT FROM AUTHOR]

Published
2000

39. Intracellular uptake and cytotoxic effect in vitro of doxorubicin and epirubicin in human leukemic and normal hematopoietic cells.

Author

Tidefelt, Ulf, Sundman-Engberg, Britt, Paul, Christer, Tidefelt, U, Sundman-Engberg, B, and Paul, C

Subjects
BONE marrow, CELL culture, CELL physiology, CELL separation, COMPARATIVE studies, DOXORUBICIN, DOSE-effect relationship in pharmacology, HEMATOPOIETIC stem cells, RESEARCH methodology, MEDICAL cooperation, RESEARCH, EVALUATION research, ACUTE myeloid leukemia, EPIRUBICIN, CANCER cell culture
Abstract

Leukemic cells from patients presenting with acute nonlymphoblastic leukemia and normal hematopoietic bone marrow cells from healthy donors for allogeneic bone marrow transplantation were incubated for 3 h with doxorubicin and epirubicin at different concentrations. The intracellular uptake at the end of the incubation was determined by photofluorometry in leukemic cells from 15 patients and in normal cells from 9 donors for bone marrow transplantation. Cytotoxicity in vitro against granulocyte/macrophage colony-forming units (CFU-GM) was determined in normal cells from 7 donors, and in vitro toxicity against leukemic cells was determined by a clonogenic technique in cells from 6 patients and by vital dye staining (DiSC) following 4 days' culture in cells from 15 patients. Epirubicin was significantly less toxic than doxorubicin to normal hematopoetic cells (72% +/- 20% survival of cells for epirubicin vs 45% +/- 13% for doxorubicin at a concentration of 0.2 microM; P less than or equal to 0.005). As analyzed by the DiSC assay, 0.2 microM epirubicin was slightly more toxic to leukemic cells than was the same concentration of doxorubicin (47% vs 61% survival, P less than or equal to 0.01), but the clonogenic assay revealed no difference in toxicity to leukemic cells. At a concentration of 0.2 microM, the mean intracellular uptake of epirubicin in leukemic cells was 0.43 +/- 0.26 nmol/mg protein as compared with 0.33 +/- 0.14 nmol/mg protein for doxorubicin (not significant). In normal cells, the uptake of epirubicin at a concentration of 0.2 microM was 0.47 +/- 0.25 nmol/mg protein as compared with 0.31 +/- 0.21 nmol/mg protein for doxorubicin (not significant). The reduced myelotoxicity observed in vitro together with the retained toxicity to leukemic cells indicates that the therapeutic index of epirubicin is better than that of doxorubicin. [ABSTRACT FROM AUTHOR]

Published
1991
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40. Comparison of the intracellular pharmacokinetics of doxorubicin and 4'-epi-doxorubicin in patients with acute leukemia.

Author

Tidefelt, Ulf, Sundman-Engberg, Britt, Paul, Christer, Tidefelt, U, Sundman-Engberg, B, and Paul, C

Subjects
COMPARATIVE studies, DOXORUBICIN, DRUG interactions, HIGH performance liquid chromatography, LEUKEMIA, LYMPHOBLASTIC leukemia, RESEARCH methodology, MEDICAL cooperation, RESEARCH, EVALUATION research, ACUTE myeloid leukemia, ACUTE diseases, EPIRUBICIN, CANCER cell culture
Abstract

A direct comparison of the intracellular pharmacokinetics of 4'-epi-doxorubicin and doxorubicin was carried out in five patients with leukemia who were given weekly low doses of a combination of these drugs at 20 mg each in an i.v. injection. Blood samples were collected for 48 h after administration and the drug concentrations in leukemic cells were determined by high-performance liquid chromatography (HPLC). The intracellular peak concentrations of 4'-epi-doxorubicin were higher than those of doxorubicin in all patients. The AUC for the intracellular drug concentration vs time curve was significantly higher for 4'-epi-doxorubicin. The intracellular uptake and retention were also studied in vitro after incubation of isolated leukemic blast cells with the two drugs; they showed the same pattern observed in vivo. We conclude that 4'-epi-doxorubicin and doxorubicin exhibit different pharmacokinetics in malignant cells. The therapeutic significance of this finding requires further evaluation. [ABSTRACT FROM AUTHOR]

Published
1989
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46. In the shadow of bad news – views of patients with acute leukaemia, myeloma or lung cancer about information, from diagnosis to cure or death

Author

Thaning Lars, Tidefelt Ulf, Hoff Lena, and Hermerén Göran

Subjects
Special situations and conditions, RC952-1245
Abstract

Abstract Background Many studies have been published about giving and receiving bad messages. However, only a few of them have followed the patients all the way through a disease as is done in this study. Many studies have been written about patients' coping strategies. In this study we will keep within the bounds of coping through information only. The aim of the study is to investigate patients' views of information during the trajectory of their disease, whether their reactions differ from each other and whether they differ in different phases of the disease. Methods Twelve patients with malignant haematological diseases or lung cancer were followed with interviews from diagnosis to recovery or into the terminal phase or at most for two years. The method is qualitative, using semi-structured interviews. Setting: Örebro University Hospital or the patient's home. Results All patients described themselves as well informed from the start but in later phases of their disease some of them came to express a great uncertainty about the progressing disease and about the approaching death. Most of them, regardless of whether they had a haematological malignancy or lung cancer, expressed a wish to be well informed all through the disease and even when the messages were bad. Different strategies for coping with information, however, affected how they then dealt with the information received. Four such coping strategies were found: 1) Information-dependent and accepting; 2) Information-dependent but denying; 3) Medically informed and accepting; 4) Medically informed but denying. Conclusion To several patients there was an unmet need for information about the progressing disease and the approaching death. To optimize the care of these patients it seems important that the physician is aware of patients' need for information even when the news is bad. Knowing the patient's information strategy could probably function as a key for the physician to communicate with patients on these matters.

Published
2007
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