Enhancement of Autologous Bone Marrow Transplantation with Recombinant Human Granulocyte-Macrophage Colony-Stimulating Factor (rhGM-CSF) View Full Text


Ontology type: schema:Chapter     


Chapter Info

DATE

1989

AUTHORS

H. Link , M. Freund , H. Kirchner , M. Stoll , H. Schmid , P. Bucsky , J. Seidel , G. Schulz , R. E. Schmidt , H. Riehm , H. Poliwoda , K. Welte

ABSTRACT

Intensive combination chemotherapy makes long-term survival possible after several lymphoid malignancies. However, a substantial number of patients have poor prognostic factors for remaining in remission and should therefore be treated with additional aggressive chemotherapy during remission. Many studies have shown that high-dose chemotherapy alone or in combination with total-body irradiation followed by bone marrow transplantation (BMT) improves the chances of survival for poor-risk patients with acute lymphoblastic leukemia (ALL) [3, 8]. The prognosis for patients with relapsed intermediate or high-grade non-Hodgkin’s lymphoma (NHL) can be improved by high-dose radiochemotherapy followed by BMT [2, 16]. Patients with Hodgkin’s disease (HD) who do not enter a complete remission with conventional chemotherapy have an unfavorable prognosis [1, 6], as do relapse patients who require treatment with chemotherapy. These patients’ chances of being cured are greater with high-dose chemoradiotherapy followed by bone marrow transplantation than with the usual salvage treatment. Neuroblastoma stage III/IV can only be cured by high-dose chemotherapy followed by BMT during remission as consolidation [15]. However, infectious complications due to bone marrow insufficiency during the immediate post-transplant phase after BMT contribute significantly to morbidity and mortality [12,17]. These infections tend to be more severe than during the granulocytopenia following conventional cytotoxic therapy. The association of the degree and duration of granulocytopenia and an increased risk of infection has long been recognized [10]. In autologous BMT for ALL, the median time for recovery to 500 neutrophils per microliter is 22 days, with a range of 14–40 days [7, 11]. The risk of severe infections and of high morbidity could be reduced markedly if the duration of neutropenia could be shortened significantly. More... »

PAGES

96-102

Book

TITLE

Cancer Therapy

ISBN

978-3-642-73723-7
978-3-642-73721-3

Author Affiliations

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/978-3-642-73721-3_12

DOI

http://dx.doi.org/10.1007/978-3-642-73721-3_12

DIMENSIONS

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