Therapy-related myelodysplastic syndromes (t-MDSs) and acute myeloid leukemia (t-AML) have a poor prognosis with conventional therapy. Encouraging results are reported after allogeneic transplantation. We analyzed outcomes in 868 persons with t-AML (n = 545) or t-MDS (n = 323) receiving allogeneic transplants from 1990 to 2004. A myeloablative regimen was used for conditioning in 77%. Treatment-related mortality (TRM) and relapse were 41% (95% confidence interval [CI], 38-44) and 27% (24-30) at 1 year and 48% (44-51) and 31% (28-34) at 5 years, respectively. Disease-free (DFS) and overall survival (OS) were 32% (95% CI, 29-36) and 37% (34-41) at 1 year and 21% (18-24) and 22% (19-26) at 5 years, respectively. In multivariate analysis, 4 risk factors had adverse impacts on DFS and OS: (1) age older than 35 years; (2) poor-risk cytogenetics; (3) t-AML not in remission or advanced t-MDS; and (4) donor other than an HLA-identical sibling or a partially or well-matched unrelated donor. Five-year survival for subjects with none, 1, 2, 3, or 4 of these risk factors was 50% (95% CI, 38-61), 26% (20-31), 21% (16-26), 10% (5-15), and 4% (0-16), respectively (P < .001). These data permit a more precise prediction of outcome and identify subjects most likely to benefit from allogeneic transplantation.
"Thus, allogeneic RIC-HSCT is a potential curative treatment option. t-MDS patients who have received more than two chemotherapeutic regimens or have undergone allograft more than 6 months after the diagnosis showed a significantly higher nonrelapse mortality [3, 4]. Thus, an earlier decision for the choice of therapies with allogeneic HSCT is necessary, once the diagnosis of t-MDS is made. "
[Show abstract][Hide abstract] ABSTRACT: A 54-year-old male was diagnosed with follicular lymphoma in September 2003. Despite multiple chemotherapies, including autologous hematopoietic stem cell transplantation (HSCT) with high-dose chemotherapy, the disease eventually relapsed. Additionally, bone marrow analysis revealed the co-emergence of therapy-related myelodysplastic syndrome (t-MDS) in February 2012. In March 2012, we performed related allogeneic HSCT for the treatment of both malignancies. This strategy was successful and the patient has remained free from both malignancies for 23 months. Allogeneic HSCT is a potent curative therapeutic option for both t-MDS and refractory follicular lymphoma.
Case Reports in Oncology 03/2014; 7(1):188-94. DOI:10.1159/000360905
"However, the analyses are difficult to compare since Litzow and coworkers also included patients who received an allograft in the early 1990’s. Results achieved with aSCT at that time are not comparable with those observed today.17 "
[Show abstract][Hide abstract] ABSTRACT: Hodgkin lymphoma (HL) is a malignancy of the lymphatic system with an incidence of 2-3/100.000/year in developed countries. With modern multi-agent chemotherapy protocols optionally combined with radiotherapy (RT), 80% to 90% of HL patients achieve long-term remission and can be considered cured. However, current standard approaches bear a considerable risk for the development of treatment-related late effects. Thus, one major focus of current clinical research in HL is reducing the incidence of these late effects that include heart failure, infertility, chronic fatigue and therapy-related myelodysplastic syndrome/acute myeloid leukemia (t-MDS/t-AML). In previous analyses, t-MDS/t-AML after treatment for HL was associated with a poor prognosis. Nearly all patients died rapidly after diagnosis. However, more recent analyses indicated an improved outcome among patients with t-MDS/t-AML who are eligible for modern anti-leukemic treatment and allogeneic stem cell transplantation (aSCT). This article gives an overview of recent reports on the incidence and the treatment of t-MDS/t-AML after HL therapy and describes the efforts currently made to reduce the risk to develop this severe late effect.
Mediterranean Journal of Hematology and Infectious Diseases 10/2011; 3(1):e2011046. DOI:10.4084/MJHID.2011.046
[Show abstract][Hide abstract] ABSTRACT: A third harmonic Landau cavity with the fundamental mode of about
1.5 GHz is under development at SRRC. The cavity consists of inner
copper layer and outer stainless steel layer. The vacuum-brazing process
is adopted for cavity construction. The maximal power flow density on
the cavity surface will be about 52.19 W/cm<sup>2</sup>, as the total
thermal loading of 32 kW. To verify the cooling capacity, the finite
element method is adopted to perform the thermal and stress analyses.
Under 15 m<sup>3</sup>/hr water flow rate, the temperature rise on the
cavity body will be less than 14°C, and the maximal equivalent
stress on the copper layer of 29.75 N/mm<sup>2</sup>(MPa) is achieved,
which is much less than the yielding stress of copper
Particle Accelerator Conference, 1997. Proceedings of the 1997; 06/1997
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