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  • 1.
    Lennmyr, Emma Bergfelt
    et al.
    Department of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden.
    Kozlowski, Piotr
    Department of Medicine.
    Ahlberg, Lucia
    Department of Hematology, University Hospital of Linköping, Linköping, Sweden.
    Bernell, Per
    Division of Hematology, Department of Medicine, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.
    Hulegårdh, Erik
    Department of Hematology and Coagulation, Sahlgrenska University Hospital, Göteborg, Sweden.
    Izarra, Antonio Santamaria
    Department of Hematology, Cancer Center, University Hospital of Umeå, Umeå, Sweden.
    Karlsson, Karin
    Department of Hematology and Oncology, Skåne University Hospital, Lund, Sweden.
    Tomaszewska-Toporska, Beata
    Department of Hematology and Oncology, Skåne University Hospital, Lund, Sweden.
    Åström, Maria
    Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Medicine.
    Hallböök, Helene
    Department of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden.
    Swedish Adult Acute Lymphoblastic Leukemia Group (SVALL), Group Author
    Real-world data on first relapse of acute lymphoblastic leukemia in patients >55 years2018In: Leukemia and Lymphoma, ISSN 1042-8194, E-ISSN 1029-2403, Vol. 59, no 10, p. 2470-2473Article in journal (Refereed)
  • 2.
    Mulligan, Stephen P
    et al.
    Department of Haematology, Royal North Shore Hospital, St LeonardsSydney, NSW, Australia .
    Karlsson, Karin
    Department of Hematology, University Hospital, Linköping, Sweden; Department of Hematology, Skåne University Hospital, Lund, Sweden .
    Strömberg, Mats
    Department of Oncology, Karolinska University Hospital, Stockholm, Sweden .
    Jønsson, Viggo
    Department of Hematology, National Hospital, Copenhagen, Denmark .
    Gill, Devinder
    Department of Haematology, Princess Alexandra Hospital, Brisbane, Australia.
    Hammerström, Jens
    Department of Hematology, St Olav University Hospital, Trondheim, Norway .
    Hertzberg, Mark
    Department of Haematology, Westmead Hospital, Sydney, Australia .
    McLennan, Roger
    Department of Haematology, Ballarat Base Hospital, Ballarat, Australia .
    Uggla, Bertil
    Örebro University Hospital. Department of Medicine, Örebro University Hospital, Örebro, Sweden.
    Norman, John
    Department of Haematology, Royal Adelaide Hospital, Adelaide, Australia .
    Wallvik, Jonas
    Department of Medicine, Region Västernorrland County Hospital, Sundsvall, Sweden .
    Sundström, Gunnel
    Department of Hematology, Norrlands University Hospital, Umeå, Sweden .
    Johansson, Hemming
    Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden .
    Brandberg, Yvonne
    Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden .
    Liliemark, Jan
    Department of Oncology, Karolinska University Hospital, Stockholm, Sweden; Swedish Council on Health Technology Assessment, Stockholm, Sweden .
    Juliusson, Gunnar
    Department of Hematology, University Hospital, Linköping, Sweden; Department of Hematology, Skåne University Hospital, Lund, Sweden .
    Cladribine prolongs progression-free survival and time to second treatment compared to fludarabine and high-dose chlorambucil in chronic lymphocytic leukemia2014In: Leukemia and Lymphoma, ISSN 1042-8194, E-ISSN 1029-2403, Vol. 55, no 12, p. 2769-2777Article in journal (Refereed)
    Abstract [en]

    We conducted a randomized phase III trial to compare the efficacy and safety of two purine analogs, cladribine and fludarabine, with high-dose chlorambucil, in patients with previously untreated chronic lymphocytic leukemia (CLL). Between 1997 and 2004, 223 patients with CLL were randomly assigned to cladribine, fludarabine or chlorambucil, for six cycles of therapy with frequent health-related quality of life assessments. There was no statistical difference for the primary endpoint of overall response with cladribine (70%), fludarabine (67%) and chlorambucil (59%), or complete remission (12%, 7% and 8%), respectively. However, the median progression-free survival (25, 10, 9 months) and median time to second treatment (40, 22, 21 months) were superior with cladribine. There was no significant difference in overall survival (96, 82 and 91 months), nor in toxicity or HRQoL assessments. Monotherapy with cladribine gives superior PFS and longer response duration than fludarabine and chlorambucil as first-line treatment of CLL.

  • 3.
    Möllgård, Lars
    et al.
    Karolinska Institutet.
    Prenkert, Malin
    Örebro University, Department of Nursing and Caring Sciences.
    Smolowicz, Adam
    Paul, Christer
    Karolinska Institutet.
    Tidefelt, Ulf
    Örebro University, Department of Clinical Medicine.
    In vitro chemosensitivity testing of selected myeloid cells in acute myeloid leukemia 2003In: Leukemia and Lymphoma, ISSN 1042-8194, E-ISSN 1029-2403, Vol. 44, no 5, p. 783-789Article in journal (Refereed)
    Abstract [en]

    In several studies different chemosensitivity assays have been examined in acute myeloid leukemia (AML). Some have shown that in vitro chemosensitivity testing is an independent prognostic factor but so far no one has been able to show that the use of these methods can improve treatment outcome. In an attempt to improve in vitro chemosensitivity testing in AML we wanted to establish and evaluate a new flow cytometry chemosensitivity assay. After 4 days of incubation viable mononuclear myeloid cells were identified by the exclusion of propidium iodide in CD13 or CD33 positive cells. Sixty-eight samples from 64 AML patients were included. In this study, we showed that the flow cytometry method is feasible in AML and we also found some correlations to clinical data. The secondary AML at diagnosis showed an in vitro resistance to etoposide and amsacrine that was significantly higher compared to de novo AML at diagnosis (p = 0.04 and p = 0.02). When AML patients at diagnosis were compared to resistant disease/relapse patients there was a significantly higher effect of ara-C in the diagnosis group (p = 0.03). Responders and non-responders were compared in vitro but we found no significant differences. In vitro mitoxantrone was more effective in multidrug resistance (MDR) negative cells compared to MDR positive cells (p < 0.01). This new method is feasible and makes it possible to selectively evaluate the effect of cytotoxic drugs in myeloid cells. Further studies with a larger group of patients are needed to evaluate the predictive value of the assay.

  • 4. Olsson-Strömberg, U.
    et al.
    Höglund, M.
    Björkholm, M.
    Braide, I.
    Carlson, K.
    Gahrton, G.
    Grimfors, G.
    Hast, R.
    Lerner, R.
    Linder, O.
    Ljungman, P.
    Löfvenberg, E.
    Malm, C.
    Nilsson, P. G.
    Paul, C.
    Rödjer, S.
    Stenke, L.
    Tidefelt, Ulf
    Örebro University, Department of Clinical Medicine.
    Turesson, I.
    Udén, A. M.
    Wahlin, A.
    Vilen, L.
    Winqvist, I.
    Zettervall, O.
    Öberg, G.
    Simonsson, B.
    Successful mobilization of Ph-negative blood stem cells with intensive chemotherapy + G-CSF in patients with chronic myelogenous leukemia in first chronic phase2006In: Leukemia and Lymphoma, ISSN 1042-8194, E-ISSN 1029-2403, Vol. 47, no 9, p. 1768-1773Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to investigate the feasibility of mobilizing Philadelphia chromosome negative (Ph-) blood stem cells (BSC) with intensive chemotherapy and lenograstim (G-CSF) in patients with CML in first chronic phase (CP1). During 1994-1999 12 centers included 37 patients <56 years. All patients received 6 months' IFN, stopping at median 36 (1-290) days prior to the mobilization chemotherapy. All received one cycle of daunorubicin 50 mg/m2 and 1 hour infusion on days 1-3, and cytarabine (ara-C) 200 mg/m2 24 hours' i.v. infusion on days 1-7 (DA) followed by G-CSF 526 microg s.c. once daily from day 8 after the start of chemotherapy. Leukaphereses were initiated when the number of CD 34+ cells was >5/microl blood. Patients mobilizing poorly could receive a 4-day cycle of chemotherapy with mitoxantrone 12 mg/m2/day and 1 hour i.v infusion, etoposide 100 mg/m2/day and 1 hour i.v. infusion and ara-C 1 g/m2/twice a day with 2 hours' i.v infusion (MEA) or a second DA, followed by G-CSF 526 microg s.c once daily from day 8 after the start of chemotherapy. Twenty-seven patients received one cycle of chemotherapy and G-CSF, whereas 10 were mobilized twice. Twenty-three patients (62%) were successfully (MNC >3.5 x 10(8)/kg, CFU-GM >1.0 x 10(4)/kg, CD34+ cells >2.0 x 10(6)/kg and no Ph+ cells in the apheresis product) [n = 16] or partially successfully (as defined above but 1-34% Ph+ cells in the apheresis product) [n = 7] mobilized. There was no mortality during the mobilization procedure. Twenty-one/23 patients subsequently underwent auto-SCT. The time with PMN <0.5 x 10(9)/l was 10 (range 7-49) and with platelets <20 x 10(9)/l was also 10 (2-173) days. There was no transplant related mortality. The estimated 5-year overall survival after auto-SCT was 68% (95% CI 47 - 90%), with a median follow-up time of 5.2 years.We conclude that in a significant proportion of patients with CML in CP 1, intensive chemotherapy combined with G-CSF mobilizes Ph- BSC sufficient for use in auto-SCT.

  • 5. Olsson-Strömberg, Ulla
    et al.
    Höglund, Martin
    Björkholm, Magnus
    Braide, Inger
    Carlson, Karin
    Gahrton, Gösta
    Grimfors, Gunnar
    Hast, Robert
    Lerner, Rickard
    Linder, Olle
    Ljungman, Per
    Löfvenberg, Eva
    Malm, Claes
    Nilsson, Per-Gunnar
    Paul, Christer
    Rödjer, Stig
    Stenke, Leif
    Tidefelt, Ulf
    Örebro University, Department of Clinical Medicine.
    Turesson, Ingemar
    Udén, Ann-Marie
    Wahlin, Anders
    Vilén, Lars
    Winqvist, Ingemar
    Zettervall, Olle
    Öberg, Gunnar
    Simonsson, Bengt
    Successful mobilization of Ph-negative blood stem cells with intensive chemotherapy + G-CSF in patients with chronic myelogenous leukemia in first chronic phase2006In: Leukemia and Lymphoma, ISSN 1042-8194, E-ISSN 1029-2403, Vol. 47, no 9, p. 1768-1773Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to investigate the feasibility of mobilizing Philadelphia chromosome negative (Ph-) blood stem cells (BSC) with intensive chemotherapy and lenograstim (G-CSF) in patients with CML in first chronic phase (CP1). During 1994-1999 12 centers included 37 patients <56 years. All patients received 6 months' IFN, stopping at median 36 (1-290) days prior to the mobilization chemotherapy. All received one cycle of daunorubicin 50 mg/m2 and 1 hour infusion on days 1-3, and cytarabine (ara-C) 200 mg/m2 24 hours' i.v. infusion on days 1-7 (DA) followed by G-CSF 526 microg s.c. once daily from day 8 after the start of chemotherapy. Leukaphereses were initiated when the number of CD 34+ cells was >5/microl blood. Patients mobilizing poorly could receive a 4-day cycle of chemotherapy with mitoxantrone 12 mg/m2/day and 1 hour i.v infusion, etoposide 100 mg/m2/day and 1 hour i.v. infusion and ara-C 1 g/m2/twice a day with 2 hours' i.v infusion (MEA) or a second DA, followed by G-CSF 526 microg s.c once daily from day 8 after the start of chemotherapy. Twenty-seven patients received one cycle of chemotherapy and G-CSF, whereas 10 were mobilized twice. Twenty-three patients (62%) were successfully (MNC >3.5 x 10(8)/kg, CFU-GM >1.0 x 10(4)/kg, CD34+ cells >2.0 x 10(6)/kg and no Ph+ cells in the apheresis product) [n = 16] or partially successfully (as defined above but 1-34% Ph+ cells in the apheresis product) [n = 7] mobilized. There was no mortality during the mobilization procedure. Twenty-one/23 patients subsequently underwent auto-SCT. The time with PMN <0.5 x 10(9)/l was 10 (range 7-49) and with platelets <20 x 10(9)/l was also 10 (2-173) days. There was no transplant related mortality. The estimated 5-year overall survival after auto-SCT was 68% (95% CI 47 - 90%), with a median follow-up time of 5.2 years.We conclude that in a significant proportion of patients with CML in CP 1, intensive chemotherapy combined with G-CSF mobilizes Ph- BSC sufficient for use in auto-SCT.

1 - 5 of 5
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  • ieee
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