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Cytokines are cellular growth factors which also provide
communication between cells and their milieu. This clearly is an
exciting area in modern medicine that will have significant impact
on various facets of transfusion. Erythropoietin therapy stimulates
red cell production while thrombopoietin seems to positively affect
megakaryopoiesis and can be an added armamentarium for the
thrombocytopenic patient. Using haematnopoietic growth factors,
stem cells could be mobilized early to the peripheral blood for
collection and subsequent transplantation into haemato-oncology
patients instead of bone marrow transplantation. Using a cocktail
of cytokines in cell culture, stem cells could be expanded and
selected for therapy. Cytokines and growth factors can even be
modified, which may lead to successful gene therapy in
malignancies, including solid tumour vaccines. However, the
presence of cytokines in certain blood products could have
biological effects following transfusion, although its clinical
relevance needs to be ascertained. There is much potential for the
use of cytokines in the treatment of infections. Early diagnostic
methods are now available to monitor their levels and relevance. It
is likely that cytokines will increasingly play a role in therapy
and could develop our fundamental knowledge about the development
of T-cells. An ethical dilemma remains, however, regarding the use
of cytokines in healthy donors for harvesting suitable specific
cells. Longer clinical observation will be necessary to gather the
necessary information. Cytokines and growth factors in blood
transfusion was the theme of the 21st International Symposium in
Blood Transfusion, where twenty clinicians and scientists, experts
in their own fields, were invited to update the above information.
Their findings are presented in four sections in this volume:
Fundamental aspects - cytokines in development of T-cells, growth
factors in haematopoiesis, growth factor receptors and signal
transduction, cytokine response in platelet and whole blood
transfusions. Function, production and diagnosis &endash;
laboratory diagnostics of cytokines and growth factors, cytokines
in blood components, cytokines and growth factors in cell
expansions, cytokines for genetic modification towards gene
therapy, progenitor cells from healthy donors. Application in
clinical medicine &endash; clinical relevance of cytokines in
transfusion products, cytokines and growth factors in solid
tumours, gene therapy in malignancies, vaccine strategies inducing
T-cell immunity against tumours, cytokines in the treatment of
infections, thrombopoietin and megakaryopoiesis. Future potential
use in transfusion medicine &endash; erythropoietin,
immunotherapy, ethical aspects of the use of cytokines and growth
factors in donors, potential of cytokines and growth factors in
transfusion medicine.
Cytokines are cellular growth factors which also provide
communication between cells and their milieu. This clearly is an
exciting area in modern medicine that will have significant impact
on various facets of transfusion. Erythropoietin therapy stimulates
red cell production while thrombopoietin seems to positively affect
megakaryopoiesis and can be an added armamentarium for the
thrombocytopenic patient. Using haematnopoietic growth factors,
stem cells could be mobilized early to the peripheral blood for
collection and subsequent transplantation into haemato-oncology
patients instead of bone marrow transplantation. Using a cocktail
of cytokines in cell culture, stem cells could be expanded and
selected for therapy. Cytokines and growth factors can even be
modified, which may lead to successful gene therapy in
malignancies, including solid tumour vaccines. However, the
presence of cytokines in certain blood products could have
biological effects following transfusion, although its clinical
relevance needs to be ascertained. There is much potential for the
use of cytokines in the treatment of infections. Early diagnostic
methods are now available to monitor their levels and relevance. It
is likely that cytokines will increasingly play a role in therapy
and could develop our fundamental knowledge about the development
of T-cells. An ethical dilemma remains, however, regarding the use
of cytokines in healthy donors for harvesting suitable specific
cells. Longer clinical observation will be necessary to gather the
necessary information. Cytokines and growth factors in blood
transfusion was the theme of the 21st International Symposium in
Blood Transfusion, where twenty clinicians and scientists, experts
in their own fields, were invited to update the above information.
Their findings are presented in four sections in this volume:
Fundamental aspects - cytokines in development of T-cells, growth
factors in haematopoiesis, growth factor receptors and signal
transduction, cytokine response in platelet and whole blood
transfusions. Function, production and diagnosis &endash;
laboratory diagnostics of cytokines and growth factors, cytokines
in blood components, cytokines and growth factors in cell
expansions, cytokines for genetic modification towards gene
therapy, progenitor cells from healthy donors. Application in
clinical medicine &endash; clinical relevance of cytokines in
transfusion products, cytokines and growth factors in solid
tumours, gene therapy in malignancies, vaccine strategies inducing
T-cell immunity against tumours, cytokines in the treatment of
infections, thrombopoietin and megakaryopoiesis. Future potential
use in transfusion medicine &endash; erythropoietin,
immunotherapy, ethical aspects of the use of cytokines and growth
factors in donors, potential of cytokines and growth factors in
transfusion medicine.
The objective of the treatment of acute leukemia involves the
eradication of all neoplastic cells, including the last one.
Ideally, treatment should be controlled by monitoring cell kill. If
the last cells could be discovered and their biological properties
be determined, the qualitative and quantitative effects of
treatment should be directly evaluable. This should ultimately
permit a calculated tumor cell reduction thereby avoiding
overtreatment and excessive toxicity and thus providing a basis for
individualized antileukemic treatment. In recent years several new
developments have contributed to the selective discovery of minimal
numbers of leukemic cells which are hidden among the normal cells
in the marrow cavities. These methods are the first steps to the
realization of the therapeutic goals indicated above. They include
the production and ap plication of monoclonal antibodies against
differentiation antigens on the cell sur face, the use of pulse
cytophotometry - and cell sorter techniques, the employment of
cytogenetics, the development of culture techniques for selective
growth of precursor cells and several others. These methodologies
offer prospects for refined diagnosis and, as far as the
elimination of leukemic cells is concerned, the further development
of autologous bone marrow transplantation. Eliminating tumor cells
from autologous grafts requires the detailed knowledge of the
cellular inter relationships within the neoplasm so that the
neoplastic cells responsible for tumor propagation are specifically
removed. Recognition and characterization of the clonogenic cells
of the neoplasm should then lead to determining their sensitivity
to the therapeutic agents which are clinically applied."
Relapse of leukemia following successful remission-induction
therapy remains a major obstacle in the treatment of patients with
acute leukemia. Leukemia recurs most frequently in patients with
acute myeloblastic leukemia (AML) and high risk acute lymphoblastic
leukemia (ALL) following chemotherapy and less often in patients
with low risk ALL and particularly in patient groups> submitted
to allogeneic marrow transplantation. ' It is likely that the great
majority of these recurrences originate from residual leukemic
cells that survive initial remission-induction chemotherapy. Today,
several research groups throughout the world place emphasis on
studies concerned with the detection and treatment of 'minimal
residual disease' (MRD). These investigations are conducted with
the common objective to tackle the remaining cells. 'Minimal
Residual Disease in Acute Leukemia: 1986' summarizes the fast
advancements in this area. Several disciplines are concerned with
the analysis of leukemic cells. The perspectives of cytogenetic and
molecular genetic approaches for applica tion in the detection of
MRD are reviewed. In this respect, modern cyto genetics provide
highly specific tumor markers. The resolution of cyto genetic
methods can be particularly improved when combined with other
techniques which select relevant subpopulations of cells.
Characterization of oncogenes and gene rearrangements, including
those of immunoglobulin and T-cell receptor genes, and the
measurement of gene products, have been established. Techniques
based on these approaches offer interesting tools for the detection
of MRD. New possibilities of employing monoclonal anti bodies are
also presented.
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R1,150
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Discovery Miles 8 870
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