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Since 1987 Acute Leukemias (AL) has regularly reported on the state
of the art in the rapidly growing, successful and exciting field of
biology and management of these diseases. In this volume large
multicenter clinical trials again form the solid basis for the
investigation of leukemic cell biology, the detection of biologic
subgroups, their differential response to alternative treatment
strategies and the further development of therapy. In particular,
this volume addresses mechanisms of chromosomal translocations and
transcription factors, risk-adapted treatment strategies,
differentiation therapy, secondary AL, special aspects in older
patients, and adoptive immunotherapy. Besides the antileukemic
approaches, supportive treatment with new antimicrobial substances
and growth factors is updated. As a forum of worldwide activities
in the field of AL this volume contains both exhaustive overviews
on major clinical issues and preliminary data and hypotheses not
previously published.
Following the major breakthroughs in the and frequent and thorough
exchange of treatment of acute leukemias in the seven- information.
Hence, it was felt that a spe- ties by the introduction of
intensive combi- cial series of symposia should be devoted to
nation regimens, therapeutic progress has "Pharmacokinetics and
Management of slowed down and the impression of stagna- Relapsed
and Refractory Disease" comple- menting the established meetings on
"Prog- tion may even have occured. In contrast, the knowledge about
the biology of leu- nostic Factors and Treatment Strategies" kemias
is rapidly expanding and allows new which will proceed in parallel.
It was the insights into the pathophysiology of the aim of the
international symposium disease. Further improvements also come
"ACUTE LEUKEMIAS - Pharmacokine- from a better understanding of the
pharma- tics and Management of Relapsed and cokinetics and
pharmacodynamics of cyto- Refractory Disease" to provide an update
static drugs and their mechanisms of action. of the present
knowledge in this area and to Hence, novel treatment modalities can
be stimulate further developments. As a sign developed on a more
solid basis and ration- for the closing distance between countries
al. These achievements need to be comple- and the development of
effective world- mented by effective eradiation wide cooperation
this symposium emerged of residual disease or its permanent control
and new from the joint efforts of the German AML approaches have
been derived from recent Cooperative Group and the M. D.
Since the introduction of new anthracycline derivatives and
anthrachi none analogues a few years ago, aclacinomycin A
(Aclarubicin) has become an established agent for the treatment of
hematologic malig nancies. A special symposium was therefore held
during the congress of the German Society of Hermatology and
Oncology in Hannover in October 1989 to provide an up-to-date
overv.iew. Leading experts from the United States, Sweden, and
Germany reported on the results being obtained with aclacinomycin
A, alone or combined with other agents, in patients with acute
leukemias and myelodysplastic syndromes. This book is based on
their contributions. As regards single-agent treatment,
aclacinomycin A in myelodys plastic syndromes is dealt with, as
well as its application in older patients with acute myeloid
leukemia. Four contributions are devoted to the use of
aclacinomycin A in combination with conventional or intermediate
dose cytosine arabinoside or etoposide in patients with relapsed or
refractory acute myeloid leukemia. The results reported indicate
that aclacinomycin A has substantial activity in the treatment of
hematologic malignancies. In summary, this book provides a valuable
update on the current status of aclacinomycin A as used by experts
in the treatment of he matologic malignancies."
The rates of acute leukemia cure have gradually improved over the
last decade. Clinical study results reflect the impact of
chemotherapy intensity and duration, the role of prolonged
maintenance, intensified consolidation or very early
intensification. Further progress has also been achieved in bone
marrow trans plantation, and recent prospective studies and
meta-analyses have contributed comparisons of the high antileukemic
efficacy of bone marrow transplantation to that of improved
chemotherapy. This allows a more successful combining of the two
forms of treatment. New prognostic factors have emerged from both
cytogenetic and molecular genetic research. Thus, the Philadelphia
chromosome translocation and the bcr/abl gene rearrangement have
proven to be the dominating risk factor in acute lymphoblastic
leukemia. Since the frequency increases with age, differences in
prognosis between children and adults can be explained. Evaluation
of molecular and immunologic leukemia cell markers has provided a
better understanding of residual leukemia in clinical remission, as
a prognostic factor and in monitoring the effectiveness of the
antileukemic strategy. Recent work on leukemic cell biology has
resulted in novel therapeutic approaches such as terminal
differentiation by all-trans-retinoic acid, modulation of
chemotherapy by hematopoietic growth factors such as GM-CSF and
enhancement of immunologic control by cytokines such as interleukin
2. New antimicrobial drugs and the application of mostly empiric
anti-infectious strategies have helped reducing the therapeutic
risk. Thus, a number of recent achievements have provided us with
new options in the management of patients with acute leukemias."
Die Rubrik "Leser fragen, Experten antworten" in den
Facharzt-Zeitschriften des Springer-Verlages stosst seit ihrer
Einfuhrung auf grosses Interesse. Das vorliegende Buch stellt eine
Zusammenfassung dieser Rubrik aus den unterschiedlichen
Facharzt-Zeitschriften dar und spiegelt damit die
Interdisziplinaritat der Medizin wider. Alle Antworten wurden von
den Autoren erneut uberarbeitet und aktualisiert. Die Ordnung nach
Fachgebieten ermoglicht ein systematisches Lesen.
Eine Sammlung, die dem Leser den Einblick in die Diskussion
fachfremder Themen ermoglicht und damit den Blick uber den
Tellerrand hinaus erleichtert."
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