home *** CD-ROM | disk | FTP | other *** search
Unknown | 1992-06-06 | 416.8 KB |
open in:
MacOS 8.1
|
Win98
|
DOS
view JSON data
|
view as text
This file was not able to be converted.
This format is not currently supported by dexvert.
Confidence | Program | Detection | Match Type | Support
|
---|
66%
| dexvert
| OS/2 Installation Package (archive/os2InstallPackage)
| ext
| Supported |
1%
| dexvert
| BeOS Installation Package (archive/beOSInstallPackage)
| ext
| Unsupported |
1%
| dexvert
| Newton Package (archive/newtonPackage)
| ext
| Unsupported |
1%
| dexvert
| Independence War 2 mod Package (other/independenceWar2ModPackage)
| ext
| Unsupported |
100%
| file
| data
| default
|
|
hex view+--------+-------------------------+-------------------------+--------+--------+
|00000000| 1a 44 50 31 2e 31 00 00 | 00 00 00 00 00 05 64 00 |.DP1.1..|......d.|
|00000010| 00 00 16 00 00 00 30 30 | 00 00 00 01 9c 05 00 00 |......00|........|
|00000020| 11 13 00 00 30 31 00 00 | 00 01 ad 18 00 00 77 11 |....01..|......w.|
|00000030| 00 00 30 32 00 00 00 01 | 24 2a 00 00 f7 0d 00 00 |..02....|$*......|
|00000040| 30 33 00 00 00 01 1b 38 | 00 00 eb 0d 00 00 30 34 |03.....8|......04|
|00000050| 00 00 00 01 06 46 00 00 | 7a 0c 00 00 30 35 00 00 |.....F..|z...05..|
|00000060| 00 01 80 52 00 00 e1 10 | 00 00 30 36 00 00 00 01 |...R....|..06....|
|00000070| 61 63 00 00 f0 0b 00 00 | 30 37 00 00 00 01 51 6f |ac......|07....Qo|
|00000080| 00 00 53 0c 00 00 30 38 | 00 00 00 01 a4 7b 00 00 |..S...08|.....{..|
|00000090| b0 12 00 00 30 39 00 00 | 00 01 54 8e 00 00 6e 0c |....09..|..T...n.|
|000000a0| 00 00 31 30 00 00 00 01 | c2 9a 00 00 03 0d 00 00 |..10....|........|
|000000b0| 31 31 00 00 00 01 c5 a7 | 00 00 f3 10 00 00 31 32 |11......|......12|
|000000c0| 00 00 00 01 b8 b8 00 00 | 13 13 00 00 31 33 00 00 |........|....13..|
|000000d0| 00 01 cb cb 00 00 8a 10 | 00 00 31 34 00 00 00 01 |........|..14....|
|000000e0| 55 dc 00 00 2b 0a 00 00 | 31 35 00 00 00 01 80 e6 |U...+...|15......|
|000000f0| 00 00 12 11 00 00 31 36 | 00 00 00 01 92 f7 00 00 |......16|........|
|00000100| 43 11 00 00 31 37 00 00 | 00 01 d5 08 01 00 07 0f |C...17..|........|
|00000110| 00 00 31 38 00 00 00 01 | dc 17 01 00 6b 0f 00 00 |..18....|....k...|
|00000120| 31 39 00 00 00 01 47 27 | 01 00 3e 0e 00 00 32 30 |19....G'|..>...20|
|00000130| 00 00 00 01 85 35 01 00 | dd 0e 00 00 32 31 00 00 |.....5..|....21..|
|00000140| 00 01 62 44 01 00 0b 0f | 00 00 32 32 00 00 00 01 |..bD....|..22....|
|00000150| 6d 53 01 00 09 0c 00 00 | 32 33 00 00 00 01 76 5f |mS......|23....v_|
|00000160| 01 00 34 14 00 00 32 34 | 00 00 00 01 aa 73 01 00 |..4...24|.....s..|
|00000170| 37 10 00 00 32 35 00 00 | 00 01 e1 83 01 00 6d 13 |7...25..|......m.|
|00000180| 00 00 32 36 00 00 00 01 | 4e 97 01 00 ac 15 00 00 |..26....|N.......|
|00000190| 32 37 00 00 00 01 fa ac | 01 00 3e 0d 00 00 32 38 |27......|..>...28|
|000001a0| 00 00 00 01 38 ba 01 00 | 1e 11 00 00 32 39 00 00 |....8...|....29..|
|000001b0| 00 01 56 cb 01 00 4c 14 | 00 00 33 30 00 00 00 01 |..V...L.|..30....|
|000001c0| a2 df 01 00 0d 15 00 00 | 33 31 00 00 00 01 af f4 |........|31......|
|000001d0| 01 00 f6 14 00 00 33 32 | 00 00 00 01 a5 09 02 00 |......32|........|
|000001e0| b8 11 00 00 33 33 00 00 | 00 01 5d 1b 02 00 6a 11 |....33..|..]...j.|
|000001f0| 00 00 33 34 00 00 00 01 | c7 2c 02 00 e6 11 00 00 |..34....|.,......|
|00000200| 33 35 00 00 00 01 ad 3e | 02 00 ca 16 00 00 33 36 |35.....>|......36|
|00000210| 00 00 00 01 77 55 02 00 | 22 0f 00 00 33 37 00 00 |....wU..|"...37..|
|00000220| 00 01 99 64 02 00 7d 13 | 00 00 33 38 00 00 00 01 |...d..}.|..38....|
|00000230| 16 78 02 00 21 0f 00 00 | 33 39 00 00 00 01 37 87 |.x..!...|39....7.|
|00000240| 02 00 8c 15 00 00 34 30 | 00 00 00 01 c3 9c 02 00 |......40|........|
|00000250| 2d 11 00 00 34 31 00 00 | 00 01 f0 ad 02 00 fe 11 |-...41..|........|
|00000260| 00 00 34 32 00 00 00 01 | ee bf 02 00 e7 12 00 00 |..42....|........|
|00000270| 34 33 00 00 00 01 d5 d2 | 02 00 e5 10 00 00 34 34 |43......|......44|
|00000280| 00 00 00 01 ba e3 02 00 | 5b 14 00 00 34 35 00 00 |........|[...45..|
|00000290| 00 01 15 f8 02 00 5b 11 | 00 00 34 36 00 00 00 01 |......[.|..46....|
|000002a0| 70 09 03 00 df 17 00 00 | 34 37 00 00 00 01 4f 21 |p.......|47....O!|
|000002b0| 03 00 c8 0a 00 00 34 38 | 00 00 00 01 17 2c 03 00 |......48|.....,..|
|000002c0| e8 14 00 00 34 39 00 00 | 00 01 ff 40 03 00 e4 0c |....49..|...@....|
|000002d0| 00 00 35 30 00 00 00 01 | e3 4d 03 00 b4 10 00 00 |..50....|.M......|
|000002e0| 35 31 00 00 00 01 97 5e | 03 00 b5 10 00 00 35 32 |51.....^|......52|
|000002f0| 00 00 00 01 4c 6f 03 00 | f6 0e 00 00 35 33 00 00 |....Lo..|....53..|
|00000300| 00 01 42 7e 03 00 ea 11 | 00 00 35 34 00 00 00 01 |..B~....|..54....|
|00000310| 2c 90 03 00 ad 12 00 00 | 35 35 00 00 00 01 d9 a2 |,.......|55......|
|00000320| 03 00 61 12 00 00 35 36 | 00 00 00 01 3a b5 03 00 |..a...56|....:...|
|00000330| a5 0e 00 00 35 37 00 00 | 00 01 df c3 03 00 3d 16 |....57..|......=.|
|00000340| 00 00 35 38 00 00 00 01 | 1c da 03 00 cf 14 00 00 |..58....|........|
|00000350| 35 39 00 00 00 01 eb ee | 03 00 77 0c 00 00 36 30 |59......|..w...60|
|00000360| 00 00 00 01 62 fb 03 00 | 8b 14 00 00 36 31 00 00 |....b...|....61..|
|00000370| 00 01 ed 0f 04 00 58 10 | 00 00 36 32 00 00 00 01 |......X.|..62....|
|00000380| 45 20 04 00 2f 0c 00 00 | 36 33 00 00 00 01 74 2c |E ../...|63....t,|
|00000390| 04 00 68 0f 00 00 36 34 | 00 00 00 01 dc 3b 04 00 |..h...64|.....;..|
|000003a0| 01 12 00 00 36 35 00 00 | 00 01 dd 4d 04 00 4c 13 |....65..|...M..L.|
|000003b0| 00 00 36 36 00 00 00 01 | 29 61 04 00 27 0e 00 00 |..66....|)a..'...|
|000003c0| 36 37 00 00 00 01 50 6f | 04 00 d7 15 00 00 36 38 |67....Po|......68|
|000003d0| 00 00 00 01 27 85 04 00 | e0 0d 00 00 36 39 00 00 |....'...|....69..|
|000003e0| 00 01 07 93 04 00 9c 11 | 00 00 37 30 00 00 00 01 |........|..70....|
|000003f0| a3 a4 04 00 ca 0e 00 00 | 37 31 00 00 00 01 6d b3 |........|71....m.|
|00000400| 04 00 ac 09 00 00 37 32 | 00 00 00 01 19 bd 04 00 |......72|........|
|00000410| fe 08 00 00 37 33 00 00 | 00 01 17 c6 04 00 bd 0e |....73..|........|
|00000420| 00 00 37 34 00 00 00 01 | d4 d4 04 00 69 14 00 00 |..74....|....i...|
|00000430| 37 35 00 00 00 01 3d e9 | 04 00 db 14 00 00 37 36 |75....=.|......76|
|00000440| 00 00 00 01 18 fe 04 00 | 31 10 00 00 37 37 00 00 |........|1...77..|
|00000450| 00 01 49 0e 05 00 67 10 | 00 00 37 38 00 00 00 01 |..I...g.|..78....|
|00000460| b0 1e 05 00 6c 11 00 00 | 37 39 00 00 00 01 1c 30 |....l...|79.....0|
|00000470| 05 00 db 0b 00 00 38 30 | 00 00 00 01 f7 3b 05 00 |......80|.....;..|
|00000480| 39 11 00 00 38 31 00 00 | 00 01 30 4d 05 00 6e 0f |9...81..|..0M..n.|
|00000490| 00 00 38 32 00 00 00 01 | 9e 5c 05 00 11 12 00 00 |..82....|.\......|
|000004a0| 38 33 00 00 00 01 af 6e | 05 00 3f 10 00 00 38 34 |83.....n|..?...84|
|000004b0| 00 00 00 01 ee 7e 05 00 | c0 11 00 00 38 35 00 00 |.....~..|....85..|
|000004c0| 00 01 ae 90 05 00 3a 0f | 00 00 38 36 00 00 00 01 |......:.|..86....|
|000004d0| e8 9f 05 00 8c 0d 00 00 | 38 37 00 00 00 01 74 ad |........|87....t.|
|000004e0| 05 00 de 0e 00 00 38 38 | 00 00 00 01 52 bc 05 00 |......88|....R...|
|000004f0| aa 0e 00 00 38 39 00 00 | 00 01 fc ca 05 00 88 10 |....89..|........|
|00000500| 00 00 39 30 00 00 00 01 | 84 db 05 00 ba 0b 00 00 |..90....|........|
|00000510| 39 31 00 00 00 01 3e e7 | 05 00 49 0f 00 00 39 32 |91....>.|..I...92|
|00000520| 00 00 00 01 87 f6 05 00 | 35 12 00 00 39 33 00 00 |........|5...93..|
|00000530| 00 01 bc 08 06 00 7d 14 | 00 00 39 34 00 00 00 01 |......}.|..94....|
|00000540| 39 1d 06 00 27 16 00 00 | 39 35 00 00 00 01 60 33 |9...'...|95....`3|
|00000550| 06 00 01 13 00 00 39 36 | 00 00 00 01 61 46 06 00 |......96|....aF..|
|00000560| 0a 0e 00 00 39 37 00 00 | 00 01 6b 54 06 00 eb 0b |....97..|..kT....|
|00000570| 00 00 39 38 00 00 00 01 | 56 60 06 00 d8 10 00 00 |..98....|V`......|
|00000580| 39 39 00 00 00 01 2e 71 | 06 00 ed 11 00 00 00 00 |99.....q|........|
|00000590| 00 00 00 00 1b 83 06 00 | 00 00 00 00 24 55 6e 69 |........|....$Uni|
|000005a0| 71 75 65 5f 49 44 7b 59 | 52 42 31 31 31 30 30 7d |que_ID{Y|RB11100}|
|000005b0| 0d 0a 24 54 69 74 6c 65 | 7b 41 20 43 6f 6d 70 61 |..$Title|{A Compa|
|000005c0| 72 69 73 6f 6e 20 6f 66 | 20 4d 61 72 72 6f 77 20 |rison of| Marrow |
|000005d0| 54 72 61 6e 73 70 6c 61 | 6e 74 61 74 69 6f 6e 20 |Transpla|ntation |
|000005e0| 57 69 74 68 20 43 68 65 | 6d 6f 74 68 65 72 61 70 |With Che|motherap|
|000005f0| 79 20 66 6f 72 20 41 64 | 75 6c 74 73 20 57 69 74 |y for Ad|ults Wit|
|00000600| 68 20 41 63 75 74 65 20 | 4c 65 75 6b 65 6d 69 61 |h Acute |Leukemia|
|00000610| 20 6f 66 20 50 6f 6f 72 | 20 50 72 6f 67 6e 6f 73 | of Poor| Prognos|
|00000620| 69 73 20 69 6e 20 46 69 | 72 73 74 20 43 6f 6d 70 |is in Fi|rst Comp|
|00000630| 6c 65 74 65 20 52 65 6d | 69 73 73 69 6f 6e 7d 0d |lete Rem|ission}.|
|00000640| 0a 24 41 75 74 68 6f 72 | 7b 5a 61 6e 64 65 72 2c |.$Author|{Zander,|
|00000650| 20 41 52 0d 0a 4b 65 61 | 74 69 6e 67 2c 20 4d 0d | AR..Kea|ting, M.|
|00000660| 0a 44 69 63 6b 65 2c 20 | 4b 0d 0a 44 69 78 6f 6e |.Dicke, |K..Dixon|
|00000670| 2c 20 44 0d 0a 50 69 65 | 72 63 65 2c 20 53 0d 0a |, D..Pie|rce, S..|
|00000680| 4a 61 67 61 6e 6e 61 74 | 68 2c 20 53 0d 0a 50 65 |Jagannat|h, S..Pe|
|00000690| 74 65 72 73 2c 20 4c 0d | 0a 48 6f 72 77 69 74 7a |ters, L.|.Horwitz|
|000006a0| 2c 20 4c 0d 0a 43 6f 63 | 6b 65 72 69 6c 6c 2c 20 |, L..Coc|kerill, |
|000006b0| 4b 0d 0a 53 70 69 74 7a | 65 72 2c 20 47 0d 0a 56 |K..Spitz|er, G..V|
|000006c0| 65 6c 6c 65 6b 6f 6f 70 | 2c 20 4c 0d 0a 4b 61 6e |ellekoop|, L..Kan|
|000006d0| 74 61 72 6a 69 61 6e 2c | 20 48 0d 0a 57 61 6c 74 |tarjian,| H..Walt|
|000006e0| 65 72 73 2c 20 52 0d 0a | 4d 63 43 72 65 64 69 65 |ers, R..|McCredie|
|000006f0| 2c 20 4b 0d 0a 46 72 65 | 69 72 65 69 63 68 2c 20 |, K..Fre|ireich, |
|00000700| 45 4a 7d 0d 0a 24 41 66 | 66 69 6c 69 61 74 69 6f |EJ}..$Af|filiatio|
|00000710| 6e 7b 55 6e 69 76 20 6f | 66 20 54 65 78 61 73 2c |n{Univ o|f Texas,|
|00000720| 20 48 6f 75 73 74 6f 6e | 7d 0d 0a 24 4a 6f 75 72 | Houston|}..$Jour|
|00000730| 6e 61 6c 7b 4a 20 43 6c | 69 6e 20 4f 6e 63 6f 6c |nal{J Cl|in Oncol|
|00000740| 7d 0d 0a 24 56 6f 6c 75 | 6d 65 7b 36 7d 0d 0a 24 |}..$Volu|me{6}..$|
|00000750| 50 61 67 65 7b 31 35 34 | 38 2d 31 35 35 37 7d 0d |Page{154|8-1557}.|
|00000760| 0a 24 44 61 74 65 7b 4f | 63 74 6f 62 65 72 20 31 |.$Date{O|ctober 1|
|00000770| 39 38 38 7d 0d 0a 24 59 | 42 56 6f 6c 7b 31 39 39 |988}..$Y|BVol{199|
|00000780| 30 20 59 65 61 72 20 42 | 6f 6f 6b 20 6f 66 20 4d |0 Year B|ook of M|
|00000790| 65 64 69 63 69 6e 65 7d | 0d 0a 24 43 68 61 70 74 |edicine}|..$Chapt|
|000007a0| 65 72 7b 32 33 2d 34 7d | 0d 0a 24 59 42 45 64 69 |er{23-4}|..$YBEdi|
|000007b0| 74 6f 72 7b 44 72 73 2e | 20 52 6f 67 65 72 73 2c |tor{Drs.| Rogers,|
|000007c0| 20 44 65 73 20 50 72 65 | 7a 2c 20 43 6c 69 6e 65 | Des Pre|z, Cline|
|000007d0| 2c 20 42 72 61 75 6e 77 | 61 6c 64 2c 20 47 72 65 |, Braunw|ald, Gre|
|000007e0| 65 6e 62 65 72 67 65 72 | 2c 20 57 69 6c 73 6f 6e |enberger|, Wilson|
|000007f0| 2c 20 45 70 73 74 65 69 | 6e 2c 20 61 6e 64 20 4d |, Epstei|n, and M|
|00000800| 61 6c 61 77 69 73 74 61 | 7d 0d 0a 24 54 61 62 6c |alawista|}..$Tabl|
|00000810| 65 7b 7d 0d 0a 24 43 6f | 6d 6d 65 6e 74 61 74 6f |e{}..$Co|mmentato|
|00000820| 72 7b 4d 2e 4a 2e 20 43 | 6c 69 6e 65 2c 20 4d 2e |r{M.J. C|line, M.|
|00000830| 44 2e 7d 0d 0a 0d 0a 43 | 6f 70 79 72 69 67 68 74 |D.}....C|opyright|
|00000840| 20 28 63 29 20 59 65 61 | 72 62 6f 6f 6b 20 4d 65 | (c) Yea|rbook Me|
|00000850| 64 69 63 61 6c 20 50 75 | 62 6c 69 73 68 65 72 73 |dical Pu|blishers|
|00000860| 2c 20 49 6e 63 2e 2c 20 | 31 39 39 30 0d 0a 0d 0a |, Inc., |1990....|
|00000870| 31 39 39 30 20 59 65 61 | 72 20 42 6f 6f 6b 20 6f |1990 Yea|r Book o|
|00000880| 66 20 4d 65 64 69 63 69 | 6e 65 20 28 52 29 0d 0a |f Medici|ne (R)..|
|00000890| 0d 0a 50 61 72 74 20 54 | 68 72 65 65 2d 2d 48 65 |..Part T|hree--He|
|000008a0| 6d 61 74 6f 6c 6f 67 79 | 20 61 6e 64 20 4f 6e 63 |matology| and Onc|
|000008b0| 6f 6c 6f 67 79 0d 0a 0d | 0a 43 68 61 70 74 65 72 |ology...|.Chapter|
|000008c0| 20 32 33 2d 2d 42 6f 6e | 65 20 4d 61 72 72 6f 77 | 23--Bon|e Marrow|
|000008d0| 20 54 72 61 6e 73 70 6c | 61 6e 74 61 74 69 6f 6e | Transpl|antation|
|000008e0| 0d 0a 0d 0a 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |....----|--------|
|000008f0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000900| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000910| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000920| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000930| 2d 2d 0d 0a 41 20 43 6f | 6d 70 61 72 69 73 6f 6e |--..A Co|mparison|
|00000940| 20 6f 66 20 4d 61 72 72 | 6f 77 20 54 72 61 6e 73 | of Marr|ow Trans|
|00000950| 70 6c 61 6e 74 61 74 69 | 6f 6e 20 57 69 74 68 20 |plantati|on With |
|00000960| 43 68 65 6d 6f 74 68 65 | 72 61 70 79 20 66 6f 72 |Chemothe|rapy for|
|00000970| 20 41 64 75 6c 74 73 20 | 57 69 74 68 20 41 63 75 | Adults |With Acu|
|00000980| 74 65 0d 0a 4c 65 75 6b | 65 6d 69 61 20 6f 66 20 |te..Leuk|emia of |
|00000990| 50 6f 6f 72 20 50 72 6f | 67 6e 6f 73 69 73 20 69 |Poor Pro|gnosis i|
|000009a0| 6e 20 46 69 72 73 74 20 | 43 6f 6d 70 6c 65 74 65 |n First |Complete|
|000009b0| 20 52 65 6d 69 73 73 69 | 6f 6e 0d 0a 0d 0a 5a 61 | Remissi|on....Za|
|000009c0| 6e 64 65 72 20 41 52 3b | 20 4b 65 61 74 69 6e 67 |nder AR;| Keating|
|000009d0| 20 4d 3b 20 44 69 63 6b | 65 20 4b 3b 20 44 69 78 | M; Dick|e K; Dix|
|000009e0| 6f 6e 20 44 3b 20 50 69 | 65 72 63 65 20 53 3b 20 |on D; Pi|erce S; |
|000009f0| 4a 61 67 61 6e 6e 61 74 | 68 20 53 3b 20 50 65 74 |Jagannat|h S; Pet|
|00000a00| 65 72 73 20 4c 3b 0d 0a | 48 6f 72 77 69 74 7a 20 |ers L;..|Horwitz |
|00000a10| 4c 3b 20 43 6f 63 6b 65 | 72 69 6c 6c 20 4b 3b 20 |L; Cocke|rill K; |
|00000a20| 53 70 69 74 7a 65 72 20 | 47 3b 20 56 65 6c 6c 65 |Spitzer |G; Velle|
|00000a30| 6b 6f 6f 70 20 4c 3b 20 | 4b 61 6e 74 61 72 6a 69 |koop L; |Kantarji|
|00000a40| 61 6e 20 48 3b 20 57 61 | 6c 74 65 72 73 20 52 3b |an H; Wa|lters R;|
|00000a50| 0d 0a 4d 63 43 72 65 64 | 69 65 20 4b 3b 20 46 72 |..McCred|ie K; Fr|
|00000a60| 65 69 72 65 69 63 68 20 | 45 4a 0d 0a 28 55 6e 69 |eireich |EJ..(Uni|
|00000a70| 76 20 6f 66 20 54 65 78 | 61 73 2c 20 48 6f 75 73 |v of Tex|as, Hous|
|00000a80| 74 6f 6e 29 0d 0a 4a 20 | 43 6c 69 6e 20 4f 6e 63 |ton)..J |Clin Onc|
|00000a90| 6f 6c 20 36 3a 31 35 34 | 38 2d 31 35 35 37 2c 20 |ol 6:154|8-1557, |
|00000aa0| 4f 63 74 6f 62 65 72 20 | 31 39 38 38 0d 0a 2d 2d |October |1988..--|
|00000ab0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000ac0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000ad0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000ae0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000af0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 0d 0a 0d 0a |--------|----....|
|00000b00| 41 62 73 74 72 61 63 74 | 0d 0a 0d 0a 20 20 20 20 |Abstract|.... |
|00000b10| 20 41 6c 74 68 6f 75 67 | 68 20 61 20 6c 6f 6e 67 | Althoug|h a long|
|00000b20| 65 72 20 64 69 73 65 61 | 73 65 2d 66 72 65 65 20 |er disea|se-free |
|00000b30| 73 75 72 76 69 76 61 6c | 20 68 61 73 20 6f 63 63 |survival| has occ|
|00000b40| 75 72 72 65 64 20 69 6e | 20 70 61 74 69 65 6e 74 |urred in| patient|
|00000b50| 73 20 74 72 65 61 74 65 | 64 0d 0a 77 69 74 68 20 |s treate|d..with |
|00000b60| 62 6f 6e 65 20 6d 61 72 | 72 6f 77 20 74 72 61 6e |bone mar|row tran|
|00000b70| 73 70 6c 61 6e 74 61 74 | 69 6f 6e 20 61 6e 64 20 |splantat|ion and |
|00000b80| 63 68 65 6d 6f 74 68 65 | 72 61 70 79 20 61 73 20 |chemothe|rapy as |
|00000b90| 6f 70 70 6f 73 65 64 20 | 74 6f 20 74 68 6f 73 65 |opposed |to those|
|00000ba0| 20 74 72 65 61 74 65 64 | 0d 0a 77 69 74 68 20 63 | treated|..with c|
|00000bb0| 68 65 6d 6f 74 68 65 72 | 61 70 79 20 61 6c 6f 6e |hemother|apy alon|
|00000bc0| 65 2c 20 74 68 65 20 73 | 75 70 65 72 69 6f 72 20 |e, the s|uperior |
|00000bd0| 72 65 73 75 6c 74 73 20 | 6d 61 79 20 68 61 76 65 |results |may have|
|00000be0| 20 62 65 65 6e 20 61 20 | 72 65 73 75 6c 74 20 6f | been a |result o|
|00000bf0| 66 0d 0a 70 61 74 69 65 | 6e 74 20 73 65 6c 65 63 |f..patie|nt selec|
|00000c00| 74 69 6f 6e 2e 20 20 41 | 20 74 6f 74 61 6c 20 6f |tion. A| total o|
|00000c10| 66 20 31 30 39 20 70 61 | 74 69 65 6e 74 73 20 77 |f 109 pa|tients w|
|00000c20| 69 74 68 20 61 63 75 74 | 65 20 6d 79 65 6c 6f 67 |ith acut|e myelog|
|00000c30| 65 6e 6f 75 73 20 6c 65 | 75 6b 65 6d 69 61 0d 0a |enous le|ukemia..|
|00000c40| 28 41 4d 4c 29 20 61 6e | 64 20 61 63 75 74 65 20 |(AML) an|d acute |
|00000c50| 6c 79 6d 70 68 6f 62 6c | 61 73 74 69 63 20 6c 65 |lymphobl|astic le|
|00000c60| 75 6b 65 6d 69 61 20 28 | 41 4c 4c 29 20 77 65 72 |ukemia (|ALL) wer|
|00000c70| 65 20 61 73 73 69 67 6e | 65 64 20 74 6f 20 70 6f |e assign|ed to po|
|00000c80| 73 74 20 72 65 6d 69 73 | 73 69 6f 6e 0d 0a 74 72 |st remis|sion..tr|
|00000c90| 65 61 74 6d 65 6e 74 73 | 20 6f 66 20 65 69 74 68 |eatments| of eith|
|00000ca0| 65 72 20 6d 61 72 72 6f | 77 20 74 72 61 6e 73 70 |er marro|w transp|
|00000cb0| 6c 61 6e 74 61 74 69 6f | 6e 20 61 6e 64 20 63 68 |lantatio|n and ch|
|00000cc0| 65 6d 6f 74 68 65 72 61 | 70 79 20 6f 72 20 63 68 |emothera|py or ch|
|00000cd0| 65 6d 6f 74 68 65 72 61 | 70 79 0d 0a 61 6c 6f 6e |emothera|py..alon|
|00000ce0| 65 2e 0d 0a 20 20 20 20 | 20 4d 6f 73 74 20 70 61 |e... | Most pa|
|00000cf0| 74 69 65 6e 74 73 20 68 | 61 64 20 70 6f 6f 72 20 |tients h|ad poor |
|00000d00| 6f 72 20 69 6e 74 65 72 | 6d 65 64 69 61 74 65 20 |or inter|mediate |
|00000d10| 70 72 6f 67 6e 6f 73 65 | 73 3b 20 32 30 20 68 61 |prognose|s; 20 ha|
|00000d20| 64 20 67 6f 6f 64 20 70 | 72 6f 67 6e 6f 73 65 73 |d good p|rognoses|
|00000d30| 2e 0d 0a 53 69 78 74 79 | 2d 6e 69 6e 65 20 70 61 |...Sixty|-nine pa|
|00000d40| 74 69 65 6e 74 73 20 77 | 69 74 68 6f 75 74 20 61 |tients w|ithout a|
|00000d50| 6e 20 48 4c 41 2d 69 64 | 65 6e 74 69 63 61 6c 20 |n HLA-id|entical |
|00000d60| 64 6f 6e 6f 72 20 73 65 | 72 76 65 64 20 61 73 20 |donor se|rved as |
|00000d70| 63 68 65 6d 6f 74 68 65 | 72 61 70 79 0d 0a 63 6f |chemothe|rapy..co|
|00000d80| 6e 74 72 6f 6c 73 2e 20 | 20 41 66 74 65 72 20 69 |ntrols. | After i|
|00000d90| 6e 64 75 63 74 69 6f 6e | 20 74 68 65 79 20 72 65 |nduction| they re|
|00000da0| 63 65 69 76 65 64 20 68 | 69 67 68 2d 64 6f 73 65 |ceived h|igh-dose|
|00000db0| 20 63 68 65 6d 6f 74 68 | 65 72 61 70 79 0d 0a 69 | chemoth|erapy..i|
|00000dc0| 6e 74 65 6e 73 69 66 69 | 63 61 74 69 6f 6e 20 66 |ntensifi|cation f|
|00000dd0| 6f 6c 6c 6f 77 65 64 20 | 62 79 20 72 6f 74 61 74 |ollowed |by rotat|
|00000de0| 69 6e 67 20 6f 75 74 70 | 61 74 69 65 6e 74 20 6d |ing outp|atient m|
|00000df0| 61 69 6e 74 65 6e 61 6e | 63 65 20 66 6f 72 20 31 |aintenan|ce for 1|
|00000e00| 38 20 6d 6f 6e 74 68 73 | 2e 0d 0a 46 6f 72 74 79 |8 months|...Forty|
|00000e10| 20 70 61 74 69 65 6e 74 | 73 20 77 69 74 68 20 48 | patient|s with H|
|00000e20| 4c 41 2d 69 64 65 6e 74 | 69 63 61 6c 20 64 6f 6e |LA-ident|ical don|
|00000e30| 6f 72 73 20 77 65 72 65 | 20 74 6f 20 72 65 63 65 |ors were| to rece|
|00000e40| 69 76 65 20 74 72 61 6e | 73 70 6c 61 6e 74 73 2e |ive tran|splants.|
|00000e50| 0d 0a 54 77 65 6e 74 79 | 2d 74 68 72 65 65 20 72 |..Twenty|-three r|
|00000e60| 65 63 65 69 76 65 64 20 | 74 72 61 6e 73 70 6c 61 |eceived |transpla|
|00000e70| 6e 74 73 20 69 6e 20 66 | 69 72 73 74 20 72 65 6d |nts in f|irst rem|
|00000e80| 69 73 73 69 6f 6e 3b 20 | 31 37 20 64 69 64 20 6e |ission; |17 did n|
|00000e90| 6f 74 20 62 65 63 61 75 | 73 65 20 6f 66 0d 0a 72 |ot becau|se of..r|
|00000ea0| 65 6c 61 70 73 65 2c 20 | 73 65 76 65 72 65 20 6d |elapse, |severe m|
|00000eb0| 65 64 69 63 61 6c 20 70 | 72 6f 62 6c 65 6d 73 2c |edical p|roblems,|
|00000ec0| 20 70 61 74 69 65 6e 74 | 27 73 20 72 65 66 75 73 | patient|'s refus|
|00000ed0| 61 6c 2c 20 70 68 79 73 | 69 63 69 61 6e 27 73 20 |al, phys|ician's |
|00000ee0| 72 65 66 75 73 61 6c 2c | 20 6f 72 0d 0a 66 69 6e |refusal,| or..fin|
|00000ef0| 61 6e 63 69 61 6c 20 63 | 6f 6e 73 69 64 65 72 61 |ancial c|onsidera|
|00000f00| 74 69 6f 6e 73 2e 20 20 | 54 65 6e 20 6f 66 20 74 |tions. |Ten of t|
|00000f10| 68 65 73 65 20 31 37 20 | 70 61 74 69 65 6e 74 73 |hese 17 |patients|
|00000f20| 20 65 76 65 6e 74 75 61 | 6c 6c 79 20 72 65 63 65 | eventua|lly rece|
|00000f30| 69 76 65 64 0d 0a 74 72 | 61 6e 73 70 6c 61 6e 74 |ived..tr|ansplant|
|00000f40| 73 20 69 6e 20 72 65 6c | 61 70 73 65 2e 20 20 52 |s in rel|apse. R|
|00000f50| 65 69 6e 64 75 63 74 69 | 6f 6e 20 63 68 65 6d 6f |einducti|on chemo|
|00000f60| 74 68 65 72 61 70 79 20 | 68 61 64 20 66 61 69 6c |therapy |had fail|
|00000f70| 65 64 20 69 6e 20 34 20 | 6f 66 20 74 68 65 73 65 |ed in 4 |of these|
|00000f80| 2e 0d 0a 20 20 20 20 20 | 57 68 65 6e 20 74 68 65 |... |When the|
|00000f90| 20 72 65 73 75 6c 74 73 | 20 6f 66 20 74 72 65 61 | results| of trea|
|00000fa0| 74 6d 65 6e 74 20 69 6e | 20 70 61 74 69 65 6e 74 |tment in| patient|
|00000fb0| 73 20 67 69 76 65 6e 20 | 74 72 61 6e 73 70 6c 61 |s given |transpla|
|00000fc0| 6e 74 73 20 69 6e 20 66 | 69 72 73 74 0d 0a 63 6f |nts in f|irst..co|
|00000fd0| 6d 70 6c 65 74 65 20 72 | 65 6d 69 73 73 69 6f 6e |mplete r|emission|
|00000fe0| 20 77 65 72 65 20 63 6f | 6d 70 61 72 65 64 20 77 | were co|mpared w|
|00000ff0| 69 74 68 20 74 68 6f 73 | 65 20 69 6e 20 74 68 65 |ith thos|e in the|
|00001000| 20 63 68 65 6d 6f 74 68 | 65 72 61 70 79 20 67 72 | chemoth|erapy gr|
|00001010| 6f 75 70 2c 20 74 68 65 | 0d 0a 73 75 62 67 72 6f |oup, the|..subgro|
|00001020| 75 70 73 20 6f 66 20 74 | 72 61 6e 73 70 6c 61 6e |ups of t|ransplan|
|00001030| 74 2d 74 72 65 61 74 65 | 64 20 70 61 74 69 65 6e |t-treate|d patien|
|00001040| 74 73 20 77 69 74 68 20 | 41 4d 4c 20 61 6e 64 20 |ts with |AML and |
|00001050| 41 4c 4c 20 69 6e 20 70 | 6f 6f 72 2c 0d 0a 69 6e |ALL in p|oor,..in|
|00001060| 74 65 72 6d 65 64 69 61 | 74 65 2c 20 61 6e 64 20 |termedia|te, and |
|00001070| 67 6f 6f 64 20 70 72 6f | 67 6e 6f 73 74 69 63 20 |good pro|gnostic |
|00001080| 67 72 6f 75 70 73 20 65 | 78 70 65 72 69 65 6e 63 |groups e|xperienc|
|00001090| 65 64 20 73 69 67 6e 69 | 66 69 63 61 6e 74 20 63 |ed signi|ficant c|
|000010a0| 6f 6e 74 72 6f 6c 20 6f | 66 0d 0a 6c 65 75 6b 65 |ontrol o|f..leuke|
|000010b0| 6d 69 61 20 72 65 6c 61 | 70 73 65 2e 20 20 48 6f |mia rela|pse. Ho|
|000010c0| 77 65 76 65 72 2c 20 74 | 68 65 72 65 20 77 61 73 |wever, t|here was|
|000010d0| 20 61 20 73 69 67 6e 69 | 66 69 63 61 6e 74 20 65 | a signi|ficant e|
|000010e0| 66 66 65 63 74 20 6f 6e | 20 73 75 72 76 69 76 61 |ffect on| surviva|
|000010f0| 6c 20 69 6e 20 6f 6e 6c | 79 0d 0a 74 68 65 20 70 |l in onl|y..the p|
|00001100| 6f 6f 72 20 61 6e 64 20 | 69 6e 74 65 72 6d 65 64 |oor and |intermed|
|00001110| 69 61 74 65 20 67 72 6f | 75 70 73 2e 0d 0a 20 20 |iate gro|ups... |
|00001120| 20 20 20 41 20 6d 6f 64 | 65 72 61 74 65 20 73 75 | A mod|erate su|
|00001130| 72 76 69 76 61 6c 20 61 | 64 76 61 6e 74 61 67 65 |rvival a|dvantage|
|00001140| 20 72 65 73 75 6c 74 65 | 64 20 69 6e 20 74 72 61 | resulte|d in tra|
|00001150| 6e 73 70 6c 61 6e 74 61 | 74 69 6f 6e 20 70 61 74 |nsplanta|tion pat|
|00001160| 69 65 6e 74 73 20 77 69 | 74 68 0d 0a 70 6f 6f 72 |ients wi|th..poor|
|00001170| 20 61 6e 64 20 69 6e 74 | 65 72 6d 65 64 69 61 74 | and int|ermediat|
|00001180| 65 20 70 72 6f 67 6e 6f | 73 65 73 2e 20 20 50 72 |e progno|ses. Pr|
|00001190| 65 64 69 63 74 69 76 65 | 20 6d 6f 64 65 6c 73 20 |edictive| models |
|000011a0| 6d 69 67 68 74 20 68 65 | 6c 70 20 73 65 6c 65 63 |might he|lp selec|
|000011b0| 74 20 70 61 74 69 65 6e | 74 73 0d 0a 66 6f 72 20 |t patien|ts..for |
|000011c0| 77 68 6f 6d 20 62 6f 6e | 65 20 6d 61 72 72 6f 77 |whom bon|e marrow|
|000011d0| 20 74 72 61 6e 73 70 6c | 61 6e 74 61 74 69 6f 6e | transpl|antation|
|000011e0| 20 69 73 20 61 70 70 72 | 6f 70 72 69 61 74 65 20 | is appr|opriate |
|000011f0| 69 6e 20 66 69 72 73 74 | 20 72 65 6d 69 73 73 69 |in first| remissi|
|00001200| 6f 6e 20 61 6e 64 0d 0a | 74 68 6f 73 65 20 66 6f |on and..|those fo|
|00001210| 72 20 77 68 6f 6d 20 74 | 72 61 6e 73 70 6c 61 6e |r whom t|ransplan|
|00001220| 74 61 74 69 6f 6e 20 77 | 6f 75 6c 64 20 62 65 20 |tation w|ould be |
|00001230| 74 68 65 20 74 72 65 61 | 74 6d 65 6e 74 20 6f 66 |the trea|tment of|
|00001240| 20 63 68 6f 69 63 65 20 | 61 74 20 69 6e 69 74 69 | choice |at initi|
|00001250| 61 6c 0d 0a 72 65 6c 61 | 70 73 65 2e 0d 0a 0d 0a |al..rela|pse.....|
|00001260| 50 6f 73 74 2d 43 6f 6d | 6d 65 6e 74 0d 0a 0d 0a |Post-Com|ment....|
|00001270| 20 20 20 20 20 49 20 73 | 65 6c 65 63 74 65 64 20 | I s|elected |
|00001280| 74 68 69 73 20 61 72 74 | 69 63 6c 65 20 62 65 63 |this art|icle bec|
|00001290| 61 75 73 65 20 69 74 20 | 63 6f 6d 70 61 72 65 73 |ause it |compares|
|000012a0| 20 74 68 65 20 72 65 73 | 75 6c 74 73 20 6f 66 20 | the res|ults of |
|000012b0| 62 6f 6e 65 20 6d 61 72 | 72 6f 77 0d 0a 74 72 61 |bone mar|row..tra|
|000012c0| 6e 73 70 6c 61 6e 74 61 | 74 69 6f 6e 20 77 69 74 |nsplanta|tion wit|
|000012d0| 68 20 74 68 6f 73 65 20 | 6f 66 20 69 6e 74 65 6e |h those |of inten|
|000012e0| 73 69 76 65 20 63 68 65 | 6d 6f 74 68 65 72 61 70 |sive che|motherap|
|000012f0| 79 20 69 6e 20 61 64 75 | 6c 74 73 20 77 69 74 68 |y in adu|lts with|
|00001300| 20 61 63 75 74 65 0d 0a | 6c 65 75 6b 65 6d 69 61 | acute..|leukemia|
|00001310| 2e 20 20 41 6c 74 68 6f | 75 67 68 20 69 6e 74 65 |. Altho|ugh inte|
|00001320| 72 70 72 65 74 61 74 69 | 6f 6e 20 6f 66 20 74 68 |rpretati|on of th|
|00001330| 65 20 64 61 74 61 20 69 | 73 20 6c 69 6d 69 74 65 |e data i|s limite|
|00001340| 64 20 62 79 20 74 68 65 | 20 66 61 63 74 20 74 68 |d by the| fact th|
|00001350| 61 74 0d 0a 70 61 74 69 | 65 6e 74 73 20 77 69 74 |at..pati|ents wit|
|00001360| 68 20 41 4d 4c 20 61 6e | 64 20 74 68 6f 73 65 20 |h AML an|d those |
|00001370| 77 69 74 68 20 41 4c 4c | 20 77 65 72 65 20 6c 75 |with ALL| were lu|
|00001380| 6d 70 65 64 20 74 6f 67 | 65 74 68 65 72 2c 20 6e |mped tog|ether, n|
|00001390| 65 76 65 72 74 68 65 6c | 65 73 73 2c 20 69 74 0d |everthel|ess, it.|
|000013a0| 0a 64 6f 65 73 20 70 72 | 6f 76 69 64 65 20 73 6f |.does pr|ovide so|
|000013b0| 6d 65 20 64 61 74 61 20 | 74 68 61 74 20 63 61 6e |me data |that can|
|000013c0| 20 62 65 20 63 6f 6d 70 | 61 72 65 64 20 77 69 74 | be comp|ared wit|
|000013d0| 68 20 70 72 65 76 69 6f | 75 73 20 73 74 75 64 69 |h previo|us studi|
|000013e0| 65 73 2e 0d 0a 20 20 20 | 20 20 54 68 65 20 66 6f |es... | The fo|
|000013f0| 6c 6c 6f 77 69 6e 67 20 | 6f 62 73 65 72 76 61 74 |llowing |observat|
|00001400| 69 6f 6e 73 20 61 72 65 | 20 70 65 72 74 69 6e 65 |ions are| pertine|
|00001410| 6e 74 2e 20 20 54 77 6f | 20 70 72 6f 73 70 65 63 |nt. Two| prospec|
|00001420| 74 69 76 65 20 74 72 69 | 61 6c 73 20 6f 66 0d 0a |tive tri|als of..|
|00001430| 74 72 65 61 74 6d 65 6e | 74 20 70 72 6f 74 6f 63 |treatmen|t protoc|
|00001440| 6f 6c 73 20 69 6e 20 41 | 4d 4c 20 68 61 76 65 20 |ols in A|ML have |
|00001450| 64 65 6d 6f 6e 73 74 72 | 61 74 65 64 20 74 68 65 |demonstr|ated the|
|00001460| 20 73 75 70 65 72 69 6f | 72 20 65 66 66 65 63 74 | superio|r effect|
|00001470| 69 76 65 6e 65 73 73 20 | 6f 66 0d 0a 74 72 61 6e |iveness |of..tran|
|00001480| 73 70 6c 61 6e 74 61 74 | 69 6f 6e 20 69 6e 20 74 |splantat|ion in t|
|00001490| 68 65 20 63 6f 6e 74 72 | 6f 6c 20 6f 66 20 6c 65 |he contr|ol of le|
|000014a0| 75 6b 65 6d 69 61 20 69 | 6e 20 79 6f 75 6e 67 65 |ukemia i|n younge|
|000014b0| 72 20 70 61 74 69 65 6e | 74 73 20 77 69 74 68 20 |r patien|ts with |
|000014c0| 61 20 6d 61 74 63 68 65 | 64 0d 0a 73 69 62 6c 69 |a matche|d..sibli|
|000014d0| 6e 67 20 62 6f 6e 65 20 | 6d 61 72 72 6f 77 20 64 |ng bone |marrow d|
|000014e0| 6f 6e 6f 72 73 20 28 31 | 2c 20 32 29 2e 20 20 4d |onors (1|, 2). M|
|000014f0| 6f 73 74 20 6d 6f 64 65 | 72 6e 20 63 68 65 6d 6f |ost mode|rn chemo|
|00001500| 74 68 65 72 61 70 79 20 | 73 74 75 64 69 65 73 20 |therapy |studies |
|00001510| 69 6e 20 41 4d 4c 0d 0a | 64 65 6d 6f 6e 73 74 72 |in AML..|demonstr|
|00001520| 61 74 65 20 63 6f 6d 70 | 6c 65 74 65 20 72 65 6d |ate comp|lete rem|
|00001530| 69 73 73 69 6f 6e 20 72 | 61 74 65 73 20 6f 66 20 |ission r|ates of |
|00001540| 62 65 74 77 65 65 6e 20 | 36 30 25 20 61 6e 64 20 |between |60% and |
|00001550| 38 30 25 20 61 6e 64 20 | 6c 6f 6e 67 2d 74 65 72 |80% and |long-ter|
|00001560| 6d 0d 0a 28 6d 6f 72 65 | 20 74 68 61 6e 20 34 20 |m..(more| than 4 |
|00001570| 6f 72 20 35 20 79 65 61 | 72 73 29 20 64 69 73 65 |or 5 yea|rs) dise|
|00001580| 61 73 65 2d 66 72 65 65 | 20 73 75 72 76 69 76 61 |ase-free| surviva|
|00001590| 6c 20 6f 66 20 6d 6f 72 | 65 20 74 68 61 6e 20 32 |l of mor|e than 2|
|000015a0| 30 25 20 69 6e 20 70 61 | 74 69 65 6e 74 73 0d 0a |0% in pa|tients..|
|000015b0| 77 68 6f 73 65 20 64 69 | 73 65 61 73 65 20 65 6e |whose di|sease en|
|000015c0| 74 65 72 73 20 63 6f 6d | 70 6c 65 74 65 20 72 65 |ters com|plete re|
|000015d0| 6d 69 73 73 69 6f 6e 2e | 0d 0a 20 20 20 20 20 41 |mission.|.. A|
|000015e0| 73 20 49 20 73 75 6d 6d | 61 72 69 7a 65 64 20 69 |s I summ|arized i|
|000015f0| 6e 20 61 6e 20 65 61 72 | 6c 69 65 72 20 63 6f 6d |n an ear|lier com|
|00001600| 6d 65 6e 74 2c 20 74 68 | 65 20 72 65 73 75 6c 74 |ment, th|e result|
|00001610| 73 20 69 6e 20 41 4c 4c | 20 61 63 68 69 65 76 65 |s in ALL| achieve|
|00001620| 64 20 62 79 0d 0a 63 68 | 65 6d 6f 74 68 65 72 61 |d by..ch|emothera|
|00001630| 70 79 20 68 61 76 65 20 | 6e 6f 74 20 62 65 65 6e |py have |not been|
|00001640| 20 61 73 20 67 6f 6f 64 | 2e 20 20 54 68 65 20 63 | as good|. The c|
|00001650| 6f 6d 70 6c 65 74 65 20 | 72 65 6d 69 73 73 69 6f |omplete |remissio|
|00001660| 6e 20 72 61 74 65 20 69 | 73 20 6f 6e 6c 79 20 61 |n rate i|s only a|
|00001670| 62 6f 75 74 0d 0a 36 30 | 25 2c 20 61 6e 64 20 6f |bout..60|%, and o|
|00001680| 6e 6c 79 20 61 20 6d 69 | 6e 6f 72 69 74 79 20 6f |nly a mi|nority o|
|00001690| 66 20 70 61 74 69 65 6e | 74 73 20 61 63 68 69 65 |f patien|ts achie|
|000016a0| 76 65 20 64 75 72 61 62 | 6c 65 20 6c 6f 6e 67 2d |ve durab|le long-|
|000016b0| 74 65 72 6d 20 72 65 6d | 69 73 73 69 6f 6e 73 2e |term rem|issions.|
|000016c0| 0d 0a 53 69 6d 69 6c 61 | 72 6c 79 2c 20 74 68 65 |..Simila|rly, the|
|000016d0| 20 72 65 73 75 6c 74 73 | 20 6f 66 20 62 6f 6e 65 | results| of bone|
|000016e0| 20 6d 61 72 72 6f 77 20 | 74 72 61 6e 73 70 6c 61 | marrow |transpla|
|000016f0| 6e 74 61 74 69 6f 6e 20 | 69 6e 20 41 4c 4c 20 61 |ntation |in ALL a|
|00001700| 72 65 20 6e 6f 74 20 61 | 73 20 67 6f 6f 64 0d 0a |re not a|s good..|
|00001710| 61 73 20 74 68 6f 73 65 | 20 69 6e 20 41 4d 4c 2e |as those| in AML.|
|00001720| 20 20 49 6e 20 41 4d 4c | 20 6f 6e 65 20 63 61 6e | In AML| one can|
|00001730| 20 61 6e 74 69 63 69 70 | 61 74 65 20 74 68 61 74 | anticip|ate that|
|00001740| 20 61 62 6f 75 74 20 35 | 30 25 20 6f 66 20 70 61 | about 5|0% of pa|
|00001750| 74 69 65 6e 74 73 20 74 | 72 65 61 74 65 64 0d 0a |tients t|reated..|
|00001760| 69 6e 20 74 68 65 69 72 | 20 66 69 72 73 74 20 72 |in their| first r|
|00001770| 65 6d 69 73 73 69 6f 6e | 20 77 69 6c 6c 20 65 78 |emission| will ex|
|00001780| 70 65 72 69 65 6e 63 65 | 20 6c 6f 6e 67 2d 74 65 |perience| long-te|
|00001790| 72 6d 20 72 65 6d 69 73 | 73 69 6f 6e 73 20 6f 66 |rm remis|sions of|
|000017a0| 20 74 68 65 69 72 0d 0a | 64 69 73 65 61 73 65 2e | their..|disease.|
|000017b0| 20 20 54 68 65 20 63 6f | 72 72 65 73 70 6f 6e 64 | The co|rrespond|
|000017c0| 69 6e 67 20 70 72 6f 70 | 6f 72 74 69 6f 6e 20 6f |ing prop|ortion o|
|000017d0| 66 20 41 4c 4c 20 70 61 | 74 69 65 6e 74 73 20 69 |f ALL pa|tients i|
|000017e0| 73 20 70 72 6f 62 61 62 | 6c 79 20 6e 6f 20 62 65 |s probab|ly no be|
|000017f0| 74 74 65 72 0d 0a 74 68 | 61 6e 20 33 30 25 2e 20 |tter..th|an 30%. |
|00001800| 20 54 68 69 73 20 61 72 | 74 69 63 6c 65 20 61 6c | This ar|ticle al|
|00001810| 73 6f 20 75 6e 64 65 72 | 73 63 6f 72 65 73 20 74 |so under|scores t|
|00001820| 68 65 20 70 6f 6f 72 20 | 72 65 73 75 6c 74 73 20 |he poor |results |
|00001830| 6f 62 74 61 69 6e 65 64 | 20 62 79 0d 0a 70 65 72 |obtained| by..per|
|00001840| 66 6f 72 6d 69 6e 67 20 | 74 72 61 6e 73 70 6c 61 |forming |transpla|
|00001850| 6e 74 61 74 69 6f 6e 20 | 69 6e 20 70 61 74 69 65 |ntation |in patie|
|00001860| 6e 74 73 20 77 69 74 68 | 20 61 63 75 74 65 20 6c |nts with| acute l|
|00001870| 65 75 6b 65 6d 69 61 20 | 77 68 65 6e 20 74 68 65 |eukemia |when the|
|00001880| 69 72 20 64 69 73 65 61 | 73 65 0d 0a 68 61 73 20 |ir disea|se..has |
|00001890| 72 65 6c 61 70 73 65 64 | 2e 2d 2d 4d 2e 4a 2e 20 |relapsed|.--M.J. |
|000018a0| 43 6c 69 6e 65 2c 20 4d | 2e 44 2e 0d 0a 24 55 6e |Cline, M|.D...$Un|
|000018b0| 69 71 75 65 5f 49 44 7b | 59 52 42 31 31 31 30 31 |ique_ID{|YRB11101|
|000018c0| 7d 0d 0a 24 54 69 74 6c | 65 7b 46 72 61 63 74 69 |}..$Titl|e{Fracti|
|000018d0| 6f 6e 61 74 65 64 20 54 | 6f 74 61 6c 20 42 6f 64 |onated T|otal Bod|
|000018e0| 79 20 49 72 72 61 64 69 | 61 74 69 6f 6e 20 61 6e |y Irradi|ation an|
|000018f0| 64 20 48 69 67 68 2d 44 | 6f 73 65 20 56 50 20 31 |d High-D|ose VP 1|
|00001900| 36 2d 32 31 33 20 46 6f | 6c 6c 6f 77 65 64 20 62 |6-213 Fo|llowed b|
|00001910| 79 20 41 6c 6c 6f 67 65 | 6e 65 69 63 20 42 6f 6e |y Alloge|neic Bon|
|00001920| 65 20 4d 61 72 72 6f 77 | 20 54 72 61 6e 73 70 6c |e Marrow| Transpl|
|00001930| 61 6e 74 61 74 69 6f 6e | 20 69 6e 20 41 64 76 61 |antation| in Adva|
|00001940| 6e 63 65 64 20 4c 65 75 | 6b 65 6d 69 61 73 7d 0d |nced Leu|kemias}.|
|00001950| 0a 24 41 75 74 68 6f 72 | 7b 53 63 68 6d 69 74 7a |.$Author|{Schmitz|
|00001960| 2c 20 4e 0d 0a 47 61 73 | 73 6d 61 6e 6e 2c 20 57 |, N..Gas|smann, W|
|00001970| 0d 0a 52 69 73 74 65 72 | 2c 20 4d 0d 0a 4a 6f 68 |..Rister|, M..Joh|
|00001980| 61 6e 6e 73 6f 6e 2c 20 | 57 0d 0a 53 75 74 74 6f |annson, |W..Sutto|
|00001990| 72 70 2c 20 4d 0d 0a 42 | 72 69 78 2c 20 46 0d 0a |rp, M..B|rix, F..|
|000019a0| 48 6f 6c 74 68 69 75 73 | 2c 20 4a 4a 4d 0d 0a 48 |Holthius|, JJM..H|
|000019b0| 65 69 74 2c 20 57 0d 0a | 48 65 72 74 65 6e 73 74 |eit, W..|Hertenst|
|000019c0| 65 69 6e 2c 20 42 0d 0a | 53 63 68 61 75 62 2c 20 |ein, B..|Schaub, |
|000019d0| 4a 0d 0a 4c 6f 66 66 6c | 65 72 2c 20 48 7d 0d 0a |J..Loffl|er, H}..|
|000019e0| 24 41 66 66 69 6c 69 61 | 74 69 6f 6e 7b 55 6e 69 |$Affilia|tion{Uni|
|000019f0| 76 20 6f 66 20 4b 69 65 | 6c 3b 20 55 6e 69 76 20 |v of Kie|l; Univ |
|00001a00| 6f 66 20 55 6c 6d 2c 20 | 57 65 73 74 20 47 65 72 |of Ulm, |West Ger|
|00001a10| 6d 61 6e 79 3b 20 55 6e | 69 76 20 6f 66 20 55 74 |many; Un|iv of Ut|
|00001a20| 72 65 63 68 74 2c 20 54 | 68 65 20 4e 65 74 68 65 |recht, T|he Nethe|
|00001a30| 72 6c 61 6e 64 73 7d 0d | 0a 24 4a 6f 75 72 6e 61 |rlands}.|.$Journa|
|00001a40| 6c 7b 42 6c 6f 6f 64 7d | 0d 0a 24 56 6f 6c 75 6d |l{Blood}|..$Volum|
|00001a50| 65 7b 37 32 7d 0d 0a 24 | 50 61 67 65 7b 31 35 36 |e{72}..$|Page{156|
|00001a60| 37 2d 31 35 37 33 7d 0d | 0a 24 44 61 74 65 7b 4e |7-1573}.|.$Date{N|
|00001a70| 6f 76 65 6d 62 65 72 20 | 31 39 38 38 7d 0d 0a 24 |ovember |1988}..$|
|00001a80| 59 42 56 6f 6c 7b 31 39 | 39 30 20 59 65 61 72 20 |YBVol{19|90 Year |
|00001a90| 42 6f 6f 6b 20 6f 66 20 | 4d 65 64 69 63 69 6e 65 |Book of |Medicine|
|00001aa0| 7d 0d 0a 24 43 68 61 70 | 74 65 72 7b 32 33 2d 35 |}..$Chap|ter{23-5|
|00001ab0| 7d 0d 0a 24 59 42 45 64 | 69 74 6f 72 7b 44 72 73 |}..$YBEd|itor{Drs|
|00001ac0| 2e 20 52 6f 67 65 72 73 | 2c 20 44 65 73 20 50 72 |. Rogers|, Des Pr|
|00001ad0| 65 7a 2c 20 43 6c 69 6e | 65 2c 20 42 72 61 75 6e |ez, Clin|e, Braun|
|00001ae0| 77 61 6c 64 2c 20 47 72 | 65 65 6e 62 65 72 67 65 |wald, Gr|eenberge|
|00001af0| 72 2c 20 57 69 6c 73 6f | 6e 2c 20 45 70 73 74 65 |r, Wilso|n, Epste|
|00001b00| 69 6e 2c 20 61 6e 64 20 | 4d 61 6c 61 77 69 73 74 |in, and |Malawist|
|00001b10| 61 7d 0d 0a 24 54 61 62 | 6c 65 7b 7d 0d 0a 24 43 |a}..$Tab|le{}..$C|
|00001b20| 6f 6d 6d 65 6e 74 61 74 | 6f 72 7b 4d 2e 4a 2e 20 |ommentat|or{M.J. |
|00001b30| 43 6c 69 6e 65 2c 20 4d | 2e 44 2e 7d 0d 0a 0d 0a |Cline, M|.D.}....|
|00001b40| 43 6f 70 79 72 69 67 68 | 74 20 28 63 29 20 59 65 |Copyrigh|t (c) Ye|
|00001b50| 61 72 62 6f 6f 6b 20 4d | 65 64 69 63 61 6c 20 50 |arbook M|edical P|
|00001b60| 75 62 6c 69 73 68 65 72 | 73 2c 20 49 6e 63 2e 2c |ublisher|s, Inc.,|
|00001b70| 20 31 39 39 30 0d 0a 0d | 0a 31 39 39 30 20 59 65 | 1990...|.1990 Ye|
|00001b80| 61 72 20 42 6f 6f 6b 20 | 6f 66 20 4d 65 64 69 63 |ar Book |of Medic|
|00001b90| 69 6e 65 20 28 52 29 0d | 0a 0d 0a 50 61 72 74 20 |ine (R).|...Part |
|00001ba0| 54 68 72 65 65 2d 2d 48 | 65 6d 61 74 6f 6c 6f 67 |Three--H|ematolog|
|00001bb0| 79 20 61 6e 64 20 4f 6e | 63 6f 6c 6f 67 79 0d 0a |y and On|cology..|
|00001bc0| 0d 0a 43 68 61 70 74 65 | 72 20 32 33 2d 2d 42 6f |..Chapte|r 23--Bo|
|00001bd0| 6e 65 20 4d 61 72 72 6f | 77 20 54 72 61 6e 73 70 |ne Marro|w Transp|
|00001be0| 6c 61 6e 74 61 74 69 6f | 6e 0d 0a 0d 0a 2d 2d 2d |lantatio|n....---|
|00001bf0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001c00| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001c10| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001c20| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001c30| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 0d 0a 46 72 61 |--------|---..Fra|
|00001c40| 63 74 69 6f 6e 61 74 65 | 64 20 54 6f 74 61 6c 20 |ctionate|d Total |
|00001c50| 42 6f 64 79 20 49 72 72 | 61 64 69 61 74 69 6f 6e |Body Irr|adiation|
|00001c60| 20 61 6e 64 20 48 69 67 | 68 2d 44 6f 73 65 20 56 | and Hig|h-Dose V|
|00001c70| 50 20 31 36 2d 32 31 33 | 20 46 6f 6c 6c 6f 77 65 |P 16-213| Followe|
|00001c80| 64 20 62 79 0d 0a 41 6c | 6c 6f 67 65 6e 65 69 63 |d by..Al|logeneic|
|00001c90| 20 42 6f 6e 65 20 4d 61 | 72 72 6f 77 20 54 72 61 | Bone Ma|rrow Tra|
|00001ca0| 6e 73 70 6c 61 6e 74 61 | 74 69 6f 6e 20 69 6e 20 |nsplanta|tion in |
|00001cb0| 41 64 76 61 6e 63 65 64 | 20 4c 65 75 6b 65 6d 69 |Advanced| Leukemi|
|00001cc0| 61 73 0d 0a 0d 0a 53 63 | 68 6d 69 74 7a 20 4e 3b |as....Sc|hmitz N;|
|00001cd0| 20 47 61 73 73 6d 61 6e | 6e 20 57 3b 20 52 69 73 | Gassman|n W; Ris|
|00001ce0| 74 65 72 20 4d 3b 20 4a | 6f 68 61 6e 6e 73 6f 6e |ter M; J|ohannson|
|00001cf0| 20 57 3b 20 53 75 74 74 | 6f 72 70 20 4d 3b 20 42 | W; Sutt|orp M; B|
|00001d00| 72 69 78 20 46 3b 20 48 | 6f 6c 74 68 69 75 73 20 |rix F; H|olthius |
|00001d10| 4a 4a 4d 3b 0d 0a 48 65 | 69 74 20 57 3b 20 48 65 |JJM;..He|it W; He|
|00001d20| 72 74 65 6e 73 74 65 69 | 6e 20 42 3b 20 53 63 68 |rtenstei|n B; Sch|
|00001d30| 61 75 62 20 4a 3b 20 4c | 6f 66 66 6c 65 72 20 48 |aub J; L|offler H|
|00001d40| 0d 0a 28 55 6e 69 76 20 | 6f 66 20 4b 69 65 6c 3b |..(Univ |of Kiel;|
|00001d50| 20 55 6e 69 76 20 6f 66 | 20 55 6c 6d 2c 20 57 65 | Univ of| Ulm, We|
|00001d60| 73 74 20 47 65 72 6d 61 | 6e 79 3b 20 55 6e 69 76 |st Germa|ny; Univ|
|00001d70| 20 6f 66 20 55 74 72 65 | 63 68 74 2c 20 54 68 65 | of Utre|cht, The|
|00001d80| 20 4e 65 74 68 65 72 6c | 61 6e 64 73 29 0d 0a 42 | Netherl|ands)..B|
|00001d90| 6c 6f 6f 64 20 37 32 3a | 31 35 36 37 2d 31 35 37 |lood 72:|1567-157|
|00001da0| 33 2c 20 4e 6f 76 65 6d | 62 65 72 20 31 39 38 38 |3, Novem|ber 1988|
|00001db0| 0d 0a 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |..------|--------|
|00001dc0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001dd0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001de0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001df0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001e00| 0d 0a 0d 0a 41 62 73 74 | 72 61 63 74 0d 0a 0d 0a |....Abst|ract....|
|00001e10| 20 20 20 20 20 46 6f 72 | 20 79 6f 75 6e 67 20 70 | For| young p|
|00001e20| 61 74 69 65 6e 74 73 20 | 77 69 74 68 20 61 63 75 |atients |with acu|
|00001e30| 74 65 20 6c 65 75 6b 65 | 6d 69 61 2c 20 61 6c 6c |te leuke|mia, all|
|00001e40| 6f 67 65 6e 65 69 63 20 | 62 6f 6e 65 20 6d 61 72 |ogeneic |bone mar|
|00001e50| 72 6f 77 0d 0a 74 72 61 | 6e 73 70 6c 61 6e 74 61 |row..tra|nsplanta|
|00001e60| 74 69 6f 6e 20 28 42 4d | 54 29 20 69 73 20 61 6e |tion (BM|T) is an|
|00001e70| 20 69 6d 70 6f 72 74 61 | 6e 74 20 74 68 65 72 61 | importa|nt thera|
|00001e80| 70 79 2c 20 62 75 74 20 | 72 65 6c 61 70 73 65 20 |py, but |relapse |
|00001e90| 69 73 20 6e 6f 74 20 75 | 6e 63 6f 6d 6d 6f 6e 2e |is not u|ncommon.|
|00001ea0| 0d 0a 46 72 61 63 74 69 | 6f 6e 61 74 65 64 20 74 |..Fracti|onated t|
|00001eb0| 6f 74 61 6c 20 62 6f 64 | 79 20 69 72 72 61 64 69 |otal bod|y irradi|
|00001ec0| 61 74 69 6f 6e 20 28 46 | 54 42 49 29 20 77 61 73 |ation (F|TBI) was|
|00001ed0| 20 63 6f 6d 62 69 6e 65 | 64 20 77 69 74 68 20 61 | combine|d with a|
|00001ee0| 20 6e 65 77 0d 0a 70 72 | 65 70 61 72 61 74 6f 72 | new..pr|eparator|
|00001ef0| 79 20 61 67 65 6e 74 2c | 20 68 69 67 68 2d 64 6f |y agent,| high-do|
|00001f00| 73 65 20 28 36 30 2d 37 | 30 20 6d 67 2f 6b 67 29 |se (60-7|0 mg/kg)|
|00001f10| 20 56 50 20 31 36 2d 32 | 31 33 2c 20 69 6e 20 61 | VP 16-2|13, in a|
|00001f20| 6e 20 65 66 66 6f 72 74 | 20 74 6f 0d 0a 69 6e 63 |n effort| to..inc|
|00001f30| 72 65 61 73 65 20 74 68 | 65 20 70 6f 74 65 6e 63 |rease th|e potenc|
|00001f40| 79 20 6f 66 20 74 68 65 | 20 70 72 65 70 61 72 61 |y of the| prepara|
|00001f50| 74 6f 72 79 20 72 65 67 | 69 6d 65 6e 20 69 6e 20 |tory reg|imen in |
|00001f60| 33 38 20 70 61 74 69 65 | 6e 74 73 2c 20 72 61 6e |38 patie|nts, ran|
|00001f70| 67 69 6e 67 20 66 72 6f | 6d 0d 0a 34 20 74 6f 20 |ging fro|m..4 to |
|00001f80| 35 30 20 79 65 61 72 73 | 20 6f 6c 64 2e 0d 0a 20 |50 years| old... |
|00001f90| 20 20 20 20 54 68 65 20 | 70 72 65 70 61 72 61 74 | The |preparat|
|00001fa0| 6f 72 79 20 72 65 67 69 | 6d 65 6e 20 77 61 73 20 |ory regi|men was |
|00001fb0| 74 6f 78 69 63 20 74 6f | 20 6d 75 63 6f 75 73 20 |toxic to| mucous |
|00001fc0| 6d 65 6d 62 72 61 6e 65 | 73 2e 20 20 41 62 64 6f |membrane|s. Abdo|
|00001fd0| 6d 69 6e 61 6c 20 70 61 | 69 6e 0d 0a 61 6e 64 20 |minal pa|in..and |
|00001fe0| 64 69 61 72 72 68 65 61 | 20 6c 61 73 74 65 64 20 |diarrhea| lasted |
|00001ff0| 6c 6f 6e 67 65 72 20 74 | 68 61 6e 20 32 20 64 61 |longer t|han 2 da|
|00002000| 79 73 20 69 6e 20 61 6c | 6d 6f 73 74 20 68 61 6c |ys in al|most hal|
|00002010| 66 20 6f 66 20 74 68 65 | 20 70 61 74 69 65 6e 74 |f of the| patient|
|00002020| 73 2c 20 61 6e 64 20 61 | 6c 6c 0d 0a 72 65 71 75 |s, and a|ll..requ|
|00002030| 69 72 65 64 20 6e 61 72 | 63 6f 74 69 63 73 2e 20 |ired nar|cotics. |
|00002040| 20 4f 6e 65 20 70 61 74 | 69 65 6e 74 20 64 69 65 | One pat|ient die|
|00002050| 64 20 6f 66 20 61 63 75 | 74 65 20 67 61 73 74 72 |d of acu|te gastr|
|00002060| 6f 69 6e 74 65 73 74 69 | 6e 61 6c 20 68 65 6d 6f |ointesti|nal hemo|
|00002070| 72 72 68 61 67 65 2e 0d | 0a 4d 6f 73 74 20 70 61 |rrhage..|.Most pa|
|00002080| 74 69 65 6e 74 73 20 68 | 61 64 20 6e 61 75 73 65 |tients h|ad nause|
|00002090| 61 20 61 6e 64 20 72 61 | 73 68 65 73 2e 20 20 49 |a and ra|shes. I|
|000020a0| 72 72 65 76 65 72 73 69 | 62 6c 65 20 68 65 70 61 |rreversi|ble hepa|
|000020b0| 74 6f 74 6f 78 69 63 69 | 74 79 20 64 65 76 65 6c |totoxici|ty devel|
|000020c0| 6f 70 65 64 20 69 6e 0d | 0a 31 20 70 61 74 69 65 |oped in.|.1 patie|
|000020d0| 6e 74 2e 20 20 43 6c 69 | 6e 69 63 61 6c 20 73 65 |nt. Cli|nical se|
|000020e0| 70 73 69 73 20 64 65 76 | 65 6c 6f 70 65 64 20 69 |psis dev|eloped i|
|000020f0| 6e 20 33 30 20 70 61 74 | 69 65 6e 74 73 20 61 6e |n 30 pat|ients an|
|00002100| 64 20 33 20 64 69 65 64 | 20 6f 66 20 69 6e 66 65 |d 3 died| of infe|
|00002110| 63 74 69 6f 6e 2e 0d 0a | 43 6f 6d 70 6c 65 74 65 |ction...|Complete|
|00002120| 20 61 6e 64 20 73 75 73 | 74 61 69 6e 65 64 20 65 | and sus|tained e|
|00002130| 6e 67 72 61 66 74 6d 65 | 6e 74 20 6f 63 63 75 72 |ngraftme|nt occur|
|00002140| 72 65 64 20 69 6e 20 33 | 31 20 70 61 74 69 65 6e |red in 3|1 patien|
|00002150| 74 73 2e 20 20 41 63 75 | 74 65 0d 0a 67 72 61 66 |ts. Acu|te..graf|
|00002160| 74 2d 76 73 2e 2d 68 6f | 73 74 20 64 69 73 65 61 |t-vs.-ho|st disea|
|00002170| 73 65 20 64 65 76 65 6c | 6f 70 65 64 20 69 6e 20 |se devel|oped in |
|00002180| 61 6c 6c 20 62 75 74 20 | 35 20 70 61 74 69 65 6e |all but |5 patien|
|00002190| 74 73 2e 20 20 41 66 74 | 65 72 20 36 2d 33 35 20 |ts. Aft|er 6-35 |
|000021a0| 6d 6f 6e 74 68 73 20 6f | 66 0d 0a 66 6f 6c 6c 6f |months o|f..follo|
|000021b0| 77 2d 75 70 2c 20 32 30 | 20 70 61 74 69 65 6e 74 |w-up, 20| patient|
|000021c0| 73 20 77 65 72 65 20 61 | 6c 69 76 65 20 61 6e 64 |s were a|live and|
|000021d0| 20 31 39 20 77 65 72 65 | 20 69 6e 20 63 6f 6d 70 | 19 were| in comp|
|000021e0| 6c 65 74 65 20 72 65 6d | 69 73 73 69 6f 6e 2e 20 |lete rem|ission. |
|000021f0| 20 54 68 65 20 6d 65 61 | 6e 0d 0a 33 2d 79 65 61 | The mea|n..3-yea|
|00002200| 72 20 61 63 74 75 61 72 | 69 61 6c 20 64 69 73 65 |r actuar|ial dise|
|00002210| 61 73 65 2d 66 72 65 65 | 20 73 75 72 76 69 76 61 |ase-free| surviva|
|00002220| 6c 20 72 61 74 65 20 77 | 61 73 20 35 36 2e 36 25 |l rate w|as 56.6%|
|00002230| 2e 20 20 54 68 65 20 61 | 63 74 75 61 72 69 61 6c |. The a|ctuarial|
|00002240| 20 72 65 6c 61 70 73 65 | 0d 0a 72 61 74 65 20 77 | relapse|..rate w|
|00002250| 61 73 20 31 31 2e 39 25 | 2e 0d 0a 20 20 20 20 20 |as 11.9%|... |
|00002260| 49 6e 20 61 63 75 74 65 | 20 6c 65 75 6b 65 6d 69 |In acute| leukemi|
|00002270| 63 20 70 61 74 69 65 6e | 74 73 20 72 65 63 65 69 |c patien|ts recei|
|00002280| 76 69 6e 67 20 61 6c 6c | 6f 67 65 6e 65 69 63 20 |ving all|ogeneic |
|00002290| 62 6f 6e 65 20 6d 61 72 | 72 6f 77 0d 0a 74 72 61 |bone mar|row..tra|
|000022a0| 6e 73 70 6c 61 6e 74 61 | 74 69 6f 6e 2c 20 46 54 |nsplanta|tion, FT|
|000022b0| 42 49 2f 56 50 20 31 36 | 20 77 61 73 20 65 66 66 |BI/VP 16| was eff|
|000022c0| 65 63 74 69 76 65 20 61 | 73 20 61 20 70 72 65 70 |ective a|s a prep|
|000022d0| 61 72 61 74 6f 72 79 20 | 72 65 67 69 6d 65 6e 2e |aratory |regimen.|
|000022e0| 20 20 54 68 69 73 0d 0a | 72 65 67 69 6d 65 6e 20 | This..|regimen |
|000022f0| 77 61 73 20 61 73 73 6f | 63 69 61 74 65 64 20 77 |was asso|ciated w|
|00002300| 69 74 68 20 74 6f 78 69 | 63 69 74 79 2c 20 62 75 |ith toxi|city, bu|
|00002310| 74 20 74 68 69 73 20 77 | 61 73 20 6e 6f 74 20 75 |t this w|as not u|
|00002320| 6e 61 63 63 65 70 74 61 | 62 6c 79 20 68 69 67 68 |naccepta|bly high|
|00002330| 2e 0d 0a 50 72 6f 73 70 | 65 63 74 69 76 65 2c 20 |...Prosp|ective, |
|00002340| 72 61 6e 64 6f 6d 69 7a | 65 64 20 74 72 69 61 6c |randomiz|ed trial|
|00002350| 73 20 61 72 65 20 72 65 | 71 75 69 72 65 64 20 74 |s are re|quired t|
|00002360| 6f 20 63 6f 6d 70 61 72 | 65 20 74 68 69 73 20 72 |o compar|e this r|
|00002370| 65 67 69 6d 65 6e 20 74 | 6f 20 74 68 65 0d 0a 73 |egimen t|o the..s|
|00002380| 74 61 6e 64 61 72 64 20 | 63 79 63 6c 6f 70 68 6f |tandard |cyclopho|
|00002390| 73 70 68 61 6d 69 64 65 | 2f 54 42 49 20 70 72 65 |sphamide|/TBI pre|
|000023a0| 70 61 72 61 74 6f 72 79 | 20 72 65 67 69 6d 65 6e |paratory| regimen|
|000023b0| 20 62 65 66 6f 72 65 20 | 74 68 69 73 20 70 72 6f | before |this pro|
|000023c0| 74 6f 63 6f 6c 20 63 61 | 6e 20 62 65 0d 0a 72 65 |tocol ca|n be..re|
|000023d0| 63 6f 6d 6d 65 6e 64 65 | 64 2e 0d 0a 0d 0a 50 6f |commende|d.....Po|
|000023e0| 73 74 2d 43 6f 6d 6d 65 | 6e 74 0d 0a 0d 0a 20 20 |st-Comme|nt.... |
|000023f0| 20 20 20 54 68 69 73 20 | 73 74 75 64 79 20 64 65 | This |study de|
|00002400| 73 63 72 69 62 65 73 20 | 74 68 65 20 72 65 73 75 |scribes |the resu|
|00002410| 6c 74 73 20 6f 66 20 75 | 73 69 6e 67 20 61 6c 6c |lts of u|sing all|
|00002420| 6f 67 65 6e 65 69 63 20 | 62 6f 6e 65 20 6d 61 72 |ogeneic |bone mar|
|00002430| 72 6f 77 0d 0a 74 72 61 | 6e 73 70 6c 61 6e 74 61 |row..tra|nsplanta|
|00002440| 74 69 6f 6e 2c 20 28 69 | 2e 65 2e 2c 20 66 72 6f |tion, (i|.e., fro|
|00002450| 6d 20 61 20 6d 61 74 63 | 68 65 64 20 73 69 62 6c |m a matc|hed sibl|
|00002460| 69 6e 67 20 64 6f 6e 6f | 72 29 20 69 6e 20 70 61 |ing dono|r) in pa|
|00002470| 74 69 65 6e 74 73 20 77 | 69 74 68 0d 0a 72 65 66 |tients w|ith..ref|
|00002480| 72 61 63 74 6f 72 79 20 | 6c 65 75 6b 65 6d 69 61 |ractory |leukemia|
|00002490| 73 2e 20 20 49 6e 20 74 | 68 69 73 20 73 74 75 64 |s. In t|his stud|
|000024a0| 79 2c 20 61 62 6f 75 74 | 20 65 71 75 61 6c 20 6e |y, about| equal n|
|000024b0| 75 6d 62 65 72 73 20 6f | 66 20 70 61 74 69 65 6e |umbers o|f patien|
|000024c0| 74 73 20 68 61 64 0d 0a | 61 64 76 61 6e 63 65 64 |ts had..|advanced|
|000024d0| 20 61 63 75 74 65 20 6e | 6f 6e 6c 79 6d 70 68 6f | acute n|onlympho|
|000024e0| 62 6c 61 73 74 69 63 20 | 6c 65 75 6b 65 6d 69 61 |blastic |leukemia|
|000024f0| 20 61 6e 64 20 61 63 75 | 74 65 20 6c 79 6d 70 68 | and acu|te lymph|
|00002500| 6f 62 6c 61 73 74 69 63 | 20 6c 65 75 6b 65 6d 69 |oblastic| leukemi|
|00002510| 61 2e 0d 0a 42 6f 74 68 | 20 61 72 65 20 64 69 73 |a...Both| are dis|
|00002520| 65 61 73 65 73 20 77 69 | 74 68 20 61 20 76 65 72 |eases wi|th a ver|
|00002530| 79 20 70 6f 6f 72 20 70 | 72 6f 67 6e 6f 73 69 73 |y poor p|rognosis|
|00002540| 2e 20 20 54 6f 20 70 75 | 74 20 74 68 69 73 20 73 |. To pu|t this s|
|00002550| 74 75 64 79 20 69 6e 0d | 0a 70 65 72 73 70 65 63 |tudy in.|.perspec|
|00002560| 74 69 76 65 2c 20 6f 6e | 65 20 77 6f 75 6c 64 20 |tive, on|e would |
|00002570| 68 61 76 65 20 74 6f 20 | 67 6f 20 62 61 63 6b 20 |have to |go back |
|00002580| 74 6f 20 74 68 65 20 65 | 61 72 6c 79 20 31 39 37 |to the e|arly 197|
|00002590| 30 73 20 77 68 65 6e 20 | 73 65 76 65 72 61 6c 0d |0s when |several.|
|000025a0| 0a 69 6e 73 74 69 74 75 | 74 69 6f 6e 73 20 65 78 |.institu|tions ex|
|000025b0| 61 6d 69 6e 65 64 20 76 | 65 72 79 20 61 67 67 72 |amined v|ery aggr|
|000025c0| 65 73 73 69 76 65 20 70 | 72 6f 67 72 61 6d 73 20 |essive p|rograms |
|000025d0| 6f 66 20 6d 75 6c 74 69 | 61 67 65 6e 74 20 63 68 |of multi|agent ch|
|000025e0| 65 6d 6f 74 68 65 72 61 | 70 79 20 61 6e 64 0d 0a |emothera|py and..|
|000025f0| 77 68 6f 6c 65 20 62 6f | 64 79 20 69 72 72 61 64 |whole bo|dy irrad|
|00002600| 69 61 74 69 6f 6e 20 61 | 73 20 70 72 65 70 61 72 |iation a|s prepar|
|00002610| 61 74 6f 72 79 20 72 65 | 67 69 6d 65 6e 73 20 62 |atory re|gimens b|
|00002620| 65 66 6f 72 65 20 61 6c | 6c 6f 67 65 6e 65 69 63 |efore al|logeneic|
|00002630| 0d 0a 74 72 61 6e 73 70 | 6c 61 6e 74 61 74 69 6f |..transp|lantatio|
|00002640| 6e 20 6f 66 20 74 68 65 | 73 65 20 61 64 76 61 6e |n of the|se advan|
|00002650| 63 65 64 20 6c 65 75 6b | 65 6d 69 61 73 2e 20 20 |ced leuk|emias. |
|00002660| 42 61 63 6b 20 74 68 65 | 6e 2c 20 61 73 20 69 6e |Back the|n, as in|
|00002670| 20 74 68 65 20 63 75 72 | 72 65 6e 74 0d 0a 73 74 | the cur|rent..st|
|00002680| 75 64 79 2c 20 61 20 66 | 61 69 72 6c 79 20 68 69 |udy, a f|airly hi|
|00002690| 67 68 20 70 65 72 63 65 | 6e 74 61 67 65 20 6f 66 |gh perce|ntage of|
|000026a0| 20 74 68 65 20 70 61 74 | 69 65 6e 74 73 20 64 69 | the pat|ients di|
|000026b0| 65 64 20 6f 66 20 74 6f | 78 69 63 69 74 79 20 72 |ed of to|xicity r|
|000026c0| 65 6c 61 74 65 64 20 74 | 6f 0d 0a 74 68 65 20 74 |elated t|o..the t|
|000026d0| 68 65 72 61 70 79 2e 20 | 20 46 72 6f 6d 20 74 68 |herapy. | From th|
|000026e0| 65 20 65 61 72 6c 79 20 | 31 39 37 30 73 20 74 6f |e early |1970s to|
|000026f0| 20 74 68 65 20 6d 69 64 | 20 31 39 38 30 73 2c 20 | the mid| 1980s, |
|00002700| 74 68 65 20 63 6f 6d 70 | 6c 65 74 65 20 72 65 6d |the comp|lete rem|
|00002710| 69 73 73 69 6f 6e 0d 0a | 72 61 74 65 20 66 6f 72 |ission..|rate for|
|00002720| 20 70 61 74 69 65 6e 74 | 73 20 77 69 74 68 20 61 | patient|s with a|
|00002730| 64 76 61 6e 63 65 64 20 | 64 69 73 65 61 73 65 20 |dvanced |disease |
|00002740| 67 69 76 65 6e 20 74 72 | 61 6e 73 70 6c 61 6e 74 |given tr|ansplant|
|00002750| 73 20 77 61 73 20 61 62 | 6f 75 74 20 32 30 25 2e |s was ab|out 20%.|
|00002760| 0d 0a 42 65 67 69 6e 6e | 69 6e 67 20 69 6e 20 74 |..Beginn|ing in t|
|00002770| 68 65 20 6c 61 74 65 20 | 31 39 38 30 73 20 6e 65 |he late |1980s ne|
|00002780| 77 20 69 6e 74 65 6e 73 | 69 76 65 20 69 6e 64 75 |w intens|ive indu|
|00002790| 63 74 69 6f 6e 20 70 72 | 6f 67 72 61 6d 73 20 77 |ction pr|ograms w|
|000027a0| 65 72 65 20 74 72 69 65 | 64 2e 20 20 54 68 69 73 |ere trie|d. This|
|000027b0| 0d 0a 73 74 75 64 79 20 | 75 73 65 64 20 69 6e 74 |..study |used int|
|000027c0| 65 6e 73 69 76 65 20 69 | 6e 64 75 63 74 69 6f 6e |ensive i|nduction|
|000027d0| 20 77 69 74 68 20 56 50 | 2d 31 36 3b 20 6f 74 68 | with VP|-16; oth|
|000027e0| 65 72 73 20 68 61 76 65 | 20 75 73 65 64 20 68 69 |ers have| used hi|
|000027f0| 67 68 2d 64 6f 73 65 0d | 0a 63 79 74 61 72 61 62 |gh-dose.|.cytarab|
|00002800| 69 6e 20 69 6e 20 63 6f | 6d 62 69 6e 61 74 69 6f |in in co|mbinatio|
|00002810| 6e 20 77 69 74 68 20 69 | 72 72 61 64 69 61 74 69 |n with i|rradiati|
|00002820| 6f 6e 2e 20 20 54 68 65 | 73 65 20 6e 65 77 20 70 |on. The|se new p|
|00002830| 72 6f 67 72 61 6d 73 20 | 6c 6f 6f 6b 20 62 65 74 |rograms |look bet|
|00002840| 74 65 72 0d 0a 74 68 61 | 6e 20 74 68 65 20 65 61 |ter..tha|n the ea|
|00002850| 72 6c 69 65 72 20 74 72 | 65 61 74 6d 65 6e 74 20 |rlier tr|eatment |
|00002860| 70 72 6f 74 6f 63 6f 6c | 73 2e 20 20 49 6e 20 74 |protocol|s. In t|
|00002870| 68 65 20 63 75 72 72 65 | 6e 74 20 73 74 75 64 79 |he curre|nt study|
|00002880| 2c 20 31 39 20 6f 66 20 | 74 68 65 20 69 6e 69 74 |, 19 of |the init|
|00002890| 69 61 6c 0d 0a 33 38 20 | 70 61 74 69 65 6e 74 73 |ial..38 |patients|
|000028a0| 20 77 65 72 65 20 61 6c | 69 76 65 20 61 6e 64 20 | were al|ive and |
|000028b0| 69 6e 20 72 65 6d 69 73 | 73 69 6f 6e 20 62 65 74 |in remis|sion bet|
|000028c0| 77 65 65 6e 20 36 20 61 | 6e 64 20 33 35 20 6d 6f |ween 6 a|nd 35 mo|
|000028d0| 6e 74 68 73 20 61 66 74 | 65 72 0d 0a 74 72 65 61 |nths aft|er..trea|
|000028e0| 74 6d 65 6e 74 2e 20 20 | 54 68 65 20 33 2d 79 65 |tment. |The 3-ye|
|000028f0| 61 72 20 61 63 74 75 61 | 72 69 61 6c 20 64 69 73 |ar actua|rial dis|
|00002900| 65 61 73 65 2d 66 72 65 | 65 20 73 75 72 76 69 76 |ease-fre|e surviv|
|00002910| 61 6c 20 72 61 74 65 20 | 69 73 20 61 62 6f 75 74 |al rate |is about|
|00002920| 20 35 36 25 2e 0d 0a 41 | 6c 74 68 6f 75 67 68 20 | 56%...A|lthough |
|00002930| 74 68 65 20 75 6c 74 69 | 6d 61 74 65 20 70 65 72 |the ulti|mate per|
|00002940| 63 65 6e 74 61 67 65 20 | 6f 66 20 70 61 74 69 65 |centage |of patie|
|00002950| 6e 74 73 20 63 75 72 65 | 64 20 62 79 20 74 68 69 |nts cure|d by thi|
|00002960| 73 20 70 72 6f 67 72 61 | 6d 20 77 69 6c 6c 20 62 |s progra|m will b|
|00002970| 65 0d 0a 6c 6f 77 65 72 | 20 74 68 61 6e 20 74 68 |e..lower| than th|
|00002980| 69 73 20 66 69 67 75 72 | 65 2c 20 74 68 65 20 72 |is figur|e, the r|
|00002990| 65 73 75 6c 74 73 20 77 | 69 6c 6c 20 73 74 69 6c |esults w|ill stil|
|000029a0| 6c 20 62 65 20 70 72 65 | 74 74 79 20 67 6f 6f 64 |l be pre|tty good|
|000029b0| 2e 20 20 54 68 65 72 65 | 20 69 73 20 6e 6f 77 0d |. There| is now.|
|000029c0| 0a 72 6f 6f 6d 20 66 6f | 72 20 73 6f 6d 65 20 68 |.room fo|r some h|
|000029d0| 6f 70 65 20 6f 66 20 63 | 75 72 65 20 66 6f 72 20 |ope of c|ure for |
|000029e0| 74 68 65 20 79 6f 75 6e | 67 20 70 61 74 69 65 6e |the youn|g patien|
|000029f0| 74 20 77 69 74 68 20 61 | 64 76 61 6e 63 65 64 20 |t with a|dvanced |
|00002a00| 61 63 75 74 65 0d 0a 6c | 65 75 6b 65 6d 69 61 2e |acute..l|eukemia.|
|00002a10| 2d 2d 4d 2e 4a 2e 20 43 | 6c 69 6e 65 2c 20 4d 2e |--M.J. C|line, M.|
|00002a20| 44 2e 0d 0a 24 55 6e 69 | 71 75 65 5f 49 44 7b 59 |D...$Uni|que_ID{Y|
|00002a30| 52 42 31 31 31 30 32 7d | 0d 0a 24 54 69 74 6c 65 |RB11102}|..$Title|
|00002a40| 7b 41 6c 6c 6f 67 65 6e | 65 69 63 20 42 6f 6e 65 |{Allogen|eic Bone|
|00002a50| 20 4d 61 72 72 6f 77 20 | 54 72 61 6e 73 70 6c 61 | Marrow |Transpla|
|00002a60| 6e 74 61 74 69 6f 6e 20 | 66 6f 72 20 41 63 75 74 |ntation |for Acut|
|00002a70| 65 20 4e 6f 6e 6c 79 6d | 70 68 6f 63 79 74 69 63 |e Nonlym|phocytic|
|00002a80| 20 4c 65 75 6b 65 6d 69 | 61 20 69 6e 20 46 69 72 | Leukemi|a in Fir|
|00002a90| 73 74 20 52 65 6d 69 73 | 73 69 6f 6e 7d 0d 0a 24 |st Remis|sion}..$|
|00002aa0| 41 75 74 68 6f 72 7b 4d | 63 47 6c 61 76 65 2c 20 |Author{M|cGlave, |
|00002ab0| 50 42 0d 0a 48 61 61 6b | 65 2c 20 52 4a 0d 0a 42 |PB..Haak|e, RJ..B|
|00002ac0| 6f 73 74 72 6f 6d 2c 20 | 42 43 0d 0a 42 72 75 6e |ostrom, |BC..Brun|
|00002ad0| 6e 69 6e 67 2c 20 52 0d | 0a 48 75 72 64 2c 20 44 |ning, R.|.Hurd, D|
|00002ae0| 44 0d 0a 4b 69 6d 2c 20 | 54 48 0d 0a 4e 65 73 62 |D..Kim, |TH..Nesb|
|00002af0| 69 74 2c 20 4d 45 0d 0a | 56 65 72 63 65 6c 6c 6f |it, ME..|Vercello|
|00002b00| 74 74 69 2c 20 47 4d 0d | 0a 57 65 69 73 64 6f 72 |tti, GM.|.Weisdor|
|00002b10| 66 2c 20 44 0d 0a 57 6f | 6f 64 73 2c 20 57 47 0d |f, D..Wo|ods, WG.|
|00002b20| 0a 52 61 6d 73 61 79 2c | 20 4e 4b 43 0d 0a 4b 65 |.Ramsay,| NKC..Ke|
|00002b30| 72 73 65 79 2c 20 4a 48 | 7d 0d 0a 24 41 66 66 69 |rsey, JH|}..$Affi|
|00002b40| 6c 69 61 74 69 6f 6e 7b | 55 6e 69 76 20 6f 66 20 |liation{|Univ of |
|00002b50| 4d 69 6e 6e 65 73 6f 74 | 61 7d 0d 0a 24 4a 6f 75 |Minnesot|a}..$Jou|
|00002b60| 72 6e 61 6c 7b 42 6c 6f | 6f 64 7d 0d 0a 24 56 6f |rnal{Blo|od}..$Vo|
|00002b70| 6c 75 6d 65 7b 37 32 7d | 0d 0a 24 50 61 67 65 7b |lume{72}|..$Page{|
|00002b80| 31 35 31 32 2d 31 35 31 | 37 7d 0d 0a 24 44 61 74 |1512-151|7}..$Dat|
|00002b90| 65 7b 4e 6f 76 65 6d 62 | 65 72 20 31 39 38 38 7d |e{Novemb|er 1988}|
|00002ba0| 0d 0a 24 59 42 56 6f 6c | 7b 31 39 39 30 20 59 65 |..$YBVol|{1990 Ye|
|00002bb0| 61 72 20 42 6f 6f 6b 20 | 6f 66 20 4d 65 64 69 63 |ar Book |of Medic|
|00002bc0| 69 6e 65 7d 0d 0a 24 43 | 68 61 70 74 65 72 7b 32 |ine}..$C|hapter{2|
|00002bd0| 33 2d 36 7d 0d 0a 24 59 | 42 45 64 69 74 6f 72 7b |3-6}..$Y|BEditor{|
|00002be0| 44 72 73 2e 20 52 6f 67 | 65 72 73 2c 20 44 65 73 |Drs. Rog|ers, Des|
|00002bf0| 20 50 72 65 7a 2c 20 43 | 6c 69 6e 65 2c 20 42 72 | Prez, C|line, Br|
|00002c00| 61 75 6e 77 61 6c 64 2c | 20 47 72 65 65 6e 62 65 |aunwald,| Greenbe|
|00002c10| 72 67 65 72 2c 20 57 69 | 6c 73 6f 6e 2c 20 45 70 |rger, Wi|lson, Ep|
|00002c20| 73 74 65 69 6e 2c 20 61 | 6e 64 20 4d 61 6c 61 77 |stein, a|nd Malaw|
|00002c30| 69 73 74 61 7d 0d 0a 24 | 54 61 62 6c 65 7b 54 61 |ista}..$|Table{Ta|
|00002c40| 62 6c 65 20 4f 6d 69 74 | 74 65 64 7d 0d 0a 24 43 |ble Omit|ted}..$C|
|00002c50| 6f 6d 6d 65 6e 74 61 74 | 6f 72 7b 4d 2e 4a 2e 20 |ommentat|or{M.J. |
|00002c60| 43 6c 69 6e 65 2c 20 4d | 2e 44 2e 7d 0d 0a 0d 0a |Cline, M|.D.}....|
|00002c70| 43 6f 70 79 72 69 67 68 | 74 20 28 63 29 20 59 65 |Copyrigh|t (c) Ye|
|00002c80| 61 72 62 6f 6f 6b 20 4d | 65 64 69 63 61 6c 20 50 |arbook M|edical P|
|00002c90| 75 62 6c 69 73 68 65 72 | 73 2c 20 49 6e 63 2e 2c |ublisher|s, Inc.,|
|00002ca0| 20 31 39 39 30 0d 0a 0d | 0a 31 39 39 30 20 59 65 | 1990...|.1990 Ye|
|00002cb0| 61 72 20 42 6f 6f 6b 20 | 6f 66 20 4d 65 64 69 63 |ar Book |of Medic|
|00002cc0| 69 6e 65 20 28 52 29 0d | 0a 0d 0a 50 61 72 74 20 |ine (R).|...Part |
|00002cd0| 54 68 72 65 65 2d 2d 48 | 65 6d 61 74 6f 6c 6f 67 |Three--H|ematolog|
|00002ce0| 79 20 61 6e 64 20 4f 6e | 63 6f 6c 6f 67 79 0d 0a |y and On|cology..|
|00002cf0| 0d 0a 43 68 61 70 74 65 | 72 20 32 33 2d 2d 42 6f |..Chapte|r 23--Bo|
|00002d00| 6e 65 20 4d 61 72 72 6f | 77 20 54 72 61 6e 73 70 |ne Marro|w Transp|
|00002d10| 6c 61 6e 74 61 74 69 6f | 6e 0d 0a 0d 0a 2d 2d 2d |lantatio|n....---|
|00002d20| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002d30| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002d40| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002d50| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002d60| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 0d 0a 41 6c 6c |--------|---..All|
|00002d70| 6f 67 65 6e 65 69 63 20 | 42 6f 6e 65 20 4d 61 72 |ogeneic |Bone Mar|
|00002d80| 72 6f 77 20 54 72 61 6e | 73 70 6c 61 6e 74 61 74 |row Tran|splantat|
|00002d90| 69 6f 6e 20 66 6f 72 20 | 41 63 75 74 65 20 4e 6f |ion for |Acute No|
|00002da0| 6e 6c 79 6d 70 68 6f 63 | 79 74 69 63 20 4c 65 75 |nlymphoc|ytic Leu|
|00002db0| 6b 65 6d 69 61 20 69 6e | 0d 0a 46 69 72 73 74 20 |kemia in|..First |
|00002dc0| 52 65 6d 69 73 73 69 6f | 6e 0d 0a 0d 0a 4d 63 47 |Remissio|n....McG|
|00002dd0| 6c 61 76 65 20 50 42 3b | 20 48 61 61 6b 65 20 52 |lave PB;| Haake R|
|00002de0| 4a 3b 20 42 6f 73 74 72 | 6f 6d 20 42 43 3b 20 42 |J; Bostr|om BC; B|
|00002df0| 72 75 6e 6e 69 6e 67 20 | 52 3b 20 48 75 72 64 20 |running |R; Hurd |
|00002e00| 44 44 3b 20 4b 69 6d 20 | 54 48 3b 20 4e 65 73 62 |DD; Kim |TH; Nesb|
|00002e10| 69 74 20 4d 45 3b 0d 0a | 56 65 72 63 65 6c 6c 6f |it ME;..|Vercello|
|00002e20| 74 74 69 20 47 4d 3b 20 | 57 65 69 73 64 6f 72 66 |tti GM; |Weisdorf|
|00002e30| 20 44 3b 20 57 6f 6f 64 | 73 20 57 47 3b 20 52 61 | D; Wood|s WG; Ra|
|00002e40| 6d 73 61 79 20 4e 4b 43 | 3b 20 4b 65 72 73 65 79 |msay NKC|; Kersey|
|00002e50| 20 4a 48 0d 0a 28 55 6e | 69 76 20 6f 66 20 4d 69 | JH..(Un|iv of Mi|
|00002e60| 6e 6e 65 73 6f 74 61 29 | 0d 0a 42 6c 6f 6f 64 20 |nnesota)|..Blood |
|00002e70| 37 32 3a 31 35 31 32 2d | 31 35 31 37 2c 20 4e 6f |72:1512-|1517, No|
|00002e80| 76 65 6d 62 65 72 20 31 | 39 38 38 0d 0a 2d 2d 2d |vember 1|988..---|
|00002e90| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002ea0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002eb0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002ec0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002ed0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 0d 0a 0d 0a 41 |--------|---....A|
|00002ee0| 62 73 74 72 61 63 74 0d | 0a 0d 0a 20 20 20 20 20 |bstract.|... |
|00002ef0| 41 20 67 72 6f 75 70 20 | 6f 66 20 37 33 20 63 6f |A group |of 73 co|
|00002f00| 6e 73 65 63 75 74 69 76 | 65 20 70 61 74 69 65 6e |nsecutiv|e patien|
|00002f10| 74 73 20 77 69 74 68 20 | 61 63 75 74 65 20 6e 6f |ts with |acute no|
|00002f20| 6e 6c 79 6d 70 68 6f 63 | 79 74 69 63 20 6c 65 75 |nlymphoc|ytic leu|
|00002f30| 6b 65 6d 69 61 20 69 6e | 0d 0a 66 69 72 73 74 20 |kemia in|..first |
|00002f40| 63 6f 6d 70 6c 65 74 65 | 20 72 65 6d 69 73 73 69 |complete| remissi|
|00002f50| 6f 6e 20 72 65 63 65 69 | 76 65 64 20 61 6c 6c 6f |on recei|ved allo|
|00002f60| 67 65 6e 65 69 63 20 62 | 6f 6e 65 20 6d 61 72 72 |geneic b|one marr|
|00002f70| 6f 77 20 74 72 61 6e 73 | 70 6c 61 6e 74 73 20 77 |ow trans|plants w|
|00002f80| 69 74 68 0d 0a 6e 6f 6e | 2d 54 2d 63 65 6c 6c 2d |ith..non|-T-cell-|
|00002f90| 64 65 70 6c 65 74 65 64 | 20 6d 61 72 72 6f 77 20 |depleted| marrow |
|00002fa0| 66 72 6f 6d 20 6d 61 74 | 63 68 65 64 20 73 69 62 |from mat|ched sib|
|00002fb0| 6c 69 6e 67 20 64 6f 6e | 6f 72 73 2e 20 20 50 61 |ling don|ors. Pa|
|00002fc0| 74 69 65 6e 74 73 20 77 | 65 72 65 0d 0a 70 72 65 |tients w|ere..pre|
|00002fd0| 70 61 72 65 64 20 77 69 | 74 68 20 63 79 63 6c 6f |pared wi|th cyclo|
|00002fe0| 70 68 6f 73 70 68 61 6d | 69 64 65 20 61 6e 64 20 |phospham|ide and |
|00002ff0| 65 69 74 68 65 72 20 37 | 35 30 20 6f 72 20 31 2c |either 7|50 or 1,|
|00003000| 33 32 30 20 63 47 79 20 | 6f 66 20 74 6f 74 61 6c |320 cGy |of total|
|00003010| 2d 62 6f 64 79 0d 0a 69 | 72 72 61 64 69 61 74 69 |-body..i|rradiati|
|00003020| 6f 6e 2c 20 74 68 65 20 | 6c 61 74 74 65 72 20 69 |on, the |latter i|
|00003030| 6e 20 34 20 64 61 69 6c | 79 20 66 72 61 63 74 69 |n 4 dail|y fracti|
|00003040| 6f 6e 73 2e 20 20 54 68 | 65 20 6d 65 64 69 61 6e |ons. Th|e median|
|00003050| 20 66 6f 6c 6c 6f 77 2d | 75 70 20 77 61 73 20 34 | follow-|up was 4|
|00003060| 30 0d 0a 6d 6f 6e 74 68 | 73 2e 0d 0a 20 20 20 20 |0..month|s... |
|00003070| 20 54 68 65 20 70 72 6f | 6a 65 63 74 65 64 20 64 | The pro|jected d|
|00003080| 69 73 65 61 73 65 2d 66 | 72 65 65 20 73 75 72 76 |isease-f|ree surv|
|00003090| 69 76 61 6c 20 72 61 74 | 65 20 77 61 73 20 36 31 |ival rat|e was 61|
|000030a0| 25 20 66 6f 72 20 34 31 | 20 63 68 69 6c 64 72 65 |% for 41| childre|
|000030b0| 6e 20 61 6e 64 20 36 32 | 25 0d 0a 66 6f 72 20 33 |n and 62|%..for 3|
|000030c0| 32 20 61 64 75 6c 74 73 | 20 61 74 20 38 34 20 6d |2 adults| at 84 m|
|000030d0| 6f 6e 74 68 73 2e 20 20 | 50 72 6f 6a 65 63 74 65 |onths. |Projecte|
|000030e0| 64 20 72 65 6c 61 70 73 | 65 20 72 61 74 65 73 20 |d relaps|e rates |
|000030f0| 77 65 72 65 20 31 35 25 | 20 66 6f 72 20 63 68 69 |were 15%| for chi|
|00003100| 6c 64 72 65 6e 20 61 6e | 64 0d 0a 39 25 20 66 6f |ldren an|d..9% fo|
|00003110| 72 20 61 64 75 6c 74 73 | 20 28 46 69 67 20 32 33 |r adults| (Fig 23|
|00003120| 2d 32 29 2e 20 20 44 69 | 73 65 61 73 65 2d 66 72 |-2). Di|sease-fr|
|00003130| 65 65 20 73 75 72 76 69 | 76 61 6c 20 77 61 73 20 |ee survi|val was |
|00003140| 63 6f 6d 70 72 6f 6d 69 | 73 65 64 20 62 79 20 61 |compromi|sed by a|
|00003150| 6e 20 69 6e 69 74 69 61 | 6c 0d 0a 77 68 69 74 65 |n initia|l..white|
|00003160| 20 62 6c 6f 6f 64 20 63 | 65 6c 6c 20 63 6f 75 6e | blood c|ell coun|
|00003170| 74 20 6f 66 20 6d 6f 72 | 65 20 74 68 61 6e 20 32 |t of mor|e than 2|
|00003180| 30 2c 30 30 30 20 6d 6d | 5e 33 2e 20 20 46 72 65 |0,000 mm|^3. Fre|
|00003190| 6e 63 68 2d 41 6d 65 72 | 69 63 61 6e 2d 42 72 69 |nch-Amer|ican-Bri|
|000031a0| 74 69 73 68 0d 0a 28 46 | 41 42 29 20 73 75 62 74 |tish..(F|AB) subt|
|000031b0| 79 70 65 73 20 4d 34 20 | 61 6e 64 20 4d 35 20 77 |ypes M4 |and M5 w|
|000031c0| 65 72 65 20 61 73 73 6f | 63 69 61 74 65 64 20 77 |ere asso|ciated w|
|000031d0| 69 74 68 20 72 65 6c 61 | 70 73 65 2e 20 20 4f 6e |ith rela|pse. On|
|000031e0| 20 6d 75 6c 74 69 76 61 | 72 69 61 74 65 0d 0a 61 | multiva|riate..a|
|000031f0| 6e 61 6c 79 73 69 73 2c | 20 73 65 76 65 72 65 20 |nalysis,| severe |
|00003200| 61 63 75 74 65 20 67 72 | 61 66 74 2d 76 73 2e 2d |acute gr|aft-vs.-|
|00003210| 68 6f 73 74 20 64 69 73 | 65 61 73 65 20 61 6e 64 |host dis|ease and|
|00003220| 20 69 6e 74 65 72 73 74 | 69 74 69 61 6c 20 70 6e | interst|itial pn|
|00003230| 65 75 6d 6f 6e 69 74 69 | 73 0d 0a 63 6f 72 72 65 |eumoniti|s..corre|
|00003240| 6c 61 74 65 64 20 77 69 | 74 68 20 70 6f 6f 72 20 |lated wi|th poor |
|00003250| 64 69 73 65 61 73 65 2d | 66 72 65 65 20 73 75 72 |disease-|free sur|
|00003260| 76 69 76 61 6c 2e 0d 0a | 20 20 20 20 20 41 6c 6c |vival...| All|
|00003270| 6f 67 65 6e 65 69 63 20 | 6d 61 72 72 6f 77 20 74 |ogeneic |marrow t|
|00003280| 72 61 6e 73 70 6c 61 6e | 74 61 74 69 6f 6e 20 6d |ransplan|tation m|
|00003290| 61 79 20 70 72 6f 76 69 | 64 65 20 73 75 73 74 61 |ay provi|de susta|
|000032a0| 69 6e 65 64 20 64 69 73 | 65 61 73 65 2d 73 75 72 |ined dis|ease-sur|
|000032b0| 76 69 76 61 6c 2c 0d 0a | 77 68 65 6e 20 64 6f 6e |vival,..|when don|
|000032c0| 65 20 69 6e 20 74 68 65 | 20 66 69 72 73 74 20 63 |e in the| first c|
|000032d0| 6f 6d 70 6c 65 74 65 20 | 72 65 6d 69 73 73 69 6f |omplete |remissio|
|000032e0| 6e 20 6f 66 20 61 63 75 | 74 65 20 6e 6f 6e 6c 79 |n of acu|te nonly|
|000032f0| 6d 70 68 6f 63 79 74 69 | 63 20 6c 65 75 6b 65 6d |mphocyti|c leukem|
|00003300| 69 61 2e 0d 0a 59 6f 75 | 6e 67 20 61 64 75 6c 74 |ia...You|ng adult|
|00003310| 73 20 72 65 73 70 6f 6e | 64 20 61 73 20 77 65 6c |s respon|d as wel|
|00003320| 6c 20 61 73 20 63 68 69 | 6c 64 72 65 6e 20 74 72 |l as chi|ldren tr|
|00003330| 65 61 74 65 64 20 75 6e | 64 65 72 20 74 68 65 20 |eated un|der the |
|00003340| 73 61 6d 65 20 63 6f 6e | 64 69 74 69 6f 6e 73 2e |same con|ditions.|
|00003350| 0d 0a 49 6e 20 70 61 74 | 69 65 6e 74 73 20 77 69 |..In pat|ients wi|
|00003360| 74 68 20 46 41 42 20 4d | 34 20 6f 72 20 4d 35 20 |th FAB M|4 or M5 |
|00003370| 64 69 73 65 61 73 65 2c | 20 61 20 6d 6f 72 65 20 |disease,| a more |
|00003380| 61 67 67 72 65 73 73 69 | 76 65 20 61 70 70 72 6f |aggressi|ve appro|
|00003390| 61 63 68 20 74 6f 20 61 | 62 6c 61 74 69 6e 67 0d |ach to a|blating.|
|000033a0| 0a 6c 65 75 6b 65 6d 69 | 61 20 6d 61 79 20 62 65 |.leukemi|a may be|
|000033b0| 20 77 61 72 72 61 6e 74 | 65 64 2e 0d 0a 0d 0a 50 | warrant|ed.....P|
|000033c0| 6f 73 74 2d 43 6f 6d 6d | 65 6e 74 0d 0a 0d 0a 20 |ost-Comm|ent.... |
|000033d0| 20 20 20 20 49 20 73 65 | 6c 65 63 74 65 64 20 74 | I se|lected t|
|000033e0| 68 69 73 20 61 72 74 69 | 63 6c 65 20 61 73 20 61 |his arti|cle as a|
|000033f0| 6e 20 65 78 61 6d 70 6c | 65 20 6f 66 20 74 68 65 |n exampl|e of the|
|00003400| 20 63 75 72 72 65 6e 74 | 20 73 74 61 74 75 73 20 | current| status |
|00003410| 6f 66 20 62 6f 6e 65 0d | 0a 6d 61 72 72 6f 77 20 |of bone.|.marrow |
|00003420| 74 72 61 6e 73 70 6c 61 | 6e 74 61 74 69 6f 6e 20 |transpla|ntation |
|00003430| 66 6f 72 20 22 65 61 72 | 6c 79 2d 73 74 61 67 65 |for "ear|ly-stage|
|00003440| 22 20 61 63 75 74 65 20 | 6d 79 65 6c 6f 69 64 20 |" acute |myeloid |
|00003450| 6c 65 75 6b 65 6d 69 61 | 2e 20 20 50 6c 65 61 73 |leukemia|. Pleas|
|00003460| 65 20 6e 6f 74 65 0d 0a | 74 68 61 74 20 61 63 75 |e note..|that acu|
|00003470| 74 65 20 6d 79 65 6c 6f | 69 64 20 6c 65 75 6b 65 |te myelo|id leuke|
|00003480| 6d 69 61 20 69 73 20 61 | 6c 73 6f 20 6b 6e 6f 77 |mia is a|lso know|
|00003490| 6e 20 61 63 75 74 65 20 | 6e 6f 6e 6c 79 6d 70 68 |n acute |nonlymph|
|000034a0| 6f 63 79 74 69 63 20 6c | 65 75 6b 65 6d 69 61 0d |ocytic l|eukemia.|
|000034b0| 0a 28 41 4e 4c 4c 29 2e | 20 20 41 73 20 61 20 67 |.(ANLL).| As a g|
|000034c0| 65 6e 65 72 61 6c 69 7a | 61 74 69 6f 6e 2c 20 74 |eneraliz|ation, t|
|000034d0| 68 65 20 62 65 6e 65 66 | 69 63 69 61 6c 20 72 65 |he benef|icial re|
|000034e0| 73 70 6f 6e 73 65 20 72 | 61 74 65 20 69 73 20 62 |sponse r|ate is b|
|000034f0| 65 74 77 65 65 6e 20 35 | 30 25 20 61 6e 64 0d 0a |etween 5|0% and..|
|00003500| 36 30 25 20 69 6e 20 70 | 61 74 69 65 6e 74 73 20 |60% in p|atients |
|00003510| 77 69 74 68 20 41 4e 4c | 4c 20 77 68 6f 20 72 65 |with ANL|L who re|
|00003520| 63 65 69 76 65 20 61 20 | 74 72 61 6e 73 70 6c 61 |ceive a |transpla|
|00003530| 6e 74 20 66 72 6f 6d 20 | 61 20 6d 61 74 63 68 65 |nt from |a matche|
|00003540| 64 20 73 69 62 6c 69 6e | 67 0d 0a 64 6f 6e 6f 72 |d siblin|g..donor|
|00003550| 20 77 68 65 6e 20 74 68 | 65 79 20 68 61 76 65 20 | when th|ey have |
|00003560| 61 63 68 69 65 76 65 64 | 20 61 20 72 65 6d 69 73 |achieved| a remis|
|00003570| 73 69 6f 6e 20 6f 66 20 | 74 68 65 69 72 20 64 69 |sion of |their di|
|00003580| 73 65 61 73 65 2e 20 20 | 54 68 65 20 72 65 73 75 |sease. |The resu|
|00003590| 6c 74 73 20 77 69 74 68 | 0d 0a 74 72 61 6e 73 70 |lts with|..transp|
|000035a0| 6c 61 6e 74 61 74 69 6f | 6e 20 61 70 70 65 61 72 |lantatio|n appear|
|000035b0| 20 74 6f 20 62 65 20 73 | 6f 6d 65 77 68 61 74 20 | to be s|omewhat |
|000035c0| 73 75 70 65 72 69 6f 72 | 20 74 6f 20 74 68 6f 73 |superior| to thos|
|000035d0| 65 20 61 63 68 69 65 76 | 65 64 20 62 79 20 69 6e |e achiev|ed by in|
|000035e0| 74 65 6e 73 69 76 65 0d | 0a 63 68 65 6d 6f 74 68 |tensive.|.chemoth|
|000035f0| 65 72 61 70 79 20 61 6c | 6f 6e 65 2e 20 20 54 68 |erapy al|one. Th|
|00003600| 65 20 6d 61 6a 6f 72 20 | 63 61 76 65 61 74 20 69 |e major |caveat i|
|00003610| 73 20 74 68 61 74 20 79 | 6f 75 6e 67 65 72 20 70 |s that y|ounger p|
|00003620| 61 74 69 65 6e 74 73 20 | 64 6f 20 6d 75 63 68 20 |atients |do much |
|00003630| 62 65 74 74 65 72 0d 0a | 74 68 61 6e 20 6f 6c 64 |better..|than old|
|00003640| 65 72 20 70 61 74 69 65 | 6e 74 73 2e 20 20 4f 6e |er patie|nts. On|
|00003650| 65 20 63 61 6e 6e 6f 74 | 20 72 65 63 6f 6d 6d 65 |e cannot| recomme|
|00003660| 6e 64 20 74 68 65 20 74 | 72 61 6e 73 70 6c 61 6e |nd the t|ransplan|
|00003670| 74 61 74 69 6f 6e 20 70 | 72 6f 63 65 64 75 72 65 |tation p|rocedure|
|00003680| 20 66 6f 72 0d 0a 70 61 | 74 69 65 6e 74 73 20 6f | for..pa|tients o|
|00003690| 6c 64 65 72 20 74 68 61 | 6e 20 61 62 6f 75 74 20 |lder tha|n about |
|000036a0| 34 35 20 79 65 61 72 73 | 2e 20 20 54 68 69 73 20 |45 years|. This |
|000036b0| 73 74 75 64 79 20 61 6c | 73 6f 20 73 75 67 67 65 |study al|so sugge|
|000036c0| 73 74 73 20 74 68 61 74 | 20 74 68 6f 73 65 20 74 |sts that| those t|
|000036d0| 79 70 65 73 0d 0a 6f 66 | 20 41 4e 4c 4c 20 6b 6e |ypes..of| ANLL kn|
|000036e0| 6f 77 6e 20 61 73 20 74 | 79 70 65 73 20 4d 34 20 |own as t|ypes M4 |
|000036f0| 61 6e 64 20 4d 35 20 64 | 6f 20 6e 6f 74 20 68 61 |and M5 d|o not ha|
|00003700| 76 65 20 61 20 67 6f 6f | 64 20 70 72 6f 67 6e 6f |ve a goo|d progno|
|00003710| 73 69 73 20 77 69 74 68 | 0d 0a 74 72 61 6e 73 70 |sis with|..transp|
|00003720| 6c 61 6e 74 61 74 69 6f | 6e 2e 20 20 4f 6e 65 20 |lantatio|n. One |
|00003730| 73 68 6f 75 6c 64 20 63 | 6f 6e 74 72 61 73 74 20 |should c|ontrast |
|00003740| 74 68 65 20 72 65 73 75 | 6c 74 73 20 6f 62 73 65 |the resu|lts obse|
|00003750| 72 76 65 64 20 69 6e 20 | 74 68 69 73 20 73 74 75 |rved in |this stu|
|00003760| 64 79 20 69 6e 0d 0a 77 | 68 69 63 68 20 70 61 74 |dy in..w|hich pat|
|00003770| 69 65 6e 74 73 20 72 65 | 63 65 69 76 65 64 20 74 |ients re|ceived t|
|00003780| 72 61 6e 73 70 6c 61 6e | 74 73 20 72 65 6c 61 74 |ransplan|ts relat|
|00003790| 69 76 65 6c 79 20 65 61 | 72 6c 79 20 69 6e 20 74 |ively ea|rly in t|
|000037a0| 68 65 69 72 20 64 69 73 | 65 61 73 65 20 77 69 74 |heir dis|ease wit|
|000037b0| 68 20 74 68 65 0d 0a 6e | 65 78 74 20 73 74 75 64 |h the..n|ext stud|
|000037c0| 79 20 69 6e 20 77 68 69 | 63 68 20 70 61 74 69 65 |y in whi|ch patie|
|000037d0| 6e 74 73 20 77 65 72 65 | 20 67 69 76 65 6e 20 74 |nts were| given t|
|000037e0| 72 61 6e 73 70 6c 61 6e | 74 73 20 61 74 20 61 20 |ransplan|ts at a |
|000037f0| 72 65 6c 61 74 69 76 65 | 6c 79 20 6c 61 74 65 0d |relative|ly late.|
|00003800| 0a 73 74 61 67 65 2e 2d | 2d 4d 2e 4a 2e 20 43 6c |.stage.-|-M.J. Cl|
|00003810| 69 6e 65 2c 20 4d 2e 44 | 2e 0d 0a 24 55 6e 69 71 |ine, M.D|...$Uniq|
|00003820| 75 65 5f 49 44 7b 59 52 | 42 31 31 31 30 33 7d 0d |ue_ID{YR|B11103}.|
|00003830| 0a 24 54 69 74 6c 65 7b | 48 4c 41 2d 49 64 65 6e |.$Title{|HLA-Iden|
|00003840| 74 69 63 61 6c 20 4d 61 | 72 72 6f 77 20 54 72 61 |tical Ma|rrow Tra|
|00003850| 6e 73 70 6c 61 6e 74 61 | 74 69 6f 6e 20 44 75 72 |nsplanta|tion Dur|
|00003860| 69 6e 67 20 41 63 63 65 | 6c 65 72 61 74 65 64 2d |ing Acce|lerated-|
|00003870| 50 68 61 73 65 20 43 68 | 72 6f 6e 69 63 20 4d 79 |Phase Ch|ronic My|
|00003880| 65 6c 6f 67 65 6e 6f 75 | 73 20 4c 65 75 6b 65 6d |elogenou|s Leukem|
|00003890| 69 61 3a 20 20 41 6e 61 | 6c 79 73 69 73 20 6f 66 |ia: Ana|lysis of|
|000038a0| 20 53 75 72 76 69 76 61 | 6c 20 61 6e 64 20 52 65 | Surviva|l and Re|
|000038b0| 6d 69 73 73 69 6f 6e 20 | 44 75 72 61 74 69 6f 6e |mission |Duration|
|000038c0| 7d 0d 0a 24 41 75 74 68 | 6f 72 7b 4d 61 72 74 69 |}..$Auth|or{Marti|
|000038d0| 6e 2c 20 50 4a 0d 0a 43 | 6c 69 66 74 2c 20 52 41 |n, PJ..C|lift, RA|
|000038e0| 0d 0a 46 69 73 68 65 72 | 2c 20 4c 44 0d 0a 42 75 |..Fisher|, LD..Bu|
|000038f0| 63 6b 6e 65 72 2c 20 43 | 44 0d 0a 48 61 6e 73 65 |ckner, C|D..Hanse|
|00003900| 6e 2c 20 4a 41 0d 0a 41 | 70 70 65 6c 62 61 75 6d |n, JA..A|ppelbaum|
|00003910| 2c 20 46 52 0d 0a 44 6f | 6e 65 79 2c 20 4b 43 0d |, FR..Do|ney, KC.|
|00003920| 0a 53 75 6c 6c 69 76 61 | 6e 2c 20 4b 4d 0d 0a 57 |.Sulliva|n, KM..W|
|00003930| 69 74 68 65 72 73 70 6f | 6f 6e 2c 20 52 50 0d 0a |itherspo|on, RP..|
|00003940| 53 74 6f 72 62 2c 20 52 | 0d 0a 54 68 6f 6d 61 73 |Storb, R|..Thomas|
|00003950| 2c 20 45 44 7d 0d 0a 24 | 41 66 66 69 6c 69 61 74 |, ED}..$|Affiliat|
|00003960| 69 6f 6e 7b 46 72 65 64 | 20 48 75 74 63 68 69 6e |ion{Fred| Hutchin|
|00003970| 73 6f 6e 20 43 61 6e 63 | 65 72 20 52 65 73 65 61 |son Canc|er Resea|
|00003980| 72 63 68 20 43 74 72 2c | 20 53 65 61 74 74 6c 65 |rch Ctr,| Seattle|
|00003990| 3b 20 50 75 67 65 74 20 | 53 6f 75 6e 64 20 42 6c |; Puget |Sound Bl|
|000039a0| 6f 6f 64 20 43 74 72 2c | 20 53 65 61 74 74 6c 65 |ood Ctr,| Seattle|
|000039b0| 3b 20 55 6e 69 76 20 6f | 66 20 57 61 73 68 69 6e |; Univ o|f Washin|
|000039c0| 67 74 6f 6e 7d 0d 0a 24 | 4a 6f 75 72 6e 61 6c 7b |gton}..$|Journal{|
|000039d0| 42 6c 6f 6f 64 7d 0d 0a | 24 56 6f 6c 75 6d 65 7b |Blood}..|$Volume{|
|000039e0| 37 32 7d 0d 0a 24 50 61 | 67 65 7b 31 39 37 38 2d |72}..$Pa|ge{1978-|
|000039f0| 31 39 38 34 7d 0d 0a 24 | 44 61 74 65 7b 44 65 63 |1984}..$|Date{Dec|
|00003a00| 65 6d 62 65 72 20 31 39 | 38 38 7d 0d 0a 24 59 42 |ember 19|88}..$YB|
|00003a10| 56 6f 6c 7b 31 39 39 30 | 20 59 65 61 72 20 42 6f |Vol{1990| Year Bo|
|00003a20| 6f 6b 20 6f 66 20 4d 65 | 64 69 63 69 6e 65 7d 0d |ok of Me|dicine}.|
|00003a30| 0a 24 43 68 61 70 74 65 | 72 7b 32 33 2d 37 7d 0d |.$Chapte|r{23-7}.|
|00003a40| 0a 24 59 42 45 64 69 74 | 6f 72 7b 44 72 73 2e 20 |.$YBEdit|or{Drs. |
|00003a50| 52 6f 67 65 72 73 2c 20 | 44 65 73 20 50 72 65 7a |Rogers, |Des Prez|
|00003a60| 2c 20 43 6c 69 6e 65 2c | 20 42 72 61 75 6e 77 61 |, Cline,| Braunwa|
|00003a70| 6c 64 2c 20 47 72 65 65 | 6e 62 65 72 67 65 72 2c |ld, Gree|nberger,|
|00003a80| 20 57 69 6c 73 6f 6e 2c | 20 45 70 73 74 65 69 6e | Wilson,| Epstein|
|00003a90| 2c 20 61 6e 64 20 4d 61 | 6c 61 77 69 73 74 61 7d |, and Ma|lawista}|
|00003aa0| 0d 0a 24 54 61 62 6c 65 | 7b 7d 0d 0a 24 43 6f 6d |..$Table|{}..$Com|
|00003ab0| 6d 65 6e 74 61 74 6f 72 | 7b 4d 2e 4a 2e 20 43 6c |mentator|{M.J. Cl|
|00003ac0| 69 6e 65 2c 20 4d 2e 44 | 2e 7d 0d 0a 0d 0a 43 6f |ine, M.D|.}....Co|
|00003ad0| 70 79 72 69 67 68 74 20 | 28 63 29 20 59 65 61 72 |pyright |(c) Year|
|00003ae0| 62 6f 6f 6b 20 4d 65 64 | 69 63 61 6c 20 50 75 62 |book Med|ical Pub|
|00003af0| 6c 69 73 68 65 72 73 2c | 20 49 6e 63 2e 2c 20 31 |lishers,| Inc., 1|
|00003b00| 39 39 30 0d 0a 0d 0a 31 | 39 39 30 20 59 65 61 72 |990....1|990 Year|
|00003b10| 20 42 6f 6f 6b 20 6f 66 | 20 4d 65 64 69 63 69 6e | Book of| Medicin|
|00003b20| 65 20 28 52 29 0d 0a 0d | 0a 50 61 72 74 20 54 68 |e (R)...|.Part Th|
|00003b30| 72 65 65 2d 2d 48 65 6d | 61 74 6f 6c 6f 67 79 20 |ree--Hem|atology |
|00003b40| 61 6e 64 20 4f 6e 63 6f | 6c 6f 67 79 0d 0a 0d 0a |and Onco|logy....|
|00003b50| 43 68 61 70 74 65 72 20 | 32 33 2d 2d 42 6f 6e 65 |Chapter |23--Bone|
|00003b60| 20 4d 61 72 72 6f 77 20 | 54 72 61 6e 73 70 6c 61 | Marrow |Transpla|
|00003b70| 6e 74 61 74 69 6f 6e 0d | 0a 0d 0a 2d 2d 2d 2d 2d |ntation.|...-----|
|00003b80| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003b90| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003ba0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003bb0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003bc0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 0d 0a 48 4c 41 2d 49 |--------|-..HLA-I|
|00003bd0| 64 65 6e 74 69 63 61 6c | 20 4d 61 72 72 6f 77 20 |dentical| Marrow |
|00003be0| 54 72 61 6e 73 70 6c 61 | 6e 74 61 74 69 6f 6e 20 |Transpla|ntation |
|00003bf0| 44 75 72 69 6e 67 20 41 | 63 63 65 6c 65 72 61 74 |During A|ccelerat|
|00003c00| 65 64 2d 50 68 61 73 65 | 20 43 68 72 6f 6e 69 63 |ed-Phase| Chronic|
|00003c10| 0d 0a 4d 79 65 6c 6f 67 | 65 6e 6f 75 73 20 4c 65 |..Myelog|enous Le|
|00003c20| 75 6b 65 6d 69 61 3a 20 | 20 41 6e 61 6c 79 73 69 |ukemia: | Analysi|
|00003c30| 73 20 6f 66 20 53 75 72 | 76 69 76 61 6c 20 61 6e |s of Sur|vival an|
|00003c40| 64 20 52 65 6d 69 73 73 | 69 6f 6e 20 44 75 72 61 |d Remiss|ion Dura|
|00003c50| 74 69 6f 6e 0d 0a 0d 0a | 4d 61 72 74 69 6e 20 50 |tion....|Martin P|
|00003c60| 4a 3b 20 43 6c 69 66 74 | 20 52 41 3b 20 46 69 73 |J; Clift| RA; Fis|
|00003c70| 68 65 72 20 4c 44 3b 20 | 42 75 63 6b 6e 65 72 20 |her LD; |Buckner |
|00003c80| 43 44 3b 20 48 61 6e 73 | 65 6e 20 4a 41 3b 20 41 |CD; Hans|en JA; A|
|00003c90| 70 70 65 6c 62 61 75 6d | 20 46 52 3b 20 44 6f 6e |ppelbaum| FR; Don|
|00003ca0| 65 79 20 4b 43 3b 0d 0a | 53 75 6c 6c 69 76 61 6e |ey KC;..|Sullivan|
|00003cb0| 20 4b 4d 3b 20 57 69 74 | 68 65 72 73 70 6f 6f 6e | KM; Wit|herspoon|
|00003cc0| 20 52 50 3b 20 53 74 6f | 72 62 20 52 3b 20 54 68 | RP; Sto|rb R; Th|
|00003cd0| 6f 6d 61 73 20 45 44 0d | 0a 28 46 72 65 64 20 48 |omas ED.|.(Fred H|
|00003ce0| 75 74 63 68 69 6e 73 6f | 6e 20 43 61 6e 63 65 72 |utchinso|n Cancer|
|00003cf0| 20 52 65 73 65 61 72 63 | 68 20 43 74 72 2c 20 53 | Researc|h Ctr, S|
|00003d00| 65 61 74 74 6c 65 3b 20 | 50 75 67 65 74 20 53 6f |eattle; |Puget So|
|00003d10| 75 6e 64 20 42 6c 6f 6f | 64 20 43 74 72 2c 20 53 |und Bloo|d Ctr, S|
|00003d20| 65 61 74 74 6c 65 3b 0d | 0a 55 6e 69 76 20 6f 66 |eattle;.|.Univ of|
|00003d30| 20 57 61 73 68 69 6e 67 | 74 6f 6e 29 0d 0a 42 6c | Washing|ton)..Bl|
|00003d40| 6f 6f 64 20 37 32 3a 31 | 39 37 38 2d 31 39 38 34 |ood 72:1|978-1984|
|00003d50| 2c 20 44 65 63 65 6d 62 | 65 72 20 31 39 38 38 0d |, Decemb|er 1988.|
|00003d60| 0a 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |.-------|--------|
|00003d70| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003d80| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003d90| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003da0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 0d |--------|-------.|
|00003db0| 0a 0d 0a 41 62 73 74 72 | 61 63 74 0d 0a 0d 0a 20 |...Abstr|act.... |
|00003dc0| 20 20 20 20 54 68 65 20 | 6f 75 74 63 6f 6d 65 20 | The |outcome |
|00003dd0| 6f 66 20 48 4c 41 2d 69 | 64 65 6e 74 69 63 61 6c |of HLA-i|dentical|
|00003de0| 20 61 6c 6c 6f 67 65 6e | 65 69 63 20 6d 61 72 72 | allogen|eic marr|
|00003df0| 6f 77 20 74 72 61 6e 73 | 70 6c 61 6e 74 61 74 69 |ow trans|plantati|
|00003e00| 6f 6e 20 77 61 73 0d 0a | 61 6e 61 6c 79 7a 65 64 |on was..|analyzed|
|00003e10| 20 69 6e 20 36 36 20 70 | 61 74 69 65 6e 74 73 20 | in 66 p|atients |
|00003e20| 73 65 65 6e 20 62 65 74 | 77 65 65 6e 20 31 39 37 |seen bet|ween 197|
|00003e30| 33 20 61 6e 64 20 31 39 | 38 35 20 77 69 74 68 20 |3 and 19|85 with |
|00003e40| 63 68 72 6f 6e 69 63 20 | 6d 79 65 6c 6f 67 65 6e |chronic |myelogen|
|00003e50| 6f 75 73 0d 0a 6c 65 75 | 6b 65 6d 69 61 20 28 43 |ous..leu|kemia (C|
|00003e60| 4d 4c 29 20 69 6e 20 61 | 63 63 65 6c 65 72 61 74 |ML) in a|ccelerat|
|00003e70| 65 64 20 70 68 61 73 65 | 2e 20 20 43 79 63 6c 6f |ed phase|. Cyclo|
|00003e80| 70 68 6f 73 70 68 61 6d | 69 64 65 20 61 6e 64 20 |phospham|ide and |
|00003e90| 74 6f 74 61 6c 2d 62 6f | 64 79 0d 0a 69 72 72 61 |total-bo|dy..irra|
|00003ea0| 64 69 61 74 69 6f 6e 20 | 77 65 72 65 20 75 73 65 |diation |were use|
|00003eb0| 64 20 74 6f 20 70 72 65 | 70 61 72 65 20 70 61 74 |d to pre|pare pat|
|00003ec0| 69 65 6e 74 73 20 66 6f | 72 20 6d 61 72 72 6f 77 |ients fo|r marrow|
|00003ed0| 20 74 72 61 6e 73 70 6c | 61 6e 74 61 74 69 6f 6e | transpl|antation|
|00003ee0| 2e 0d 0a 49 6e 74 72 61 | 74 68 65 63 61 6c 20 6d |...Intra|thecal m|
|00003ef0| 65 74 68 6f 74 72 65 78 | 61 74 65 20 77 61 73 20 |ethotrex|ate was |
|00003f00| 75 73 65 64 20 74 6f 20 | 70 72 65 76 65 6e 74 20 |used to |prevent |
|00003f10| 43 4e 53 20 6c 65 75 6b | 65 6d 69 63 20 72 65 6c |CNS leuk|emic rel|
|00003f20| 61 70 73 65 2e 20 20 49 | 6e 20 61 6e 0d 0a 61 74 |apse. I|n an..at|
|00003f30| 74 65 6d 70 74 20 74 6f | 20 70 72 65 76 65 6e 74 |tempt to| prevent|
|00003f40| 20 67 72 61 66 74 2d 76 | 73 2e 2d 68 6f 73 74 20 | graft-v|s.-host |
|00003f50| 64 69 73 65 61 73 65 2c | 20 54 20 63 65 6c 6c 73 |disease,| T cells|
|00003f60| 20 77 65 72 65 20 64 65 | 70 6c 65 74 65 64 20 69 | were de|pleted i|
|00003f70| 6e 20 64 6f 6e 6f 72 0d | 0a 6d 61 72 72 6f 77 2e |n donor.|.marrow.|
|00003f80| 0d 0a 20 20 20 20 20 54 | 68 65 20 70 72 6f 6a 65 |.. T|he proje|
|00003f90| 63 74 65 64 20 35 2d 79 | 65 61 72 20 73 75 72 76 |cted 5-y|ear surv|
|00003fa0| 69 76 61 6c 20 72 61 74 | 65 20 77 61 73 20 31 38 |ival rat|e was 18|
|00003fb0| 25 2e 20 20 4d 6f 73 74 | 20 64 65 61 74 68 73 20 |%. Most| deaths |
|00003fc0| 77 65 72 65 20 72 65 6c | 61 74 65 64 20 74 6f 0d |were rel|ated to.|
|00003fd0| 0a 69 6e 74 65 72 73 74 | 69 74 69 61 6c 20 70 6e |.interst|itial pn|
|00003fe0| 65 75 6d 6f 6e 69 61 2c | 20 69 6e 66 65 63 74 69 |eumonia,| infecti|
|00003ff0| 6f 6e 2c 20 61 6e 64 20 | 72 65 6c 61 70 73 65 2e |on, and |relapse.|
|00004000| 20 20 42 6f 74 68 20 73 | 70 6c 65 6e 6f 6d 65 67 | Both s|plenomeg|
|00004010| 61 6c 79 20 61 74 20 66 | 69 72 73 74 0d 0a 64 69 |aly at f|irst..di|
|00004020| 61 67 6e 6f 73 69 73 20 | 61 6e 64 20 61 20 6c 6f |agnosis |and a lo|
|00004030| 6e 67 65 72 20 69 6e 74 | 65 72 76 61 6c 20 66 72 |nger int|erval fr|
|00004040| 6f 6d 20 64 69 61 67 6e | 6f 73 69 73 20 74 6f 20 |om diagn|osis to |
|00004050| 6d 61 72 72 6f 77 20 74 | 72 61 6e 73 70 6c 61 6e |marrow t|ransplan|
|00004060| 74 61 74 69 6f 6e 20 77 | 65 72 65 0d 0a 75 6e 66 |tation w|ere..unf|
|00004070| 61 76 6f 72 61 62 6c 65 | 20 70 72 6f 67 6e 6f 73 |avorable| prognos|
|00004080| 74 69 63 20 66 61 63 74 | 6f 72 73 2e 20 20 4c 65 |tic fact|ors. Le|
|00004090| 75 6b 65 6d 69 63 20 72 | 65 6c 61 70 73 65 20 77 |ukemic r|elapse w|
|000040a0| 61 73 20 6d 6f 72 65 20 | 6c 69 6b 65 6c 79 20 77 |as more |likely w|
|000040b0| 68 65 6e 20 6d 61 72 72 | 6f 77 0d 0a 64 65 70 6c |hen marr|ow..depl|
|000040c0| 65 74 65 64 20 6f 66 20 | 54 20 63 65 6c 6c 73 20 |eted of |T cells |
|000040d0| 77 61 73 20 75 73 65 64 | 2e 20 20 47 72 65 61 74 |was used|. Great|
|000040e0| 65 72 20 61 67 65 20 6f | 66 20 65 69 74 68 65 72 |er age o|f either|
|000040f0| 20 64 6f 6e 6f 72 20 6f | 72 20 72 65 63 69 70 69 | donor o|r recipi|
|00004100| 65 6e 74 20 77 61 73 0d | 0a 61 73 73 6f 63 69 61 |ent was.|.associa|
|00004110| 74 65 64 20 77 69 74 68 | 20 61 6e 20 69 6e 63 72 |ted with| an incr|
|00004120| 65 61 73 65 64 20 72 69 | 73 6b 20 6f 66 20 72 65 |eased ri|sk of re|
|00004130| 6c 61 70 73 65 2e 0d 0a | 20 20 20 20 20 4d 61 72 |lapse...| Mar|
|00004140| 72 6f 77 20 74 72 61 6e | 73 70 6c 61 6e 74 61 74 |row tran|splantat|
|00004150| 69 6f 6e 20 63 61 6e 6e | 6f 74 20 62 65 20 65 78 |ion cann|ot be ex|
|00004160| 70 65 63 74 65 64 20 74 | 6f 20 62 65 20 65 66 66 |pected t|o be eff|
|00004170| 65 63 74 69 76 65 20 69 | 66 20 64 65 66 65 72 72 |ective i|f deferr|
|00004180| 65 64 0d 0a 75 6e 74 69 | 6c 20 61 63 63 65 6c 65 |ed..unti|l accele|
|00004190| 72 61 74 69 6e 67 20 43 | 4d 4c 20 69 73 20 70 72 |rating C|ML is pr|
|000041a0| 65 73 65 6e 74 2e 20 20 | 4f 6c 64 65 72 20 70 61 |esent. |Older pa|
|000041b0| 74 69 65 6e 74 73 20 6d | 61 79 20 72 65 71 75 69 |tients m|ay requi|
|000041c0| 72 65 20 6d 6f 72 65 20 | 69 6e 74 65 6e 73 69 76 |re more |intensiv|
|000041d0| 65 0d 0a 63 6f 6e 64 69 | 74 69 6f 6e 69 6e 67 2c |e..condi|tioning,|
|000041e0| 20 62 75 74 20 6d 6f 72 | 74 61 6c 69 74 79 20 6d | but mor|tality m|
|000041f0| 69 67 68 74 20 69 6e 63 | 72 65 61 73 65 20 66 72 |ight inc|rease fr|
|00004200| 6f 6d 20 6f 74 68 65 72 | 20 63 61 75 73 65 73 2e |om other| causes.|
|00004210| 20 20 44 65 70 6c 65 74 | 69 6f 6e 20 6f 66 20 54 | Deplet|ion of T|
|00004220| 0d 0a 63 65 6c 6c 73 20 | 69 6e 20 74 68 65 20 64 |..cells |in the d|
|00004230| 6f 6e 6f 72 20 6d 61 72 | 72 6f 77 20 70 72 6f 62 |onor mar|row prob|
|00004240| 61 62 6c 79 20 69 73 20 | 6e 6f 74 20 77 69 73 65 |ably is |not wise|
|00004250| 20 77 68 65 6e 20 70 61 | 74 69 65 6e 74 73 20 61 | when pa|tients a|
|00004260| 72 65 20 67 69 76 65 6e | 0d 0a 74 72 61 6e 73 70 |re given|..transp|
|00004270| 6c 61 6e 74 73 20 66 6f | 72 20 43 4d 4c 2e 0d 0a |lants fo|r CML...|
|00004280| 0d 0a 50 6f 73 74 2d 43 | 6f 6d 6d 65 6e 74 0d 0a |..Post-C|omment..|
|00004290| 0d 0a 20 20 20 20 20 4d | 61 6e 79 20 70 65 6f 70 |.. M|any peop|
|000042a0| 6c 65 20 62 65 6c 69 65 | 76 65 20 74 68 61 74 20 |le belie|ve that |
|000042b0| 61 6c 6c 6f 67 65 6e 65 | 69 63 20 62 6f 6e 65 20 |allogene|ic bone |
|000042c0| 6d 61 72 72 6f 77 20 74 | 72 61 6e 73 70 6c 61 6e |marrow t|ransplan|
|000042d0| 74 61 74 69 6f 6e 20 69 | 73 20 74 68 65 0d 0a 74 |tation i|s the..t|
|000042e0| 72 65 61 74 6d 65 6e 74 | 20 6f 66 20 63 68 6f 69 |reatment| of choi|
|000042f0| 63 65 20 66 6f 72 20 43 | 4d 4c 20 69 6e 20 69 74 |ce for C|ML in it|
|00004300| 73 20 63 68 72 6f 6e 69 | 63 20 70 68 61 73 65 2c |s chroni|c phase,|
|00004310| 20 70 72 6f 76 69 64 65 | 64 20 74 68 61 74 20 61 | provide|d that a|
|00004320| 20 6d 61 74 63 68 65 64 | 0d 0a 64 6f 6e 6f 72 20 | matched|..donor |
|00004330| 69 73 20 61 76 61 69 6c | 61 62 6c 65 2e 20 20 42 |is avail|able. B|
|00004340| 75 74 20 43 4d 4c 20 69 | 73 20 6e 6f 74 20 61 20 |ut CML i|s not a |
|00004350| 73 74 61 74 69 63 20 64 | 69 73 65 61 73 65 2e 20 |static d|isease. |
|00004360| 20 46 6f 72 20 65 76 65 | 72 79 20 79 65 61 72 20 | For eve|ry year |
|00004370| 6f 66 20 74 68 65 0d 0a | 64 69 73 65 61 73 65 20 |of the..|disease |
|00004380| 74 68 65 72 65 20 69 73 | 20 61 70 70 72 6f 78 69 |there is| approxi|
|00004390| 6d 61 74 65 6c 79 20 61 | 20 32 30 25 20 63 68 61 |mately a| 20% cha|
|000043a0| 6e 63 65 20 74 68 61 74 | 20 69 74 20 77 69 6c 6c |nce that| it will|
|000043b0| 20 65 76 6f 6c 76 65 20 | 69 6e 74 6f 20 61 6e 0d | evolve |into an.|
|000043c0| 0a 61 63 63 65 6c 65 72 | 61 74 65 64 20 70 68 61 |.acceler|ated pha|
|000043d0| 73 65 20 6f 72 20 69 6e | 74 6f 20 66 72 61 6e 6b |se or in|to frank|
|000043e0| 20 62 6c 61 73 74 20 63 | 72 69 73 69 73 20 28 72 | blast c|risis (r|
|000043f0| 65 73 65 6d 62 6c 69 6e | 67 20 61 63 75 74 65 20 |esemblin|g acute |
|00004400| 6d 79 65 6c 6f 69 64 0d | 0a 6c 65 75 6b 65 6d 69 |myeloid.|.leukemi|
|00004410| 61 29 2e 20 20 54 68 69 | 73 20 63 75 72 72 65 6e |a). Thi|s curren|
|00004420| 74 20 73 74 75 64 79 2c | 20 61 6e 64 20 73 65 76 |t study,| and sev|
|00004430| 65 72 61 6c 20 6f 74 68 | 65 72 73 2c 20 68 61 76 |eral oth|ers, hav|
|00004440| 65 20 73 68 6f 77 6e 20 | 74 68 61 74 20 62 6f 6e |e shown |that bon|
|00004450| 65 0d 0a 6d 61 72 72 6f | 77 20 74 72 61 6e 73 70 |e..marro|w transp|
|00004460| 6c 61 6e 74 61 74 69 6f | 6e 20 69 73 20 6e 6f 74 |lantatio|n is not|
|00004470| 20 6e 65 61 72 6c 79 20 | 61 73 20 65 66 66 65 63 | nearly |as effec|
|00004480| 74 69 76 65 20 77 68 65 | 6e 20 74 68 65 20 64 69 |tive whe|n the di|
|00004490| 73 65 61 73 65 20 68 61 | 73 0d 0a 70 72 6f 67 72 |sease ha|s..progr|
|000044a0| 65 73 73 65 64 20 62 65 | 79 6f 6e 64 20 74 68 65 |essed be|yond the|
|000044b0| 20 63 68 72 6f 6e 69 63 | 20 70 68 61 73 65 2e 20 | chronic| phase. |
|000044c0| 20 4e 6f 74 65 20 74 68 | 61 74 20 73 75 72 76 69 | Note th|at survi|
|000044d0| 76 61 6c 20 69 6e 20 74 | 68 69 73 20 67 72 6f 75 |val in t|his grou|
|000044e0| 70 20 6f 66 0d 0a 70 61 | 74 69 65 6e 74 73 20 74 |p of..pa|tients t|
|000044f0| 72 65 61 74 65 64 20 62 | 79 20 62 6f 6e 65 20 6d |reated b|y bone m|
|00004500| 61 72 72 6f 77 20 74 72 | 61 6e 73 70 6c 61 6e 74 |arrow tr|ansplant|
|00004510| 61 74 69 6f 6e 20 77 61 | 73 20 6f 6e 6c 79 20 31 |ation wa|s only 1|
|00004520| 38 25 2e 20 20 54 68 65 | 20 63 68 61 6c 6c 65 6e |8%. The| challen|
|00004530| 67 65 2c 0d 0a 74 68 65 | 72 65 66 6f 72 65 2c 20 |ge,..the|refore, |
|00004540| 69 73 20 74 6f 20 69 64 | 65 6e 74 69 66 79 20 74 |is to id|entify t|
|00004550| 68 6f 73 65 20 70 61 74 | 69 65 6e 74 73 20 77 68 |hose pat|ients wh|
|00004560| 6f 20 61 72 65 20 6c 69 | 6b 65 6c 79 20 74 6f 20 |o are li|kely to |
|00004570| 62 65 6e 65 66 69 74 20 | 62 79 0d 0a 74 72 61 6e |benefit |by..tran|
|00004580| 73 70 6c 61 6e 74 61 74 | 69 6f 6e 20 61 6e 64 20 |splantat|ion and |
|00004590| 74 6f 20 67 69 76 65 20 | 74 68 65 6d 20 74 72 61 |to give |them tra|
|000045a0| 6e 73 70 6c 61 6e 74 73 | 20 73 75 66 66 69 63 69 |nsplants| suffici|
|000045b0| 65 6e 74 6c 79 20 65 61 | 72 6c 79 2c 20 77 68 65 |ently ea|rly, whe|
|000045c0| 6e 20 74 68 65 79 0d 0a | 61 72 65 20 73 74 69 6c |n they..|are stil|
|000045d0| 6c 20 69 6e 20 74 68 65 | 20 63 68 72 6f 6e 69 63 |l in the| chronic|
|000045e0| 20 70 68 61 73 65 20 6f | 66 20 69 6c 6c 6e 65 73 | phase o|f illnes|
|000045f0| 73 2e 2d 2d 4d 2e 4a 2e | 20 43 6c 69 6e 65 2c 20 |s.--M.J.| Cline, |
|00004600| 4d 2e 44 2e 0d 0a 24 55 | 6e 69 71 75 65 5f 49 44 |M.D...$U|nique_ID|
|00004610| 7b 59 52 42 31 31 31 30 | 34 7d 0d 0a 24 54 69 74 |{YRB1110|4}..$Tit|
|00004620| 6c 65 7b 54 68 65 20 4e | 61 74 69 6f 6e 61 6c 20 |le{The N|ational |
|00004630| 4d 61 72 72 6f 77 20 44 | 6f 6e 6f 72 20 50 72 6f |Marrow D|onor Pro|
|00004640| 67 72 61 6d 3a 20 20 48 | 6f 77 20 69 74 20 57 6f |gram: H|ow it Wo|
|00004650| 72 6b 73 2c 20 41 63 63 | 6f 6d 70 6c 69 73 68 6d |rks, Acc|omplishm|
|00004660| 65 6e 74 73 20 74 6f 20 | 44 61 74 65 7d 0d 0a 24 |ents to |Date}..$|
|00004670| 41 75 74 68 6f 72 7b 4d | 63 43 75 6c 6c 6f 75 67 |Author{M|cCulloug|
|00004680| 68 2c 20 4a 0d 0a 48 61 | 6e 73 65 6e 2c 20 4a 0d |h, J..Ha|nsen, J.|
|00004690| 0a 50 65 72 6b 69 6e 73 | 2c 20 48 0d 0a 53 74 72 |.Perkins|, H..Str|
|000046a0| 6f 6e 63 65 6b 2c 20 44 | 0d 0a 42 61 72 74 73 63 |oncek, D|..Bartsc|
|000046b0| 68 2c 20 47 7d 0d 0a 24 | 41 66 66 69 6c 69 61 74 |h, G}..$|Affiliat|
|000046c0| 69 6f 6e 7b 4e 61 74 6c | 20 4d 61 72 72 6f 77 20 |ion{Natl| Marrow |
|000046d0| 44 6f 6e 6f 72 20 50 72 | 6f 67 72 61 6d 20 43 6f |Donor Pr|ogram Co|
|000046e0| 6f 72 64 69 6e 61 74 69 | 6e 67 20 43 74 72 2c 20 |ordinati|ng Ctr, |
|000046f0| 53 74 20 50 61 75 6c 3b | 20 55 6e 69 76 20 6f 66 |St Paul;| Univ of|
|00004700| 20 4d 69 6e 6e 65 73 6f | 74 61 3b 20 46 72 65 64 | Minneso|ta; Fred|
|00004710| 20 48 75 74 63 68 69 6e | 73 6f 6e 20 43 61 6e 63 | Hutchin|son Canc|
|00004720| 65 72 20 52 65 73 65 61 | 72 63 68 20 43 74 72 2c |er Resea|rch Ctr,|
|00004730| 20 53 65 61 74 74 6c 65 | 3b 20 49 72 77 69 6e 20 | Seattle|; Irwin |
|00004740| 4d 65 6d 20 42 6c 6f 6f | 64 20 42 61 6e 6b 2c 20 |Mem Bloo|d Bank, |
|00004750| 53 61 6e 20 46 72 61 6e | 63 69 73 63 6f 7d 0d 0a |San Fran|cisco}..|
|00004760| 24 4a 6f 75 72 6e 61 6c | 7b 4f 6e 63 6f 6c 6f 67 |$Journal|{Oncolog|
|00004770| 79 7d 0d 0a 24 56 6f 6c | 75 6d 65 7b 33 7d 0d 0a |y}..$Vol|ume{3}..|
|00004780| 24 50 61 67 65 7b 36 33 | 2d 36 38 7d 0d 0a 24 44 |$Page{63|-68}..$D|
|00004790| 61 74 65 7b 46 65 62 72 | 75 61 72 79 20 31 39 38 |ate{Febr|uary 198|
|000047a0| 39 7d 0d 0a 24 59 42 56 | 6f 6c 7b 31 39 39 30 20 |9}..$YBV|ol{1990 |
|000047b0| 59 65 61 72 20 42 6f 6f | 6b 20 6f 66 20 4d 65 64 |Year Boo|k of Med|
|000047c0| 69 63 69 6e 65 7d 0d 0a | 24 43 68 61 70 74 65 72 |icine}..|$Chapter|
|000047d0| 7b 32 33 2d 38 7d 0d 0a | 24 59 42 45 64 69 74 6f |{23-8}..|$YBEdito|
|000047e0| 72 7b 44 72 73 2e 20 52 | 6f 67 65 72 73 2c 20 44 |r{Drs. R|ogers, D|
|000047f0| 65 73 20 50 72 65 7a 2c | 20 43 6c 69 6e 65 2c 20 |es Prez,| Cline, |
|00004800| 42 72 61 75 6e 77 61 6c | 64 2c 20 47 72 65 65 6e |Braunwal|d, Green|
|00004810| 62 65 72 67 65 72 2c 20 | 57 69 6c 73 6f 6e 2c 20 |berger, |Wilson, |
|00004820| 45 70 73 74 65 69 6e 2c | 20 61 6e 64 20 4d 61 6c |Epstein,| and Mal|
|00004830| 61 77 69 73 74 61 7d 0d | 0a 24 54 61 62 6c 65 7b |awista}.|.$Table{|
|00004840| 7d 0d 0a 24 43 6f 6d 6d | 65 6e 74 61 74 6f 72 7b |}..$Comm|entator{|
|00004850| 4d 2e 4a 2e 20 43 6c 69 | 6e 65 2c 20 4d 2e 44 2e |M.J. Cli|ne, M.D.|
|00004860| 7d 0d 0a 0d 0a 43 6f 70 | 79 72 69 67 68 74 20 28 |}....Cop|yright (|
|00004870| 63 29 20 59 65 61 72 62 | 6f 6f 6b 20 4d 65 64 69 |c) Yearb|ook Medi|
|00004880| 63 61 6c 20 50 75 62 6c | 69 73 68 65 72 73 2c 20 |cal Publ|ishers, |
|00004890| 49 6e 63 2e 2c 20 31 39 | 39 30 0d 0a 0d 0a 31 39 |Inc., 19|90....19|
|000048a0| 39 30 20 59 65 61 72 20 | 42 6f 6f 6b 20 6f 66 20 |90 Year |Book of |
|000048b0| 4d 65 64 69 63 69 6e 65 | 20 28 52 29 0d 0a 0d 0a |Medicine| (R)....|
|000048c0| 50 61 72 74 20 54 68 72 | 65 65 2d 2d 48 65 6d 61 |Part Thr|ee--Hema|
|000048d0| 74 6f 6c 6f 67 79 20 61 | 6e 64 20 4f 6e 63 6f 6c |tology a|nd Oncol|
|000048e0| 6f 67 79 0d 0a 0d 0a 43 | 68 61 70 74 65 72 20 32 |ogy....C|hapter 2|
|000048f0| 33 2d 2d 42 6f 6e 65 20 | 4d 61 72 72 6f 77 20 54 |3--Bone |Marrow T|
|00004900| 72 61 6e 73 70 6c 61 6e | 74 61 74 69 6f 6e 0d 0a |ransplan|tation..|
|00004910| 0d 0a 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |..------|--------|
|00004920| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004930| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004940| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004950| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004960| 0d 0a 54 68 65 20 4e 61 | 74 69 6f 6e 61 6c 20 4d |..The Na|tional M|
|00004970| 61 72 72 6f 77 20 44 6f | 6e 6f 72 20 50 72 6f 67 |arrow Do|nor Prog|
|00004980| 72 61 6d 3a 20 20 48 6f | 77 20 69 74 20 57 6f 72 |ram: Ho|w it Wor|
|00004990| 6b 73 2c 20 41 63 63 6f | 6d 70 6c 69 73 68 6d 65 |ks, Acco|mplishme|
|000049a0| 6e 74 73 20 74 6f 20 44 | 61 74 65 0d 0a 0d 0a 4d |nts to D|ate....M|
|000049b0| 63 43 75 6c 6c 6f 75 67 | 68 20 4a 3b 20 48 61 6e |cCulloug|h J; Han|
|000049c0| 73 65 6e 20 4a 3b 20 50 | 65 72 6b 69 6e 73 20 48 |sen J; P|erkins H|
|000049d0| 3b 20 53 74 72 6f 6e 63 | 65 6b 20 44 3b 20 42 61 |; Stronc|ek D; Ba|
|000049e0| 72 74 73 63 68 20 47 0d | 0a 28 4e 61 74 6c 20 4d |rtsch G.|.(Natl M|
|000049f0| 61 72 72 6f 77 20 44 6f | 6e 6f 72 20 50 72 6f 67 |arrow Do|nor Prog|
|00004a00| 72 61 6d 20 43 6f 6f 72 | 64 69 6e 61 74 69 6e 67 |ram Coor|dinating|
|00004a10| 20 43 74 72 2c 20 53 74 | 20 50 61 75 6c 3b 20 55 | Ctr, St| Paul; U|
|00004a20| 6e 69 76 20 6f 66 20 4d | 69 6e 6e 65 73 6f 74 61 |niv of M|innesota|
|00004a30| 3b 0d 0a 46 72 65 64 20 | 48 75 74 63 68 69 6e 73 |;..Fred |Hutchins|
|00004a40| 6f 6e 20 43 61 6e 63 65 | 72 20 52 65 73 65 61 72 |on Cance|r Resear|
|00004a50| 63 68 20 43 74 72 2c 20 | 53 65 61 74 74 6c 65 3b |ch Ctr, |Seattle;|
|00004a60| 20 49 72 77 69 6e 20 4d | 65 6d 20 42 6c 6f 6f 64 | Irwin M|em Blood|
|00004a70| 20 42 61 6e 6b 2c 0d 0a | 53 61 6e 20 46 72 61 6e | Bank,..|San Fran|
|00004a80| 63 69 73 63 6f 29 0d 0a | 4f 6e 63 6f 6c 6f 67 79 |cisco)..|Oncology|
|00004a90| 20 33 3a 36 33 2d 36 38 | 2c 20 46 65 62 72 75 61 | 3:63-68|, Februa|
|00004aa0| 72 79 20 31 39 38 39 0d | 0a 2d 2d 2d 2d 2d 2d 2d |ry 1989.|.-------|
|00004ab0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004ac0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004ad0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004ae0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004af0| 2d 2d 2d 2d 2d 2d 2d 0d | 0a 0d 0a 41 62 73 74 72 |-------.|...Abstr|
|00004b00| 61 63 74 0d 0a 0d 0a 20 | 20 20 20 20 4f 6e 6c 79 |act.... | Only|
|00004b10| 20 61 62 6f 75 74 20 34 | 30 25 20 6f 66 20 70 61 | about 4|0% of pa|
|00004b20| 74 69 65 6e 74 73 20 72 | 65 71 75 69 72 69 6e 67 |tients r|equiring|
|00004b30| 20 6d 61 72 72 6f 77 20 | 74 72 61 6e 73 70 6c 61 | marrow |transpla|
|00004b40| 6e 74 61 74 69 6f 6e 20 | 68 61 76 65 20 61 0d 0a |ntation |have a..|
|00004b50| 73 75 69 74 61 62 6c 65 | 20 6d 61 74 63 68 65 64 |suitable| matched|
|00004b60| 20 73 69 62 6c 69 6e 67 | 20 64 6f 6e 6f 72 2e 20 | sibling| donor. |
|00004b70| 20 48 6f 77 65 76 65 72 | 2c 20 6d 61 72 72 6f 77 | However|, marrow|
|00004b80| 20 74 72 61 6e 73 70 6c | 61 6e 74 61 74 69 6f 6e | transpl|antation|
|00004b90| 20 6e 6f 77 20 63 61 6e | 20 62 65 0d 0a 64 6f 6e | now can| be..don|
|00004ba0| 65 20 73 75 63 63 65 73 | 73 66 75 6c 6c 79 20 75 |e succes|sfully u|
|00004bb0| 73 69 6e 67 20 48 4c 41 | 2d 6d 61 74 63 68 65 64 |sing HLA|-matched|
|00004bc0| 20 75 6e 72 65 6c 61 74 | 65 64 20 64 6f 6e 6f 72 | unrelat|ed donor|
|00004bd0| 73 2e 20 20 54 68 65 20 | 4e 61 74 69 6f 6e 61 6c |s. The |National|
|00004be0| 20 4d 61 72 72 6f 77 0d | 0a 44 6f 6e 6f 72 20 50 | Marrow.|.Donor P|
|00004bf0| 72 6f 67 72 61 6d 20 28 | 4e 4d 44 50 29 20 77 61 |rogram (|NMDP) wa|
|00004c00| 73 20 65 73 74 61 62 6c | 69 73 68 65 64 20 69 6e |s establ|ished in|
|00004c10| 20 61 6e 20 61 74 74 65 | 6d 70 74 20 74 6f 20 72 | an atte|mpt to r|
|00004c20| 65 63 72 75 69 74 20 64 | 6f 6e 6f 72 73 2e 20 20 |ecruit d|onors. |
|00004c30| 54 68 65 0d 0a 4e 4d 44 | 50 20 63 75 72 72 65 6e |The..NMD|P curren|
|00004c40| 74 6c 79 20 63 6f 6e 73 | 69 73 74 73 20 6f 66 20 |tly cons|ists of |
|00004c50| 35 30 20 62 6c 6f 6f 64 | 20 62 61 6e 6b 73 20 61 |50 blood| banks a|
|00004c60| 6e 64 20 32 30 20 6d 61 | 72 72 6f 77 20 74 72 61 |nd 20 ma|rrow tra|
|00004c70| 6e 73 70 6c 61 6e 74 20 | 63 65 6e 74 65 72 73 0d |nsplant |centers.|
|00004c80| 0a 74 68 72 6f 75 67 68 | 6f 75 74 20 74 68 65 20 |.through|out the |
|00004c90| 55 6e 69 74 65 64 20 53 | 74 61 74 65 73 2e 20 20 |United S|tates. |
|00004ca0| 4d 6f 72 65 20 74 68 61 | 6e 20 32 30 2c 30 30 30 |More tha|n 20,000|
|00004cb0| 20 48 4c 41 2d 74 79 70 | 65 64 20 61 70 68 65 72 | HLA-typ|ed apher|
|00004cc0| 65 73 69 73 20 64 6f 6e | 6f 72 73 0d 0a 66 72 6f |esis don|ors..fro|
|00004cd0| 6d 20 74 68 65 20 62 6c | 6f 6f 64 20 62 61 6e 6b |m the bl|ood bank|
|00004ce0| 73 20 61 72 65 20 72 65 | 67 69 73 74 65 72 65 64 |s are re|gistered|
|00004cf0| 2e 20 20 53 75 69 74 61 | 62 6c 79 20 6d 61 74 63 |. Suita|bly matc|
|00004d00| 68 65 64 20 64 6f 6e 6f | 72 73 20 77 65 72 65 20 |hed dono|rs were |
|00004d10| 6c 6f 63 61 74 65 64 20 | 66 6f 72 0d 0a 39 39 25 |located |for..99%|
|00004d20| 20 6f 66 20 31 2c 31 31 | 36 20 70 61 74 69 65 6e | of 1,11|6 patien|
|00004d30| 74 73 2e 0d 0a 20 20 20 | 20 20 41 20 6d 61 74 63 |ts... | A matc|
|00004d40| 68 65 64 20 75 6e 72 65 | 6c 61 74 65 64 20 74 72 |hed unre|lated tr|
|00004d50| 61 6e 73 70 6c 61 6e 74 | 20 69 73 20 61 20 72 65 |ansplant| is a re|
|00004d60| 61 6c 69 73 74 69 63 20 | 61 6c 74 65 72 6e 61 74 |alistic |alternat|
|00004d70| 69 76 65 20 66 6f 72 20 | 70 61 74 69 65 6e 74 73 |ive for |patients|
|00004d80| 0d 0a 77 68 6f 20 63 61 | 6e 20 62 65 6e 65 66 69 |..who ca|n benefi|
|00004d90| 74 20 66 72 6f 6d 20 6d | 61 72 72 6f 77 20 74 72 |t from m|arrow tr|
|00004da0| 61 6e 73 70 6c 61 6e 74 | 61 74 69 6f 6e 20 62 75 |ansplant|ation bu|
|00004db0| 74 20 6c 61 63 6b 20 61 | 20 73 69 62 6c 69 6e 67 |t lack a| sibling|
|00004dc0| 20 64 6f 6e 6f 72 2e 0d | 0a 54 72 61 6e 73 70 6c | donor..|.Transpl|
|00004dd0| 61 6e 74 73 20 68 61 76 | 65 20 62 65 65 6e 20 63 |ants hav|e been c|
|00004de0| 61 72 72 69 65 64 20 6f | 75 74 20 61 74 20 38 20 |arried o|ut at 8 |
|00004df0| 63 65 6e 74 65 72 73 20 | 69 6e 20 74 68 65 20 70 |centers |in the p|
|00004e00| 72 6f 67 72 61 6d 2e 20 | 20 54 68 65 20 72 61 74 |rogram. | The rat|
|00004e10| 65 20 61 74 0d 0a 77 68 | 69 63 68 20 73 65 61 72 |e at..wh|ich sear|
|00004e20| 63 68 65 73 20 61 72 65 | 20 72 65 71 75 65 73 74 |ches are| request|
|00004e30| 65 64 20 68 61 73 20 69 | 6e 63 72 65 61 73 65 64 |ed has i|ncreased|
|00004e40| 20 73 69 6e 63 65 20 74 | 68 65 20 4e 4d 44 50 20 | since t|he NMDP |
|00004e50| 62 65 63 61 6d 65 20 6f | 70 65 72 61 74 69 6f 6e |became o|peration|
|00004e60| 61 6c 2e 0d 0a 41 62 6f | 75 74 20 6f 6e 65 20 74 |al...Abo|ut one t|
|00004e70| 68 69 72 64 20 6f 66 20 | 74 68 65 20 70 61 74 69 |hird of |the pati|
|00004e80| 65 6e 74 73 20 68 61 76 | 65 20 72 65 71 75 69 72 |ents hav|e requir|
|00004e90| 65 64 20 61 6e 20 65 78 | 74 65 6e 73 69 76 65 20 |ed an ex|tensive |
|00004ea0| 66 6f 72 6d 61 6c 20 73 | 65 61 72 63 68 2c 0d 0a |formal s|earch,..|
|00004eb0| 69 6e 63 6c 75 64 69 6e | 67 20 64 6f 6e 6f 72 20 |includin|g donor |
|00004ec0| 48 4c 41 2d 44 52 20 74 | 79 70 69 6e 67 2c 20 6d |HLA-DR t|yping, m|
|00004ed0| 69 78 65 64 20 6c 79 6d | 70 68 6f 63 79 74 65 20 |ixed lym|phocyte |
|00004ee0| 63 75 6c 74 75 72 65 20 | 74 65 73 74 69 6e 67 2c |culture |testing,|
|00004ef0| 20 61 6e 64 20 61 20 64 | 6f 6e 6f 72 0d 0a 77 6f | and a d|onor..wo|
|00004f00| 72 6b 2d 75 70 2e 0d 0a | 0d 0a 50 6f 73 74 2d 43 |rk-up...|..Post-C|
|00004f10| 6f 6d 6d 65 6e 74 0d 0a | 0d 0a 20 20 20 20 20 49 |omment..|.. I|
|00004f20| 20 69 6e 63 6c 75 64 65 | 64 20 74 68 69 73 20 61 | include|d this a|
|00004f30| 72 74 69 63 6c 65 20 74 | 6f 20 6d 61 6b 65 20 70 |rticle t|o make p|
|00004f40| 68 79 73 69 63 69 61 6e | 73 20 61 77 61 72 65 20 |hysician|s aware |
|00004f50| 74 68 61 74 20 61 20 72 | 65 73 6f 75 72 63 65 20 |that a r|esource |
|00004f60| 66 6f 72 0d 0a 69 64 65 | 6e 74 69 66 69 63 61 74 |for..ide|ntificat|
|00004f70| 69 6f 6e 20 6f 66 20 70 | 6f 74 65 6e 74 69 61 6c |ion of p|otential|
|00004f80| 20 62 6f 6e 65 20 6d 61 | 72 72 6f 77 20 64 6f 6e | bone ma|rrow don|
|00004f90| 6f 72 73 20 69 73 20 6e | 6f 77 20 61 76 61 69 6c |ors is n|ow avail|
|00004fa0| 61 62 6c 65 2e 20 20 41 | 73 20 6e 6f 74 65 64 20 |able. A|s noted |
|00004fb0| 69 6e 0d 0a 74 68 65 20 | 61 72 74 69 63 6c 65 2c |in..the |article,|
|00004fc0| 20 63 6f 6e 73 69 64 65 | 72 61 62 6c 79 20 6d 6f | conside|rably mo|
|00004fd0| 72 65 20 74 68 61 6e 20 | 68 61 6c 66 20 6f 66 20 |re than |half of |
|00004fe0| 74 68 65 20 70 61 74 69 | 65 6e 74 73 20 77 68 6f |the pati|ents who|
|00004ff0| 20 6d 69 67 68 74 20 62 | 65 6e 65 66 69 74 0d 0a | might b|enefit..|
|00005000| 66 72 6f 6d 20 61 20 62 | 6f 6e 65 20 6d 61 72 72 |from a b|one marr|
|00005010| 6f 77 20 74 72 61 6e 73 | 70 6c 61 6e 74 20 64 6f |ow trans|plant do|
|00005020| 20 6e 6f 74 20 68 61 76 | 65 20 61 6e 20 61 76 61 | not hav|e an ava|
|00005030| 69 6c 61 62 6c 65 20 66 | 61 6d 69 6c 79 20 6d 65 |ilable f|amily me|
|00005040| 6d 62 65 72 20 77 68 6f | 20 63 61 6e 0d 0a 73 65 |mber who| can..se|
|00005050| 72 76 65 20 61 73 20 61 | 20 64 6f 6e 6f 72 2e 20 |rve as a| donor. |
|00005060| 20 41 20 6d 61 74 63 68 | 65 64 2c 20 62 75 74 20 | A match|ed, but |
|00005070| 6e 6f 6e 72 65 6c 61 74 | 65 64 20 64 6f 6e 6f 72 |nonrelat|ed donor|
|00005080| 20 69 73 20 6e 6f 77 20 | 61 20 70 6f 73 73 69 62 | is now |a possib|
|00005090| 69 6c 69 74 79 2e 20 20 | 49 74 0d 0a 69 73 20 74 |ility. |It..is t|
|000050a0| 6f 6f 20 65 61 72 6c 79 | 20 74 6f 20 61 73 73 65 |oo early| to asse|
|000050b0| 73 73 20 74 68 65 20 72 | 65 73 75 6c 74 73 20 6f |ss the r|esults o|
|000050c0| 66 20 74 72 61 6e 73 70 | 6c 61 6e 74 61 74 69 6f |f transp|lantatio|
|000050d0| 6e 20 66 72 6f 6d 20 75 | 6e 72 65 6c 61 74 65 64 |n from u|nrelated|
|000050e0| 20 64 6f 6e 6f 72 73 20 | 69 6e 0d 0a 61 6c 6c 20 | donors |in..all |
|000050f0| 6f 66 20 74 68 6f 73 65 | 20 64 69 73 65 61 73 65 |of those| disease|
|00005100| 20 63 61 74 65 67 6f 72 | 69 65 73 20 66 6f 72 20 | categor|ies for |
|00005110| 77 68 69 63 68 20 62 6f | 6e 65 20 6d 61 72 72 6f |which bo|ne marro|
|00005120| 77 20 74 72 61 6e 73 70 | 6c 61 6e 74 61 74 69 6f |w transp|lantatio|
|00005130| 6e 20 69 73 20 75 73 65 | 64 2e 0d 0a 49 20 77 6f |n is use|d...I wo|
|00005140| 75 6c 64 20 67 75 65 73 | 73 20 74 68 61 74 20 61 |uld gues|s that a|
|00005150| 74 20 74 68 65 20 6d 6f | 6d 65 6e 74 20 74 68 61 |t the mo|ment tha|
|00005160| 74 20 74 68 65 20 72 65 | 73 75 6c 74 73 20 61 63 |t the re|sults ac|
|00005170| 68 69 65 76 65 64 20 77 | 69 74 68 20 6e 6f 6e 6d |hieved w|ith nonm|
|00005180| 61 74 63 68 65 64 0d 0a | 64 6f 6e 6f 72 73 20 61 |atched..|donors a|
|00005190| 72 65 20 69 6e 66 65 72 | 69 6f 72 20 74 6f 20 74 |re infer|ior to t|
|000051a0| 68 6f 73 65 20 61 63 68 | 69 65 76 65 64 20 77 69 |hose ach|ieved wi|
|000051b0| 74 68 20 61 20 66 61 6d | 69 6c 79 20 6d 65 6d 62 |th a fam|ily memb|
|000051c0| 65 72 20 64 6f 6e 6f 72 | 20 62 79 20 61 74 20 6c |er donor| by at l|
|000051d0| 65 61 73 74 0d 0a 33 30 | 25 2e 20 20 42 75 74 20 |east..30|%. But |
|000051e0| 74 68 69 73 20 69 73 20 | 62 79 20 6e 6f 20 6d 65 |this is |by no me|
|000051f0| 61 6e 73 20 61 20 68 61 | 72 64 20 66 69 67 75 72 |ans a ha|rd figur|
|00005200| 65 2c 20 61 6e 64 20 63 | 6c 65 61 72 6c 79 20 77 |e, and c|learly w|
|00005210| 65 20 73 68 6f 75 6c 64 | 20 65 78 61 6d 69 6e 65 |e should| examine|
|00005220| 20 74 68 65 0d 0a 70 6f | 74 65 6e 74 69 61 6c 73 | the..po|tentials|
|00005230| 20 6f 66 20 61 6c 6c 6f | 67 65 6e 65 69 63 2c 20 | of allo|geneic, |
|00005240| 75 6e 72 65 6c 61 74 65 | 64 20 6d 61 72 72 6f 77 |unrelate|d marrow|
|00005250| 20 74 72 61 6e 73 70 6c | 61 6e 74 73 20 69 6e 20 | transpl|ants in |
|00005260| 74 68 65 20 66 75 74 75 | 72 65 2e 2d 2d 4d 2e 4a |the futu|re.--M.J|
|00005270| 2e 0d 0a 43 6c 69 6e 65 | 2c 20 4d 2e 44 2e 0d 0a |...Cline|, M.D...|
|00005280| 24 55 6e 69 71 75 65 5f | 49 44 7b 59 52 42 31 31 |$Unique_|ID{YRB11|
|00005290| 31 30 35 7d 0d 0a 24 54 | 69 74 6c 65 7b 52 65 67 |105}..$T|itle{Reg|
|000052a0| 69 6d 65 6e 2d 52 65 6c | 61 74 65 64 20 54 6f 78 |imen-Rel|ated Tox|
|000052b0| 69 63 69 74 79 20 69 6e | 20 50 61 74 69 65 6e 74 |icity in| Patient|
|000052c0| 73 20 55 6e 64 65 72 67 | 6f 69 6e 67 20 42 6f 6e |s Underg|oing Bon|
|000052d0| 65 20 4d 61 72 72 6f 77 | 20 54 72 61 6e 73 70 6c |e Marrow| Transpl|
|000052e0| 61 6e 74 61 74 69 6f 6e | 7d 0d 0a 24 41 75 74 68 |antation|}..$Auth|
|000052f0| 6f 72 7b 42 65 61 72 6d | 61 6e 2c 20 53 49 0d 0a |or{Bearm|an, SI..|
|00005300| 41 70 70 65 6c 62 61 75 | 6d 2c 20 46 52 0d 0a 42 |Appelbau|m, FR..B|
|00005310| 75 63 6b 6e 65 72 2c 20 | 43 44 0d 0a 50 65 74 65 |uckner, |CD..Pete|
|00005320| 72 73 65 6e 2c 20 46 42 | 0d 0a 46 69 73 68 65 72 |rsen, FB|..Fisher|
|00005330| 2c 20 4c 44 0d 0a 43 6c | 69 66 74 2c 20 52 41 0d |, LD..Cl|ift, RA.|
|00005340| 0a 54 68 6f 6d 61 73 20 | 45 44 7d 0d 0a 24 41 66 |.Thomas |ED}..$Af|
|00005350| 66 69 6c 69 61 74 69 6f | 6e 7b 46 72 65 64 20 48 |filiatio|n{Fred H|
|00005360| 75 74 63 68 69 6e 73 6f | 6e 20 43 61 6e 63 65 72 |utchinso|n Cancer|
|00005370| 20 52 65 73 65 61 72 63 | 68 20 43 74 72 2c 20 53 | Researc|h Ctr, S|
|00005380| 65 61 74 74 6c 65 3b 20 | 55 6e 69 76 20 6f 66 20 |eattle; |Univ of |
|00005390| 57 61 73 68 69 6e 67 74 | 6f 6e 7d 0d 0a 24 4a 6f |Washingt|on}..$Jo|
|000053a0| 75 72 6e 61 6c 7b 4a 20 | 43 6c 69 6e 20 4f 6e 63 |urnal{J |Clin Onc|
|000053b0| 6f 6c 7d 0d 0a 24 56 6f | 6c 75 6d 65 7b 36 7d 0d |ol}..$Vo|lume{6}.|
|000053c0| 0a 24 50 61 67 65 7b 31 | 35 36 32 2d 31 35 36 38 |.$Page{1|562-1568|
|000053d0| 7d 0d 0a 24 44 61 74 65 | 7b 4f 63 74 6f 62 65 72 |}..$Date|{October|
|000053e0| 20 31 39 38 38 7d 0d 0a | 24 59 42 56 6f 6c 7b 31 | 1988}..|$YBVol{1|
|000053f0| 39 39 30 20 59 65 61 72 | 20 42 6f 6f 6b 20 6f 66 |990 Year| Book of|
|00005400| 20 4d 65 64 69 63 69 6e | 65 7d 0d 0a 24 43 68 61 | Medicin|e}..$Cha|
|00005410| 70 74 65 72 7b 32 33 2d | 39 7d 0d 0a 24 59 42 45 |pter{23-|9}..$YBE|
|00005420| 64 69 74 6f 72 7b 44 72 | 73 2e 20 52 6f 67 65 72 |ditor{Dr|s. Roger|
|00005430| 73 2c 20 44 65 73 20 50 | 72 65 7a 2c 20 43 6c 69 |s, Des P|rez, Cli|
|00005440| 6e 65 2c 20 42 72 61 75 | 6e 77 61 6c 64 2c 20 47 |ne, Brau|nwald, G|
|00005450| 72 65 65 6e 62 65 72 67 | 65 72 2c 20 57 69 6c 73 |reenberg|er, Wils|
|00005460| 6f 6e 2c 20 45 70 73 74 | 65 69 6e 2c 20 61 6e 64 |on, Epst|ein, and|
|00005470| 20 4d 61 6c 61 77 69 73 | 74 61 7d 0d 0a 24 54 61 | Malawis|ta}..$Ta|
|00005480| 62 6c 65 7b 7d 0d 0a 24 | 43 6f 6d 6d 65 6e 74 61 |ble{}..$|Commenta|
|00005490| 74 6f 72 7b 4d 2e 4a 2e | 20 43 6c 69 6e 65 2c 20 |tor{M.J.| Cline, |
|000054a0| 4d 2e 44 2e 7d 0d 0a 0d | 0a 43 6f 70 79 72 69 67 |M.D.}...|.Copyrig|
|000054b0| 68 74 20 28 63 29 20 59 | 65 61 72 62 6f 6f 6b 20 |ht (c) Y|earbook |
|000054c0| 4d 65 64 69 63 61 6c 20 | 50 75 62 6c 69 73 68 65 |Medical |Publishe|
|000054d0| 72 73 2c 20 49 6e 63 2e | 2c 20 31 39 39 30 0d 0a |rs, Inc.|, 1990..|
|000054e0| 0d 0a 31 39 39 30 20 59 | 65 61 72 20 42 6f 6f 6b |..1990 Y|ear Book|
|000054f0| 20 6f 66 20 4d 65 64 69 | 63 69 6e 65 20 28 52 29 | of Medi|cine (R)|
|00005500| 0d 0a 0d 0a 50 61 72 74 | 20 54 68 72 65 65 2d 2d |....Part| Three--|
|00005510| 48 65 6d 61 74 6f 6c 6f | 67 79 20 61 6e 64 20 4f |Hematolo|gy and O|
|00005520| 6e 63 6f 6c 6f 67 79 0d | 0a 0d 0a 43 68 61 70 74 |ncology.|...Chapt|
|00005530| 65 72 20 32 33 2d 2d 42 | 6f 6e 65 20 4d 61 72 72 |er 23--B|one Marr|
|00005540| 6f 77 20 54 72 61 6e 73 | 70 6c 61 6e 74 61 74 69 |ow Trans|plantati|
|00005550| 6f 6e 0d 0a 0d 0a 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |on....--|--------|
|00005560| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005570| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005580| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005590| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000055a0| 2d 2d 2d 2d 0d 0a 52 65 | 67 69 6d 65 6e 2d 52 65 |----..Re|gimen-Re|
|000055b0| 6c 61 74 65 64 20 54 6f | 78 69 63 69 74 79 20 69 |lated To|xicity i|
|000055c0| 6e 20 50 61 74 69 65 6e | 74 73 20 55 6e 64 65 72 |n Patien|ts Under|
|000055d0| 67 6f 69 6e 67 20 42 6f | 6e 65 20 4d 61 72 72 6f |going Bo|ne Marro|
|000055e0| 77 20 54 72 61 6e 73 70 | 6c 61 6e 74 61 74 69 6f |w Transp|lantatio|
|000055f0| 6e 0d 0a 0d 0a 42 65 61 | 72 6d 61 6e 20 53 49 3b |n....Bea|rman SI;|
|00005600| 20 41 70 70 65 6c 62 61 | 75 6d 20 46 52 3b 20 42 | Appelba|um FR; B|
|00005610| 75 63 6b 6e 65 72 20 43 | 44 3b 20 50 65 74 65 72 |uckner C|D; Peter|
|00005620| 73 65 6e 20 46 42 3b 20 | 46 69 73 68 65 72 20 4c |sen FB; |Fisher L|
|00005630| 44 3b 20 43 6c 69 66 74 | 20 52 41 3b 0d 0a 54 68 |D; Clift| RA;..Th|
|00005640| 6f 6d 61 73 20 45 44 0d | 0a 28 46 72 65 64 20 48 |omas ED.|.(Fred H|
|00005650| 75 74 63 68 69 6e 73 6f | 6e 20 43 61 6e 63 65 72 |utchinso|n Cancer|
|00005660| 20 52 65 73 65 61 72 63 | 68 20 43 74 72 2c 20 53 | Researc|h Ctr, S|
|00005670| 65 61 74 74 6c 65 3b 20 | 55 6e 69 76 20 6f 66 20 |eattle; |Univ of |
|00005680| 57 61 73 68 69 6e 67 74 | 6f 6e 29 0d 0a 4a 20 43 |Washingt|on)..J C|
|00005690| 6c 69 6e 20 4f 6e 63 6f | 6c 20 36 3a 31 35 36 32 |lin Onco|l 6:1562|
|000056a0| 2d 31 35 36 38 2c 20 4f | 63 74 6f 62 65 72 20 31 |-1568, O|ctober 1|
|000056b0| 39 38 38 0d 0a 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |988..---|--------|
|000056c0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000056d0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000056e0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000056f0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005700| 2d 2d 2d 0d 0a 0d 0a 41 | 62 73 74 72 61 63 74 0d |---....A|bstract.|
|00005710| 0a 0d 0a 20 20 20 20 20 | 44 65 61 74 68 20 72 65 |... |Death re|
|00005720| 73 75 6c 74 73 20 66 72 | 6f 6d 20 72 65 67 69 6d |sults fr|om regim|
|00005730| 65 6e 2d 72 65 6c 61 74 | 65 64 20 74 6f 78 69 63 |en-relat|ed toxic|
|00005740| 69 74 79 20 28 52 52 54 | 29 20 69 6e 20 6d 61 6e |ity (RRT|) in man|
|00005750| 79 20 70 61 74 69 65 6e | 74 73 20 77 68 6f 0d 0a |y patien|ts who..|
|00005760| 68 61 76 65 20 62 6f 6e | 65 20 6d 61 72 72 6f 77 |have bon|e marrow|
|00005770| 20 74 72 61 6e 73 70 6c | 61 6e 74 61 74 69 6f 6e | transpl|antation|
|00005780| 2e 20 20 41 20 6d 61 6a | 6f 72 20 67 6f 61 6c 20 |. A maj|or goal |
|00005790| 69 6e 20 74 68 65 20 64 | 65 76 65 6c 6f 70 6d 65 |in the d|evelopme|
|000057a0| 6e 74 20 6f 66 0d 0a 74 | 72 65 61 74 6d 65 6e 74 |nt of..t|reatment|
|000057b0| 20 69 73 20 61 20 6c 65 | 73 73 20 74 6f 78 69 63 | is a le|ss toxic|
|000057c0| 20 63 68 65 6d 6f 72 61 | 64 69 6f 74 68 65 72 61 | chemora|diothera|
|000057d0| 70 79 20 70 72 65 70 61 | 72 61 74 69 76 65 20 70 |py prepa|rative p|
|000057e0| 72 6f 63 65 64 75 72 65 | 2e 20 20 41 20 6e 65 77 |rocedure|. A new|
|000057f0| 0d 0a 6d 65 74 68 6f 64 | 20 6f 66 20 67 72 61 64 |..method| of grad|
|00005800| 69 6e 67 20 74 6f 78 69 | 63 69 74 79 20 63 61 75 |ing toxi|city cau|
|00005810| 73 65 64 20 62 79 20 74 | 68 65 20 74 72 61 6e 73 |sed by t|he trans|
|00005820| 70 6c 61 6e 74 20 72 65 | 67 69 6d 65 6e 20 77 61 |plant re|gimen wa|
|00005830| 73 20 75 73 65 64 0d 0a | 72 65 74 72 6f 73 70 65 |s used..|retrospe|
|00005840| 63 74 69 76 65 6c 79 20 | 74 6f 20 61 6e 61 6c 79 |ctively |to analy|
|00005850| 7a 65 20 31 39 35 20 74 | 72 61 6e 73 70 6c 61 6e |ze 195 t|ransplan|
|00005860| 74 61 74 69 6f 6e 20 70 | 61 74 69 65 6e 74 73 20 |tation p|atients |
|00005870| 74 6f 20 63 6f 6e 66 69 | 72 6d 20 74 68 65 0d 0a |to confi|rm the..|
|00005880| 76 61 6c 69 64 69 74 79 | 20 6f 66 20 74 68 65 20 |validity| of the |
|00005890| 67 72 61 64 69 6e 67 20 | 73 79 73 74 65 6d 2e 0d |grading |system..|
|000058a0| 0a 20 20 20 20 20 54 68 | 65 20 70 61 74 69 65 6e |. Th|e patien|
|000058b0| 74 73 20 72 65 63 65 69 | 76 65 64 20 74 72 61 6e |ts recei|ved tran|
|000058c0| 73 70 6c 61 6e 74 73 20 | 66 6f 72 20 6c 65 75 6b |splants |for leuk|
|000058d0| 65 6d 69 61 20 75 73 69 | 6e 67 20 6d 61 74 63 68 |emia usi|ng match|
|000058e0| 65 64 2c 20 6d 69 73 6d | 61 74 63 68 65 64 2c 0d |ed, mism|atched,.|
|000058f0| 0a 6f 72 20 61 75 74 6f | 6c 6f 67 6f 75 73 20 62 |.or auto|logous b|
|00005900| 6f 6e 65 20 6d 61 72 72 | 6f 77 2c 20 31 32 2e 30 |one marr|ow, 12.0|
|00005910| 20 47 79 20 6f 72 20 31 | 35 2e 37 35 20 47 79 20 | Gy or 1|5.75 Gy |
|00005920| 74 6f 74 61 6c 20 62 6f | 64 79 20 69 72 72 61 64 |total bo|dy irrad|
|00005930| 69 61 74 69 6f 6e 2c 20 | 61 6e 64 0d 0a 76 61 72 |iation, |and..var|
|00005940| 69 6f 75 73 20 70 6f 73 | 74 67 72 61 66 74 69 6e |ious pos|tgraftin|
|00005950| 67 20 69 6d 6d 75 6e 6f | 73 75 70 70 72 65 73 73 |g immuno|suppress|
|00005960| 69 76 65 20 74 68 65 72 | 61 70 69 65 73 2e 20 20 |ive ther|apies. |
|00005970| 4c 65 76 65 6c 73 20 6f | 66 20 52 52 54 20 77 65 |Levels o|f RRT we|
|00005980| 72 65 20 67 72 61 64 65 | 64 0d 0a 69 6e 20 38 20 |re grade|d..in 8 |
|00005990| 6f 72 67 61 6e 73 3a 20 | 20 68 65 61 72 74 2c 20 |organs: | heart, |
|000059a0| 6c 75 6e 67 73 2c 20 62 | 6c 61 64 64 65 72 2c 20 |lungs, b|ladder, |
|000059b0| 6b 69 64 6e 65 79 73 2c | 20 6c 69 76 65 72 2c 20 |kidneys,| liver, |
|000059c0| 6d 75 63 6f 73 61 2c 20 | 43 4e 53 2c 20 61 6e 64 |mucosa, |CNS, and|
|000059d0| 20 67 75 74 2e 0d 0a 52 | 65 67 69 6d 65 6e 2d 72 | gut...R|egimen-r|
|000059e0| 65 6c 61 74 65 64 20 74 | 6f 78 69 63 69 74 79 20 |elated t|oxicity |
|000059f0| 77 61 73 20 63 6c 61 73 | 73 69 66 69 65 64 20 66 |was clas|sified f|
|00005a00| 72 6f 6d 20 30 20 28 6e | 6f 20 74 6f 78 69 63 69 |rom 0 (n|o toxici|
|00005a10| 74 79 29 20 74 6f 20 49 | 56 20 28 66 61 74 61 6c |ty) to I|V (fatal|
|00005a20| 29 2e 0d 0a 20 20 20 20 | 20 47 72 61 64 65 20 49 |)... | Grade I|
|00005a30| 20 52 52 54 20 64 65 76 | 65 6c 6f 70 65 64 20 69 | RRT dev|eloped i|
|00005a40| 6e 20 61 74 20 6c 65 61 | 73 74 20 31 20 6f 72 67 |n at lea|st 1 org|
|00005a50| 61 6e 20 73 79 73 74 65 | 6d 20 6f 66 20 65 61 63 |an syste|m of eac|
|00005a60| 68 20 70 61 74 69 65 6e | 74 2e 20 20 4d 6f 72 65 |h patien|t. More|
|00005a70| 0d 0a 67 72 61 64 65 73 | 20 49 49 49 2d 49 56 20 |..grades| III-IV |
|00005a80| 74 6f 78 69 63 69 74 79 | 20 64 65 76 65 6c 6f 70 |toxicity| develop|
|00005a90| 65 64 20 69 6e 20 70 61 | 74 69 65 6e 74 73 20 69 |ed in pa|tients i|
|00005aa0| 6e 20 72 65 6c 61 70 73 | 65 20 74 68 61 6e 20 69 |n relaps|e than i|
|00005ab0| 6e 20 74 68 6f 73 65 20 | 69 6e 0d 0a 72 65 6d 69 |n those |in..remi|
|00005ac0| 73 73 69 6f 6e 2e 20 20 | 53 65 76 65 72 65 20 74 |ssion. |Severe t|
|00005ad0| 6f 78 69 63 69 74 79 20 | 77 61 73 20 61 73 73 6f |oxicity |was asso|
|00005ae0| 63 69 61 74 65 64 20 77 | 69 74 68 20 74 68 65 20 |ciated w|ith the |
|00005af0| 68 69 67 68 65 72 20 72 | 61 64 69 61 74 69 6f 6e |higher r|adiation|
|00005b00| 20 64 6f 73 65 20 61 6e | 64 0d 0a 77 69 74 68 20 | dose an|d..with |
|00005b10| 74 68 65 20 63 6f 6d 62 | 69 6e 61 74 69 6f 6e 20 |the comb|ination |
|00005b20| 6f 66 20 63 79 63 6c 6f | 73 70 6f 72 69 6e 65 20 |of cyclo|sporine |
|00005b30| 61 6e 64 20 6d 65 74 68 | 6f 74 72 65 78 61 74 65 |and meth|otrexate|
|00005b40| 2e 20 20 47 72 61 64 65 | 73 20 49 49 49 2d 49 56 |. Grade|s III-IV|
|00005b50| 20 74 6f 78 69 63 69 74 | 79 0d 0a 64 69 64 20 6e | toxicit|y..did n|
|00005b60| 6f 74 20 61 70 70 65 61 | 72 20 69 6e 20 61 75 74 |ot appea|r in aut|
|00005b70| 6f 6c 6f 67 6f 75 73 20 | 6d 61 72 72 6f 77 20 72 |ologous |marrow r|
|00005b80| 65 63 69 70 69 65 6e 74 | 73 2e 0d 0a 20 20 20 20 |ecipient|s... |
|00005b90| 20 4d 6f 73 74 20 74 6f | 78 69 63 69 74 79 20 77 | Most to|xicity w|
|00005ba0| 61 73 20 6d 69 6c 64 20 | 74 6f 20 6d 6f 64 65 72 |as mild |to moder|
|00005bb0| 61 74 65 20 61 6e 64 20 | 77 61 73 20 66 6f 75 6e |ate and |was foun|
|00005bc0| 64 20 69 6e 20 74 68 65 | 20 6c 69 76 65 72 2c 20 |d in the| liver, |
|00005bd0| 6d 6f 75 74 68 2c 20 61 | 6e 64 0d 0a 67 61 73 74 |mouth, a|nd..gast|
|00005be0| 72 6f 69 6e 74 65 73 74 | 69 6e 61 6c 20 74 72 61 |rointest|inal tra|
|00005bf0| 63 74 2e 20 20 47 72 61 | 64 65 73 20 49 49 49 2d |ct. Gra|des III-|
|00005c00| 49 56 20 74 6f 78 69 63 | 69 74 79 20 6f 63 63 75 |IV toxic|ity occu|
|00005c10| 72 72 65 64 20 6d 6f 73 | 74 20 66 72 65 71 75 65 |rred mos|t freque|
|00005c20| 6e 74 6c 79 20 69 6e 0d | 0a 74 68 65 20 6c 69 76 |ntly in.|.the liv|
|00005c30| 65 72 2c 20 6b 69 64 6e | 65 79 73 2c 20 61 6e 64 |er, kidn|eys, and|
|00005c40| 20 6c 75 6e 67 73 2e 20 | 20 41 6c 6c 20 6f 66 20 | lungs. | All of |
|00005c50| 74 68 65 20 31 37 20 70 | 61 74 69 65 6e 74 73 20 |the 17 p|atients |
|00005c60| 77 69 74 68 20 67 72 61 | 64 65 73 20 49 49 49 20 |with gra|des III |
|00005c70| 61 6e 64 20 49 56 0d 0a | 6c 69 76 65 72 20 74 6f |and IV..|liver to|
|00005c80| 78 69 63 69 74 79 20 64 | 69 65 64 20 77 69 74 68 |xicity d|ied with|
|00005c90| 69 6e 20 31 30 30 20 64 | 61 79 73 2e 20 20 53 75 |in 100 d|ays. Su|
|00005ca0| 72 76 69 76 61 6c 20 61 | 74 20 31 30 30 20 64 61 |rvival a|t 100 da|
|00005cb0| 79 73 20 63 6f 72 72 65 | 6c 61 74 65 64 20 77 69 |ys corre|lated wi|
|00005cc0| 74 68 20 74 68 65 0d 0a | 6c 65 76 65 6c 20 6f 66 |th the..|level of|
|00005cd0| 20 74 6f 78 69 63 69 74 | 79 2e 20 20 50 61 74 69 | toxicit|y. Pati|
|00005ce0| 65 6e 74 73 20 77 69 74 | 68 20 67 72 61 64 65 20 |ents wit|h grade |
|00005cf0| 49 20 74 6f 78 69 63 69 | 74 79 20 68 61 64 20 61 |I toxici|ty had a|
|00005d00| 20 31 30 30 2d 64 61 79 | 20 73 75 72 76 69 76 61 | 100-day| surviva|
|00005d10| 6c 20 72 61 74 65 0d 0a | 6f 66 20 38 35 25 2c 20 |l rate..|of 85%, |
|00005d20| 77 68 65 72 65 61 73 20 | 6f 6e 6c 79 20 31 30 2e |whereas |only 10.|
|00005d30| 35 25 20 6f 66 20 74 68 | 6f 73 65 20 77 69 74 68 |5% of th|ose with|
|00005d40| 20 67 72 61 64 65 20 49 | 49 49 20 74 6f 78 69 63 | grade I|II toxic|
|00005d50| 69 74 79 20 77 65 72 65 | 20 61 6c 69 76 65 20 61 |ity were| alive a|
|00005d60| 74 20 31 30 30 0d 0a 64 | 61 79 73 2e 20 20 41 75 |t 100..d|ays. Au|
|00005d70| 74 6f 6c 6f 67 6f 75 73 | 20 6d 61 72 72 6f 77 20 |tologous| marrow |
|00005d80| 72 65 63 69 70 69 65 6e | 74 73 20 68 61 64 20 61 |recipien|ts had a|
|00005d90| 6c 6d 6f 73 74 20 74 77 | 69 63 65 20 74 68 65 20 |lmost tw|ice the |
|00005da0| 31 30 30 2d 64 61 79 20 | 73 75 72 76 69 76 61 6c |100-day |survival|
|00005db0| 20 72 61 74 65 0d 0a 6f | 66 20 6d 69 73 6d 61 74 | rate..o|f mismat|
|00005dc0| 63 68 65 64 20 6d 61 72 | 72 6f 77 20 72 65 63 69 |ched mar|row reci|
|00005dd0| 70 69 65 6e 74 73 2e 0d | 0a 20 20 20 20 20 49 6e |pients..|. In|
|00005de0| 20 61 20 6d 75 6c 74 69 | 76 61 72 69 61 74 65 20 | a multi|variate |
|00005df0| 61 6e 61 6c 79 73 69 73 | 2c 20 74 68 65 20 6f 6e |analysis|, the on|
|00005e00| 6c 79 20 73 69 67 6e 69 | 66 69 63 61 6e 74 20 76 |ly signi|ficant v|
|00005e10| 61 72 69 61 62 6c 65 73 | 20 77 65 72 65 20 72 65 |ariables| were re|
|00005e20| 63 65 69 76 69 6e 67 0d | 0a 61 75 74 6f 6c 6f 67 |ceiving.|.autolog|
|00005e30| 6f 75 73 20 6d 61 72 72 | 6f 77 20 61 6e 64 20 31 |ous marr|ow and 1|
|00005e40| 32 2e 30 20 47 79 20 6f | 66 20 74 6f 74 61 6c 20 |2.0 Gy o|f total |
|00005e50| 62 6f 64 79 20 69 72 72 | 61 64 69 61 74 69 6f 6e |body irr|adiation|
|00005e60| 2e 20 20 42 65 63 61 75 | 73 65 20 6f 74 68 65 72 |. Becau|se other|
|00005e70| 0d 0a 66 61 63 74 6f 72 | 73 20 77 65 72 65 20 69 |..factor|s were i|
|00005e80| 6d 70 6f 72 74 61 6e 74 | 20 69 6e 20 75 6e 69 76 |mportant| in univ|
|00005e90| 61 72 69 61 74 65 20 61 | 6e 61 6c 79 73 69 73 2c |ariate a|nalysis,|
|00005ea0| 20 69 6e 74 65 72 70 72 | 65 74 61 74 69 6f 6e 20 | interpr|etation |
|00005eb0| 6f 66 20 74 6f 78 69 63 | 69 74 79 0d 0a 74 72 69 |of toxic|ity..tri|
|00005ec0| 61 6c 73 20 73 68 6f 75 | 6c 64 20 74 61 6b 65 20 |als shou|ld take |
|00005ed0| 69 6e 74 6f 20 61 63 63 | 6f 75 6e 74 20 74 68 65 |into acc|ount the|
|00005ee0| 20 63 61 74 65 67 6f 72 | 69 65 73 20 6f 66 20 70 | categor|ies of p|
|00005ef0| 61 74 69 65 6e 74 73 20 | 74 72 65 61 74 65 64 2e |atients |treated.|
|00005f00| 20 20 54 68 65 0d 0a 73 | 79 73 74 65 6d 20 64 65 | The..s|ystem de|
|00005f10| 73 63 72 69 62 65 64 20 | 67 65 6e 65 72 61 6c 6c |scribed |generall|
|00005f20| 79 20 77 61 73 20 61 62 | 6c 65 20 74 6f 20 64 69 |y was ab|le to di|
|00005f30| 73 74 69 6e 67 75 69 73 | 68 20 52 52 54 20 66 72 |stinguis|h RRT fr|
|00005f40| 6f 6d 20 6f 74 68 65 72 | 20 74 79 70 65 73 20 6f |om other| types o|
|00005f50| 66 0d 0a 74 6f 78 69 63 | 69 74 79 2e 0d 0a 0d 0a |f..toxic|ity.....|
|00005f60| 50 6f 73 74 2d 43 6f 6d | 6d 65 6e 74 0d 0a 0d 0a |Post-Com|ment....|
|00005f70| 20 20 20 20 20 54 68 69 | 73 20 69 73 20 74 68 65 | Thi|s is the|
|00005f80| 20 6c 61 73 74 20 6f 66 | 20 74 68 65 20 61 72 74 | last of| the art|
|00005f90| 69 63 6c 65 73 20 49 20 | 68 61 76 65 20 73 65 6c |icles I |have sel|
|00005fa0| 65 63 74 65 64 20 6f 6e | 20 62 6f 6e 65 20 6d 61 |ected on| bone ma|
|00005fb0| 72 72 6f 77 0d 0a 74 72 | 61 6e 73 70 6c 61 6e 74 |rrow..tr|ansplant|
|00005fc0| 61 74 69 6f 6e 2e 20 20 | 41 70 70 72 6f 70 72 69 |ation. |Appropri|
|00005fd0| 61 74 65 6c 79 2c 20 69 | 74 20 69 73 20 63 6f 6e |ately, i|t is con|
|00005fe0| 63 65 72 6e 65 64 20 77 | 69 74 68 20 74 6f 78 69 |cerned w|ith toxi|
|00005ff0| 63 69 74 79 2e 20 20 49 | 20 77 6f 75 6c 64 20 6e |city. I| would n|
|00006000| 6f 74 0d 0a 77 61 6e 74 | 20 74 68 65 20 72 65 61 |ot..want| the rea|
|00006010| 64 65 72 73 20 74 6f 20 | 74 68 69 6e 6b 20 74 68 |ders to |think th|
|00006020| 61 74 20 74 68 65 20 72 | 65 73 75 6c 74 73 20 61 |at the r|esults a|
|00006030| 63 68 69 65 76 65 64 20 | 62 79 20 62 6f 6e 65 20 |chieved |by bone |
|00006040| 6d 61 72 72 6f 77 0d 0a | 74 72 61 6e 73 70 6c 61 |marrow..|transpla|
|00006050| 6e 74 61 74 69 6f 6e 20 | 64 6f 20 6e 6f 74 20 68 |ntation |do not h|
|00006060| 61 76 65 20 61 20 68 69 | 67 68 20 70 72 69 63 65 |ave a hi|gh price|
|00006070| 20 74 61 67 2e 20 20 54 | 68 69 73 20 70 72 69 63 | tag. T|his pric|
|00006080| 65 20 74 61 67 20 69 6e | 63 6c 75 64 65 73 0d 0a |e tag in|cludes..|
|00006090| 6d 6f 72 62 69 64 69 74 | 79 20 61 6e 64 20 6d 6f |morbidit|y and mo|
|000060a0| 72 74 61 6c 69 74 79 20 | 61 73 20 77 65 6c 6c 20 |rtality |as well |
|000060b0| 61 73 20 64 6f 6c 6c 61 | 72 73 2e 20 20 4c 65 74 |as dolla|rs. Let|
|000060c0| 20 6d 65 20 70 72 6f 76 | 69 64 65 20 61 20 66 65 | me prov|ide a fe|
|000060d0| 77 20 65 78 61 6d 70 6c | 65 73 20 6f 66 0d 0a 74 |w exampl|es of..t|
|000060e0| 68 65 20 63 61 74 65 67 | 6f 72 69 65 73 20 6f 66 |he categ|ories of|
|000060f0| 20 74 6f 78 69 63 69 74 | 79 20 74 68 61 74 20 77 | toxicit|y that w|
|00006100| 65 72 65 20 63 61 74 61 | 6c 6f 67 65 64 20 69 6e |ere cata|loged in|
|00006110| 20 74 68 69 73 20 72 65 | 70 6f 72 74 3a 20 20 28 | this re|port: (|
|00006120| 31 29 20 43 61 72 64 69 | 61 63 0d 0a 74 6f 78 69 |1) Cardi|ac..toxi|
|00006130| 63 69 74 79 20 76 61 72 | 69 65 64 20 66 72 6f 6d |city var|ied from|
|00006140| 20 6d 69 6c 64 20 45 43 | 47 20 61 62 6e 6f 72 6d | mild EC|G abnorm|
|00006150| 61 6c 69 74 69 65 73 20 | 74 6f 20 73 65 76 65 72 |alities |to sever|
|00006160| 65 20 45 43 47 20 61 62 | 6e 6f 72 6d 61 6c 69 74 |e ECG ab|normalit|
|00006170| 69 65 73 2c 20 77 69 74 | 68 0d 0a 6e 6f 20 6f 72 |ies, wit|h..no or|
|00006180| 20 6f 6e 6c 79 20 70 61 | 72 74 69 61 6c 20 72 65 | only pa|rtial re|
|00006190| 73 70 6f 6e 73 65 20 74 | 6f 20 6d 65 64 69 63 61 |sponse t|o medica|
|000061a0| 6c 20 69 6e 74 65 72 76 | 65 6e 74 69 6f 6e 2e 20 |l interv|ention. |
|000061b0| 20 49 74 20 61 6c 73 6f | 20 69 6e 63 6c 75 64 65 | It also| include|
|000061c0| 64 20 68 65 61 72 74 0d | 0a 66 61 69 6c 75 72 65 |d heart.|.failure|
|000061d0| 2e 20 20 28 32 29 20 53 | 65 76 65 72 65 20 62 6c |. (2) S|evere bl|
|000061e0| 61 64 64 65 72 20 74 6f | 78 69 63 69 74 79 20 69 |adder to|xicity i|
|000061f0| 6e 63 6c 75 64 65 64 20 | 68 65 6d 6f 72 72 68 61 |ncluded |hemorrha|
|00006200| 67 69 63 20 63 79 73 74 | 69 74 69 73 20 77 69 74 |gic cyst|itis wit|
|00006210| 68 20 66 72 61 6e 6b 0d | 0a 62 6c 6f 6f 64 2c 20 |h frank.|.blood, |
|00006220| 6e 65 63 65 73 73 69 74 | 61 74 69 6e 67 20 69 6e |necessit|ating in|
|00006230| 76 61 73 69 76 65 20 6c | 6f 63 61 6c 20 69 6e 74 |vasive l|ocal int|
|00006240| 65 72 76 65 6e 74 69 6f | 6e 2c 20 6e 65 70 68 72 |erventio|n, nephr|
|00006250| 6f 73 74 6f 6d 79 2c 20 | 6f 72 20 6f 74 68 65 72 |ostomy, |or other|
|00006260| 0d 0a 73 75 72 67 69 63 | 61 6c 20 70 72 6f 63 65 |..surgic|al proce|
|00006270| 64 75 72 65 73 2e 20 20 | 28 33 29 20 53 65 76 65 |dures. |(3) Seve|
|00006280| 72 65 20 72 65 6e 61 6c | 20 74 6f 78 69 63 69 74 |re renal| toxicit|
|00006290| 79 20 72 65 71 75 69 72 | 65 64 20 64 69 61 6c 79 |y requir|ed dialy|
|000062a0| 73 69 73 2e 20 20 28 34 | 29 20 53 65 76 65 72 65 |sis. (4|) Severe|
|000062b0| 0d 0a 70 75 6c 6d 6f 6e | 61 72 79 20 74 6f 78 69 |..pulmon|ary toxi|
|000062c0| 63 69 74 79 20 69 6e 63 | 6c 75 64 65 64 20 69 6e |city inc|luded in|
|000062d0| 74 65 72 73 74 69 74 69 | 61 6c 20 63 68 61 6e 67 |terstiti|al chang|
|000062e0| 65 73 20 72 65 71 75 69 | 72 69 6e 67 20 6d 65 63 |es requi|ring mec|
|000062f0| 68 61 6e 69 63 61 6c 0d | 0a 76 65 6e 74 69 6c 61 |hanical.|.ventila|
|00006300| 74 6f 72 79 20 73 75 70 | 70 6f 72 74 20 6f 72 20 |tory sup|port or |
|00006310| 6d 6f 72 65 20 74 68 61 | 6e 20 35 30 25 20 6f 78 |more tha|n 50% ox|
|00006320| 79 67 65 6e 20 62 79 20 | 6d 61 73 6b 2c 20 61 6e |ygen by |mask, an|
|00006330| 64 20 28 35 29 20 73 6f | 20 66 6f 72 74 68 20 61 |d (5) so| forth a|
|00006340| 6e 64 20 73 6f 0d 0a 66 | 6f 72 74 68 2e 2d 2d 4d |nd so..f|orth.--M|
|00006350| 2e 4a 2e 20 43 6c 69 6e | 65 2c 20 4d 2e 44 2e 0d |.J. Clin|e, M.D..|
|00006360| 0a 24 55 6e 69 71 75 65 | 5f 49 44 7b 59 52 42 31 |.$Unique|_ID{YRB1|
|00006370| 31 31 30 36 7d 0d 0a 24 | 54 69 74 6c 65 7b 41 64 |1106}..$|Title{Ad|
|00006380| 6a 75 76 61 6e 74 20 43 | 68 65 6d 6f 74 68 65 72 |juvant C|hemother|
|00006390| 61 70 79 20 69 6e 20 4f | 70 65 72 61 62 6c 65 20 |apy in O|perable |
|000063a0| 47 61 73 74 72 69 63 20 | 43 61 6e 63 65 72 3a 20 |Gastric |Cancer: |
|000063b0| 20 35 20 59 65 61 72 20 | 46 6f 6c 6c 6f 77 2d 55 | 5 Year |Follow-U|
|000063c0| 70 20 6f 66 20 46 69 72 | 73 74 20 42 72 69 74 69 |p of Fir|st Briti|
|000063d0| 73 68 20 53 74 6f 6d 61 | 63 68 20 43 61 6e 63 65 |sh Stoma|ch Cance|
|000063e0| 72 20 47 72 6f 75 70 20 | 54 72 69 61 6c 7d 0d 0a |r Group |Trial}..|
|000063f0| 24 41 75 74 68 6f 72 7b | 41 6c 6c 75 6d 2c 20 57 |$Author{|Allum, W|
+--------+-------------------------+-------------------------+--------+--------+
Only 25.0 KB of data is shown above.