Upfront plerixafor plus G-CSF versus cyclophosphamide plus G-CSF for stem cell mobilization in multiple myeloma: efficacy and cost analysis study.

Cyclophosphamide plus G-CSF (C+G-CSF) is one of the most widely used stem cell (SC) mobilization regimens for patients with multiple myeloma (MM). Plerixafor plus G-CSF (P+G-CSF) has demonstrated superior SC mobilization efficacy when compared with G-CSF alone and has been shown to rescue patients who fail mobilization with G-CSF or C+G-CSF. Despite the proven efficacy of P+G-CSF in upfront SC mobilization, its use has been limited, mostly due to concerns of high price of the drug. However, a comprehensive comparison of the efficacy and cost effectiveness of SC mobilization using C+G-CSF versus P+G-CSF is not available. In this study, we compared 111 patients receiving C+G-CSF to 112 patients receiving P+G-CSF. The use of P+G-CSF was associated with a higher success rate of SC collection defined as ⩾5 × 10(6) CD34+ cells/kg (94 versus 83%, P=0.013) and less toxicities. Thirteen patients in the C+G-CSF arm were hospitalized owing to complications while none in the P+G-CSF group. C+G-CSF was associated with higher financial burden as assessed using institutional-specific costs and charges (P<0.001) as well as using Medicare reimbursement rates (P=0.27). Higher rate of hospitalization, increased need for salvage mobilization, and increased G-CSF use account for these differences.

Expression of blood group A and B antigens in gastric cancer examined by monoclonal antibodies.

Fourty-eight patients with gastric carcinoma were histologically examined and classified according to Laurén as intestinal or diffuse type. Employing monoclonal antibodies, in all samples the expression of blood group A and B antigens was studied using the method of indirect immunoperoxidase reaction. In patients with blood groups A and AB the comparison of expression revealed marked differences between the intestinal and diffuse type carcinomas. In the intestinal type, the expression of the blood group antigens was highly heterogenous, while diffuse type carcinomas displayed a homogenous expression. The obtained differences support Laurén's classification. The staining of supranuclear regions of tumor cells by the monoclonal antibody HE 10 (which reacts with antigenic determinants A and H of type 3 and 4) was found more frequently in intestinal type carcinomas. The possible prognostic significance of these findings is discussed.

Detection of blood group A antigen expression in human colon cancer using monoclonal antibodies with different specificities.

Blood group antigen expression in human colon cancer was studied by means of two monoclonal antibodies of broad anti-A (HE-14) and anti-type 3 and type 4 chain-based A and H (HE-10) specificity. These antigens were proved to reappear in tumors of the distal colon, the HE-10 antibody reacting more frequently (9 out of 12 samples) than HE-14 (5 out of 12 samples) and frequently with supranuclear staining of the cytoplasm probably in those places of the Golgi apparatus where carbohydrate antigens are synthesized. This staining pattern is characteristic of HE-10 in normal colonic mucosa as well. With HE-14, staining was often absent in less differentiated tumors, while HE-10 did react in such tumors. In this connection, the possible expression of type 3 and type 4 chain H antigens in the tumor tissue is discussed. In some cases, these two antibodies gave different staining patterns in parallel sections from the same tissue sample, primarily at the cellular level. Three out of 12 cases showed blood group antigen expression in the mucosa of the distal colon adjacent to the tumor only when HE-10 antibody was used.

[Expression of the blood group antigens A and B in carcinoma of the urinary bladder]. / Exprese krevních skupinových antigenu A a B v karcinomu mocového mechýre.

In 21 patients with transitional cell carcinoma of the urinary bladder expression of A and B blood group antigens was studied by means of monoclonal antibodies on using indirect immunoperoxide reaction. Expression of the investigated antigens was found to be dependent on the degree of histological differentiation of the tumor tissue. In well-defined carcinomas mostly pronounced expression of A and B blood group antigens was observed. Middle and low-differentiated carcinomas were characterized by reduction or even total deletion of expression. The expected favorable prognosis in transitional cell carcinomas expressing A and B blood group antigens failed to be confirmed. The expression of incompatible A-like antigens in 0 and B blood group patients with carcinoma is discussed. (Tab. 3, Fig. 3, Ref. 22.).

[Differences in the expression of blood group antigens A and B in carcinoma of the stomach in relation to Laurén's classification]. / Rozdíly v expresi krevních skupinových antigenu A a B v karcinomu zaludku s prihlédnutím k Laurénove klasifikaci.

Expression of blood group antigens A and B was studied in a group of 48 gastric carcinomas (classified according to Laurén as intestinal and diffuse types respectively) by monoclonal antibodies in an indirect immunoperoxidase method. Results could be summarized as followings: 1. Significant difference concerned the expression of blood group antigens A and AB. Intestinal type was characterized by striking heterogeneity of expression and more pronounced deletion of antigens. Diffuse type had a homogenous expression and a distinctly smaller deletion. 2. Supranuclear immunoreactivity with monoclonal antibody HE 10 in intestinal type carcinoma may have a prognostic importance. This expression could not be observed in diffuse type carcinoma.

[Expression of A,B and H blood group antigens in urothelial carcinoma of the urinary bladder]. / Exprese krevních skupinových antigenu A, B a H v uroteliálním karcinomu mocového mechýre.

Expression of blood group antigens A, B, and H was studied in transitional carcinoma of the urinary bladder. Positive result was obtained in 16 cases of a group of 21 tumours by indirect immunoperoxidase reaction with monoclonal antibodies. A relation of quantitative expression to histological grading of tumour differentiation was noticed. Well differentiated transitional carcinomas mostly had more conspicuous expression of A, B, and H antigens. However, expected more favourable prognosis in cases of transitional carcinoma with expression of A, B, and H blood group antigens failed to be proved.

Blood-group related antigens A and B in gastric cancer.

Using monoclonal antibodies the expression of blood group antigens A and B was studied by the method of indirect immunoperoxidase reaction in a series of 48 gastric carcinomas classified by Laurén's criteria into diffuse and intestinal types. Expression in intestinal and diffuse types of carcinoma differed significantly in patients of blood group A and AB. Intestinal type was characterized by a marked heterogeneity of expression of blood group antigens, while diffuse type displayed a homogeneous expression. The observed differences testify the validity of Laurén's classification. A more frequent staining of supranuclear regions of the cytoplasm of tumor cells in intestinal type carcinoma was recorded with the monoclonal antibody HE 10 (reacting with antigenic determinants A and H of type 3 and 4). A possible prognostic significance of this finding is discussed.

Blood group H antigen in transitional carcinoma of the urinary bladder.

A total of 21 transitional carcinomas of the urinary bladder were examined by the method of indirect immunoperoxidase reaction using anti-H monoclonal antibody. Expression of blood group H antigen was detected in ten cases but no association with the grade of differentiation of the tumor tissue was established. The prognosis of carcinomas expressing blood group H antigen is not more favorable than that of carcinomas with absent expression.

Murine monoclonal antibodies to human A erythrocytes: differential reactivity with N-acetyl-D-galactosamine.

Six different hybridoma cell lines were obtained producing IgM monoclonal antibodies (MAbs) against human blood group A antigen. All these MAbs agglutinate the A1, A1B and A2 erythrocytes, while only one of them agglutinates the A2B erythrocytes. The agglutination activity of 3 of these MAbs is inhibited by N-acetyl-D-galactosamine (D-GalNAc). Dissociation constants of complexes of these MAbs with D-GalNAc are approximately 2.2 X 10(-3) mol/l.