The possible cost effectiveness of peripheral blood stem cell mobilization with clophosphamide and the late addition of G-CSF

The purpose of this study was to develop a cost-effective protocol for the mobilization of peripheral blood stem cells (PBSC) in patients with malignancy. Thirty consecutive patients were randomized to mobilize PBSC with the late addition of a standard 250 microg dose of G-CSF (Neutrogen) from day 8 or early addition of the same dose of G-CSF from day 2, following cyclophosphamide (CY) 4 g/m2. The median yield of CD34+ cells from evaluated patients was 7.87 x 10(6)/kg (range, 2.06-27.25), collected in a median of four apheresis (range, 2-9). Target CD34 + cell doses > or = 2.0 x 10(6)/kg were achieved in all patients able to be evaluated. There were no statistically significant differences in CD34+ cell yields or toxicities. Overall engraftment occurred with median days to neutrophils > or = 0.5 x 10(9)/L or platelets > 20 x 10(9)/L of 11 and 17 days, respectively. However, the duration of G-CSF administration was markedly shorter in the late use of G-CSF group than in the early use of G-CSF group, with a median of 9 days compared with 15 days (p>0.001). PBSC harvesting after priming with CY plus delayed use of G-CSF made it a safe and cost-effective procedure.

Primary Central Nervous System Lymphoma / 대한암학회지

PURPOSE: Primary central nervous system lymphoma (PCNSL) is defined as lymphoma limited to the cranial-spinal axis without evidence of systemic disease and its incidence has risen threefold during the last fifteen years among apparantly healthy population. This study was intended to analyze the clinicopathologic features and treatment outcome of the patient with PCNSL. MATERIALS AND METHODS: Twenty one patients were diagnosed and treated for the PCNSL limited to brain parenchyme at Asan Medical Center between March 1989 and December 1996. We reviewed clinical records of these patients and analyzed clinicopathologic features, treatment response, survival time and prognostic factors. RESULTS: The ratio of male to female was 1.3: 1 and the most prevalent age group was the 4th decade. Most patients had diffuse large cell (19/21) and B-cell type (8/8). Seventeen (94.4%) among 18 evaluable patients achieved complete remission (CR) as initial response, but 53% of patients showed recurence of the disease. Median times of disease-free and overall survival were 40 and 50 months, respectively and 5 year overall survival rate was 35.3 %. Prognostic factors such as age and performance status, had a statistically significant influence on the overall survival but not on disease-free survival. CONCLUSION: CR rate of the patients with PCNSL was high, but relapses were frequent. There fore further studies are needed to define the pmgnostic factors and to decrease relapse rate.

Chromosome Analysis of Korean Adult Patients with Acute Myelogenous Leukemia / 대한혈액학회지

BACKGROUND: There has been some reports demonstrating the geographic heterogeneity in frequency of specific cytogenetic aberrations, but little is known about the types, frequency and prognostic value of specific chromosomal abnormalities in Korean adults with acute myelogenous leukemia. To evaluate cytogenetic characteristics of Korean adults with acute myelogenous leukemia, following study was performed. METHODS: Cytogenetic studies using high-resolution banding technique were done on newly diagnosed 38 patients with de nono acute myelogenous leukemia (AML) admitted to Asan medical center from January 1995 to May 1996. RESULTS: 1) Sixteen patients (42.1%) had clonal chromosomal abnormalities. 2) The t (8;21) was detected in 8 patients (21.1%). The t (15;17) was detected in 2 patients. The inv (16), del (11)(q23) and 7q- were detected in 1 patient each. Trisomy 21 as a sole abnormality was detected in 1 patient and complex abnormalities were detected in 2 patients. risomy 8 was not detected. 3) Eight (50%) of the 16 patients with AML-M2 had t (8;21), 2 of the 3 patients with AML-M3 had t (15;17) and 1 patient with AML-M4Eo had inv (16). 4) The median age of patients with chromosomal abnormalities was significantly younger than that of patients with normal karyotype (34 vs. 48 years, P=0.003). Other clinical andlaboratory characteristics were not significantly different between abnormal and normal cytogenetic groups. 5) The complete remission rate of patients with chromosomal abnormalities was lower than that of patients with normal karyotype, but the difference of CR rates was not statistically significant (78.1 vs. 84.2%, P=NS). CONCLUSION: These results suggest that lower incidence of trisomy 8, higher incidence of t (8;21) and stronger association between t (8;21) and AML-M2 than usually described may be the cytogenetic characteristics of acute myelogenous leukemia in Korean adult.

Safety Profile of Adenosine Myocardial Perfusion Imaging

BACKGROUND: Myocardial perfusion scintigraphy with intravenous adenosine has proved efficacy for the diagonosis and risk stratification of coronary artery disease. To determine the safety of adenosine infusion in conjunction with radionuclide imaging, we evaluated prospectively 1,093 patients who underwent myocardial perfusion study. METHODS: Informations on safety and adverse events during and immediately after adenosine infusion were collected and statistical analysis was performed. RESULTS: The adverse events were reported in 730 patients (66.8%), but no death or myocardial infarction. There asverse events were well tolerated and no prolonged effect was noted. Chest pain occured in 223 patients(20.4%) and facial flushing and dyspnea were reported by 246 patients(22.5%) and 253 patients(23.1%), respectively. ECG changes, such as mild arrhythmia, ST depression and AV block were checked in 230 patients(21.0%). The infusion was prematurely terminated in 32 patients(2.9%), due to serve chest pain, serve brochospasm, or third degree AV block. Higher frequency of chest pain was reported in women compare to men(p<0.05), and ST segment depression was more frequent in patients with abnormal myocardial perfusion scitigraphic findings(p<0.05). CONCLUSION: These results demonstrate that intravenous infusion of adenosine is relatively safe, and myocardial perfusion scintigraphy with intravenous ademosine is feasible technique in the evaluation of the coronary artery disease patients unable to exercise.