Subject(s)
Hypertrophy/surgery , Pyloric Stenosis/surgery , Humans , Postoperative Complications , VomitingABSTRACT
Between 1996 and 2004, a total of 708 patients were enrolled in the acute myeloid leukaemia (AML) '96 and '02 studies of the East German Study Group (OSHO). Of these, 138 patients (19.5%) had unfavourable cytogenetics defined as complex karyotype, del (5q)/-5, del (7q)/-7, abn (3q26) and abn (11q23). In all, 77 (56%) achieved complete remission 1 (CR1) after induction chemotherapy and were eligible for haematopoietic cell transplantation (HCT). HCT was performed after a median of two cycles of consolidation chemotherapy (CT) in the AML '96 and one cycle in the AML '02 study (P=0.03). After a median follow-up of 19 months, overall survival (OS) at two years was significantly better in the donor group (52+/-9%) versus the no-donor group (24+/-8%; P=0.005). Differences in outcomes were mainly because of a lower relapse incidence in patients after HCT (39+/-11%) compared with a higher relapse incidence in patients undergoing CT (77+/-10%; P=0.0005). Treatment-related mortality was low and not statistically significantly different between the two treatment groups (15+/-7 and 5+/-5% for HCT and chemotherapy, respectively; P=0.49).We conclude that early HCT from related or unrelated donors led to significantly better OS and leukaemia-free survival compared with chemotherapy in patients with unfavourable karyotype.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Hematopoietic Stem Cell Transplantation/mortality , Leukemia, Myeloid, Acute/mortality , Leukemia, Myeloid, Acute/therapy , Adolescent , Adult , Disease-Free Survival , Female , Hematopoietic Stem Cell Transplantation/methods , Humans , Karyotyping , Leukemia, Myeloid, Acute/genetics , Male , Middle Aged , Recurrence , Remission Induction , Survival Rate , Transplantation, Homologous , Young AdultSubject(s)
Bone Marrow Transplantation , Graft Rejection/drug therapy , Graft vs Host Disease/therapy , Immunosuppressive Agents/therapeutic use , Muromonab-CD3/therapeutic use , Peripheral Blood Stem Cell Transplantation , Steroids/therapeutic use , Adult , Aged , Bacterial Infections/immunology , Bacterial Infections/microbiology , Bacterial Infections/therapy , CD3 Complex/analysis , Female , Graft Rejection/immunology , Graft Rejection/microbiology , Graft vs Host Disease/microbiology , Humans , Incidence , Leukemia/complications , Leukemia/therapy , Lymphoma/complications , Lymphoma/therapy , Male , Middle Aged , Prospective Studies , Remission InductionABSTRACT
The primary aim of any DNA Database is to link individuals to unsolved offenses and unsolved offenses to each other via DNA profiling. This aim has been successfully realised during the operation of the New Zealand (NZ) DNA Databank over the past five years. The DNA Intelligence Project (DIP), a collaborative project involving NZ forensic and law enforcement agencies, interrogated the forensic case data held on the NZ DNA databank and collated it into a functional intelligence database. This database has been used to identify significant trends which direct Police and forensic personnel towards the most appropriate use of DNA technology. Intelligence is being provided in areas such as the level of usage of DNA techniques in criminal investigation, the relative success of crime scene samples and the geographical distribution of crimes. The DIP has broadened the dimensions of the information offered through the NZ DNA Databank and has furthered the understanding and investigative capability of both Police and forensic scientists. The outcomes of this research fit soundly with the current policies of 'intelligence led policing', which are being adopted by Police jurisdictions locally and overseas.