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1.
Bone Marrow Transplant ; 59(2): 224-231, 2024 02.
Article in English | MEDLINE | ID: mdl-37993503

ABSTRACT

The optimal conditioning for patients with higher risk MDS receiving potentially curative allogeneic haematopoietic stem cell transplant(allo-HCT) remains to be defined. This is particularly the case for patients with excess of blasts at time of allo-HCT. Sequential (Seq) conditioning, whereby chemotherapy is followed rapidly by transplant conditioning, offers an opportunity to decrease disease burden, potentially improving outcomes allo-HCT outcomes. Herein we present the only analysis comparing Seq to myeloablative (MAC) and reduced intensity conditioning (RIC) specifically focussed on MDS patients with excess of blasts at allo-HCT. 303 patients were identified in the EBMT registry, receiving RIC (n = 158), Seq (n = 105), and MAC (n = 40). Median follow-up was 67.2 months and median age at allo-HCT was 59.5 years (IQR 53.5-65.6). For the entire cohort, 3 y overall survival (OS) was 50% (95% CI 45-56%) and relapse free survival (RFS) 45% (95% CI 40-51%). No significant differences in OS (log-rank p = 0.13) and RFS (log-rank p = 0.18) were observed between conditioning protocols. On multivariable analysis, lower performance status, worse IPSS-R cytogenetics, sibling donor (compared to 8/8 MUD) and ≥20% blasts at allo-HCT were associated with worse outcomes. In conclusion, the Seq protocol did little to influence the outcome in this high-risk group of patients, with outcomes mostly determined by baseline disease risk and patient characteristics such as performance status.


Subject(s)
Graft vs Host Disease , Hematopoietic Stem Cell Transplantation , Myelodysplastic Syndromes , Humans , Middle Aged , Aged , Retrospective Studies , Transplantation, Homologous/methods , Neoplasm Recurrence, Local , Myelodysplastic Syndromes/therapy , Chronic Disease , Hematopoietic Stem Cell Transplantation/methods , Transplantation Conditioning/methods , Graft vs Host Disease/etiology
2.
Med Klin Intensivmed Notfmed ; 116(2): 111-120, 2021 Mar.
Article in German | MEDLINE | ID: mdl-33564899

ABSTRACT

Allogeneic hematopoetic stem cell transplantation yields improved long-term survival for patients with high-risk malignant and non-malignant hematologic disease. However, it is associated with high morbidity and mortality. A proportion of patients need intensive care due to infectious, immunological and/or toxic complications. The utility of intensive care unit (ICU) treatments as mechanical ventilation and renal replacement therapy for these patients is uncertain since mortality is high. We describe the most frequent complications and the treatment options concerning the ICU in recipients of allogeneic hematopoetic stem cells.


Subject(s)
Bone Marrow Transplantation , Hematopoietic Stem Cell Transplantation , Critical Care , Humans , Intensive Care Units , Retrospective Studies
4.
Bone Marrow Transplant ; 51(5): 654-62, 2016 May.
Article in English | MEDLINE | ID: mdl-26855152

ABSTRACT

Allogeneic hematopoietic cell transplantation (HCT) offers the chance of cure for patients with non-transformed follicular lymphoma (FL), but is associated with the risk of non-relapse mortality (NRM). The aim of this study was to identify subgroups of FL patients who benefit from HCT. The European Society for Blood and Marrow Transplantation (EBMT) Minimum-Essential-A Data of 146 consecutive patients who received HCT for FL between 1998 and 2008 were extracted from the database of the German Registry 'DRST'. Diagnosis of FL was verified by contact with the reference pathologists. Estimated 1-, 2- and 5-year overall survivals (OS) were 67%, 60% and 53%, respectively. Day 100 NRM was 15%. Thirteen out of 33 patients (40%) with treatment-refractory disease (RD) at the time of transplantation survived long term. Univariate statistical analysis suggested limited chronic GvHD, donor age ⩽42 years and TBI-based conditioning in treatment refractory patients to correlate with favorable OS. Independent prognostic factors for OS were treatment-sensitive disease and limited chronic GvHD for the whole cohort, and additionally TBI-based conditioning for the treatment refractory subgroup. In contrast, patient age ⩾55 years had no impact on outcome. Thus, HCT for FL is associated with acceptable NRM, and offers a substantial chance of cure for patients with RD or advanced age. Donors ⩽42 years should be preferred if available.


Subject(s)
Hematopoietic Stem Cell Transplantation/methods , Lymphoma, Follicular/therapy , Adolescent , Adult , Age Factors , Aged , Female , Germany , Graft vs Host Disease , Humans , Lymphoma, Follicular/mortality , Male , Middle Aged , Prognosis , Registries , Salvage Therapy/methods , Survival Rate , Tissue Donors , Transplantation Conditioning/methods , Treatment Outcome , Whole-Body Irradiation , Young Adult
5.
Bone Marrow Transplant ; 51(2): 186-93, 2016 Feb.
Article in English | MEDLINE | ID: mdl-26437057

ABSTRACT

Limited therapeutic options are available after relapse of acute leukaemia following first reduced intensity conditioning haematopoietic stem cell transplantation (RIC1). A retrospective study on European Society for Blood and Marrow Transplantation (EBMT) registry data was performed on 234 adult patients with acute leukaemia who received a second RIC transplantation (RIC2) from 2000 to 2012 as a salvage treatment for relapse following RIC1. At the time of RIC2, 167 patients (71.4%) had relapsed or refractory disease, 49 (20.9%) were in second CR and 18 (7.7%) in third or higher CR. With a median follow-up of 21 (1.5-79) months after RIC2, 51 patients are still alive. At 2 years, the cumulative incidence of non-relapse mortality (NRM), relapse incidence (RI), leukaemia-free survival (LFS) and overall survival (OS) were 22.4% (95% confidence interval (CI): 17-28.4), 63.9% (56.7-70.1), 14.6% (8.8-18.5) and 20.5% (14.9-26.1), respectively. In patients with acute myelogenous, biphenotypic and undifferentiated leukaemia (representing 89.8% of all patients), duration of remission following RIC1 >225 days, presence of CR at RIC2, patient's Karnofsky performance status >80 at RIC2 and non-myeloablative conditioning were found to be the strongest predictors of patients' favourable outcome.


Subject(s)
Hematopoietic Stem Cell Transplantation , Leukemia , Transplantation Conditioning/methods , Acute Disease , Adult , Aged , Allografts , Disease-Free Survival , Female , Follow-Up Studies , Humans , Leukemia/mortality , Leukemia/prevention & control , Male , Middle Aged , Recurrence , Risk Factors , Survival Rate
6.
Bone Marrow Transplant ; 51(5): 663-7, 2016 May.
Article in English | MEDLINE | ID: mdl-26437060

ABSTRACT

Adjuvant transfusion of donor lymphocytes (aDLT) may reduce the risk of relapse after allogeneic stem cell transplantation in high-risk AML. We performed a retrospective analysis on the safety and efficacy of aDLT in a cohort of 46 patients. To be eligible for aDLT, patients had to be in CR for at least 120 days from transplantation, off immunosuppression for ⩾30 days and free of GvHD. Thirty-four patients with similar disease characteristics and fulfilling the same selection criteria served as controls. Median follow-up among aDLT recipients was 7.2 years. Ten patients (22%) relapsed inspite of aDLT, as compared with 53% in the control group. Induction of GvHD was the main complication. However, non-relapse mortality was low with patients dying from infection (n=2), severe chronic GvHD (n=1) and secondary malignancy (n=2). At the time of analysis, 31/46 aDLT recipients were alive in CR at a median of 5.7 years after first aDLT. Overall survival at 7 years after transplant was 67% as compared with 31% in the control group (P<0.001). In conclusion, aDLT is safe, when given in escalating doses to a well predefined group of patients. Long-term survival can be achieved.


Subject(s)
Leukemia, Myeloid, Acute/therapy , Lymphocyte Transfusion/methods , Stem Cell Transplantation/methods , Adolescent , Adult , Aged , Case-Control Studies , Disease-Free Survival , Female , Follow-Up Studies , Graft vs Host Disease , Humans , Infections , Leukemia, Myeloid, Acute/complications , Leukemia, Myeloid, Acute/mortality , Male , Middle Aged , Neoplasms, Second Primary , Recurrence , Retrospective Studies , Stem Cell Transplantation/adverse effects , Stem Cell Transplantation/mortality , Young Adult
8.
Bone Marrow Transplant ; 50(5): 679-84, 2015 May.
Article in English | MEDLINE | ID: mdl-25642765

ABSTRACT

Prognosis is poor for patients with biologically aggressive Non-Hodgkin lymphoma (NHL), refractory to chemotherapy or relapsed after autologous transplantation, especially when no disease control before allogeneic transplantation is achieved. In 16 patients (median age 53, median prior regimes 5) with relapsed or refractory non-remission NHL, we analysed retrospectively the efficacy of a sequential therapy comprising clofarabine re-induction followed by a reduced-intensity conditioning with fludarabine, CY and melphalan, and T-cell-replete HLA-haploidentical transplantation. High-dose CY was utilized post-transplantation. All patients engrafted. Early response (day +30) was achieved in 94%. Treatment-related grade III-IV toxicity occurred in 56%, most commonly transient elevation of transaminases (36%), while there was a low incidence of infections (19% CMV reactivation, 19% invasive fungal infection) and GVHD (GVHD: acute III-IV: 6%; mild chronic: 25%). One-year non-relapse mortality was 19%. After a median follow-up of 21 months, estimated 1- and 2-year PFS was 56 and 50%, respectively, with 11 patients (69%) still alive after 2 years. In summary, sequential therapy is feasible and effective and provides an acceptable toxicity profile in high-risk non-remission NHL. Presumably, cytotoxic reinduction with clofarabine provides enough remission time for the graft-versus lymphoma effect of HLA-haploidentical transplantation to kick in, even in lymphomas that are otherwise chemo-refractory.


Subject(s)
Adenine Nucleotides/administration & dosage , Antimetabolites, Antineoplastic/administration & dosage , Arabinonucleosides/administration & dosage , HLA Antigens , Hematopoietic Stem Cell Transplantation , Lymphoma, Non-Hodgkin , Adult , Aged , Allografts , Clofarabine , Disease-Free Survival , Female , Humans , Lymphoma, Non-Hodgkin/mortality , Lymphoma, Non-Hodgkin/therapy , Male , Middle Aged , Recurrence , Retrospective Studies , Survival Rate
9.
Leukemia ; 29(5): 1069-75, 2015 May.
Article in English | MEDLINE | ID: mdl-25434302

ABSTRACT

The use of unmanipulated graft is increasingly adopted in the setting of allogeneic hematopoietic stem cell transplantation from haploidentical family donors (haplo-SCT) in acute leukemia (AL). We analyzed the outcome of 229 adult patients with de novo AL, who received an unmanipulated haploidentical transplant as their first allo-SCT between 2007 and 2011. Median follow-up was 30 months. Disease status at transplant was: first complete remission (CR1) for 77, second CR (CR2) for 56, and advanced for 96 patients. One hundred and seventy-one patients received in vivo T-cell depletion by monoclonal antibodies (75%). The 60-day cumulative incidence (CI) of engraftment was 93±2%. The 100-day CI of acute graft-versus-host disease (GvHD) was 32±3% for grade II-IV, 12±3% for grade III-IV. The 3-year CI of chronic GvHD was 34±3%. The 3-year CI of non-relapse mortality was 31±4% with in vivo T-cell depletion and 17±5% without. At 3 years, for patients transplanted in CR1, CR2 or advanced disease leukemia-free survival was 44±6, 42±7 and 12±3%, overall survival was 55±6, 51±7 and 14±4% and CI of relapse was 32±6, 24±6 and 61±5%, respectively. These data suggest that unmanipulated haplo-SCT is a valid treatment option for adult AL patients in complete remission lacking a matched donor.


Subject(s)
Graft vs Host Disease/immunology , Hematopoietic Stem Cell Transplantation/methods , Leukemia, Myeloid, Acute/therapy , Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy , Adolescent , Adult , Aged , Alleles , Antibodies, Monoclonal/immunology , Disease-Free Survival , Female , Histocompatibility Testing , Humans , Leukemia, Myeloid, Acute/metabolism , Lymphocyte Depletion , Male , Middle Aged , Precursor Cell Lymphoblastic Leukemia-Lymphoma/metabolism , Recurrence , Remission Induction , Stem Cell Transplantation , Time Factors , Transplantation Conditioning/methods , Transplantation, Homologous , Treatment Outcome , Young Adult
10.
Bone Marrow Transplant ; 49(7): 895-901, 2014 Jul.
Article in English | MEDLINE | ID: mdl-24820212

ABSTRACT

Haploidentical haematopoietic SCT (HSCT) using T-cell-replete grafts and post-transplant high-dose CY has found increasing acceptance. Our purpose was to evaluate the feasibility and outcome of this strategy as second HSCT incorporating donor change for acute leukaemia relapse after a first allogeneic transplantation. The courses of 20 consecutive adults (median age 37 years, 12 male) with AML (n=14), ALL (n=5) and acute bi-phenotypic leukaemia (n=1) were analysed retrospectively. Conditioning consisted of fludarabine, CY and either melphalan or TBI or tresosulfan+/-etoposide. Engraftment was achieved in 17 (85%), and a second remission was induced in 15 patients (75%) on day +30. The rate of grade II-IV acute GvHD was 35%, while chronic GvHD occurred in five patients. Most commonly observed grade III-IV toxicities were mucositis (30%), hyperbilirubinemia (20%), elevation of transaminases (20%) and creatinine (20%), while invasive fungal infection affected 30%. One-year non-relapse mortality (NRM) was 36%. At a median follow-up of 17 months, estimated 1-year OS was 45%, and 1-year relapse-free survival was 33%. This strategy was feasible and allowed for successful engraftment with a moderate rate of toxicity. Early outcome and NRM are at least comparable with results after a second HSCT from HLA-matched donors without donor change at HSCT2.


Subject(s)
Hematopoietic Stem Cell Transplantation/methods , Leukemia/therapy , Transplantation Conditioning/methods , Acute Disease , Adult , Female , Humans , Male , Middle Aged , Recurrence , Tissue Donors , Transplantation, Homologous , Young Adult
11.
Bone Marrow Transplant ; 47(1): 46-53, 2012 Jan.
Article in English | MEDLINE | ID: mdl-21358688

ABSTRACT

In AML, a complex aberrant karyotype is associated with poor response to chemotherapy and dismal prognosis. We prospectively studied the concept of allogeneic haematopoietic SCT (HSCT), performed early and regardless of response to induction treatment in patients with complex karyotype AML (CK-AML). The preparative regimen consisted of fludarabine, Ara-C and amsacrine (FLAMSA) chemotherapy, followed by reduced intensity conditioning (RIC) 3 days later. In vivo T-cell depletion by anti-thymocyte globulin was used to protect from early GvHD, and prophylactic donor lymphocyte transfusion was given from day+120 to augment the GvL effect, once tolerance was established. Eighteen consecutive patients with CK-AML (median age: 53 years) received HSCT from related (n=7) or unrelated (n=11) donors. Before FLAMSA-RIC, nine patients each had received one and two induction courses. Stage at start of FLAMSA-RIC was CR/CRi (n=8) or persistent disease (n=10). Following HSCT, 16 patients achieved CR. After a follow-up of 51 months, 11 patients are alive in CR, whereas seven have died in remission (n=3), or from leukaemia (n=4). Cumulative incidence of relapse, non-relapse mortality, acute GvHD≥II and chronic GvHD were 0.222±0.098, 0.235±0.104, 0.367±0.120 and 0.481±0.123, respectively. Four-year survival from HSCT is 61%. Early HSCT following FLAMSA-RIC may improve the outcome of this unfavourable AML subgroup.


Subject(s)
Abnormal Karyotype , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Hematopoietic Stem Cell Transplantation , Leukemia, Myeloid, Acute , Transplantation Conditioning/methods , Acute Disease , Adolescent , Adult , Amsacrine/administration & dosage , Amsacrine/adverse effects , Antilymphocyte Serum , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Child , Cytarabine/administration & dosage , Cytarabine/adverse effects , Disease-Free Survival , Female , Follow-Up Studies , Graft vs Host Disease/etiology , Graft vs Host Disease/genetics , Graft vs Host Disease/mortality , Graft vs Host Disease/pathology , Graft vs Host Disease/therapy , Humans , Immunosuppressive Agents/administration & dosage , Immunosuppressive Agents/adverse effects , Leukemia, Myeloid, Acute/genetics , Leukemia, Myeloid, Acute/mortality , Leukemia, Myeloid, Acute/pathology , Leukemia, Myeloid, Acute/therapy , Lymphocyte Depletion/adverse effects , Lymphocyte Depletion/methods , Male , Middle Aged , Pilot Projects , Prospective Studies , Survival Rate , Transplantation Conditioning/adverse effects , Transplantation, Homologous , Vidarabine/administration & dosage , Vidarabine/adverse effects , Vidarabine/analogs & derivatives
12.
Internist (Berl) ; 50(11): 1270-5, 2009 Nov.
Article in German | MEDLINE | ID: mdl-19565209

ABSTRACT

A 42 year-old woman develops steroid refractory graft-versus-host disease (GVHD) after second allogeneic stem cell transplantation for acute myelogenous leukemia with severe GVHD of her skin with blisters, severe GVHD of her gut with watery and bloody diarrhea and GVHD of her liver with cholestasis. In a further attempt to control GVHD extracorporeal photochemotherapy is administered. The treatment exposures peripheral mononuclear cells to photoactivated psoralen before they subsequently are given back to the patient. This approach apparently offers selective immune tolerance.


Subject(s)
Ficusin/therapeutic use , Graft vs Host Disease/therapy , Immunity, Innate/drug effects , Immunity, Innate/radiation effects , Leukocytes/drug effects , Leukocytes/radiation effects , Photopheresis/methods , Adult , Female , Humans , Photosensitizing Agents/therapeutic use , Steroids/therapeutic use , Treatment Failure , Treatment Outcome
13.
Bone Marrow Transplant ; 41(8): 721-7, 2008 Apr.
Article in English | MEDLINE | ID: mdl-18176613

ABSTRACT

The goal of this analysis was to define the role of the moderate-intensity fludarabin Ara-C amsacrin (FLAMSA)-reduced intensity conditioning (RIC) regimen for patients with high-risk AML undergoing allogeneic SCT (alloSCT) in first CR1. High-risk was defined by (1) AML secondary to MDS or radio/chemotherapy, (2) unfavorable cytogenetics or (3) delayed response to induction chemotherapy. A total of 23 of 44 AML patients referred to the University of Munich for alloSCT in CR1 between 1999 and 2006 fulfilled these criteria and received FLAMSA chemotherapy, followed by RIC (4 Gy TBI/cyclophosphamide/ATG) for alloSCT. Twenty-two patients engrafted, one died in aplasia. Two-year cumulative incidences for relapse and nonrelapse mortality (NRM) were 4.6 and 22.5%, respectively. Four-year overall and leukemia-free survival was 72.7% (median follow-up among survivors: 35 months). The results of this high-risk cohort were compared to the outcome of 21 consecutive standard-risk patients <55 years, who had received standard, myeloablative sibling SCT in CR1 AML within the same center and time period. Survival and cumulative incidences of relapse and NRM were identical in both groups. In conclusion, the FLAMSA-RIC regimen produces long-term remission in a high proportion of patients with high-risk AML transplanted in CR1. In this cohort, FLAMSA-RIC showed equivalent antileukemic activity as compared to the standard protocols.


Subject(s)
Hematopoietic Stem Cell Transplantation/methods , Leukemia, Myeloid, Acute/therapy , Transplantation Conditioning/methods , Adult , Case-Control Studies , Female , Humans , Male , Middle Aged , Remission Induction , Retrospective Studies , Survival Analysis , Transplantation, Homologous
14.
Anticancer Drugs ; 15(4): 347-50, 2004 Apr.
Article in English | MEDLINE | ID: mdl-15057138

ABSTRACT

This retrospective trial was performed to determine risk factors, incidence and severity of ifosfamide-induced encephalopathy in correlation with patient and treatment characteristics. Patients receiving ifosfamide were included consecutively with no restrictions concerning disease, prior chemotherapy or disease stage. Incidence and severity of encephalopathy were graduated according to common toxicity criteria. Between July 2001 and July 2002, 60 patients (32 male, 28 female, median age 47.5 years) were included; 26.6% of the patients (n = 16) developed neurological symptoms [grade 1: 6.7% (n = 4); grade 2: 3.3% (n = 2); grade 3: 11.7% (n = 7); grade 4: 5% (n = 3)]. Encephalopathy occurred for the first time in 87.5% (n = 14) in chemotherapy courses 1 and 2. In 56.25% (n = 9) of these 16 patients only one episode was observed. There was no significant difference concerning age (38 versus 50 years, p = 0.08) and dosage (median 2.9 versus 2.8 g, p = 0.74) between patients with and without encephalopathy. No risk factors could be identified by this study, suggesting an individual predisposition in each patient. On the other hand, ifosfamide can be administered in older patients without increased risk of neurotoxicity.


Subject(s)
Antineoplastic Agents, Alkylating/adverse effects , Ifosfamide/adverse effects , Neurotoxicity Syndromes/etiology , Adult , Aged , Antineoplastic Agents, Alkylating/administration & dosage , Cohort Studies , Dose-Response Relationship, Drug , Female , Humans , Ifosfamide/administration & dosage , Male , Middle Aged , Neoplasms/drug therapy , Retrospective Studies , Risk Factors
15.
Bone Marrow Transplant ; 32(3): 243-50, 2003 Aug.
Article in English | MEDLINE | ID: mdl-12858194

ABSTRACT

We conducted a dose-escalation study with antithymocyte globulin (ATG) in patients undergoing unrelated donor bone marrow transplantation (URD-BMT). This study analyzes the results for 97 patients with chronic myelogenous leukemia (CML) in first chronic phase. Median age was 36 years (16-51). In all, 40 patients were transplanted within 2 years after diagnosis and 57 later during disease. ATG-S (Fresenius) 20-120 mg/kg body weight (b.w.) was given prior to transplantation. A total of 31 patients received less than 60 mg/kg b.w. and 66 patients received 60 mg/kg b.w. or more. All patients except one were grafted with bone marrow, and graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporin A and methotrexate. Graft failure did occur in one patient. Grade II-IV acute GVHD developed in 56.7% and extensive chronic GVHD in 11.3% of the patients. The relapse rate was 13.4%. With a median follow-up of 5.8 years (1.5-12.1), 5-year disease-free and overall survival for all patients were 56 and 66%, and for patients transplanted within 2 years of diagnosis it was 72 and 82%. A lower dose of ATG was a significant risk factor for poor outcome. In summary, URD-BMT remains an excellent treatment option for patients with early phase CML, if a sufficient amount of ATG is included in the preparative regimen.


Subject(s)
Antilymphocyte Serum/administration & dosage , Bone Marrow Transplantation/methods , Leukemia, Myeloid, Chronic-Phase/therapy , Transplantation Conditioning/methods , Adolescent , Adult , Antilymphocyte Serum/therapeutic use , Bone Marrow Transplantation/adverse effects , Bone Marrow Transplantation/mortality , Dose-Response Relationship, Drug , Female , Graft Survival , Graft vs Host Disease , Humans , Leukemia, Myeloid, Chronic-Phase/complications , Leukemia, Myeloid, Chronic-Phase/mortality , Male , Middle Aged , Recurrence , Survival Analysis , Tissue Donors , Transplantation Conditioning/adverse effects , Transplantation Conditioning/mortality , Transplantation, Homologous
18.
DNA Cell Biol ; 17(11): 945-9, 1998 Nov.
Article in English | MEDLINE | ID: mdl-9839803

ABSTRACT

Plasmids containing the complete genome of poliovirus-1 are transcribed at random in transfected cells and give rise to infectious RNA molecules. These generate viruses which can be detected easily in a plaque assay. Using this system, we analyzed the persistence of the biologically active portion of transfected poliovirus cDNA by determining its infectious activity in mammalian cells. Transfection and the cultivation of the cells for up to 16 days were performed under the influence of guanidine or other drugs which inhibit plaque formation. Removal of the drug then allowed viral development to start at defined time points. We thus ensured that the reduction of plaques correlated with the decay of the transfected polio cDNA or the viral RNA synthesized exclusively from that DNA. We showed that the intracellular cDNA kept its full capacity to generate viruses for as long as 8 to 10 days post-transfection. After this time, this capacity declined, and no viruses were detected after 14 to 16 days. The plaque-producing activity depended primarily on the stability of the cDNA and its ability to be transcribed and not on the stability of the RNA transcripts, which decayed within hours.


Subject(s)
DNA, Complementary/metabolism , DNA, Viral/metabolism , Poliovirus/genetics , RNA, Viral/metabolism , Animals , Cell Line , Chlorocebus aethiops , Plasmids/metabolism , Poliovirus/growth & development , Poliovirus/pathogenicity , Transcription, Genetic , Transfection , Viral Plaque Assay , Virus Assembly
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