PubMed Health⌕ Search

Biomedical subjects

Arne Kolstad

Publications and source records attributed to Arne Kolstad.

13 recordsLinked to original sources
PubMed2007

Pneumocystis jirovecii pneumonia in B-cell lymphoma patients treated with the rituximab-CHOEP-14 regimen.

We report six cases of Pneumocystis jirovecii pneumonia (PCP) verified by immunoflourescence/polymerase chain reaction of bronchoalveolar fluid among 46 lymphoma patients (13%) who received rituximab-CHOEP-14 at our institution. PCP prophylaxis should be standard management for this group of patients and also considered for patients treated with rituximab-CHOP-14, CHOP-14 or CHOEP-14.

Adult↗
PubMed2006

Phase I clinical trial of costimulated, IL-4 polarized donor CD4+ T cells as augmentation of allogeneic hematopoietic cell transplantation.

The primary objective of this clinical trial was to evaluate the safety, feasibility, and biologic effects of administering costimulated, interleukin (IL)-4 polarized donor CD4(+) T cells in the setting of HLA-matched sibling, T cell-replete allogeneic hematopoietic cell transplantation (HCT). Forty-seven subjects with hematologic malignancy received granulocyte colony-stimulating factor-mobilized allogeneic hematopoietic cell transplants and cyclosporine graft-versus-host disease (GVHD) prophylaxis after reduced intensity conditioning. Initial subjects received no additional cells (n = 19); subsequent subjects received additional donor CD4(+) T cells generated ex vivo by CD3/CD28 costimulation in medium containing IL-4 and IL-2 (administered day 1 after HCT at 5, 25, or 125 x 10(6) cells/kg). Studies after HCT included measurement of monocyte IL-1alpha and tumor necrosis factor alpha, detection of T cells with antitumor specificity, and characterization of T cell cytokine phenotype. The culture method generated donor CD4(+) T cells that secreted increased T helper 2 (Th2) cytokines and decreased T helper 1 (Th1) cytokines. Such Th2-like cells were administered without infusional or dose-limiting toxicity. The Th2 cohort had accelerated lymphocyte reconstitution; both cohorts had rapid hematopoietic recovery and alloengraftment. Acute GVHD and overall survival were similar in the Th2 and non-Th2 cohorts. Th2 cell recipients tended to have increased monocyte IL-1alpha and had increased tumor necrosis factor alpha secretion. CD8(+) T cells with antitumor specificity were observed in Th2 and non-Th2 cohorts. Post-transplantation T cells from Th2 cell recipients secreted IL-4 and IL-10 (Th2 cytokines) and IL-2 and interferon gamma (Th1 cytokines). Allograft augmentation with costimulated, IL-4-polarized donor CD4(+) T cells resulted in activated Th1, Th2, and inflammatory cytokine pathways without an apparent increase in GVHD.

Adult↗
PubMed2005

131I-tositumomab therapy as initial treatment for follicular lymphoma.

BACKGROUND: Advanced-stage follicular B-cell lymphoma is considered incurable. Anti-CD20 radioimmunotherapy is effective in patients who have had a relapse after chemotherapy or who have refractory follicular lymphoma, but it has not been tested in previously untreated patients. METHODS: Seventy-six patients with stage III or IV follicular lymphoma received as initial therapy a single course of treatment with 131I-tositumomab therapy (registered as Tositumomab and Iodine I 131 Tositumomab [the Bexxar therapeutic regimen]). This consisted of a dosimetric dose of tositumomab and 131I-labeled tositumomab followed one week later by a therapeutic dose, delivering 75 cGy of radiation to the total body. RESULTS: Ninety-five percent of the patients had any response, and 75 percent had a complete response. The use of polymerase chain reaction (PCR) to detect rearrangement of the BCL2 gene showed molecular responses in 80 percent of assessable patients who had a clinical complete response. After a median follow-up of 5.1 years, the actuarial 5-year progression-free survival for all patients was 59 percent, with a median progression-free survival of 6.1 years. The annualized rate of relapse progressively decreased over time: 25 percent, 13 percent, and 12 percent during the first, second, and third years, respectively, and 4.4 percent per year after three years. Of 57 patients who had a complete response, 40 remained in remission for 4.3 to 7.7 years. Hematologic toxicity was moderate, with no patient requiring transfusions or hematopoietic growth factors. No cases of myelodysplastic syndrome have been observed. CONCLUSIONS: A single one-week course of 131I-tositumomab therapy as initial treatment can induce prolonged clinical and molecular remissions in patients with advanced follicular lymphoma.

Adult↗
PubMed2004

[Should complementary therapies be offered in hospitals?].

BACKGROUND: This study compares attitudes among oncology professionals to whether complementary therapies should be offered in integrated units affiliated with departments of oncology. MATERIAL AND METHODS: In June 2002 a questionnaire on alternative and complementary medicine was distributed among 156 physicians, 414 nurses, 164 radiation therapists and 94 administrative staff members in the five Norwegian university hospitals responsible for cancer treatment. 61% returned the questionnaire. RESULTS: More than half of the physicians (56%) and most of the other health care workers (85-93%) had a positive attitude to departments of integrative medicine. If the service was provided, about half of the physicians expressed the opinion that the cost of treatment should be covered by the patient. By contrast, more than 80% of nurses, clerks and therapeutic radiographers answered that the cost had to be covered by public funding. Most oncology professionals, including the physicians, felt that the decision on the type of treatment to be offered to patients should be made in collaboration between patients, complementary therapists and oncology health care workers. However, one third of the physicians thought that treatment decisions had to be made by health care workers only. INTERPRETATION: In general, this survey demonstrated a positive attitude towards integrated units offering complementary therapies, also among oncologists. However, major differences among professions were found.

Adult↗
PubMed2004

The Patient Experiences Questionnaire: development, validity and reliability.

OBJECTIVE: . To describe the development of the Patient Experiences Questionnaire (PEQ) and to evaluate reliability and validity of constructed summed rating scales. DESIGN: Literature review, focus groups and pilot surveys. Two national cross-sectional studies performed in 1996 and 1998. SETTING: Two postal surveys in a national sample of 14 hospitals stratified by geographical region and hospital size. Subjects. Patients consecutively discharged from surgical wards and wards of internal medicine. The surveys included 36 845 patients and 19 578 responded (53%). RESULTS: We constructed 10 summed rating scales based on factor analysis and theoretical considerations: Information on future complaints, Nursing services, Communication, Information examinations, Contact with next-of-kin, Doctor services, Hospital and equipment, Information medication, Organization and General satisfaction. Eight scales had a Cronbach alpha coefficient of >0.70, the remaining two were >0.60. Repeatability was >0.70 for five scales and >0.60 for the remaining scales. CONCLUSIONS: The PEQ is a self-report instrument covering the most important subjects of interest to hospital patients. Results are presented as 10 scales with good validity and reliability. It emphasizes practicability and comprehensibility while at the same time providing sufficient information about domains applicable to most patients admitted to medical and surgical wards.

Cross-Sectional Studies↗
PubMed2003

[Should alternative therapists treat cancer--what is the opinion of oncology health personnel?].

BACKGROUND: This study compares attitudes to the proposed new Alternative medicine act that would give Norwegian practitioners of alternative medicine more scope in treating patients with cancer. MATERIAL AND METHODS: In June 2002 a questionnaire on alternative and complementary medicine was distributed among 156 physicians, 414 nurses, 164 radiation therapists and 94 administrative staff members in the five Norwegian university hospitals responsible for cancer treatment. 61% returned the questionnaire. RESULTS: Of all respondents, 29% described themselves as having a positive attitude to alternative medicine. When the health services can offer no healing or palliative treatment to offer, 41% of the physicians and 60% of other health care workers were of the opinion that alternative practitioners could treat cancer. More than 50% of respondents were of the opinion that the patients themselves had the right to determine whether or not to use alternative medicine. When health authorities require communication between practitioners and physicians more than 70% of all health care workers felt that this contact had to be in writing. INTERPRETATION: Most health care workers treating cancer are of the opinion that practitioner of alternative medicine might treat cancer if the health services have no healing or palliative treatment. Required contact between physicians and alternative practitioners must be in writing.

Attitude of Health Personnel↗
PubMed2003

Primary treatment with autologous stem cell transplantation in mantle cell lymphoma: outcome related to remission pretransplant.

OBJECTIVES: The aim of the first Nordic mantle cell lymphoma (MCL) protocol was to study the clinical significance of an augmented CHOP induction chemotherapy followed by high-dose chemotherapy and autologous stem cell transplantation (ASCT) and to examine the prognostic significance of stem cell contamination rates in newly diagnosed patients with MCL. PATIENTS AND METHODS: Forty-one newly diagnosed patients below 66 yr were enrolled and given three series of an augmented CHOP regimen. Responders underwent stem cell mobilization with a fourth course of CHOP, stem cell harvest and ASCT. Stem cell purging was optional in the protocol and followed the routine of each participating centre. The number of tumour cells in the reinfused autografts was estimated by flow cytometry or quantitative PCR. RESULTS: Induction therapy led to complete remission (CR) in 11 of 41 patients (27%), partial remission (PR) in 20 of 41 patients (49%) and no response in nine patients (22%), whereas one patient was not evaluable. Twenty-seven of the 31 responders underwent ASCT and 24 achieved or maintained a CR. The overall and failure-free 4-yr survival on intention-to-treat basis were 51% and 15%, respectively. Among the transplanted patients, a significantly increased failure-free (P<0.03) and overall survival (P=0.03) was noted among patients transplanted in CR compared with PR, respectively. By contrast, reinfusion of highly variable numbers of tumour cells with the autografts (range 0.71-80 x 10(6) tumour cells), did not affect outcome. CONCLUSION: In MCL, an important strategy to improve the outcome will be to intensify the induction chemotherapy.

Adult↗
PubMed2002

Structure of conduct problems in adolescence.

Scholars disagree about whether adolescent conduct problems (CPs) form a single behavioral syndrome or whether such problems are better conceptualized as different dimensions. The arguments raised by both sides are addressed and tested empirically by analysing data from a large general population sample of Norwegian adolescents (n = 9,342). Confirmatory factor analyses show that a single syndrome of CPs may be subdivided into three highly correlated factors. The first dimension, destructive covert, includes theft and vandalism, whereas the second, nondestructive covert, reflects avoidance of arenas under adult control. The last dimension, overt, includes school opposition and fighting. This three-factor model fits well for both girls and boys, and individuals in their early and late teens. Results from scale analyses are modestly to moderately indicative of a developmental continuum of severity of CPs ranging from nondestructive covert to overt to destructive covert. Taken together the findings imply that both a unidimensional and a multidimensional perspective on CPs are applicable in the general youth population.

Adolescent↗
PubMed2002

Cancer patients undergoing chemotherapy show adequate serological response to vaccinations against influenza virus and Streptococcus pneumoniae.

Cancer patients receiving chemotherapy are prone to develop infections that might postpone treatment and lead to complications. The aim of our study was to investigate whether a heterogeneous population of patients with solid tumors and malignant lymphoma undergoing chemotherapy would respond serologically to vaccination against influenza and pneumococcal disease. There are no established routines in oncology departments in Norway regarding vaccination of these patients. The study included 35 cancer patients with median age 53 yr (range 20-74) and 38 controls with median age 57 yr (range 43-75). The chemotherapy regimens used were mild or moderately immunosuppressive. After one vaccination, 25 patients (72%) and 34 controls (87%) were serologically protected against two or three influenza strains. A higher proportion of patients with solid tumors (81%) than lymphoma (38%) achieved protection. Age, months on chemotherapy, and curative versus palliative treatment did not influence responses to vaccination. After vaccination with a 23-valent polysaccharide vaccine against pneumococci, most patients and controls achieved protective serum levels of antibodies against the different serotypes, with the exception that fewer patients were protected against serotype 4. The responses in controls were, however, generally stronger to all serotypes. Tumor type did not influence this vaccination response. We conclude that our cancer patients achieved adequate responses to influenza virus and Streptococcus pneumoniae. These are not live vaccines and are therefore safe for immunocompromised patients. Routine vaccinations against influenza virus and Streptococcus pneumoniae should be considered in cancer patients undergoing mild to moderately immunosuppressive chemotherapy.

Adult↗
PubMed2002

Use of alternative medicine among Norwegian cancer patients is associated with mental distress--a follow-up study.

The purpose of this study was to investigate the relationship between the use of alternative medicine (AM) by cancer patients' and the level of self-perceived mental distress. One hundred and fifty-seven cancer patients were included in a longitudinal questionnaire-based study 12 months after their first contact with the Department of Oncology, University Hospital of Tromsø, during the period 1990 to 1991. Eligible patients received follow-up questionnaires after 24 and 60 months recording their use of AM and measuring their perceived mental distress (GHQ-20). A total of 64 (41%) of the 157 patients who completed at least one questionnaire reported using AM one or more times during follow-up (ever-use). Between 65% and 79% of patients who were eligible at each point of the study completed the GHQ questionnaire. After 60 months of follow-up, 104 patients were still alive and 54 patients (52% of the survivors) had completed all the questionnaires. At inclusion in the study, significantly more AM users reported mental distress (57%) than non-users (20%) (p = 0.001). After 24 and 60 months, the corresponding figures were 42% versus 29% (p = 0.18), and 30% versus 10% (p = 0.02), respectively. When adjusted for sex, age and disease progression, use of AM was found to be an independent factor highly associated with mental distress at 12 months (OR = 5.5, 95% CI 2.1-14.4). Later in the study, progression/relapse of cancer proved to be a more important predictor of mental distress. These findings suggest that, in North Norway, seeking alternative treatment is more common among mentally distressed cancer patients.

Adult↗