Biomedical subjects

T Klingebiel

Publications and source records attributed to T Klingebiel.

183 records · Page 11Linked to original sources

PubMedDate not supplied

Effect of amifostine on neuroblastoma during high dose chemotherapy: in vivo and in vitro investigations.

Amifostine (Ethyol, WR-2721) has been clinically used in combination with high dose therapy of neuroblastoma stage 4 with melphalan, carboplatin and VP-16 in 14 patients. The amifostine group was compared to a historical control group of 24 comparably-treated patients. There were no significant differences regarding the time of hematological recovery, the duration of hospitalization, the duration of antibiotic treatment and the extent of renal toxicity. However, in contrast to four patients of the control group, no patient in the amifostine group developed such severe mucositis that artificial ventilation became necessary. Pretreatment of neuroblastoma cell lines for 30 minutes with amifostine and the free thiol(WR-1065) did not reduce the cytotoxic effects of melphalan, carboplatin and VP-16. Evidence was obtained that the uptake of the activated thiol could be achieved by a polyamine transporter. Taken together, the data do not support the use of amifostine in high dose chemotherapy of neuroblastoma prior to autologous stem cell transplantation. However, amifostine may be more effective in conventional neuroblastoma therapy where protection of bone marrow stem cells is necessary.

Amifostine↗

PubMedDate not supplied

Treatment of neuroblastoma with [131I]metaiodobenzylguanidine: long-term results in 25 patients.

From 1984 to 1990 we have treated altogether 25 children with [131I]metaiodobenzylguanidine (131I-MIBG) for a refractory, relapsed or metastasized neuroblastoma. Three children had stage III and 22 children had stage IV of the disease; at diagnosis their ages were between 4 months and 10 years. Children with stage III disease had at diagnosis a median age of 3.0 years and at treatment 3.8 years. After first-line chemotherapy 2 children had achieved a complete remission (CR), while in 1 child the tumor did not respond (NR) to the initial treatment. At the time of 131I-MIBG treatment 2 children had relapsed and in the other one no further response was achievable. The children were treated by a 13.5 +/- 12.9 mCi/kg BW per course with a mean total dose of 280.7 +/- 243.9 mCi. One child achieved CR by 131I-MIBG alone, while in 2 cases no measurable success was observed. All 3 children were treated additionally by surgery, chemotherapy and bone marrow transplantation (BMT). Two children have died but one is alive and in CR. The 22 children with stage IV disease were treated in two different study groups. In group A, 14 children were studied for side-effects and response to 131I-MIBG. All children were pretreated with standard chemotherapy. Five were treated in relapse, 5 in progression and 3 at a refractory state of the disease; only 1 child was in complete remission when being treated with 131I-MIBG. Group A patients were treated with a mean of 2.4 courses, with 10.3 mCi/kg BW for each course.(ABSTRACT TRUNCATED AT 250 WORDS)

3-Iodobenzylguanidine↗

PubMedDate not supplied

Quantitative assessment of mixed hematopoietic chimerism by polymerase chain reaction after allogeneic BMT.

Patients who develop mixed hematopoietic chimerism (MHC) after allogeneic bone marrow transplantation (allo-BMT) might have an increased risk of relapse or graft failure. In order to identify patients with MHC we established a quantitative polymerase chain reaction (PCR) approach to estimate the individual degree of autologous recovery and investigate the dynamics of MHC posttransplant. Therefore standardized mixed chimeric samples were generated in each individual case by mixing pretransplant recipient and donor DNA at a range of percentages. After amplification the samples were analyzed densitometrically and signal intensities were taken as the basis of individual standard curves. Subsequently posttransplant DNA samples were also analyzed, the intensity of the informative signals were compared to the standard curves and autologous recovery was expressed in percentage related to host DNA. We investigated 40 pediatric patients receiving allo-BMT by this method. 10/40 developed MHC during course of the observation period. Each patient with MHC revealed a certain dynamic. This approach might be helpful when deciding on early intervention and additional treatment to prevent graft failure or relapse.

Bone Marrow Transplantation↗