By H. Joachim Deeg M.D., Hans-Georg Klingemann M.D., Gordon L. Phillips M.D. (auth.)
In 1988 we provided our consultant to Bone Marrow Transplan tation. The reception has been enthusiastic and we have now re ceived a flood of severe reviews, feedback and requests to supply an replace in due time. even if a number of books on marrow transplantation have lately been released, their scope and aim have normally been diversified. accordingly, now we have determined to arrange a moment version of the advisor. Our goal used to be to keep up a brief, concise textual content which by no means theless could comprise alterations that experience happened over the last 4 or 5 years. we've streamlined the outline of pretransplant concerns, by way of condensing sections into one (Treatment making plans and Timing of Transplantation). This additionally facilitated the evaluate of debatable symptoms for marrow transplantation, for instance in sufferers with acute myelogenous leukemia in first chemotherapy-induced remission. now we have up-to-date the bankruptcy facing conditioning regimens and feature improved the part on donor choice, particularly in regard to the present point of tissue typing and the id of unrelated volunteer donors. within the bankruptcy on assortment, processing, and infusion of marrow, we have now included contemporary advancements, for instance, using closed structures for marrow harvesting and processing and using strong part separation of stem cells.
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Extra resources for A Guide to Bone Marrow Transplantation
Other late complications should also be discussed, even if they are poorly defined. The possibility of an increased risk of second malignancy must be mentioned. Although many male patients with previouslytreated malignancy may be sterile before conditioning, the option of sperm banking should be discussed. Finally, it should be noted that the number of transplant patients followed for more than 10-15 years is relatively small, and as-yetunrecognized late complications may arise. Of course, patients frequently need some idea of their chances for cure.
N Engl J Med 322:417-421 Moore MAS, Castro-Malaspina H (1991) Immunosuppression in aplastic anemia - postponing the inevitable? N Engl J Med 324:1358-1360 Reece DE, Barnett MJ, Connors JM, et al. (1991) Intensive chemotherapy with cyclophosphamide, carmustine, and etoposide followed by autologous bone marrow transplantation for relapsed Hodgkin's disease. J Clin Oncol 9:1871 Santos GW (1989) Marrow Transplantation in acute nonlymphocytic leukemia. Blood 74:901-908 Simon W, Segel GB, Lichtman MA (1988) Upper and lower time limits in the decision to recommend marrow transplantation for patients with chronic myelogenous leukaemia.
Lymphoblastic lymphomas of the convoluted cell type also have a very poor prognosis with conventional chemotherapy alone. Nodular poorly differentiated lymphocytic lymphoma, although relatively indolent in its course, is unlikely to be cured by chemo- Treatment Planning and Timing of Transplantation 23 therapy. In these patients allogeneic marrow transplantation from a suitable related donor might be carried out early in the disease course and even in first remission. Alternatively, if the marrow is cleared or can be purged by appropriate agents, autologous marrow can be cryopreserved and used at the time of relapse or immediately, analogous to allogeneic marrow.
A Guide to Bone Marrow Transplantation by H. Joachim Deeg M.D., Hans-Georg Klingemann M.D., Gordon L. Phillips M.D. (auth.)