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Link H, Thompson S, Tian M, Meise D, Haas J, Maas C, Dimitrov S. 1706P A comparative assessment of neutropenia events, healthcare resource use, and costs among patients treated with long-acting granulocyte-colony stimulating factor in Germany. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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2
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Huang‐Link Y, Eleftheriou A, Yang G, Johansson JM, Apostolou A, Link H, Jin Y. Optical coherence tomography represents a sensitive and reliable tool for routine monitoring of idiopathic intracranial hypertension with and without papilledema. Eur J Neurol 2019; 26:808-e57. [DOI: 10.1111/ene.13893] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 12/17/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Y. Huang‐Link
- Department of Neurology Institution of Clinical and Experimental Medicine (IKE) Linköping University Hospital Linköping Sweden
| | - A. Eleftheriou
- Department of Neurology Institution of Clinical and Experimental Medicine (IKE) Linköping University Hospital Linköping Sweden
| | - G. Yang
- School of First Clinical Medicine Southern Medical University Guangzhou China
| | - J. M. Johansson
- Department of Ophthalmology IKE Linköping University Hospital Linköping
| | - A. Apostolou
- Department of Neurology Institution of Clinical and Experimental Medicine (IKE) Linköping University Hospital Linköping Sweden
| | - H. Link
- Department of Neuroscience Karolinska Institute Stockholm Sweden
| | - Y.‐P. Jin
- Department of Ophthalmology and Vision Sciences University of Toronto Toronto ON Canada
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Link H, Illerhaus G, Martens U, Salar A, Depenbusch R, Kohler A, Engelhardt M, Mahlmann S, Zaiss M, Lammerich A, Bias P, Buchner A. A randomized, open-label, non-inferiority study comparing the efficacy and safety of lipegfilgrastim versus pegfilgrastim in elderly patients with aggressive B-cell non-Hodgkin lymphomas (B-NHL): AVOID neutropenia. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy300.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Aapro M, Beguin Y, Bokemeyer C, Dicato M, Gascón P, Glaspy J, Hofmann A, Link H, Littlewood T, Ludwig H, Österborg A, Pronzato P, Santini V, Schrijvers D, Stauder R, Jordan K, Herrstedt J. Management of anaemia and iron deficiency in patients with cancer: ESMO Clinical Practice Guidelines. Ann Oncol 2018; 29:iv96-iv110. [PMID: 29471514 DOI: 10.1093/annonc/mdx758] [Citation(s) in RCA: 115] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023] Open
Affiliation(s)
- M Aapro
- Genolier Cancer Centre, Clinique de Genolier, Genolier, Switzerland
| | - Y Beguin
- University of Liège, Liège
- CHU of Liège, Liège, Belgium
| | - C Bokemeyer
- Department of Oncology, Hematology and BMT with Section Pneumology, University of Hamburg, Hamburg, Germany
| | - M Dicato
- Hématologie-Oncologie, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
| | - P Gascón
- Department of Haematology-Oncology, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - J Glaspy
- Division of Hematology and Oncology, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, USA
| | - A Hofmann
- Medical Society for Blood Management, Laxenburg, Austria
| | - H Link
- Klinik für Innere Medizin I, Westpfalz-Klinikum, Kaiserslautern, Germany
| | - T Littlewood
- Department of Haematology, John Radcliffe Hospital, Oxford, UK
| | - H Ludwig
- Wilhelminen Cancer Research Institute, Wilhelminenspital, Vienna, Austria
| | - A Österborg
- Karolinska Institute and Karolinska Hospital, Stockholm, Sweden
| | - P Pronzato
- Medica Oncology, IRCCS Asiana Pedaliter Universitaria San Martino - IST, Institutor Nazionale per la Ricercars sol Chancre, Genova
| | - V Santini
- Department of Experimental and Clinical Medicine, Haematology, University of Florence, Florence, Italy
| | - D Schrijvers
- Department of Medical Oncology, Ziekenhuisnetwerk Antwerpen, Antwerp, Belgium
| | - R Stauder
- Department of Internal Medicine V (Haematology and Oncology), Innsbruck Medical University, Innsbruck, Austria
| | - K Jordan
- Department of Medicine V, University of Heidelberg, Heidelberg, Germany
| | - J Herrstedt
- Department of Oncology, Zealand University Hospital Roskilde, Roskilde
- University of Copenhagen, Copenhagen, Denmark
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5
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Aapro M, Beguin Y, Bokemeyer C, Dicato M, Gascón P, Glaspy J, Hofmann A, Link H, Littlewood T, Ludwig H, Österborg A, Pronzato P, Santini V, Schrijvers D, Stauder R, Jordan K, Herrstedt J. Management of anaemia and iron deficiency in patients with cancer: ESMO Clinical Practice Guidelines. Ann Oncol 2018; 29:iv271. [PMID: 30285221 DOI: 10.1093/annonc/mdy323] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Röllig C, Kramer M, Gabrecht M, Hänel M, Herbst R, Kaiser U, Schmitz N, Kullmer J, Fetscher S, Link H, Mantovani-Löffler L, Krümpelmann U, Neuhaus T, Heits F, Einsele H, Ritter B, Bornhäuser M, Schetelig J, Thiede C, Mohr B, Schaich M, Platzbecker U, Schäfer-Eckart K, Krämer A, Berdel W, Serve H, Ehninger G, Schuler U. Intermediate-dose cytarabine plus mitoxantrone versus standard-dose cytarabine plus daunorubicin for acute myeloid leukemia in elderly patients. Ann Oncol 2018; 29:973-978. [DOI: 10.1093/annonc/mdy030] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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7
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Heinz WJ, Buchheidt D, Christopeit M, von Lilienfeld-Toal M, Cornely OA, Einsele H, Karthaus M, Link H, Mahlberg R, Neumann S, Ostermann H, Penack O, Ruhnke M, Sandherr M, Schiel X, Vehreschild JJ, Weissinger F, Maschmeyer G. Diagnosis and empirical treatment of fever of unknown origin (FUO) in adult neutropenic patients: guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO). Ann Hematol 2017; 96:1775-1792. [PMID: 28856437 PMCID: PMC5645428 DOI: 10.1007/s00277-017-3098-3] [Citation(s) in RCA: 92] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 08/06/2017] [Indexed: 02/07/2023]
Abstract
Fever may be the only clinical symptom at the onset of infection in neutropenic cancer patients undergoing myelosuppressive chemotherapy. A prompt and evidence-based diagnostic and therapeutic approach is mandatory. A systematic search of current literature was conducted, including only full papers and excluding allogeneic hematopoietic stem cell transplant recipients. Recommendations for diagnosis and therapy were developed by an expert panel and approved after plenary discussion by the AGIHO. Randomized clinical trials were mainly available for therapeutic decisions, and new diagnostic procedures have been introduced into clinical practice in the past decade. Stratification into a high-risk versus low-risk patient population is recommended. In high-risk patients, initial empirical antimicrobial therapy should be active against pathogens most commonly involved in microbiologically documented and most threatening infections, including Pseudomonas aeruginosa, but excluding coagulase-negative staphylococci. In patients whose expected duration of neutropenia is more than 7 days and who do not respond to first-line antibacterial treatment, specifically in the absence of mold-active antifungal prophylaxis, further therapy should be directed also against fungi, in particular Aspergillus species. With regard to antimicrobial stewardship, treatment duration after defervescence in persistently neutropenic patients must be critically reconsidered and the choice of anti-infective agents adjusted to local epidemiology. This guideline updates recommendations for diagnosis and empirical therapy of fever of unknown origin in adult neutropenic cancer patients in light of the challenges of antimicrobial stewardship.
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Affiliation(s)
- W J Heinz
- Department of Internal Medicine II, University of Würzburg Medical Center, Würzburg, Germany
| | - D Buchheidt
- Department of Internal Medicine-Hematology and Oncology, Mannheim University Hospital, Mannheim, Germany
| | - M Christopeit
- Department of Stem Cell Transplantation, University Hospital UKE, Hamburg, Germany
| | | | - O A Cornely
- Department I for Internal Medicine, University Hospital of Cologne, Cologne, Germany.,German Centre for Infection Research, partner site Bonn-Cologne, Cologne, Germany.,Clinical Trials Centre Cologne, ZKS Köln, Cölogne, Germany.,Center for Integrated Oncology CIO Köln-Bonn, Cologne, Germany.,Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Medical Faculty, University of Cologne, Cologne, Germany
| | - H Einsele
- Department of Internal Medicine II, University of Würzburg Medical Center, Würzburg, Germany
| | - M Karthaus
- Department of Hematology, Oncology and Palliative Care, Klinikum Neuperlach and Klinikum Harlaching, München, Germany.,Department of Hematology, Oncology and Palliative Care, Klinikum Harlaching, Munich, Germany
| | - H Link
- Hematology and Medical Oncology Private Practice, Kaiserslautern, Germany
| | - R Mahlberg
- Klinikum Mutterhaus der Borromäerinnen, Trier, Germany
| | - S Neumann
- Medical Oncology, AMO MVZ, Wolfsburg, Germany
| | - H Ostermann
- Department of Hematology and Oncology, University of Munich, Munich, Germany
| | - O Penack
- Internal Medicine, Hematology, Oncology and Tumor Immunology, University Hospital Charité, Campus Virchow Klinikum, Berlin, Germany
| | - M Ruhnke
- Department of Hematology and Oncology, Paracelsus-Klinik, Osnabrück, Germany
| | - M Sandherr
- Hematology and Oncology Practice, Weilheim, Germany
| | - X Schiel
- Department of Hematology, Oncology and Palliative Care, Klinikum Harlaching, Munich, Germany
| | - J J Vehreschild
- Department I for Internal Medicine, University Hospital of Cologne, Cologne, Germany.,German Centre for Infection Research, partner site Bonn-Cologne, Cologne, Germany
| | - F Weissinger
- Department of Internal Medicine, Hematology, Oncology and Palliative Care, Evangelisches Klinikum Bethel, Bielefeld, Germany
| | - G Maschmeyer
- Department of Hematology, Oncology and Palliative Care, Klinikum Ernst von Bergmann, Potsdam, Germany.
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8
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Hehlmann R, Lauseker M, Saußele S, Pfirrmann M, Krause S, Kolb HJ, Neubauer A, Hossfeld DK, Nerl C, Gratwohl A, Baerlocher GM, Heim D, Brümmendorf TH, Fabarius A, Haferlach C, Schlegelberger B, Müller MC, Jeromin S, Proetel U, Kohlbrenner K, Voskanyan A, Rinaldetti S, Seifarth W, Spieß B, Balleisen L, Goebeler MC, Hänel M, Ho A, Dengler J, Falge C, Kanz L, Kremers S, Burchert A, Kneba M, Stegelmann F, Köhne CA, Lindemann HW, Waller CF, Pfreundschuh M, Spiekermann K, Berdel WE, Müller L, Edinger M, Mayer J, Beelen DW, Bentz M, Link H, Hertenstein B, Fuchs R, Wernli M, Schlegel F, Schlag R, de Wit M, Trümper L, Hebart H, Hahn M, Thomalla J, Scheid C, Schafhausen P, Verbeek W, Eckart MJ, Gassmann W, Pezzutto A, Schenk M, Brossart P, Geer T, Bildat S, Schäfer E, Hochhaus A, Hasford J. Assessment of imatinib as first-line treatment of chronic myeloid leukemia: 10-year survival results of the randomized CML study IV and impact of non-CML determinants. Leukemia 2017; 31:2398-2406. [PMID: 28804124 PMCID: PMC5668495 DOI: 10.1038/leu.2017.253] [Citation(s) in RCA: 185] [Impact Index Per Article: 26.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 07/04/2017] [Indexed: 01/06/2023]
Abstract
Chronic myeloid leukemia (CML)-study IV was designed to explore whether treatment with imatinib (IM) at 400 mg/day (n=400) could be optimized by doubling the dose (n=420), adding interferon (IFN) (n=430) or cytarabine (n=158) or using IM after IFN-failure (n=128). From July 2002 to March 2012, 1551 newly diagnosed patients in chronic phase were randomized into a 5-arm study. The study was powered to detect a survival difference of 5% at 5 years. After a median observation time of 9.5 years, 10-year overall survival was 82%, 10-year progression-free survival was 80% and 10-year relative survival was 92%. Survival between IM400 mg and any experimental arm was not different. In a multivariate analysis, risk group, major-route chromosomal aberrations, comorbidities, smoking and treatment center (academic vs other) influenced survival significantly, but not any form of treatment optimization. Patients reaching the molecular response milestones at 3, 6 and 12 months had a significant survival advantage. For responders, monotherapy with IM400 mg provides a close to normal life expectancy independent of the time to response. Survival is more determined by patients' and disease factors than by initial treatment selection. Although improvements are also needed for refractory disease, more life-time can currently be gained by carefully addressing non-CML determinants of survival.
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Affiliation(s)
- R Hehlmann
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - M Lauseker
- IBE, Universität München, Munich, Germany
| | - S Saußele
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | | | - S Krause
- Medizinische Klinik 5, Universitätsklinikum, Erlangen, Germany
| | - H J Kolb
- Medizinische Klinik III, Universität München, Munich, Germany
| | - A Neubauer
- Klinik für innere Medizin, Universitätsklinikum, Marburg, Germany
| | - D K Hossfeld
- 2. Medizinische Klinik, Universitätsklinikum Eppendorf, Hamburg, Germany
| | - C Nerl
- Klinikum Schwabing, Munich, Germany
| | | | | | - D Heim
- Universitätsspital, Basel, Switzerland
| | | | - A Fabarius
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | | | | | - M C Müller
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | | | - U Proetel
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - K Kohlbrenner
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - A Voskanyan
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - S Rinaldetti
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - W Seifarth
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - B Spieß
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | | | - M C Goebeler
- Medizinische Klinik und Poliklinik, Universitätsklinikum, Würzburg, Germany
| | - M Hänel
- Klinik für innere Medizin 3, Chemnitz, Germany
| | - A Ho
- Medizinische Klinik V, Universität Heidelberg, Heidelberg, Germany
| | - J Dengler
- Onkologische Schwerpunktpraxis, Heilbronn, Germany
| | - C Falge
- Medizinische Klinik 5, Klinikum Nürnberg-Nord, Nürnberg, Germany
| | - L Kanz
- Medizinische Abteilung 2, Universitätsklinikum, Tübingen, Germany
| | - S Kremers
- Caritas Krankenhaus, Lebach, Germany
| | - A Burchert
- Klinik für innere Medizin, Universitätsklinikum, Marburg, Germany
| | - M Kneba
- 2. Medizinische Klinik und Poliklinik, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - F Stegelmann
- Klinik für Innere Medizin 3, Universitätsklinikum, Ulm, Germany
| | - C A Köhne
- Klinik für Onkologie und Hämatologie, Oldenburg, Germany
| | | | - C F Waller
- Innere Medizin 1, Universitätsklinikum, Freiburg, Germany
| | - M Pfreundschuh
- Klinik für Innere Medizin 1, Universität des Saarlandes, Homburg, Germany
| | - K Spiekermann
- Medizinische Klinik III, Universität München, Munich, Germany
| | - W E Berdel
- Medizinische Klinik A, Universitätsklinikum, Münster, Germany
| | - L Müller
- Onkologie Leer UnterEms, Leer, Germany
| | - M Edinger
- Klinik und Poliklinik für Innere Medizin 3, Universitätsklinikum, Regensburg, Germany
| | - J Mayer
- Masaryk University Hospital, Brno, Czech Republic
| | - D W Beelen
- Klinik für Knochenmarktransplantation, Essen, Germany
| | - M Bentz
- Medizinische Klinik 3, Städtisches Klinikum, Karlsruhe, Germany
| | - H Link
- Klinik für Innere Medizin 3, Westpfalz-Klinikum, Kaiserslautern, Germany
| | - B Hertenstein
- 1. Medizinische Klinik, Klinikum Bremen Mitte, Bremen, Germany
| | | | - M Wernli
- Kantonsspital, Aarau, Switzerland
| | - F Schlegel
- St Antonius-Hospital, Eschweiler, Germany
| | - R Schlag
- Hämatologische-Onkologische Schwerpunktpraxis, Würzburg, Germany
| | - M de Wit
- Vivantes Klinikum Neukölln, Berlin, Germany
| | - L Trümper
- Klinik für Hämatologie und medizinische Onkologie, Universitätsmedizin, Göttingen, Germany
| | - H Hebart
- Stauferklinikum Schwäbisch Gmünd, Mutlangen, Germany
| | - M Hahn
- Onkologie Zentrum, Ansbach, Germany
| | - J Thomalla
- Praxisklinik für Hämatologie und Onkologie, Koblenz, Germany
| | - C Scheid
- Klinik 1 für Innere Medizin, Universitätsklinikum, Köln, Germany
| | - P Schafhausen
- 2. Medizinische Klinik, Universitätsklinikum Eppendorf, Hamburg, Germany
| | - W Verbeek
- Ambulante Hämatologie und Onkologie, Bonn, Germany
| | - M J Eckart
- Internistische Schwerpunktpraxis, Erlangen, Germany
| | | | | | - M Schenk
- Barmherzige Brüder, Regensburg, Germany
| | - P Brossart
- Medizinische Klinik 3, Universität, Bonn, Germany
| | - T Geer
- Diakonie, Schwäbisch Hall, Germany
| | - S Bildat
- Medizinische Klinik 2, Herford, Germany
| | - E Schäfer
- Onkologische Schwerpunktpraxis, Bielefeld, Germany
| | - A Hochhaus
- Klinik für Innere Medizin 2, Universitätsklinikum, Jena, Germany
| | - J Hasford
- IBE, Universität München, Munich, Germany
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Aapro M, Boccia R, Choquet S, Hus I, Link H, Sliwa T. Optimal use of pegfilgrastim (a long-acting granulocyte-colony stimulating factor [G-CSF]) to manage chemotherapy-induced febrile neutropenia (FN) in haematological malignancies: consensus guidance recommendations. Eur J Cancer 2017. [DOI: 10.1016/s0959-8049(17)30619-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Zhu WH, Lu CZ, Huang YM, Link H, Xiao BG. A putative mechanism on remission of multiple sclerosis during pregnancy: estrogen-induced indoleamine 2,3-dioxygenase by dendritic cells. Mult Scler 2016; 13:33-40. [PMID: 17294609 DOI: 10.1177/1352458506071171] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The basis for the reduced relapse rate of multiple sclerosis (MS) during pregnancy remains unexplained but, if defined, could create novel treatment options. Estrogen constitutes one candidate molecule, but the mechanism by which estrogen may affect MS during pregnancy is unclear. In this study, we used monocyte-derived dendritic cells (DCs) from MS patients to explore the estrogen (17-b-estradiol)-related pathway of immune modulation. Estrogen induced the expression of indoleamine 2,3-dioxygenase (IDO) on DCs, limiting T-cell proliferation and both Th1 and Th2 cytokine production. The suppression of T-cell proliferation mediated by estrogenexposed DCs was partly abolished by the IDO-inhibitor, 1-methyl-dl-tryptophan, indicating that estrogen-exposed DCs induced IDO-dependent T-cell suppression. Our data support the hypothesis that the change in the clinical course of MS observed in pregnancy may be related to the estrogen DC-IDO axis, which could represent a novel target for MS therapy.
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Affiliation(s)
- W H Zhu
- Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
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Zhu J, Bengtsson BO, Mix E, Thorell LH, Olsson T, Link H. Peripheral Nerve Myelin Modulates the Effect of Antidepressants on Major Histocompatibility Complex Expression on Macrophages in Experimental Allergic Neuritis. Int J Immunopathol Pharmacol 2016. [DOI: 10.1177/039463209500800305] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The effect of bovine peripheral nerve myelin (BPM) used for induction of experimental allergic neuritis (EAN) in Lewis rats, on antidepressants' modulation of interferon-gamma (IFN-γ)-induced major histocompatibility complex (MHC) class I and II antigen expression on peritoneal macrophages in EAN rats was studied. Antidepressants with different profiles concerning inhibition of the neuronal reuptake of the monoamines serotonin (5-HT) and noradrenalin (NA), respectively, in concentrations of 10−4 to 10−8 M were used. At the concentration of 1.0 U/ml IFN-γ, most antidepressants significantly enhanced both MHC class I and class II expression, except maprotiline, a selective NA reuptake inhibiting antidepressant that suppressed MHC class I expression. Zimeldine, a selective 5-HT reuptake inhibitor did not affect MHC class II expression. BPM in general had an enhancing effect on modulation of both MHC class I and class II expression by antidepressants. By itself BPM enhanced MHC class I expression, but did not affect class II expression at IFN-γ 1.0 U/ml. The modulating effect of BPM on regulation of MHC expression by antidepressants could be the result of contaminating T cells and release of IFN-γ into cultures. The modulatory effect of antidepressants on MHC expression may to some extent be exerted by the action on 5-HT and/or NA regulation, but also by direct effects of antidepressants on macrophages. They probably play a role in zimeldine-induced Guillain-Barré syndrome in some patients and in the suppression of clinical signs of EAN in Lewis rats reported for some antidepressants.
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Affiliation(s)
- J. Zhu
- Department of Neurology, Karolinska Institute, Huddinge Hospital, S-141 86 Huddinge, Stockholm, Sweden
| | - B.-O. Bengtsson
- Department of Psychiatry, Faculty of Health Sciences, University Hospital, S-581 85 Linköping, Sweden
| | - E. Mix
- Department of Neurology, Karolinska Institute, Huddinge Hospital, S-141 86 Huddinge, Stockholm, Sweden
| | - L.-H. Thorell
- Department of Psychiatry, Faculty of Health Sciences, University Hospital, S-581 85 Linköping, Sweden
| | - T. Olsson
- Department of Neurology, Karolinska Institute, Huddinge Hospital, S-141 86 Huddinge, Stockholm, Sweden
| | - H. Link
- Department of Neurology, Karolinska Institute, Huddinge Hospital, S-141 86 Huddinge, Stockholm, Sweden
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Müller-Tidow C, Tschanter P, Röllig C, Thiede C, Koschmieder A, Stelljes M, Koschmieder S, Dugas M, Gerss J, Butterfaß-Bahloul T, Wagner R, Eveslage M, Thiem U, Krause SW, Kaiser U, Kunzmann V, Steffen B, Noppeney R, Herr W, Baldus CD, Schmitz N, Götze K, Reichle A, Kaufmann M, Neubauer A, Schäfer-Eckart K, Hänel M, Peceny R, Frickhofen N, Kiehl M, Giagounidis A, Görner M, Repp R, Link H, Kiani A, Naumann R, Brümmendorf TH, Serve H, Ehninger G, Berdel WE, Krug U. Azacitidine in combination with intensive induction chemotherapy in older patients with acute myeloid leukemia: The AML-AZA trial of the Study Alliance Leukemia. Leukemia 2015; 30:555-61. [PMID: 26522083 DOI: 10.1038/leu.2015.306] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 10/05/2015] [Accepted: 10/08/2015] [Indexed: 11/09/2022]
Abstract
DNA methylation changes are a constant feature of acute myeloid leukemia. Hypomethylating drugs such as azacitidine are active in acute myeloid leukemia (AML) as monotherapy. Azacitidine monotherapy is not curative. The AML-AZA trial tested the hypothesis that DNA methyltransferase inhibitors such as azacitidine can improve chemotherapy outcome in AML. This randomized, controlled trial compared the efficacy of azacitidine applied before each cycle of intensive chemotherapy with chemotherapy alone in older patients with untreated AML. Event-free survival (EFS) was the primary end point. In total, 214 patients with a median age of 70 years were randomized to azacitidine/chemotherapy (arm-A) or chemotherapy (arm-B). More arm-A patients (39/105; 37%) than arm-B (25/109; 23%) showed adverse cytogenetics (P=0.057). Adverse events were more frequent in arm-A (15.44) versus 13.52 in arm-B, (P=0.26), but early death rates did not differ significantly (30-day mortality: 6% versus 5%, P=0.76). Median EFS was 6 months in both arms (P=0.96). Median overall survival was 15 months for patients in arm-A compared with 21 months in arm-B (P=0.35). Azacitidine added to standard chemotherapy increases toxicity in older patients with AML, but provides no additional benefit for unselected patients.
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Affiliation(s)
- C Müller-Tidow
- Department of Medicine, Hematology and Oncology, University of Halle, Halle, Germany.,Department of Medicine A - Hematology, Oncology and Pneumology, University of Muenster, Muenster, Germany
| | - P Tschanter
- Department of Medicine, Hematology and Oncology, University of Halle, Halle, Germany.,Department of Medicine A - Hematology, Oncology and Pneumology, University of Muenster, Muenster, Germany
| | - C Röllig
- Department of Internal Medicine I, Dresden University Medical Center, Dresden, Germany
| | - C Thiede
- Department of Internal Medicine I, Dresden University Medical Center, Dresden, Germany
| | - A Koschmieder
- Department of Medicine A - Hematology, Oncology and Pneumology, University of Muenster, Muenster, Germany.,Department of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, RWTH Aachen University Hospital, Aachen, Germany
| | - M Stelljes
- Department of Medicine A - Hematology, Oncology and Pneumology, University of Muenster, Muenster, Germany
| | - S Koschmieder
- Department of Medicine A - Hematology, Oncology and Pneumology, University of Muenster, Muenster, Germany.,Department of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, RWTH Aachen University Hospital, Aachen, Germany
| | - M Dugas
- Institute of Medical Informatics, University Hospital of Muenster, Muenster, Germany
| | - J Gerss
- Institute of Biometry, University Hospital of Muenster, Muenster, Germany
| | | | - R Wagner
- Center for Clinical Trials, University Hospital Muenster, Muenster, Germany
| | - M Eveslage
- Institute of Biometry, University Hospital of Muenster, Muenster, Germany
| | - U Thiem
- Department of Medical Informatics, Biometry and Epidemiology, University Bochum, Bochum, Germany
| | - S W Krause
- Department of Internal Medicine 5, University of Erlangen-Nürnberg Medical Center, Erlangen, Germany
| | - U Kaiser
- Hematology and Oncology, St Bernward Hospital, Hildesheim, Germany
| | - V Kunzmann
- Department of Internal Medicine II, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | - B Steffen
- Department of Medicine, Hematology/Oncology, Goethe University of Frankfurt, Frankfurt, Germany
| | - R Noppeney
- Department of Hematology, University of Essen Medical Center, Essen, Germany
| | - W Herr
- Department for Hematology/Oncology, University of Regensburg, Regensburg, Germany
| | - C D Baldus
- Department of Hematology and Oncology, Charité Campus Benjamin Franklin, Berlin, Germany
| | - N Schmitz
- Department of Hematology and Stem Cell Transplantation, ASKLEPIOS Klinik St. Georg, Hamburg, Germany
| | - K Götze
- Department of Internal Medicine III, University Hospital of Munich, Munich, Germany
| | - A Reichle
- Department for Hematology/Oncology, University of Regensburg, Regensburg, Germany
| | - M Kaufmann
- Hematology and Oncology, Robert-Bosch-Krankenhaus, Stuttgart, Germany
| | - A Neubauer
- Department Hematology, Oncology and Immunology, Philipps University Marburg, Marburg, Germany
| | - K Schäfer-Eckart
- Department of Internal Medicine V, Klinikum Nuernberg Nord, Nuernberg, Germany
| | - M Hänel
- Department of Internal Medicine III, Klinikum Chemnitz GmbH, Chemnitz, Germany
| | - R Peceny
- Department of Hematology and Oncology, Klinikum Osnabrück, Osnabrück, Germany
| | - N Frickhofen
- Department of Hematology and Oncology, HSK, Dr -Horst-Schmidt-Klinik, Wiesbaden, Germany
| | - M Kiehl
- Department of Internal Medicine, Frankfurt (Oder) General hospital, Frankfurt/Oder, Germany
| | - A Giagounidis
- Department of Oncology and Hematology, Marien Hospital Düsseldorf, Duesseldorf, Germany
| | - M Görner
- Department of Hematology and Oncology, Städtische Kliniken, Bielefeld, Germany
| | - R Repp
- Department of Medicine V, Klinikum am Bruderwald, Bamberg, Germany
| | - H Link
- Department of Internal Medicine I, Westpfalz-Klinikum, Kaiserslautern, Germany
| | - A Kiani
- Department IV Hematology and Onkology, Klinikum Bayreuth, Bayreuth, Germany
| | - R Naumann
- Department of Internal Medicine, Stiftungsklinikum Mittelrhein, Koblenz, Germany
| | - T H Brümmendorf
- Department of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, RWTH Aachen University Hospital, Aachen, Germany
| | - H Serve
- Department of Medicine, Hematology/Oncology, Goethe University of Frankfurt, Frankfurt, Germany
| | - G Ehninger
- Department of Internal Medicine I, Dresden University Medical Center, Dresden, Germany
| | - W E Berdel
- Department of Medicine A - Hematology, Oncology and Pneumology, University of Muenster, Muenster, Germany
| | - U Krug
- Department of Medicine A - Hematology, Oncology and Pneumology, University of Muenster, Muenster, Germany.,Department of Medicine, Hematology and Oncology, Klinikum Leverkusen, Leverkusen, Germany
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Gross NJ, Link H, Biermann J, Kiechle M, Lagrèze WA. [Induced Incomitance of one Muscle Strabismus Surgery in Comparison to Unilateral Recess-Resect Procedures]. Klin Monbl Augenheilkd 2015; 232:1174-7. [PMID: 26512848 DOI: 10.1055/s-0041-104776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Surgical correction of intermediate squint angles may be performed on one muscle alone or as a combined unilateral recess-resect procedure. No larger case series has yet systematically measured the amount of induced incomitance that could potentially lead to visual disturbances. METHODS 31 patients with strabismus and binocular vision (phoria or intermittent strabismus) were operated on one extraocular eye muscle; 30 patients underwent a unilateral recess-resect procedure. Preoperatively and three months postoperatively, we measured the latent angle of squint on a tangent screen over the horizontal 60° in 10° increments and then calculated the amount of induced incomitance. RESULTS After one muscle surgery, the induced incomitance was 1.7° over a 20° gaze range, 3.2° over a 40° gaze range and 3.8° over a 60° gaze range. For recess-resect procedures, the induced incomitance was 1.4°, 2.6° and 3.4°, respectively. A significant correlation between the surgical dose and the induced incomitance was only seen in one muscle surgery for the 40° and 60° gaze range, but not for the 20° gaze range. A subgroup analysis of patients with an identical surgical dose in one and two muscle procedures (6-8 mm) found greater induced incomitance in one muscle procedures, but only for the 40° and 60° gaze range (p = 0.02). Double vision in any gaze direction was reported by 16 % of patients after one muscle surgery and 10 % of patients after unilateral recess-resect surgery (p > 0.05). CONCLUSION One muscle surgery is a viable option in small and intermediate angles of squint. The induced incomitance is rather small and does not lead to significant visual disturbances in the central gaze range.
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Affiliation(s)
- N J Gross
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg
| | - H Link
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg
| | - J Biermann
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg
| | - M Kiechle
- Praxis für Augenheilkunde, Praxis Prof. Grüb und Kollegen, Breisach
| | - W A Lagrèze
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg
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von Minckwitz G, Loibl S, Untch M, Eidtmann H, Rezai M, Fasching PA, Tesch H, Eggemann H, Schrader I, Kittel K, Hanusch C, Huober J, Solbach C, Jackisch C, Kunz G, Blohmer JU, Hauschild M, Fehm T, Nekljudova V, Gerber B, Gnauert K, Heinrich B, Prätz T, Groh U, Tanzer H, Villena C, Tulusan A, Liedtke B, Blohmer JU, Kittel K, Mau C, Potenberg J, Schilling J, Just M, Weiss E, Bückner U, Wolfgarten M, Lorenz R, Doering G, Feidicker S, Krabisch P, Deichert U, Augustin D, Kunz G, Kast K, von Minckwitz G, Nestle-Krämling C, Rezai M, Höß C, Terhaag J, Fasching P, Staib P, Aktas B, Kühn T, Khandan F, Möbus V, Solbach C, Tesch H, Stickeler E, Heinrich G, Wagner H, Abdallah A, Dewitz T, Emons G, Belau A, Rethwisch V, Lantzsch T, Thomssen C, Mattner U, Nugent A, Müller V, Noesselt T, Holms F, Müller T, Deuker JU, Schrader I, Strumberg D, Uleer C, Solomayer E, Runnebaum I, Link H, Tomé O, Ulmer HU, Conrad B, Feisel-Schwickardi G, Eidtmann H, Schumacher C, Steinmetz T, Bauerfeind I, Kremers S, Langanke D, Kullmer U, Ober A, Fischer D, Kohls A, Weikel W, Bischoff J, Freese K, Schmidt M, Wiest W, Sütterlin M, Dietrich M, Grießhammer M, Burgmann DM, Hanusch C, Rack B, Salat C, Sattler D, Tio J, von Abel E, Christensen B, Burkamp U, Köhne CH, Meinerz W, Graßhoff ST, Decker T, Overkamp F, Thalmann I, Sallmann A, Beck T, Reimer T, Bartzke G, Deryal M, Weigel M, Huober J, Weder P, Steffens CC, Lemster S, Stefek A, Ruhland F, Hofmann M, Schuster J, Simon W, Kronawitter U, Clemens M, Fehm T, Janni W, Latos K, Bauer W, Roßmann A, Bauer L, Lampe D, Heyl V, Hoffmann G, Lorenz-Salehi F, Hackmann J, Schlag R. Survival after neoadjuvant chemotherapy with or without bevacizumab or everolimus for HER2-negative primary breast cancer (GBG 44-GeparQuinto)†. Ann Oncol 2014; 25:2363-2372. [PMID: 25223482 DOI: 10.1093/annonc/mdu455] [Citation(s) in RCA: 97] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The GeparQuinto study showed that adding bevacizumab to 24 weeks of anthracycline-taxane-based neoadjuvant chemotherapy increases pathological complete response (pCR) rates overall and specifically in patients with triple-negative breast cancer (TNBC). No difference in pCR rate was observed for adding everolimus to paclitaxel in nonearly responding patients. Here, we present disease-free (DFS) and overall survival (OS) analyses. PATIENTS AND METHODS Patients (n = 1948) with HER2-negative tumors of a median tumor size of 4 cm were randomly assigned to neoadjuvant treatment with epirubicin/cyclophosphamide followed by docetaxel (EC-T) with or without eight infusions of bevacizumab every 3 weeks before surgery. Patients without clinical response to EC ± Bevacizumab were randomized to 12 weekly cycles paclitaxel with or without everolimus 5 mg/day. To detect a hazard ratio (HR) of 0.75 (α = 0.05, β = 0.8) 379 events had to be observed in the bevacizumab arms. RESULTS With a median follow-up of 3.8 years, 3-year DFS was 80.8% and 3-year OS was 89.7%. Outcome was not different for patients receiving bevacizumab (HR 1.03; P = 0.784 for DFS and HR 0.974; P = 0.842 for OS) compared with patients receiving chemotherapy alone. Patients with TNBC similarly showed no improvement in DFS (HR = 0.99; P = 0.941) and OS (HR = 1.02; P = 0.891) when treated with bevacizumab. No other predefined subgroup (HR+/HER2-; locally advanced (cT4 or cN3) or not; cT1-3 or cT4; pCR or not) showed a significant benefit. No difference in DFS (HR 0.997; P = 0.987) and OS (HR 1.11; P = 0.658) was observed for nonearly responding patients receiving paclitaxel with or without everolimus overall as well as in subgroups. CONCLUSIONS Long-term results, in opposite to the results of pCR, do not support the neoadjuvant use of bevacizumab in addition to an anthracycline-taxane-based chemotherapy or everolimus in addition to paclitaxel for nonearly responding patients. CLINICAL TRIAL NUMBER NCT 00567554, www.clinicaltrials.gov.
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Affiliation(s)
- G von Minckwitz
- Headquarter, German Breast Group, Neu-Isenburg; Department of Gynaecology and Obstetrics, University Hospital, Frankfurt.
| | - S Loibl
- Headquarter, German Breast Group, Neu-Isenburg
| | - M Untch
- Department of Gynaecology and Obstetrics, Klinikum Berlin-Buch, Berlin
| | - H Eidtmann
- Department of Gynaecology and Obstetrics, University Hospital, Kiel
| | - M Rezai
- Breast Center, Luisenkrankenhaus, Düsseldorf
| | - P A Fasching
- Department of Gynaecology and Obstetrics, University Hospital, Erlangen
| | - H Tesch
- Department of Medical Oncology, Chop GmbH, Frankfurt
| | - H Eggemann
- Department of Gynaecology and Obstetrics, University Hospital, Magdeburg
| | - I Schrader
- Department of Gynaecology and Obstetrics, Henriettenstiftung, Hannover
| | - K Kittel
- Department of Gynaecology and Obstetrics, Praxisklinik, Berlin
| | - C Hanusch
- Department of Gynaecology and Obstetrics, Rot-Kreuz-Klinikum, München
| | - J Huober
- Department of Gynaecology and Obstetrics, University Hospital, Ulm
| | - C Solbach
- Department of Gynaecology and Obstetrics, University Hospital, Frankfurt
| | - C Jackisch
- Department of Gynaecology and Obstetrics, Sana-Klinikum, Offenbach
| | - G Kunz
- Department of Gynaecology and Obstetrics, St Johannes Hospital, Dortmund
| | - J U Blohmer
- Department of Gynaecology and Obstetrics, St Gertrauden-Hospital, Berlin
| | - M Hauschild
- Department of Gynaecology and Obstetrics, Hospital, Rheinfelden
| | - T Fehm
- Department of Gynaecology and Obstetrics, University Hospital, Tübingen
| | | | - B Gerber
- Department of Gynaecology and Obstetrics, University Hospital, Rostock, Germany
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Kühn W, Gieseking F, Menton M, Link H, Quass J, Küppers V, Lellé RJ. Remarks by the Board of the Study Group for Cervical Pathology and Colposcopy on the "Comments on the Publication of Munich Nomenclature III by the Cytology Coordination Conference" by A. Schneider and P. Hillemanns (Geburtsh Frauenheilk 2014; 74: 242-243). Geburtshilfe Frauenheilkd 2014; 74:634-635. [PMID: 25100875 DOI: 10.1055/s-0034-1368553] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- W Kühn
- German Society of Cervical Pathology and Colposcopy (AG-CPC)
| | - F Gieseking
- German Society of Cervical Pathology and Colposcopy (AG-CPC)
| | - M Menton
- German Society of Cervical Pathology and Colposcopy (AG-CPC)
| | - H Link
- German Society of Cervical Pathology and Colposcopy (AG-CPC)
| | - J Quass
- German Society of Cervical Pathology and Colposcopy (AG-CPC)
| | - V Küppers
- German Society of Cervical Pathology and Colposcopy (AG-CPC)
| | - R J Lellé
- German Society of Cervical Pathology and Colposcopy (AG-CPC)
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Link H. Wo geht die Reise hin bei Hüftimplantaten? AKTUEL RHEUMATOL 2014. [DOI: 10.1055/s-0034-1368788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- H. Link
- Geschäftsleitung, Waldemar Link GmbH & Co. KG, Hamburg
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Link H. [Supportive therapy in medical therapy of head and neck tumors]. Laryngorhinootologie 2012; 91 Suppl 1:S151-75. [PMID: 22456916 DOI: 10.1055/s-0031-1299720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Fever during neutropenia may be a symptom of severe life threatening infection, which must be treated immediately with antibiotics. If signs of infection persist, therapy must be modified. Diagnostic measures should not delay treatment. If the risk of febrile neutropenia after chemotherapy is ≥ 20%, then prophylactic therapy with G-CSF is standard of care. After protocols with a risk of febrile neutropenia of 10-20%, G-CSF is necessary, in patients older than 65 years or with severe comorbidity, open wounds, reduced general condition. Anemia in cancer patients must be diagnosed carefully, even preoperatively. Transfusions of red blood cells are indicated in Hb levels below 7-8 g/dl. Erythropoiesis stimulating agents (ESA) are recommended after chemotherapy only when hemoglobin levels are below 11 g/dl. The Hb-level must not be increased above 12 g/dl. Anemia with functional iron deficiency (transferrin saturation < 20%) should be treated with intravenous iron, as oral iron is ineffective being not absorbed. Therapy of pain must follow diagnostic and treatment standards. Nausea or emesis following chemotherapy can be classified as minimal, low, moderate and high. The antiemetic prophylaxis should be escalated accordingly. In chemotherapy with low emetogenic potential steroids are sufficient, in the moderate level 5-HT3 receptor antagonists (setrons) are added, and in the highest level Aprepitant as third drug.
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Affiliation(s)
- H Link
- Medizinische Klinik I, Westpfalz-Klinikum, Kaiserslautern.
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Schmittel A, Sebastian M, Fischer von Weikersthal L, Martus P, Gauler T, Kaufmann C, Hortig P, Fischer J, Link H, Binder D, Fischer B, Caca K, Eberhardt W, Keilholz U. A German multicenter, randomized phase III trial comparing irinotecan–carboplatin with etoposide–carboplatin as first-line therapy for extensive-disease small-cell lung cancer. Ann Oncol 2011; 22:1798-804. [DOI: 10.1093/annonc/mdq652] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Hofheinz R, Wenz FK, Post S, Matzdorff A, Laechelt S, Hartmann JT, Müller L, Link H, Moehler MH, Kettner E, Fritz E, Hieber U, Lindemann HW, Grunewald M, Kremers S, Constantin C, Hipp M, Gencer D, Burkholder I, Hochhaus A. Capecitabine (Cape) versus 5-fluorouracil (5-FU)–based (neo)adjuvant chemoradiotherapy (CRT) for locally advanced rectal cancer (LARC): Long-term results of a randomized, phase III trial. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.3504] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Moehler M, Al-Batran SE, Andus T, Anthuber M, Arends J, Arnold D, Aust D, Baier P, Baretton G, Bernhardt J, Boeing H, Böhle E, Bokemeyer C, Bornschein J, Budach W, Burmester E, Caca K, Diemer WA, Dietrich CF, Ebert M, Eickhoff A, Ell C, Fahlke J, Feussner H, Fietkau R, Fischbach W, Fleig W, Flentje M, Gabbert HE, Galle PR, Geissler M, Gockel I, Graeven U, Grenacher L, Gross S, Hartmann JT, Heike M, Heinemann V, Herbst B, Herrmann T, Höcht S, Hofheinz RD, Höfler H, Höhler T, Hölscher AH, Horneber M, Hübner J, Izbicki JR, Jakobs R, Jenssen C, Kanzler S, Keller M, Kiesslich R, Klautke G, Körber J, Krause BJ, Kuhn C, Kullmann F, Lang H, Link H, Lordick F, Ludwig K, Lutz M, Mahlberg R, Malfertheiner P, Merkel S, Messmann H, Meyer HJ, Mönig S, Piso P, Pistorius S, Porschen R, Rabenstein T, Reichardt P, Ridwelski K, Röcken C, Roetzer I, Rohr P, Schepp W, Schlag PM, Schmid RM, Schmidberger H, Schmiegel WH, Schmoll HJ, Schuch G, Schuhmacher C, Schütte K, Schwenk W, Selgrad M, Sendler A, Seraphin J, Seufferlein T, Stahl M, Stein H, Stoll C, Stuschke M, Tannapfel A, Tholen R, Thuss-Patience P, Treml K, Vanhoefer U, Vieth M, Vogelsang H, Wagner D, Wedding U, Weimann A, Wilke H, Wittekind C. [German S3-guideline "Diagnosis and treatment of esophagogastric cancer"]. Z Gastroenterol 2011; 49:461-531. [PMID: 21476183 DOI: 10.1055/s-0031-1273201] [Citation(s) in RCA: 151] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- M Moehler
- Medizinische Klinik und Poliklinik, Johannes-Gutenberg-Universität, Langenbeckstraße 1, 55101 Mainz.
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Zhu J, Mix E, Issazadeh S, Link H. Dynamics of mRNA expression of interferon-γ, interleukin 4 and transforming growth factor β1 in sciatic nerves and lymphoid organs in experimental allergic neuritis. Eur J Neurol 2011; 3:232-40. [DOI: 10.1111/j.1468-1331.1996.tb00428.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Matusevicius D, Kivisäkk P, Navikas V, Xiao BG, Söderström M, Olsson T, Pirskanen R, Fredrikson S, Link H. Autoantigen-induced IL-13 mRNA expression is increased in blood mononuclear cells in myasthenia gravis and multiple sclerosis. Eur J Neurol 2011. [DOI: 10.1111/j.1468-1331.1997.tb00386.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Wang WZ, Fredrikson S, Xiao BG, Sun JB, Kostulas V, Link H. Lyme neuroborreliosis: cerebrospinal fluid contains myelin protein-reactive cells secreting interferon-γ. Eur J Neurol 2011. [DOI: 10.1111/j.1468-1331.1996.tb00203.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kivisäkk P, Tian W, Fredrikson S, Link H, Söderström M. Multiple sclerosis: myelin basic protein induced mRNA expression of proinflammatory cytokines in mononuclear cells is suppressed by interferon-β 1b in vitro. Eur J Neurol 2011. [DOI: 10.1111/j.1468-1331.1997.tb00385.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Braun M, Link H, Liu L, Schmid R, Aigner A, Weuster-Botz D. Kinetische Modellierung eines Zwei-Enzym-Systems zur Oxidation von Cholsäure. CHEM-ING-TECH 2010. [DOI: 10.1002/cite.201050267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Link H, Weuster-Botz D. Metabolic control analysis of cells in fed-batch processes. N Biotechnol 2009. [DOI: 10.1016/j.nbt.2009.06.821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Arseniev L, Link H, Kadar J, Lieb B, Battmer K, Südmeier I, Stucki A, Pape I, Novotny J, Ganser A, Hertenstein B. Immunoaffinity Selection of CD34 + Blood Cells for Allogeneic Transplantation. Transfus Med Hemother 2009. [DOI: 10.1159/000223516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Schmittel AH, Sebastian M, von Weikersthal LF, Gauler T, Hortig P, Fischer JR, Link H, Binder D, Eberhardt W, Keilholz U. Irinotecan plus carboplatin versus etoposide plus carboplatin in extensive disease small cell lung cancer: Results of the German randomized phase III trial. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.8029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8029 Background: Superiority of irinotecan over etoposide in combination with cis- or carboplatin was demonstrated in a Japanese and a Scandinavian phase III trial. However, both cisplatin-based North American phase III studies could not detect any difference in efficacy. We report the final results of the German randomized phase III trial comparing etoposide/carboplatin (PE) to irinotecan/carboplatin (IP) in small cell lung cancer (SCLC) extensive disease. Methods: Chemotherapy-naïve extensive disease SCLC patients were randomly assigned to receive carboplatin AUC 5 mg × min/mL either in combination with 50 mg/m2 of irinotecan on days 1, 8 and 15 (IP, Arm A) or with etoposide 140mg/m2 days 1–3 (EP). IP treatment was repeated every 4 weeks, EP every 3 weeks. Response assessment was performed after cycles 2, 4 and 6 and every 3 months thereafter. Toxicity was assessed once weekly. Primary endpoint was detection of progression free survival (PFS), secondary endpoints were overall survival (OS), response rate, and toxicity. Results: A total of 216 patients from 8 centres were randomized. No significant differences in survival or response rate could be detected. Median PFS was 6 months in both arms. Median OS was 10 months (95% confidence interval (CI) 8.3 -11.7) in the IP arm and 9 months (95% CI 7.6 -10.4) in the EP arm. 1 year survival was 37% (95% CI 25.6 - 47.6) and 28% (95% CI 18.2 - 37.4) in the IP and EP arm. 62% of patients in the IP and 63% in the EP arm had a confirmed complete or partial remission according to RECIST criteria. Significant differences in grade 3 and 4 toxicity were observed for thrombopenia (22% IP vs 47% EP) and neutropenia (23% IP vs 61% PE) without differences in the rate of febrile neutropenia. Grade 3 and 4 diarrhea was manageable and as expected significantly more frequent with IP (15%) than with EP (6%). Conclusions: Our phase III trial shows equivalent efficacy of irinotecan when compared to etoposide in combination with carboplatin. [Table: see text]
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Affiliation(s)
- A. H. Schmittel
- Charité University Hospital, Campus Benjamin Franklin, Berlin, Germany; 3rd Medical Clinic, Mainz, Germany; MVZ Gesundheitszentrum St. Marien, Amberg, Germany; West German Cancer Centre, Essen, Germany; Charité Campus Benjamin Franklin, Berlin, Germany; Klinikum Löwenstein, Löwenstein, Germany; Westpfalz Kliniken, Kaiserslautern, Germany; Charité Campus Virchow, Berlin, Germany; West German Cancer Centre, Essen, Germany; AIO Germany
| | - M. Sebastian
- Charité University Hospital, Campus Benjamin Franklin, Berlin, Germany; 3rd Medical Clinic, Mainz, Germany; MVZ Gesundheitszentrum St. Marien, Amberg, Germany; West German Cancer Centre, Essen, Germany; Charité Campus Benjamin Franklin, Berlin, Germany; Klinikum Löwenstein, Löwenstein, Germany; Westpfalz Kliniken, Kaiserslautern, Germany; Charité Campus Virchow, Berlin, Germany; West German Cancer Centre, Essen, Germany; AIO Germany
| | - L. Fischer von Weikersthal
- Charité University Hospital, Campus Benjamin Franklin, Berlin, Germany; 3rd Medical Clinic, Mainz, Germany; MVZ Gesundheitszentrum St. Marien, Amberg, Germany; West German Cancer Centre, Essen, Germany; Charité Campus Benjamin Franklin, Berlin, Germany; Klinikum Löwenstein, Löwenstein, Germany; Westpfalz Kliniken, Kaiserslautern, Germany; Charité Campus Virchow, Berlin, Germany; West German Cancer Centre, Essen, Germany; AIO Germany
| | - T. Gauler
- Charité University Hospital, Campus Benjamin Franklin, Berlin, Germany; 3rd Medical Clinic, Mainz, Germany; MVZ Gesundheitszentrum St. Marien, Amberg, Germany; West German Cancer Centre, Essen, Germany; Charité Campus Benjamin Franklin, Berlin, Germany; Klinikum Löwenstein, Löwenstein, Germany; Westpfalz Kliniken, Kaiserslautern, Germany; Charité Campus Virchow, Berlin, Germany; West German Cancer Centre, Essen, Germany; AIO Germany
| | - P. Hortig
- Charité University Hospital, Campus Benjamin Franklin, Berlin, Germany; 3rd Medical Clinic, Mainz, Germany; MVZ Gesundheitszentrum St. Marien, Amberg, Germany; West German Cancer Centre, Essen, Germany; Charité Campus Benjamin Franklin, Berlin, Germany; Klinikum Löwenstein, Löwenstein, Germany; Westpfalz Kliniken, Kaiserslautern, Germany; Charité Campus Virchow, Berlin, Germany; West German Cancer Centre, Essen, Germany; AIO Germany
| | - J. R. Fischer
- Charité University Hospital, Campus Benjamin Franklin, Berlin, Germany; 3rd Medical Clinic, Mainz, Germany; MVZ Gesundheitszentrum St. Marien, Amberg, Germany; West German Cancer Centre, Essen, Germany; Charité Campus Benjamin Franklin, Berlin, Germany; Klinikum Löwenstein, Löwenstein, Germany; Westpfalz Kliniken, Kaiserslautern, Germany; Charité Campus Virchow, Berlin, Germany; West German Cancer Centre, Essen, Germany; AIO Germany
| | - H. Link
- Charité University Hospital, Campus Benjamin Franklin, Berlin, Germany; 3rd Medical Clinic, Mainz, Germany; MVZ Gesundheitszentrum St. Marien, Amberg, Germany; West German Cancer Centre, Essen, Germany; Charité Campus Benjamin Franklin, Berlin, Germany; Klinikum Löwenstein, Löwenstein, Germany; Westpfalz Kliniken, Kaiserslautern, Germany; Charité Campus Virchow, Berlin, Germany; West German Cancer Centre, Essen, Germany; AIO Germany
| | - D. Binder
- Charité University Hospital, Campus Benjamin Franklin, Berlin, Germany; 3rd Medical Clinic, Mainz, Germany; MVZ Gesundheitszentrum St. Marien, Amberg, Germany; West German Cancer Centre, Essen, Germany; Charité Campus Benjamin Franklin, Berlin, Germany; Klinikum Löwenstein, Löwenstein, Germany; Westpfalz Kliniken, Kaiserslautern, Germany; Charité Campus Virchow, Berlin, Germany; West German Cancer Centre, Essen, Germany; AIO Germany
| | - W. Eberhardt
- Charité University Hospital, Campus Benjamin Franklin, Berlin, Germany; 3rd Medical Clinic, Mainz, Germany; MVZ Gesundheitszentrum St. Marien, Amberg, Germany; West German Cancer Centre, Essen, Germany; Charité Campus Benjamin Franklin, Berlin, Germany; Klinikum Löwenstein, Löwenstein, Germany; Westpfalz Kliniken, Kaiserslautern, Germany; Charité Campus Virchow, Berlin, Germany; West German Cancer Centre, Essen, Germany; AIO Germany
| | - U. Keilholz
- Charité University Hospital, Campus Benjamin Franklin, Berlin, Germany; 3rd Medical Clinic, Mainz, Germany; MVZ Gesundheitszentrum St. Marien, Amberg, Germany; West German Cancer Centre, Essen, Germany; Charité Campus Benjamin Franklin, Berlin, Germany; Klinikum Löwenstein, Löwenstein, Germany; Westpfalz Kliniken, Kaiserslautern, Germany; Charité Campus Virchow, Berlin, Germany; West German Cancer Centre, Essen, Germany; AIO Germany
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Hofheinz R, Wenz F, Post S, Matzdorff A, Laechelt S, Mueller L, Link H, Moehler M, Burkholder I, Hochhaus A. Capecitabine (Cape) versus 5-fluorouracil (5-FU)-based (neo-)adjuvant chemoradiotherapy (CRT) for locally advanced rectal cancer (LARC): Safety results of a randomized, phase III trial. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.4014] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4014 Background: 5-FU based CRT is regarded standard perioperative treatment in LARC. Here we report safety data of a non-inferiority phase III trial investigating (neo-)adjuvant CRT with Cape in comparison with 5-FU. Methods: Patients (pts) aged ≥18 years with LARC UICC stages II or III were recruited in this two-arm, two-strata randomized phase-III trial (arm A: Cape, arm B: 5-FU; stratum [S] I: adjuvant, S II: neoadjuvant). Regimens: Arm A: CRT: 50.4 Gy + Cape 1,650 mg/m2 days 1–38 plus five cycles of Cape 2,500 mg/m2 d 1–14, rep. d 22 (S I: 2 x Cape, CRT, 3 x Cape; S II: CRT, TME surgery followed by Cape x 5). Arm B: CRT: 50.4 Gy + 5-FU 225 mg/m2 c.i. daily [S I] or 5-FU 1,000 mg/m2 c.i. d 1–5 and 29–33 [S II] plus 4 cycles of bolus 5-FU 500mg/m2 d 1–5, rep. d 29 (S I: 2 x 5-FU, CRT, 2 x 5-FU; S II: CRT, TME surgery followed by 5-FU x 4). Primary endpoint was survival, secondary endpoints comprised safety and disease-free survival. Results: Of 401 randomized pts a total of 392 are evaluable (Arm A n=197, arm B n=195; S I n=231, S II n=161). Both arms were well balanced with respect to age, sex, WHO status, T- and N- stages. Regarding duration of treatment, 78% (Cape) and 80% (5-FU) completed all scheduled treatment cycles in S I, and 46% (Cape) and 40% (5-FU) in neoadjuvant stratum S II. In S II a total of 38% (Cape) and 43% (5-FU) did not continue chemotherapy after tumour resection. Concerning early efficacy endpoints in S II, pts treated with Cape (evaluable thus far n=121) exhibited a higher rate of T-downstaging (defined as ypT0–2; 52 vs 39%; p=0.16) and N0 (71 vs 56%; p=0.09). Regarding overall safety (NCI-CTC), pts receiving Cape experienced significantly less leukopenia (25 vs 35%; p=0.04), but more hand-foot syndrome (31 vs. 2%; p<0.001). Stomatitis/mucositis, diarrhea, nausea/vomiting, and radiodermatitis were not significantly different between both arms. Conclusions: Given the observed safety profile and the trend in improved downstaging in neoadjuvant stratum, Cape exhibits a potential to replace 5-FU as perioperative treatment of LARC. Efficacy results on the primary endpoint are expected for 2010. [Table: see text]
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Affiliation(s)
- R. Hofheinz
- Interdisziplinäres Tumorzentrum, Mannheim, Germany; Klinik für Strahlentherapie und Radioonkologie, Mannheim, Germany; Chirurgische Klinik und Poliklinik, Mannheim, Germany; Caritasklinik St. Theresa, Saarbrücken, Germany; Klinik für Strahlentherapie, Tübingen, Germany; Onkologische Praxis, Leer, Germany; Westpfalz Klinikum, Kaiserslautern, Germany; Medizinische Universitätsklinik, Mainz, Germany; Abteilung Biostatistik, DKFZ, Heidelberg, Germany; III. Medizinische Universitätsklinik, Mannheim, Germany
| | - F. Wenz
- Interdisziplinäres Tumorzentrum, Mannheim, Germany; Klinik für Strahlentherapie und Radioonkologie, Mannheim, Germany; Chirurgische Klinik und Poliklinik, Mannheim, Germany; Caritasklinik St. Theresa, Saarbrücken, Germany; Klinik für Strahlentherapie, Tübingen, Germany; Onkologische Praxis, Leer, Germany; Westpfalz Klinikum, Kaiserslautern, Germany; Medizinische Universitätsklinik, Mainz, Germany; Abteilung Biostatistik, DKFZ, Heidelberg, Germany; III. Medizinische Universitätsklinik, Mannheim, Germany
| | - S. Post
- Interdisziplinäres Tumorzentrum, Mannheim, Germany; Klinik für Strahlentherapie und Radioonkologie, Mannheim, Germany; Chirurgische Klinik und Poliklinik, Mannheim, Germany; Caritasklinik St. Theresa, Saarbrücken, Germany; Klinik für Strahlentherapie, Tübingen, Germany; Onkologische Praxis, Leer, Germany; Westpfalz Klinikum, Kaiserslautern, Germany; Medizinische Universitätsklinik, Mainz, Germany; Abteilung Biostatistik, DKFZ, Heidelberg, Germany; III. Medizinische Universitätsklinik, Mannheim, Germany
| | - A. Matzdorff
- Interdisziplinäres Tumorzentrum, Mannheim, Germany; Klinik für Strahlentherapie und Radioonkologie, Mannheim, Germany; Chirurgische Klinik und Poliklinik, Mannheim, Germany; Caritasklinik St. Theresa, Saarbrücken, Germany; Klinik für Strahlentherapie, Tübingen, Germany; Onkologische Praxis, Leer, Germany; Westpfalz Klinikum, Kaiserslautern, Germany; Medizinische Universitätsklinik, Mainz, Germany; Abteilung Biostatistik, DKFZ, Heidelberg, Germany; III. Medizinische Universitätsklinik, Mannheim, Germany
| | - S. Laechelt
- Interdisziplinäres Tumorzentrum, Mannheim, Germany; Klinik für Strahlentherapie und Radioonkologie, Mannheim, Germany; Chirurgische Klinik und Poliklinik, Mannheim, Germany; Caritasklinik St. Theresa, Saarbrücken, Germany; Klinik für Strahlentherapie, Tübingen, Germany; Onkologische Praxis, Leer, Germany; Westpfalz Klinikum, Kaiserslautern, Germany; Medizinische Universitätsklinik, Mainz, Germany; Abteilung Biostatistik, DKFZ, Heidelberg, Germany; III. Medizinische Universitätsklinik, Mannheim, Germany
| | - L. Mueller
- Interdisziplinäres Tumorzentrum, Mannheim, Germany; Klinik für Strahlentherapie und Radioonkologie, Mannheim, Germany; Chirurgische Klinik und Poliklinik, Mannheim, Germany; Caritasklinik St. Theresa, Saarbrücken, Germany; Klinik für Strahlentherapie, Tübingen, Germany; Onkologische Praxis, Leer, Germany; Westpfalz Klinikum, Kaiserslautern, Germany; Medizinische Universitätsklinik, Mainz, Germany; Abteilung Biostatistik, DKFZ, Heidelberg, Germany; III. Medizinische Universitätsklinik, Mannheim, Germany
| | - H. Link
- Interdisziplinäres Tumorzentrum, Mannheim, Germany; Klinik für Strahlentherapie und Radioonkologie, Mannheim, Germany; Chirurgische Klinik und Poliklinik, Mannheim, Germany; Caritasklinik St. Theresa, Saarbrücken, Germany; Klinik für Strahlentherapie, Tübingen, Germany; Onkologische Praxis, Leer, Germany; Westpfalz Klinikum, Kaiserslautern, Germany; Medizinische Universitätsklinik, Mainz, Germany; Abteilung Biostatistik, DKFZ, Heidelberg, Germany; III. Medizinische Universitätsklinik, Mannheim, Germany
| | - M. Moehler
- Interdisziplinäres Tumorzentrum, Mannheim, Germany; Klinik für Strahlentherapie und Radioonkologie, Mannheim, Germany; Chirurgische Klinik und Poliklinik, Mannheim, Germany; Caritasklinik St. Theresa, Saarbrücken, Germany; Klinik für Strahlentherapie, Tübingen, Germany; Onkologische Praxis, Leer, Germany; Westpfalz Klinikum, Kaiserslautern, Germany; Medizinische Universitätsklinik, Mainz, Germany; Abteilung Biostatistik, DKFZ, Heidelberg, Germany; III. Medizinische Universitätsklinik, Mannheim, Germany
| | - I. Burkholder
- Interdisziplinäres Tumorzentrum, Mannheim, Germany; Klinik für Strahlentherapie und Radioonkologie, Mannheim, Germany; Chirurgische Klinik und Poliklinik, Mannheim, Germany; Caritasklinik St. Theresa, Saarbrücken, Germany; Klinik für Strahlentherapie, Tübingen, Germany; Onkologische Praxis, Leer, Germany; Westpfalz Klinikum, Kaiserslautern, Germany; Medizinische Universitätsklinik, Mainz, Germany; Abteilung Biostatistik, DKFZ, Heidelberg, Germany; III. Medizinische Universitätsklinik, Mannheim, Germany
| | - A. Hochhaus
- Interdisziplinäres Tumorzentrum, Mannheim, Germany; Klinik für Strahlentherapie und Radioonkologie, Mannheim, Germany; Chirurgische Klinik und Poliklinik, Mannheim, Germany; Caritasklinik St. Theresa, Saarbrücken, Germany; Klinik für Strahlentherapie, Tübingen, Germany; Onkologische Praxis, Leer, Germany; Westpfalz Klinikum, Kaiserslautern, Germany; Medizinische Universitätsklinik, Mainz, Germany; Abteilung Biostatistik, DKFZ, Heidelberg, Germany; III. Medizinische Universitätsklinik, Mannheim, Germany
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Link H. Pneumocystis-carinii-Pneumonie bei Immunsuppression in der Hämatologie, Onkologie und bei Organtransplantation. Oncol Res Treat 2009. [DOI: 10.1159/000216802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Kistler A, Mariauzouls C, Link H, von Berlepsch K. Does Fragrance Exposure Affect Autonomic Responses or Salivary IgA and Cortisol Levels? Complement Med Res 2009. [DOI: 10.1159/000210345] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Zbornikova V, Åkesson J, Link H. NON-INVASIVE DIAGNOSIS OF CAROTID ARTERY LESIONS: COMPARISON BETWEEN DIRECTIONAL DOPPLER, DUPLEX SCANNER AND ANGIOGRAPHY. Acta Neurol Scand 2009. [DOI: 10.1111/j.1600-0404.1982.tb03432.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kostulas V, Link H. AGAROSE ISOELECTRIC FOCUSING OF CEREBROSPINAL FLUID AND SERUM EVALUATED ON 998 NEUROLOGICAL PATIENTS. Acta Neurol Scand 2009. [DOI: 10.1111/j.1600-0404.1982.tb03482.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kostulas V, Olsson T, Link H. Detection of oligoclonal IgG in unconcentrated CSF by agarose isoelectric focusing and double antibody avidin-biotin peroxidase labeling. Acta Neurol Scand 2009. [DOI: 10.1111/j.1600-0404.1984.tb02515.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Olsson T, Henriksson A, Link H. IgG antimyelin antibody synthesis demonstrated in vitro in relapsing experimental allergic encephalomyelitis (r-EAE). Acta Neurol Scand 2009. [DOI: 10.1111/j.1600-0404.1984.tb02513.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Olsson T, Link H, Kristensson K. DEMONSTRATION OF SERUM IgG ANTIBODIES AGAINST MYELIN DURING THE COURSE OF RELAPSING EXPERIMENTAL ALLERGIC ENCEPHALOMYELITIS IN GUINEA PIGS. Acta Neurol Scand 2009. [DOI: 10.1111/j.1600-0404.1982.tb03476.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Olsson T, Link H, Henriksson K. DIRECT TISSUE ISOELECTRIC FOCUSING OF NERVOUS SYSTEM AND MUSCLE SECTIONS FOR DETECTION OF IgG PATTERNS. Acta Neurol Scand 2009. [DOI: 10.1111/j.1600-0404.1982.tb03478.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Huebner G, Link H, Kohne CH, Stahl M, Kretzschmar A, Steinbach S, Folprecht G, Bernhard H, Al-Batran SE, Schoffski P, Burkart C, Kullmann F, Otremba B, Menges M, Hoffmann M, Kaiser U, Aldaoud A, Jahn A. Paclitaxel and carboplatin vs gemcitabine and vinorelbine in patients with adeno- or undifferentiated carcinoma of unknown primary: a randomised prospective phase II trial. Br J Cancer 2008; 100:44-9. [PMID: 19066607 PMCID: PMC2634671 DOI: 10.1038/sj.bjc.6604818] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Platinum/taxane combinations are widely used in patients with carcinoma of unknown primary (CUP), yielding response rates of 30% and median overall survival of 9-11 months in selected patients. Yet these combinations have not been subject to a randomised trial to overcome selection bias, a major problem in CUP. We randomised 92 patients to either paclitaxel/carboplatin (arm A) or the non-platinum non-taxane regimen gemcitabine/vinorelbine (arm B). The primary endpoint was rate of practicability as defined: application of >or=2 cycles of therapy (1) with a maximal delay of 1 week (2) and survival of >or=8 months (3). Practicability was shown in 52.4% (95% CI 36-68%) in arm A and in 42.2% (95% CI 28-58%) in arm B, respectively. The median overall survival, 1-year survival -rate and response rate of patients treated in arm A was 11.0 months, 38, and 23.8%, arm B 7.0 months, 29, and 20%. In conclusion, the paclitaxel/carboplatin regimen showed clinically meaningful activity in this randomised trial (Clinical trial registration number 219, 'Deutsches KrebsStudienRegister', German Cancer Society.)
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Affiliation(s)
- G Huebner
- Westpfalz-Klinikum, Hellmut-Hartert-Str 1, 67655 Kaiserslautern, Germany.
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Sanna A, Huang YM, Arru G, Fois ML, Link H, Rosati G, Sotgiu S. Multiple sclerosis: reduced proportion of circulating plasmacytoid dendritic cells expressing BDCA-2 and BDCA-4 and reduced production of IL-6 and IL-10 in response to herpes simplex virus type 1. Mult Scler 2008; 14:1199-207. [PMID: 18653740 DOI: 10.1177/1352458508094401] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE We hypothesized that autoaggressive immune responses observed in multiple sclerosis (MS) could be associated with an imbalance in proportion of immune cell subsets and in cytokine production in response to infection, including viruses. METHODS We collected blood mononuclear cells (MNC) from 23 patients with MS and 23 sex- and age-matched healthy controls (HC) from the island of Sardinia, Italy, where the prevalence of MS is extraordinarily high. Using flow cytometry, we studied MNC for expression of blood dendritic cell antigens (BDCA)-2 and BDCA-4 surface markers reflecting the proportion of plasmacytoid dendritic cells (pDC) that produce type I interferons (IFNs) after virus challenge and promote Th2/anti-inflammtory cytokine production. In parallel, pro-inflammatory (interleukin [IL]-2, IL-12, IFN-gamma), anti-inflammatory (IL-4, IL-10), and immuno-regulatory/pleiotropic cytokines (type I IFNs including IFN-alpha and beta, IL-6) were measured before and after an in vitro exposure to herpes simplex virus type 1 (HSV-1). RESULTS The subset of lineage negative (lin(-)), BDCA-2(+) cells was lower in patients with MS compared with HC (0.08 + or - 0.02% vs 0.24 + or - 0.02%; P < 0.001). A similar pattern was observed for lin(-)BDCA-4(+) cells (0.08 + or - 0.02% vs 0.17% + or - 0.03; P < 0.01). Spontaneous productions of IL-6 (45 + or - 10 pg/mL vs 140 + or - 26 pg/mL; P < 0.01) and IL-10 (17 + or - 0.4 pg/mL vs 21 + or - 1 pg/mL; P < 0.05) by MNC were lower in patients with MS compared with HC. Spontaneous production of IL-6 (6.5 + or - 0.15 pg/mL vs 21 + or - 5 pg/mL; P < 0.01 and IL-10 (11 + or - 1 pg/mL vs 14 + or - 3 pg/mL; P < 0.05) by pDC was also lower in patients with MS compared with HC. Exposure of MNC to HSV-1 showed, in both patients with MS and HC, increased production of IFN-alpha, IL-6, and IL-10 but decreased production of IL-4. In response to HSV-1 exposure, productions of IL-6 (165 +or - 28 pg/mL vs 325 + or - 35 pg/mL; P < 0.01) and IL-10 (27 +or - 3 vs 33 + or - 3 P < 0.05) by MNC as well as by pDC (IL-6: 28 + or - 7 vs 39 + or - 12 P < 0.05; IL-10: 14 + or - 1 vs 16 + or - 3 P < 0.05) were lower in patients with MS compared with HC. CONCLUSION The results implicate a new evidence for altered immune cells and reduced immune responses in response to viral challenge in MS.
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Affiliation(s)
- A Sanna
- Department of Neuroscience, Institute of Clinical Neurology, University of Sassari, Sassari, Italy.
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Huang Y, Liu X, Steffensen K, Sanna A, Arru G, Sominanda A, Sotgiu S, Rosati G, Gustafsson J, Link H. Anti-Inflammatory Liver X Receptors and Related Molecules in Multiple Sclerosis Patients from Sardinia and Sweden. Scand J Immunol 2008. [PMCID: PMC7169544 DOI: 10.1111/j.0300-9475.2004.01423d.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Y.‐M. Huang
- Division of Neuroimmunology, Neurotec Department, Karolinska Institute, Stockholm
| | - X. Liu
- Division of Neuroimmunology, Neurotec Department, Karolinska Institute, Stockholm
| | - K. Steffensen
- Department of Biosciences, Karolinska Institutet at NOVUM, Huddinge, Sweden, and
| | - A. Sanna
- Institute of Clinical Neurology, University of Sassari, Sassari, Italy. E‐mail:
| | - G. Arru
- Institute of Clinical Neurology, University of Sassari, Sassari, Italy. E‐mail:
| | - A. Sominanda
- Division of Neuroimmunology, Neurotec Department, Karolinska Institute, Stockholm
| | - S. Sotgiu
- Institute of Clinical Neurology, University of Sassari, Sassari, Italy. E‐mail:
| | - G. Rosati
- Institute of Clinical Neurology, University of Sassari, Sassari, Italy. E‐mail:
| | - J.‐Å. Gustafsson
- Department of Biosciences, Karolinska Institutet at NOVUM, Huddinge, Sweden, and
| | - H. Link
- Division of Neuroimmunology, Neurotec Department, Karolinska Institute, Stockholm
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Sprenger K, Kretzschmar A, Folprecht G, Link H, Gruenwald V, Köhne C, Stahl M, Buhl K, Huebner G. Phase II trial of capecitabine (CAP) and oxaliplatin (OX) in patients (pts) with adeno- and undifferentiated carcinoma of unknown primary (CUP). J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.15594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Köhne CH, De Greve J, Hartmann JT, Lang I, Vergauwe P, Becker K, Braumann D, Joosens E, Müller L, Janssens J, Bokemeyer C, Reimer P, Link H, Späth-Schwalbe E, Wilke HJ, Bleiberg H, Van Den Brande J, Debois M, Bethe U, Van Cutsem E. Irinotecan combined with infusional 5-fluorouracil/folinic acid or capecitabine plus celecoxib or placebo in the first-line treatment of patients with metastatic colorectal cancer. EORTC study 40015. Ann Oncol 2007; 19:920-6. [PMID: 18065406 DOI: 10.1093/annonc/mdm544] [Citation(s) in RCA: 125] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The study aimed to demonstrate the noninferiority of capecitabine to 5-fluorouracil (5-FU)/folinic acid (FA), in relation to progression-free survival (PFS) after first-line treatment of metastatic colorectal cancer and the benefit of adding celecoxib (C) to irinotecan/fluoropyrimidine regimens compared with placebo (P). PATIENTS AND METHODS Patients were randomly assigned to receive FOLFIRI: irinotecan (180 mg/m(2) i.v. on days 1, 15 and 22); FA (200 mg/m(2) i.v. on days 1, 2, 15, 16, 29 and 30); 5-FU (400 mg/m(2) i.v. bolus, then 22-h, 600 mg/m(2) infusion) or CAPIRI: irinotecan (250 mg/m(2) i.v. infusion on days 1 and 22); capecitabine p.o. (1000 mg/m(2) b.i.d. on days 1-15 and 22-36). Patients were additionally randomly assigned to receive either placebo or celecoxib (800 mg: 2 x 200 mg b.i.d.). RESULTS The trial was closed following eight deaths unrelated to disease progression in the 85 enrolled (629 planned) patients. Response rates were 22% for CAPIRI + C, 48% for CAPIRI + P, 32% for FOLFIRI + C and 46% for FOLFIRI + P. Median PFS and overall survival (OS) times were shorter for CAPIRI versus FOLFIRI (PFS 5.9 versus 9.6 months and OS 14.8 versus 19.9 months) and celecoxib versus placebo (PFS 6.9 versus 7.8 months and OS 18.3 versus 19.9 months). CONCLUSION Due to the small sample size following early termination, no definitive conclusions can be drawn in relation to the noninferiority of CAPIRI compared with FOLFIRI.
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Affiliation(s)
- C-H Köhne
- Department of Oncology and Hematology, Klinikum Oldenburg, Oldenburg, Germany.
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Ytterberg C, Johansson S, Andersson M, Olsson D, Link H, Holmqvist LW, von Koch L. Combination therapy with interferon-beta and glatiramer acetate in multiple sclerosis. Acta Neurol Scand 2007; 116:96-9. [PMID: 17661794 DOI: 10.1111/j.1600-0404.2007.00801.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To compare the effects of mono-therapy with interferon-beta (IFN-beta) or glatiramer acetate (GA) with IFN-beta + GA combination therapy for persons with multiple sclerosis (MS). MATERIALS & METHODS In the context of a longitudinal observational study at the MS Centre, Karolinska University Hospital, Huddinge, 83 persons with MS receiving mono-therapy at baseline were studied. Because of MS worsening 21 switched to IFN-beta + GA combination therapy for 16-24 months, and 62 remained on the same mono-therapy for 24 months. Multiple Sclerosis Functional Composite, cognitive function, depressed mood, relapse occurrence and perceived physical and psychological impact were assessed. Linear mixed-effects models and generalized estimating equations were employed to evaluate changes in each outcome over time. RESULTS Patients on IFN-beta + GA therapy showed greater change in odds for high perceived psychological impact. No other significant differences between treatments were found. CONCLUSIONS The results underline the need for a randomized trial of IFN-beta + GA in MS.
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Affiliation(s)
- C Ytterberg
- Division of Neurology, Department of Clinical Neuroscience, Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm, Sweden.
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Bokemeyer C, Aapro MS, Courdi A, Foubert J, Link H, Osterborg A, Repetto L, Soubeyran P. EORTC guidelines for the use of erythropoietic proteins in anaemic patients with cancer: 2006 update. Eur J Cancer 2006; 43:258-70. [PMID: 17182241 DOI: 10.1016/j.ejca.2006.10.014] [Citation(s) in RCA: 314] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2006] [Revised: 10/06/2006] [Accepted: 10/10/2006] [Indexed: 12/31/2022]
Abstract
Anaemia is frequently diagnosed in patients with cancer, and may have a detrimental effect on quality of life (QoL). We previously conducted a systematic literature review (1996-2003) to produce evidence-based guidelines on the use of erythropoietic proteins in anaemic patients with cancer.[Bokemeyer C, Aapro MS, Courdi A, et al. EORTC guidelines for the use of erythropoietic proteins in anaemic patients with cancer. Eur J Cancer 2004;40:2201-2216.] We report here an update to these guidelines, including literature published through to November 2005. The results of this updated systematic literature review have enabled us to refine our guidelines based on the full body of data currently available. Level I evidence exists for a positive impact of erythropoietic proteins on haemoglobin (Hb) levels when administered to patients with chemotherapy-induced anaemia or anaemia of chronic disease, when used to prevent cancer anaemia, and in patients undergoing cancer surgery. The addition of further Level I studies confirms our recommendation that in cancer patients receiving chemotherapy and/or radiotherapy, treatment with erythropoietic proteins should be initiated at a Hb level of 9-11 g/dL based on anaemia-related symptoms rather than a fixed Hb concentration. Early intervention with erythropoietic proteins may be considered in asymptomatic anaemic patients with Hb levels 11.9 g/dL provided that individual factors like intensity and expected duration of chemotherapy are considered. Patients whose Hb level is below 9 g/dL should primarily be evaluated for need of transfusions potentially followed by the application of erythropoietic proteins. We do not recommend the prophylactic use of erythropoietic proteins to prevent anaemia in patients undergoing chemotherapy or radiotherapy who have normal Hb levels at the start of treatment, as the literature has not shown a benefit with this approach. The addition of further supporting studies confirms our recommendation that the target Hb concentration following treatment with erythropoietic proteins should be 12-13 g/dL. Once this level is achieved, maintenance doses should be titrated individually. There is Level I evidence that dosing of erythropoietic proteins less frequently than three times per week is efficacious when used to treat chemotherapy-induced anaemia or prevent cancer anaemia, with studies supporting the use of epoetin alfa and epoetin beta weekly and darbepoetin alfa given every week or every 3 weeks. We do not recommend the use of higher than standard initial doses of erythropoietic proteins with the aim of producing higher haematological responses, due to the limited body of evidence available. There is Level I evidence that, within reasonable limits of body weight, fixed doses of erythropoietic proteins can be used to treat patients with chemotherapy-induced anaemia. This analysis confirms that there are no baseline predictive factors of response to erythropoietic proteins that can be routinely used in clinical practice if functional iron deficiency or vitamin deficiency is ruled out; a low serum erythropoietin (EPO) level (only in haematological malignancies) appears to be the only predictive factor to be verified in Level I studies. Further studies are needed to investigate the value of hepcidin, c-reactive protein, and other measures as predictive factors. In these updated guidelines, we explored a new question of whether oral or intravenous iron supplementation increases the response rate to erythropoietic proteins. We found no evidence of increased response with the addition of oral iron supplementation, but there is Level II evidence of improved response to erythropoietic proteins with the addition of intravenous iron. However, the doses and schedules for intravenous iron supplementation are not yet well defined, and further studies in this area are warranted. The two major goals of erythropoietic protein therapy are prevention or elimination of transfusions and improvement of QoL. The total body of evidence shows that red blood cell (RBC) transfusion requirements are reduced following treatment with erythropoietic proteins. This analysis also confirms that QoL is significantly improved in patients with chemotherapy-induced anaemia and in those with anaemia of chronic disease following erythropoietic protein therapy, with more robust evidence now available that QoL was improved in studies investigating early intervention in cases of chemotherapy- or radiotherapy-induced anaemia. There is only indirect evidence that patients with chemotherapy-induced anaemia or anaemia of chronic disease initially classified as non-responders to standard doses proceed to respond to treatment following a dose increase. None of the studies addressed the question in a prospective, randomised fashion, and so the Taskforce does not recommend dose escalation as a general approach in all patients who are not responding. There is still insufficient data to determine the effect on survival following treatment with erythropoietic proteins in conjunction with chemotherapy or radiotherapy. Our analysis of survival endpoints in studies involving patients receiving radio(chemo)therapy found that most studies were inconclusive, with no clear link between the use of erythropoietic proteins and survival. Likewise, we found no clear link between erythropoietic therapy and other endpoints such as local tumour control, time to progression, and progression-free survival. There is no evidence that pure red cell aplasia occurs in cancer patients following treatment with erythropoietic proteins, and the fear of this condition developing should not lead to erythropoietic proteins being withheld in patients with cancer. There is Level I evidence that the risk of thromboembolic events and hypertension are slightly elevated in patients with chemotherapy-induced anaemia receiving erythropoietic proteins. Additional trials are warranted, especially to define the optimal doses and schedules of intravenous iron supplementation during erythropoietic therapy. While our review did not address cost benefit evaluations in detail, the consensus is that studies taking into account all real determinants of cost and benefit need to be performed prospectively.
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Affiliation(s)
- C Bokemeyer
- Universitaetsklinikum Hamburg Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany, and Department of Haematology, Karolinska University Hospital, Stockholm, Sweden.
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Schiel X, Link H, Maschmeyer G, Glass B, Cornely OA, Buchheidt D, Wilhelm M, Silling G, Helmerking M, Hiddemann W, Ostermann H, Hentrich M. A prospective, randomized multicenter trial of the empirical addition of antifungal therapy for febrile neutropenic cancer patients: results of the Paul Ehrlich Society for Chemotherapy (PEG) Multicenter Trial II. Infection 2006; 34:118-26. [PMID: 16804654 DOI: 10.1007/s15010-006-5113-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2005] [Accepted: 03/08/2006] [Indexed: 11/29/2022]
Abstract
BACKGROUND The aim of the study was to compare the efficacy of empirical antifungals in combination with broad spectrum antibiotics with that of antibiotics alone in high risk febrile neutropenic cancer patients not responding to initial antibacterial therapy. PATIENTS AND METHODS A prospective, randomized controlled trial was conducted at 22 cancer centers in Germany. Patients with fever of unknown origin were randomized to either piperacillin (Pip) plus an aminoglycoside (AMG) (arm A) or a third generation cephalosporin (Ceph) plus AMG (arm B). Patients not responding after 4-6 days were randomized to either imipenem (Imi) plus glycopeptide (GLP) (arm C), or Imi/GLP plus amphotericin B deoxycholate (AmB) plus 5-flucytosine (5-FC) (arm D), or Imi/GLP plus fluconazole (Fluco) (arm E). A successful outcome was defined as resolution of fever. RESULTS In arm A, 192 of 373 patients (51.5%) responded as compared to 176 of 344 patients (51.2%) in arm B. The response rates of 155 patients randomized for further empirical treatment were 55.6%, 77.8% and 62.5% in arm C, D and E, respectively. The difference between arm C and D was of borderline statistical significance (p = 0.06) after correction for multiple testing. CONCLUSION In neutropenic cancer patients with persistent fever the combination of antibiotics with AmB/5-FC is superior to salvage antibacterial therapy alone. There is no difference in efficacy between Pip and third generation Ceph given as initial empirical therapy in combination with an AMG.
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Affiliation(s)
- X Schiel
- Dept. of Internal Medicine III, Ludwig Maximillian University-Grosshadern, Munich, Germany
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Kelaidi C, Ades L, Chevret S, Sanz M, Guerci A, Thomas X, de Botton S, Raffoux E, Rayon C, Fegueux N, Bordessoule D, Rigal-Huguet F, Link H, Stoppa A, Vekhoff A, Meyer-Monard S, Castaigne S, Dombret H, Degos L, Fenaux P. Late first relapses in APL treated with all-trans-retinoic acid- and anthracycline- based chemotherapy: the European APL group experience (APL 91 and APL 93 trials). Leukemia 2006; 20:905-7. [PMID: 16541143 DOI: 10.1038/sj.leu.2404158] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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