J. Ritter – författare

Hematopoietic stem cell and immune cell transplantation has cont- ued as a promising therapeutic alternative and a fascinating area of cell biology as well as a field of persistent procedural problems. This - plains why substantial parts of basic research on cell growth and d- ferentiation, immune tolerance and antitumor effects, gene transfer, minimal residual disease and supportive care have settled around cli- cal transplantation in hematology and oncology. This second volume again updates the current role of allogeneic and autologous transpl- tation in leukemias, lymphomas and solid cancers, including cont- versial strategies and novel experimental approaches. In particular, cellular immune therapy, new conditioning strategies, mismatched donor transplantation, updated clinical transplantation, antiangiogenesis and strategies against fungal infections are focused upon. Outstanding representatives of leading groups guarantee fir- hand information and indicate how we can work and cooperate more effectively to the benefit of our patients.The editors are indebted to the Gesellschaft zur Bekampfung der Krebskrankheiten Nordrhein-Westfalen for a substantial support of the publication. They also acknowledge the major contribution of Beate Kosel as coordinator of the editorial work.

Since 1987 Acute Leukemias (AL) has regularly reported on the state of the art in the rapidly growing, successful and exciting field of biology and management of these diseases. In this volume large multicenter clinical trials again form the solid basis for the investigation of leukemic cell biology, the detection of biologic subgroups, their differential response to alternative treatment strategies and the further development of therapy. In particular, this volume addresses mechanisms of chromosomal translocations and transcription factors, risk-adapted treatment strategies, differentiation therapy, secondary AL, special aspects in older patients, and adoptive immunotherapy. Besides the antileukemic approaches, supportive treatment with new antimicrobial substances and growth factors is updated. As a forum of worldwide activities in the field of AL this volume contains both exhaustive overviews on major clinical issues and preliminary data and hypotheses not previously published.

Some three decades after bone marrow transplantation was introduced in the field of hematology and oncology, transplantation today continues to rapidly grow and expand into a variety of new modalities. Peripheral blood has been established as an effective source of autologous progenitor cells. Furthermore, the graft-versus-leukemia effect has resulted in novel strategies of adoptive immunotherapy for cancer. Finally, approaches to gene transfer and therapy are utilizing transplantation methodologies and can augment their effects. Current results, new developments and perspectives are presented in this volume. Conventional and innovative experimental approaches, the past and the future of bone marrow transplantation are reviewed and discussed by leading representatives.

Since 1987 Acute Leukemias (AL) has regularly reported on the state of the art in the rapidly growing, successful and exciting field of biology and management of these diseases. In this volume large multicenter clinical trials again form the solid basis for the investigation of leukemic cell biology, the detection of biologic subgroups, their differential response to alternative treatment strategies and the further development of therapy. In particular, this volume addresses mechanisms of chromosomal translocations and transcription factors, risk-adapted treatment strategies, differentiation therapy, secondary AL, special aspects in older patients, and adoptive immunotherapy. Besides the antileukemic approaches, supportive treatment with new antimicrobial substances and growth factors is updated. As a forum of worldwide activities in the field of AL this volume contains both exhaustive overviews on major clinical issues and preliminary data and hypotheses not previously published.

Hematopoietic stem cell and immune cell transplantation has cont- ued as a promising therapeutic alternative and a fascinating area of cell biology as well as a field of persistent procedural problems. This - plains why substantial parts of basic research on cell growth and d- ferentiation, immune tolerance and antitumor effects, gene transfer, minimal residual disease and supportive care have settled around cli- cal transplantation in hematology and oncology. This second volume again updates the current role of allogeneic and autologous transpl- tation in leukemias, lymphomas and solid cancers, including cont- versial strategies and novel experimental approaches. In particular, cellular immune therapy, new conditioning strategies, mismatched donor transplantation, updated clinical transplantation, antiangiogenesis and strategies against fungal infections are focused upon. Outstanding representatives of leading groups guarantee fir- hand information and indicate how we can work and cooperate more effectively to the benefit of our patients.The editors are indebted to the Gesellschaft zur Bekampfung der Krebskrankheiten Nordrhein-Westfalen for a substantial support of the publication. They also acknowledge the major contribution of Beate Kosel as coordinator of the editorial work.

Some three decades after bone marrow transplantation was introduced in the field of hematology and oncology, transplantation today continues to rapidly grow and expand into a variety of new modalities. Peripheral blood has been established as an effective source of autologous progenitor cells. Furthermore, the graft-versus-leukemia effect has resulted in novel strategies of adoptive immunotherapy for cancer. Finally, approaches to gene transfer and therapy are utilizing transplantation methodologies and can augment their effects. Current results, new developments and perspectives are presented in this volume. Conventional and innovative experimental approaches, the past and the future of bone marrow transplantation are reviewed and discussed by leading representatives.

The rates of acute leukemia cure have gradually improved over the last decade. Clinical study results reflect the impact of chemotherapy intensity and duration, the role of prolonged maintenance, intensified consolidation or very early intensification. Further progress has also been achieved in bone marrow trans­ plantation, and recent prospective studies and meta-analyses have contributed comparisons of the high antileukemic efficacy of bone marrow transplantation to that of improved chemotherapy. This allows a more successful combining of the two forms of treatment. New prognostic factors have emerged from both cytogenetic and molecular genetic research. Thus, the Philadelphia chromosome translocation and the bcr/abl gene rearrangement have proven to be the dominating risk factor in acute lymphoblastic leukemia. Since the frequency increases with age, differences in prognosis between children and adults can be explained. Evaluation of molecular and immunologic leukemia cell markers has provided a better understanding of residual leukemia in clinical remission, as a prognostic factor and in monitoring the effectiveness of the antileukemic strategy. Recent work on leukemic cell biology has resulted in novel therapeutic approaches such as terminal differentiation by all-trans-retinoic acid, modulation of chemotherapy by hematopoietic growth factors such as GM-CSF and enhancement of immunologic control by cytokines such as interleukin 2. New antimicrobial drugs and the application of mostly empiric anti-infectious strategies have helped reducing the therapeutic risk. Thus, a number of recent achievements have provided us with new options in the management of patients with acute leukemias.

The rates of acute leukemia cure have gradually improved over the last decade. Clinical study results reflect the impact of chemotherapy intensity and duration, the role of prolonged maintenance, intensified consolidation or very early intensification. Further progress has also been achieved in bone marrow trans­ plantation, and recent prospective studies and meta-analyses have contributed comparisons of the high antileukemic efficacy of bone marrow transplantation to that of improved chemotherapy. This allows a more successful combining of the two forms of treatment. New prognostic factors have emerged from both cytogenetic and molecular genetic research. Thus, the Philadelphia chromosome translocation and the bcr/abl gene rearrangement have proven to be the dominating risk factor in acute lymphoblastic leukemia. Since the frequency increases with age, differences in prognosis between children and adults can be explained. Evaluation of molecular and immunologic leukemia cell markers has provided a better understanding of residual leukemia in clinical remission, as a prognostic factor and in monitoring the effectiveness of the antileukemic strategy. Recent work on leukemic cell biology has resulted in novel therapeutic approaches such as terminal differentiation by all-trans-retinoic acid, modulation of chemotherapy by hematopoietic growth factors such as GM-CSF and enhancement of immunologic control by cytokines such as interleukin 2. New antimicrobial drugs and the application of mostly empiric anti-infectious strategies have helped reducing the therapeutic risk. Thus, a number of recent achievements have provided us with new options in the management of patients with acute leukemias.

150 years after the first description of the clinical picture of "white blood" and the introduction of the term "leukemia" by R. Virchow it appears, that the leukemias, and the acute leukemias in particular, serve as an impressive example for the major improvements that have been achieved in the treatment but also in the understand­ ing of the biology of malignant dis orders. The international symposia "Acute Leukemia" which are held at Münster since 1986 have developed into an interna­ tional forum to review the current progress and the future perspectives of leukemia research and therapy at a high scientific and clinicallevel. Since the possibility for active participation in these symposia is somewhat restricted we are glad to have the opportunity to extend the information that was presented at the symposium "Acute Leukemias V - Experimental Approaches and Management of Refractory Disease" which was held from February 27 to March 2, 1994 to a broader audience of basic scientists and clinicians. This meeting was especiaIly designed to discuss experimen­ tal approaches and the management of refractory disease which allows to evaluate new experimental therapies on the basis of preclinical studies.