T. Büchner – författare

Das Buch berichtet tiber das 1. Hauptthema der 28. Jahrestagung der Deutschen Gesellschaft flir Hamatologie und Onkologie 1983 in Mtinster. Der Zeitpunkt flir eine neue Bestandsaufnahme der Therapie der akuten Leukamien ist gtinstig, da ei- nige, in den 70er Jahren konzipierte Fortschritte inzwischen auf ausreichender Beobachtungszeit der behandelten Patienten beruhen. Die hier mitgeteilten und daB das diskutierten Ergebnisse aus maBgeblichen Zentren und Studien zeigen, Nahziel der kompletten Remission heute bei der Mehrzahl der Patienten zu er- reichen ist und daB dieses das Erreichen des Femziels Heilung flir einen Teil der Pa- tienten bedeutet. Dieser Teil erscheint bei lymphatischem Zelltyp groBer als bei myeloischem und innerhalb der Zelltypen bei Kindem groBer als bei Erwachsenen. Auf dem Weg bis hierher findet sich zunachst der therapeutische Durchbruch bei der Akuten Lymphatischen Leukamie des Kindes mittels Kombinations-Chemo- therapie und prophylaktischer antileukamischer Behandlung des Zentralnervensy- stems. Ihm folgten zahlreiche kleine Schritte der besseren Nutzung der verfligba- ren Chemotherapie durch ihre Intensivierung und Risiko-Anpassung.Parallel hier- zu wurde die Knochenmark-Transplantation hoch entwickelt. Die Immuntherapie fand konsequentere Formen. Wesentliche Altemativen und Modifikationen der Therapie akuter Leukamien befinden sich noch in Erprobung durch vergleichende Studien. Zuktinftiger Fortschritt ist zu sehen in einer Senkung der Frtihletalitat durch rechtzeitigen Therapiebeginn und verbesserte Supportivbehandlung, in der Entwicklung neuer, nicht kreuzresistenter Schemata zur Ausweich-Chemotherapie und ihre Einbeziehung in die primare Induktions- oder Konsolidierungs-Chemo- therapie, schlieBlich in der Erkennung von Risiko-Gruppen auch bei akuter mye- loischer Leukamie und einer Risiko-adaptierten Therapie oder Altemativ-Therapie.

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.

Following the major breakthroughs in the and frequent and thorough exchange of treatment of acute leukemias in the seven- information. Hence, it was felt that a spe- ties by the introduction of intensive combi- cial series of symposia should be devoted to nation regimens, therapeutic progress has "Pharmacokinetics and Management of slowed down and the impression of stagna- Relapsed and Refractory Disease" comple- menting the established meetings on "Prog- tion may even have occured. In contrast, the knowledge about the biology of leu- nostic Factors and Treatment Strategies" kemias is rapidly expanding and allows new which will proceed in parallel. It was the insights into the pathophysiology of the aim of the international symposium disease. Further improvements also come "ACUTE LEUKEMIAS - Pharmacokine- from a better understanding of the pharma- tics and Management of Relapsed and cokinetics and pharmacodynamics of cyto- Refractory Disease" to provide an update static drugs and their mechanisms of action. of the present knowledge in this area and to Hence, novel treatment modalities can be stimulate further developments.As a sign developed on a more solid basis and ration- for the closing distance between countries al. These achievements need to be comple- and the development of effective world- mented by effective eradiation wide cooperation this symposium emerged of residual disease or its permanent control and new from the joint efforts of the German AML approaches have been derived from recent Cooperative Group and the M. D.

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.