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Frankfurt am Main, Germany

Schmidt C.,Ludwig Maximilians University of Munich | Fingerle-Rowson G.,University of Cologne | Fingerle-Rowson G.,Hoffmann-La Roche | Fingerle-Rowson G.,Janssen Cilag GmbH | And 11 more authors.
Leukemia and Lymphoma | Year: 2015

Today's treatment options for indolent lymphoma and chronic lymphocytic leukemia (CLL) range from watch & wait, immunochemotherapy up to allogeneic transplantation. We describe changes in the diagnosis and treatment of indolent lymphoma and CLL in Germany between 2006 and 2009. Two nation-wide surveys in the fourth quarter of 2006 and 2009 included patients with indolent lymphoma and CLL. Data from 576 patients from 46 centers in Q4/2006 were compared with data from 521 patients from 57 centers in Q4/2009. The subpopulation of patients ≥ 70 years of age and the number of patients with comorbidities increased from 39% to 55% and 47% to 55%, respectively. Both in indolent lymphoma and CLL, Rituximab and R-based immunochemotherapy (50.6% vs. 64.4%) as well as bendamustine (4.8 % vs. 24%) were much more frequently applied. In contrast, high dose chemotherapy consolidation was almost abandoned in first line treatment. Supportive care is given more frequently, with exception of erythropoietin and immunoglobulins. Our national survey confirmed that scientific results were rapidly transferred into clinical care of indolent lymphoma. © 2014 Informa UK, Ltd.

Heinz W.J.,University of Wuerzburg Medical Center | Silling G.,University of Munster | Bohme A.,ONKOLOGIKUM
Current Medical Research and Opinion | Year: 2011

Objective: Invasive fungal infections (IFIs) are an important cause of morbidity and mortality, particularly in patients with cancer. The triazole voriconazole, given as oral or intravenous formulation, has a high bioavailability and proven efficacy against invasive aspergillosis, candidiasis and other fungi. We aimed to assess the utilisation, efficacy and safety of voriconazole with emphasis on the route of administration under standard clinical conditions. Methods: Prospective, observational study performed by 17 hospitals and office-based physicians in Germany. Results: A total of 264 patients received oral (53) or intravenous (22) voriconazole or both formulations sequentially (25). Of 228 patients with specified fungal diagnosis, 95 (36.0) had aspergillosis, 73 (27.7) candidiasis. Sixty (22.7) received voriconazole for other fungal indications (OFI). In 195 of 226 patients (86.2), treatment was successful (39.8 cured and 46.5 partial response). In terms of primary diagnoses, favourable responses were noted in 90 for pulmonary aspergillosis, 85 for candidiasis and 87 for OFI. Microbiological success was documented in 138 patients, of whom 105 (76.1) had complete eradication of fungi. Response rates by initial route were similar for oral and intravenous administration (86 and 87). Twenty-six of 264 patients died during the study, 53 patients experienced a serious adverse event (five treatment related), and 10 withdrew due to all-causality adverse events (AEs). Tolerability was assessed as very good in 55, and good in 40 of patients. Conclusions: Voriconazole as oral or intravenous formulation was well tolerated and equally effective in critically ill patients with IFIs. This study in daily care confirms the outcomes of controlled clinical trials. © 2011 Informa UK Ltd All rights reserved.

Hoelzer D.,ONKOLOGIKUM | Gokbuget N.,Goethe University Frankfurt
Blood Reviews | Year: 2012

ALL blast cells express a variety of specific antigens e.g. CD19, CD20, CD22, CD33, and CD52, which serve as targets for Monoclonal Antibodies (MoAbs). So far, the most experience is available for anti-CD20 (rituximab), which has been combined with chemotherapy for treatment of mature B-ALL/Burkitt's lymphoma. Studies with rituximab have also been completed in B-precursor ALL. Another antigen, CD19, is of great interest due to a very high rate of expression in ALL. It can be targeted by a bispecific monoclonal antibody, Blinatumomab, directed against CD19 and CD3. Smaller studies or case reports are also available for the anti CD52 antibody (Alemtuzumab), for anti CD22 (Epratuzumab) or anti CD33 (Gemtuzumab). Available data demonstrate that MoAb therapy in ALL is a highly promising targeted treatment. However, several details for an optimal treatment approach e.g. the required level of antigen expression, timing, schedule, dosage and stage of disease still need to be defined. © 2012.

Heimpel H.,University of Ulm | Diem H.,Wurmtal Labor | Nebe T.,ONKOLOGIKUM
Medizinische Klinik | Year: 2010

In clinical practice, the reticulocyte count is the most useful method to estimate red cell life span and red cell production. However, experience of hematologists as well as surveys have shown that counting of reticulocytes is often neglected in the diagnostic work-up of unclassified anemias, and many physicians have difficulties in interpreting the results. Formerly, this was partly due to the low precision of manual counts. Today, this method is largely replaced by flow cytometry, available in almost all larger systems for automated blood count analysis, at low costs and sufficient analytic precision. Interpretation is supported by calculated parameters such as the Reticulocyte Production Index. Here, the authors discuss the limits of the analytic methods and the problems of interpretation in the context of the laboratory profile and the clinical setting. © 2010 Urban & Vogel.

Inotuzumab ozogamicin achieves high response and molecular remission rates in patients with relapsed/refractory acute lymphoblastic leukemia with tolerable toxicity. It warrants further studies of inotuzumab in combination with chemotherapy or other targeted therapy. © 2013 American Cancer Society.

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