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958 Publications visible to you, out of a total of 958
CHOP-like chemotherapy plus rituximab versus CHOP-like chemotherapy alone in young patients with good-prognosis diffuse large-B-cell lymphoma: a randomised controlled trial by the MabThera International Trial (MInT) Group.
GLA - German Lymphoma Alliance

Abstract (Expand)

BACKGROUND: The role of rituximab in combination with different CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone)-like chemotherapy regimens in young patients with good-prognosis diffuse … large-B-cell lymphoma remains to be defined. We aimed to compare CHOP-like chemotherapy and rituximab with CHOP-like chemotherapy alone in these patients. METHODS: 824 patients who were from 18 countries; aged 18-60 years; and who had no risk factors or one risk factor according to age-adjusted International Prognostic Index (IPI), stage II-IV disease, or stage I disease with bulk were enrolled. These patients were randomly assigned to six cycles of CHOP-like chemotherapy and rituximab (n=413) or to six cycles of CHOP-like chemotherapy alone (n=411). Bulky and extranodal sites received additional radiotherapy. The primary endpoint was event-free survival; secondary endpoints were response, progression under therapy, progression-free survival, overall survival, and frequency of toxic effects. Analyses were done by intention to treat and per protocol. This trial is registered at http://www.clinicaltrials.gov, NCT 00064116. FINDINGS: After a median follow-up of 34 months (range 0.03-61), patients assigned chemotherapy and rituximab had increased 3-year event-free survival compared with those assigned chemotherapy alone (79% [95% CI 75-83] vs 59% [54-64]; difference between groups 20% [13-27], log-rank p<0.0001), and had increased 3-year overall survival (93% [90-95] vs 84% [80-88]; difference between groups 9% [3-13], log-rank p=0.0001). Event-free survival was affected by treatment group, presence of bulky disease, and age-adjusted IPI: after chemotherapy and rituximab, a favourable subgroup (ie, IPI=0, no bulk) could be defined from a less-favourable subgroup (ie, IPI=1 or bulk, or both). Groups did not differ in the frequency of adverse events. INTERPRETATION: Rituximab added to six cycles of CHOP is an effective treatment for young patients with good-prognosis diffuse large-B-cell lymphoma. The definition of two prognostic subgroups allows for a more refined therapeutic approach for these patients.

Authors: M. Pfreundschuh, L. Trumper, A. Osterborg, R. Pettengell, M. Trneny, K. Imrie, D. Ma, D. Gill, J. Walewski, P. L. Zinzani, R. Stahel, S. Kvaloy, O. Shpilberg, U. Jaeger, M. Hansen, T. Lehtinen, A. Lopez-Guillermo, C. Corrado, A. Scheliga, N. Milpied, M. Mendila, M. Rashford, E. Kuhnt, M. Loeffler

Date Published: 2nd May 2006

Publication Type: Not specified

Human Diseases: non-Hodgkin lymphoma, diffuse large B-cell lymphoma

Model-based design of chemotherapeutic regimens that account for heterogeneity in leucopoenia
Genetical Statistics and Systems Biology

Abstract (Expand)

Patients treated with multicycle chemotherapy can exhibit large interindividual heterogeneity of haematotoxicity. We describe how a biomathematical model of human granulopoiesis can be used to design … risk-adapted dose-dense chemotherapies, leading to more similar leucopoenias in the population. Calculations were performed on a large data set for cyclophosphamide/doxorubicin/vincristine/prednisone (CHOP)-like chemotherapies for aggressive non-Hodgkin lymphoma. Age, gender, Eastern Cooperative Oncology Group performance status, lactate dehydrogenase and the degree of leucopoenia within the first therapy cycle were used to stratify patients into groups with different expected severity of leucopoenia. We estimated risk-specific bone marrow toxicities depending on the drug doses administered. These toxicities were used to derive risk-adapted therapy schedules. We determined different doses of cyclophosphamide and additional etoposide for patients treated with CHOP-14. Alternatively, the model predicted that further reductions of cycle duration were feasible in groups with low toxicity. We also used the model to identify appropriate granulocyte colony-stimulating factor (G-CSF) schedules. In conclusion, we present a method to estimate the potential of risk-specific dose adaptation of different cytotoxic drugs in order to design chemotherapy protocols that result in decreased diversity of leucopoenia between patients, to develop dose-escalation strategies in cases of low leucopoenic reaction and to determine optimal G-CSF support.

Authors: Markus Scholz, Christoph Engel, Markus Loeffler

Date Published: 1st Mar 2006

Publication Type: Journal article

CalcDalton: a tool for multiplex genotyping primer design for single-base extension reactions using cleavable primers
Genetical Statistics and Systems Biology

Abstract

Not specified

Authors: Holger Kirsten, Steffen Dienst, Frank Emmrich, Peter Ahnert

Date Published: 2006

Publication Type: Journal article

The 3LGM^2-Tool to Support Information Management in Health Care
Management of health information systems

Abstract

Not specified

Author: Alfred Winter

Date Published: 2006

Publication Type: InCollection

Grundlagen von Informations- und Kommunikationstechnologien im Krankenhaus
Management of health information systems

Abstract

Not specified

Authors: Alfred Winter, Elske Ammenwerth, Birgit Brigl, Reinhold Haux

Date Published: 2006

Publication Type: InCollection

DO TRAIN DRIVERS DEFINE TIME TABLES? ENABLING WORKFLOWS IN ANAESTHESIA AND INTENSIVE CARE BY STRATEGIC INFORMATION MANAGEMENT FOR HOSPITALS AND REGIONAL HEALTH CARE
Management of health information systems

Abstract

Not specified

Authors: Alfred Winter, Birgit Brigl, Thomas Wendt

Date Published: 2006

Publication Type: Journal article

Medical informatics education needs information system practicums in health care settings–experiences and lessons learned from 32 practicums at four universities in two countries
Management of health information systems

Abstract (Expand)

OBJECTIVES: To report about the themes and about experiences with practicums in the management of information systems in health care settings (health information management) for medical informatics … students. METHODS: We first summarize the topics of the health information management practicums/projects that the authors organized between 1990 and 2003 for the medical informatics programs at Heidelberg/Heilbronn, Germany, UMIT, Austria, as well as for the informatics program at the University of Leipzig, Germany. Experiences and lessons learned, obtained from the faculty that organized the practicums in the past 14 years, are reported. RESULTS: Thirty (of 32) health information management practicums focused on the analysis of health information systems. These took place inside university medical centers. Although the practicums were time-intensive and required intensively tutoring students with regard to health information management and project management, feedback from the students and graduates was mainly positive. DISCUSSION: It is clearly recommended that students specializing in medical informatics need to be confronted with real-world problems of health information systems during their studies.

Authors: Reinhold Haux, Elske Ammenwerth, A. Haber, Gudrun Hübner-Bloder, Petra Knaup-Gregori, G. Lechleitner, F. Leiner, R. Weber, Alfred Winter, A. C. Wolff

Date Published: 2006

Publication Type: Journal article

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