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Hengeveld M, Suciu S, Chelgoum Y, Marie JP, Muus P, Lefrère F, Mandelli F, Pane F, Amadori S, Fioritoni G, Labar B, Baron F, Cermak J, Bourhis JH, Storti G, Fazi P, Hagemeijer A, Vignetti M, Willemze R, de Witte T. High numbers of mobilized CD34+ cells collected in AML in first remission are associated with high relapse risk irrespective of treatment with autologous peripheral blood SCT or autologous BMT. Bone Marrow Transplant 2014; 50:341-7. [PMID: 25402418 DOI: 10.1038/bmt.2014.262] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Revised: 09/18/2014] [Accepted: 09/19/2014] [Indexed: 11/09/2022]
Abstract
The faster hematopoietic recovery after autologous peripheral blood SCT (APBSCT) in patients with AML may be offset by an increased relapse risk as compared with autologous BMT (ABMT). The EORTC and GIMEMA Leukemia Groups conducted a trial (AML-10) in which they compared, as second randomization, APBSCT and ABMT in first CR patients without an HLA compatible donor. A total of 292 patients were randomized. The 5-year DFS rate was 41% in the APBSCT arm and 46% in the ABMT arm with a hazard ratio (HR) of 1.17; 95% confidence interval=0.85-1.59; P=0.34. The 5-year cumulative relapse incidence was 56% vs 49% (P=0.26), and the 5-year OS 50% and 55% (P=0.6) in the APBSCT and ABMT groups, respectively. APBSCT was associated with significantly faster recovery of neutrophils and platelets, shorter duration of hospitalization, reduced need of transfusion packed RBC and less days of intravenous antibiotics. In both treatment groups, higher numbers of mobilized CD34+ cells were associated with a significantly higher relapse risk irrespective of the treatment given after the mobilization. Randomization between APBSCT and ABMT did not result in significantly different outcomes in terms of DFS, OS and relapse incidence.
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Affiliation(s)
- M Hengeveld
- Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - S Suciu
- EORTC Headquarters, Brussels, Belgium
| | | | | | - P Muus
- Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - F Lefrère
- Necker-Institut Curie, Paris, France
| | | | - F Pane
- Federico II University, Napoli, Italy
| | - S Amadori
- Tor Vergata University Hospital, Roma, Italy
| | | | - B Labar
- University Hospital Rebro, Zagreb, Croatia
| | - F Baron
- CHU Sart-Tilman, Liège, Belgium
| | - J Cermak
- Institute Hematology, Prague, Czech Republic
| | - J-H Bourhis
- Gustave Roussy Comprehensive Cancer Center, Villejuif, France
| | - G Storti
- A.O.R.N. San Giuseppe Moscati, Avelino, Italy
| | - P Fazi
- GIMEMA Data Center, Roma, Italy
| | - A Hagemeijer
- Universitair Ziekenhuis Gasthuisberg, Leuven, Belgium
| | | | - R Willemze
- Leiden University Medical Center, Leiden, The Netherlands
| | - T de Witte
- Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
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Sucic M, Ilic I, Dotlic S, Mikulic M, Labar B, Ljubic N, Krmek DZ. P-250 Nucleophosmin cytoplasmic and nucleus immunohistochemical cell positivity of bone marrow biopsy sections in AML and MDS patients. Leuk Res 2013. [DOI: 10.1016/s0145-2126(13)70297-2] [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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3
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Willemze R, Lely NV, Zwierzina H, Gerhartz H, Suciu S, Solbu G, Labar B, Visani G, Zittoun R. GM-CSF and IL-3 in Myelodysplastic Syndromes at Low Risk of Developing Acute Leukemia (MDS-LR). Leuk Lymphoma 2009. [DOI: 10.3109/10428199209058663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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4
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Aljurf MD, Zaidi SZ, El Solh H, Hussain F, Ghavamzadeh A, Mahmoud HK, Shamsi T, Othman TB, Sarhan MM, Dennison D, Ibrahim A, Benchekroun S, Chaudhri N, Labar B, Horowitz M, Niederwieser D, Gratwohl A. Special issues related to hematopoietic SCT in the Eastern Mediterranean region and the first regional activity report. Bone Marrow Transplant 2009; 43:1-12. [PMID: 19043456 PMCID: PMC3351791 DOI: 10.1038/bmt.2008.389] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2008] [Revised: 09/30/2008] [Accepted: 10/04/2008] [Indexed: 12/27/2022]
Abstract
Although several centers are now performing allogeneic hematopoietic SCT (HSCT) in the Eastern Mediterranean (EM) region, the availability is still limited. Special issues including compatible donor availability and potential for alternative donor programs are discussed. In comparison to Europe and North America, differences in patterns of diseases and pre-HSCT general status, particularly for patients with BM failure, are described. Other differences including high sero-positivity for CMV, hepatitis B and C infection, and specific observations about GVHD and its relation to genetically homogeneous communities are also discussed. We report that a total of 17 HSCT programs (performing five or more HSCTs annually) exist in 9 countries of the EM region. Only six programs are currently reporting to European Group for Blood and Marrow Transplantation or Center for International Blood and Marrow Transplantation Research. A total of 7617 HSCTs have been performed by these programs including 5701 allogeneic HSCTs. The area has low-HSCT team density (1.56 teams per 10 million inhabitants vs 14.43 in Europe) and very low-HSCT team distribution (0.27 teams per 10 000 sq km area vs <1-6 teams in Europe). Gross national income per capita had no clear association with low-HSCT activity. Much improvement in infrastructure and formation of an EM regional HSCT registry are needed.
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Affiliation(s)
- M D Aljurf
- Adult HSCT, King Faisal Cancer Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
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Aurer I, Mitrović Z, Nemet D, Radman I, Sertić D, Serventi-Seiwerth R, Stern-Padovan R, Santek F, Nola M, Mrsić M, Labar B. Treatment of relapsed or refractory aggressive non-hodgkin lymphoma with two ifosfamide-based regimens, IMVP and ICE. J Chemother 2008; 20:640-4. [PMID: 19048695 DOI: 10.1179/joc.2008.20.5.640] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
We report the outcomes of 45 patients with relapsed or refractory aggressive non-Hodgkin's lymphoma (NHL) treated with a combination of ifosfamide, carboplatinum and etoposide (ICE) and 28 patients treated with a combination of ifosfamide, methotrexate and etoposide (IMVP) during two 5-year periods. The response rate (RR) to ICE was 47%, 2-year overall survival (OS) 31% and 2-year event-free survival (EFS) 22%. These results were similar to those obtained with IMVP (RR 39%, 2-year OS 23%, 2-year EFS 13%; p=0.355 for RR, 0.275 for OS, 0.668 for EFS). Higher IPI scores and refractoriness to treatment were negative prognostic factors, immunophenotype (B vs. T) had no influence on prognosis. Changing from IMVP to ICE does not substantially improve the outcome of patients with relapsed or refractory aggressive NHL. Patients with relapsed/refractory aggressive B-NHL do not have a superior outcome in comparison to those with T-NHL if treated with chemotherapy alone.
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Affiliation(s)
- I Aurer
- Department of Internal Medicine, University Hospital Center Rebro and Medical School, Zagreb, Croatia.
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Wachowiak J, Labopin M, Miano M, Chybicka A, Stary J, Sterba J, Masszi T, Labar B, Maschan A, Kowalczyk JR, Lange A, Holowiecki J, Kalman N, Afanassiev BV, Dini G. Haematopoietic stem cell transplantation in children in eastern European countries 1985–2004: development, recent activity and role of the EBMT/ESH Outreach Programme. Bone Marrow Transplant 2008; 41 Suppl 2:S112-7. [DOI: 10.1038/bmt.2008.68] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [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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Bojanic I, Cepulic BG, Mazic S, Batinic D, Nemet D, Labar B. Toxicity related to autologous peripheral blood haematopoietic progenitor cell infusion is associated with number of granulocytes in graft, gender and diagnosis of multiple myeloma. Vox Sang 2008; 95:70-5. [PMID: 18422859 DOI: 10.1111/j.1423-0410.2008.01060.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVES We prospectively evaluated the infusion-related toxicity of autologous peripheral blood progenitor cells (PBPC) in 215 patients with haematologic malignancies or solid tumours. MATERIALS AND METHODS PBPCs were collected by apheresis after mobilization with chemotherapy and/or granulocyte-colony-stimulating factor (G-CSF). The grafts were cryopreserved in 10% dimethyl sulfoxide (DMSO) and stored in liquid nitrogen. Patients were monitored for vital signs and symptoms of the toxicity during and after infusion. RESULTS The adverse reactions were reported during 149 (56.9%) infusions. During 21.0% infusions occurred just one symptom classified as grade 1, while during 35.9% occurred multiple symptoms classified as grade 2. Logistic regression analysis showed that female gender, diagnosis of multiple myeloma and number of granulocytes infused per kg body weight were significant predictors of occurrence of adverse reactions during infusion. CONCLUSION Our results indicate that beside the infused DMSO dose, the composition of graft as well as patient's diagnosis are also very important factors for infusion-related toxicity.
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Affiliation(s)
- I Bojanic
- Department of Transfusion Medicine, Clinical Hospital Centar, Zargreb, Croatia.
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Zupančić-Šalek S, Ajduković R, Bilić E, Peraica A, Femenić R, Rajić L, Aurer I, Pulanić D, Konja J, Labar B. OP05 ATG for pure red cell aplasia: case series. Leuk Res 2007. [DOI: 10.1016/s0145-2126(07)70285-0] [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: 10/22/2022]
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9
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Vince A, Židovec-Lepej S, Kozić S, Baća-Vrakela I, Serventi-Seiwerth R, Grković L, Labar B. P090 Molecular detection of Epstein-Barr virus in patients with bone marrow transplantation. Leuk Res 2007. [DOI: 10.1016/s0145-2126(07)70438-1] [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: 10/22/2022]
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Grković L, Rnjak L, Sertić D, Serventi-Seiwerth R, Mikulic M, Dubravčić K, Batinić D, Labar B. P040 Chronic natural killer cell lymphocytosis. Leuk Res 2007. [DOI: 10.1016/s0145-2126(07)70388-0] [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: 10/22/2022]
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11
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Durakovic N, Boban A, Mrsić M, Sertić D, Serventi-Seiwerth R, Nemet D, Labar B. P099 Efficacy and safety of colistin for the treatment of infections caused by multidrug-resistant isolates of Pseudomonas aeruginosa sensitive to colistin in patients with haematological malignancy. Leuk Res 2007. [DOI: 10.1016/s0145-2126(07)70447-2] [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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12
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Boban A, Zadro R, Bogdanić B, Mrsić S, Aurer I, Labar B. P032 Long term follow up of a patient with chronic myeloid leukemia treated with umbilical cord blood transplantation, buffy coat and interferon-α. Leuk Res 2007. [DOI: 10.1016/s0145-2126(07)70380-6] [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: 10/22/2022]
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13
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Willemze R, Suciu S, Mandelli F, de Witte T, Labar B, Marie J, Meloni G, Mistrik M, Liso V, Selleslag D, Beksac M, Fabbiano F, Peta A, Thomas X, Bron D, Fillet G, Muus P, Theys A, Fazi P, Baila L, Vignetti M, Amadori S. OP08 High dose (HD-AraC) vs standard dose cytosine arabinoside (SD-AraC) during induction in acute myelogenous leukemia (AML): Impact on stem cell mobilization after consolidation and on autologous transplantation (AML-12 trial). Leuk Res 2007. [DOI: 10.1016/s0145-2126(07)70288-6] [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: 11/30/2022]
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14
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Sučić M, Marošević L, Šimonović B, Marković-Glamočak M, Ries S, Gjadrov-Kuveždić K, Nemet D, Mikulic M, Labar B. P003 CD11a, myeloperoxidase and alkaline phosphatase expression in bone marrow mature granulopoietic cells in patients with AML and ALL. Leuk Res 2007. [DOI: 10.1016/s0145-2126(07)70351-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: 11/28/2022]
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15
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Grubic Z, Stingl K, Cecuk-Jelicic E, Zunec R, Serventi-Seiwerth R, Rajić L, Labar B, Brkljacic-Kerhin V. P088 PCR-STR method in monitoring chimerism status after hematopoietic stem cell transplantation. Leuk Res 2007. [DOI: 10.1016/s0145-2126(07)70436-8] [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: 10/22/2022]
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16
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Golemović M, Rnjak L, Sučić M, Mitrovic Z, Pisk-Mikulic M, Labar B, Batinić D. P002 Microenvironment influence on cyclin A1 mRNA expression in AML blasts. Leuk Res 2007. [DOI: 10.1016/s0145-2126(07)70350-8] [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: 11/25/2022]
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17
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Golubić-Ćepulić B, Bojanić I, Mazić S, Mrsić M, Labar B. P091 Cord blood banking in Croatia. Leuk Res 2007. [DOI: 10.1016/s0145-2126(07)70439-3] [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: 11/27/2022]
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18
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Zupančić-Šalek S, Radman I, Pulanić D, Pašić A, Nola M, Labar B. P021 Multiple relapsing non-melanoma skin cancers in patient with severe hemophilia A – a case report. Leuk Res 2007. [DOI: 10.1016/s0145-2126(07)70369-7] [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: 10/22/2022]
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19
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Mikulic M, Batinić D, Rnjak L, Mrsić M, Nemet D, Serventi-Seiwerth R, Sertić D, Dubravčić K, Golemović M, Mrsić S, Sučić M, Gjadrov K, Zadro R, Labar B. P015 Outcome in a small series of biphenotypic acute leukemia (BAL) patients. Leuk Res 2007. [DOI: 10.1016/s0145-2126(07)70363-6] [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: 11/25/2022]
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20
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Mrsić M, Labar B, Serventi-Seiwerth R, Potočki K, Fumić K, Stern-Padovan R, Prutki M, Duraković N, Bogdanić V. P102 Bone marrow trabnsplantation for acute myeloid leukemia from donor with Gaucher disease followed by enzyme replacement therapy (ERT). Leuk Res 2007. [DOI: 10.1016/s0145-2126(07)70450-2] [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: 11/17/2022]
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21
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Stingl K, Grubic Z, Cecuk-Jelicic E, Zunec R, Serventi-Seiwerth R, Labar B, Brkljacic-Kerhin V. P089 HLA microsatellites analysis: implications for unrelated donor matching in hematopoietic stem cell transplantation. Leuk Res 2007. [DOI: 10.1016/s0145-2126(07)70437-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: 10/22/2022]
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22
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Nemet D, Sertić D, Mrsić M, Bojanić I, Batinić D, Duraković N, Golubić-Ćepulić B, Serventi-Seiwerth R, Radman I, Aurer I, Zupančić-Šalek S, Labar B. E10 Stem cell transplantation for multiple myeloma in Croatia: evaluation of the efficacy of double autologous stem cell transplantation. Leuk Res 2007. [DOI: 10.1016/s0145-2126(07)70275-8] [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: 10/22/2022]
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23
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Duraković N, Nemet D, Sertić D, Mrsić M, Golubić-Ćepulić B, Bojanić I, Batinić D, Serventi-Seiwerth R, Mazić S, Zadro R, Mrsić-Davidović S, Labar B. P094 Autologous blood stem cell (PBSCT) vs bone marrow transplantation (ABMT) for acute myeloid leukaemia in 1st remission. Leuk Res 2007. [DOI: 10.1016/s0145-2126(07)70442-3] [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: 10/22/2022]
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24
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Radić Antolic M, Zadro R, Sertić D, Labar B. P028 Monitoring CML patients responding to treatment with tyrosine kinase inhibitors with real-time quantitative polymerase chain reaction. Leuk Res 2007. [DOI: 10.1016/s0145-2126(07)70376-4] [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: 10/22/2022]
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25
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Lasan-Trčić R, Šušterčić D, Kardum I, Jakšić B, Host I, Labar B, Konja J, Begović D, Hitrec V. P026 Variant Philadelphia translocation in chronic myeloid leukemia. Leuk Res 2007. [DOI: 10.1016/s0145-2126(07)70374-0] [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: 11/25/2022]
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26
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Radič Antolic M, Zadro R, Rončevič P, Bašič Kinda S, Labar B. P124 The prevalence of JAK2 V617F mutation in myelodysplastic syndrome. Blood Rev 2007. [DOI: 10.1016/s0268-960x(07)70202-3] [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: 11/16/2022]
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27
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Labar B, Suciu S, Muus P, Willemze R, Marie JP, Fillet G, Berneman Z, Jaksic B, Feremans W, Bron D, Sinnige H, Mistrik M, Vreugdenhil G, De Bock R, Nemet D, Gilotay C, de Witte T, Amadori S. O07 Dexamethasone versus methyl-prednisolone for adult acute lymphoblastic leukaemia (ALL) and non-Hodgkin lymphoma (NHL) in patients ≤60 yrs old: final results of the EORTC ALL-4 Phase III Trial. Blood Rev 2007. [DOI: 10.1016/s0268-960x(07)70025-5] [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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28
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Mikulic M, Batinic D, Rnjak L, Dubravcic K, Golemovic M, Mrsic S, Sucic M, Zadro R, Mrsic M, Nemet D, Serventi-Seiwerth R, Sertic D, Durakovic N, Labar B. O52 Biological and clinical features of adult biphenotypic acute leukemia: a case series. Blood Rev 2007. [DOI: 10.1016/s0268-960x(07)70068-1] [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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29
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Grubic Z, Stingl K, Cecuk-Jelicic E, Zunec R, Serventi-Seiwerth R, Rajic L, Labar B, Brkljacic-Kerhin V. P023 PCR-STR method in monitoring chimerism status after hematopoietic stem cell transplantation. Blood Rev 2007. [DOI: 10.1016/s0268-960x(07)70096-6] [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: 11/29/2022]
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30
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Duletić-Nacinović A, Sever-Prebelić M, Stifter S, Jonjić N, Hasan M, Labar B. Interleukin-6 in Patients with Aggressive and Indolent Non-Hodgkin's Lymphoma: A Predictor of Prognosis? Clin Oncol (R Coll Radiol) 2006; 18:367-8. [PMID: 16703758 DOI: 10.1016/j.clon.2006.01.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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31
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Mrsic M, Labar B, Potocki K, Fumic K, Stern-Padovan R, Bogdanic V. Bone marrow transplantation for acute myeloid leukemia from donor with Gaucher disease followed by Enzyme Replacement Therapy (ERT). Biol Blood Marrow Transplant 2006. [DOI: 10.1016/j.bbmt.2005.11.143] [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: 11/26/2022]
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32
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Labar B, Suciu S, Muus P, Willemze R, Marie JP, Fillet G, Berneman Z, Jaksic B, Feremans W, Bron D, Sinnige H, Mistrik M, Vreugdenhil G, De Bock R, Nemet D, Gilotay C, De Witte T, Amadori S. Allogeneic transplantation for adult acute lymphoblastic leukemia: Intention to treat analysis of the EORTC ALL-4 phase III trial. Biol Blood Marrow Transplant 2006. [DOI: 10.1016/j.bbmt.2005.11.026] [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: 11/24/2022]
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33
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Golemović M, Sucić M, Zadro R, Mrsić S, Mikulić M, Labar B, Rajić LJ, Batinić D. IgH and TCRgamma gene rearrangements, cyclin A1 and HOXA9 gene expression in biphenotypic acute leukemias. Leuk Res 2005; 30:211-21. [PMID: 16102826 DOI: 10.1016/j.leukres.2005.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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: 04/05/2005] [Revised: 07/06/2005] [Accepted: 07/06/2005] [Indexed: 10/25/2022]
Abstract
In this study we investigated IgH and TCRgamma gene rearrangements, cyclin A1 and HOXA9 gene expression as well as the in vitro growth of biphenotypic acute leukemia (BAL) blasts in relation to acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). The aim of the study was to correlate BAL morphology and its biological parameters in order to get information that might be used for additional stratification of BAL. This rare form of AL was identified in a total of 10 patients, comprising 4.3% of adult and 3.0% of pediatric patients with de novo AL referred to our institution during the 1999-2003 period. Our results indicate that IgH and TCRgamma gene rearrangements correlated well with lymphoid BAL morphology, whereas the expression of cyclin A1 correlated with myeloid and undifferentiated BAL morphology. Surprisingly, HOXA9 expression, a marker associated with myeloid cell lineage, showed no strong correlation with BAL morphology. Finally, in vitro growth of blasts during a 7-day culture showed autonomous cell growth in 3/10 AML and 3/8 myeloid BAL samples tested, but not in any of the AL with lymphoid features. Further studies are needed to confirm these findings and to extend research to a broader spectrum of cell markers.
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Affiliation(s)
- M Golemović
- Division of Immunology, Clinical Institute of Laboratory Diagnosis, Zagreb University School of Medicine, Zagreb Clinical Hospital Center, 10000 Zagreb, Croatia.
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Ludwig H, Drach J, Tóthová E, Gisslinger H, Jaksic B, Linkesch W, Hajek R, Greil R, Fridrik M, Labar B, Zojer N. Thalidomide-dexamethasone versus melphalan-prednisolone as first line treatment in elderly patients with multiple myeloma: An interim analysis. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.6537] [Citation(s) in RCA: 3] [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: 11/20/2022] Open
Affiliation(s)
- H. Ludwig
- Wilhelminenhospital, Vienna, Austria; Univ Hosp, Vienna, Austria; Univ Hosp PJS, Kosice, Slovakia; Kl. Krank. Merkur, Zagreb, Croatia; Univ Hosp, Graz, Austria; Faculty Hosp, Brno, Czech Republic; LKH, Salzburg, Austria; Allgemeines Krankenhaus, Linz, Austria; Clin Hosp Rebro, Zagreb, Croatia
| | - J. Drach
- Wilhelminenhospital, Vienna, Austria; Univ Hosp, Vienna, Austria; Univ Hosp PJS, Kosice, Slovakia; Kl. Krank. Merkur, Zagreb, Croatia; Univ Hosp, Graz, Austria; Faculty Hosp, Brno, Czech Republic; LKH, Salzburg, Austria; Allgemeines Krankenhaus, Linz, Austria; Clin Hosp Rebro, Zagreb, Croatia
| | - E. Tóthová
- Wilhelminenhospital, Vienna, Austria; Univ Hosp, Vienna, Austria; Univ Hosp PJS, Kosice, Slovakia; Kl. Krank. Merkur, Zagreb, Croatia; Univ Hosp, Graz, Austria; Faculty Hosp, Brno, Czech Republic; LKH, Salzburg, Austria; Allgemeines Krankenhaus, Linz, Austria; Clin Hosp Rebro, Zagreb, Croatia
| | - H. Gisslinger
- Wilhelminenhospital, Vienna, Austria; Univ Hosp, Vienna, Austria; Univ Hosp PJS, Kosice, Slovakia; Kl. Krank. Merkur, Zagreb, Croatia; Univ Hosp, Graz, Austria; Faculty Hosp, Brno, Czech Republic; LKH, Salzburg, Austria; Allgemeines Krankenhaus, Linz, Austria; Clin Hosp Rebro, Zagreb, Croatia
| | - B. Jaksic
- Wilhelminenhospital, Vienna, Austria; Univ Hosp, Vienna, Austria; Univ Hosp PJS, Kosice, Slovakia; Kl. Krank. Merkur, Zagreb, Croatia; Univ Hosp, Graz, Austria; Faculty Hosp, Brno, Czech Republic; LKH, Salzburg, Austria; Allgemeines Krankenhaus, Linz, Austria; Clin Hosp Rebro, Zagreb, Croatia
| | - W. Linkesch
- Wilhelminenhospital, Vienna, Austria; Univ Hosp, Vienna, Austria; Univ Hosp PJS, Kosice, Slovakia; Kl. Krank. Merkur, Zagreb, Croatia; Univ Hosp, Graz, Austria; Faculty Hosp, Brno, Czech Republic; LKH, Salzburg, Austria; Allgemeines Krankenhaus, Linz, Austria; Clin Hosp Rebro, Zagreb, Croatia
| | - R. Hajek
- Wilhelminenhospital, Vienna, Austria; Univ Hosp, Vienna, Austria; Univ Hosp PJS, Kosice, Slovakia; Kl. Krank. Merkur, Zagreb, Croatia; Univ Hosp, Graz, Austria; Faculty Hosp, Brno, Czech Republic; LKH, Salzburg, Austria; Allgemeines Krankenhaus, Linz, Austria; Clin Hosp Rebro, Zagreb, Croatia
| | - R. Greil
- Wilhelminenhospital, Vienna, Austria; Univ Hosp, Vienna, Austria; Univ Hosp PJS, Kosice, Slovakia; Kl. Krank. Merkur, Zagreb, Croatia; Univ Hosp, Graz, Austria; Faculty Hosp, Brno, Czech Republic; LKH, Salzburg, Austria; Allgemeines Krankenhaus, Linz, Austria; Clin Hosp Rebro, Zagreb, Croatia
| | - M. Fridrik
- Wilhelminenhospital, Vienna, Austria; Univ Hosp, Vienna, Austria; Univ Hosp PJS, Kosice, Slovakia; Kl. Krank. Merkur, Zagreb, Croatia; Univ Hosp, Graz, Austria; Faculty Hosp, Brno, Czech Republic; LKH, Salzburg, Austria; Allgemeines Krankenhaus, Linz, Austria; Clin Hosp Rebro, Zagreb, Croatia
| | - B. Labar
- Wilhelminenhospital, Vienna, Austria; Univ Hosp, Vienna, Austria; Univ Hosp PJS, Kosice, Slovakia; Kl. Krank. Merkur, Zagreb, Croatia; Univ Hosp, Graz, Austria; Faculty Hosp, Brno, Czech Republic; LKH, Salzburg, Austria; Allgemeines Krankenhaus, Linz, Austria; Clin Hosp Rebro, Zagreb, Croatia
| | - N. Zojer
- Wilhelminenhospital, Vienna, Austria; Univ Hosp, Vienna, Austria; Univ Hosp PJS, Kosice, Slovakia; Kl. Krank. Merkur, Zagreb, Croatia; Univ Hosp, Graz, Austria; Faculty Hosp, Brno, Czech Republic; LKH, Salzburg, Austria; Allgemeines Krankenhaus, Linz, Austria; Clin Hosp Rebro, Zagreb, Croatia
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Grubic Z, Stingl K, Cecuk-Jelicic E, Zunec R, Serventi Seiwerth R, Labar B, Rajic L, Brkljacic-Kerhin V. Evaluation of Mixed Chimerism in Bone Marrow Transplantation Program in Croatia. Transplant Proc 2005; 37:1388-91. [PMID: 15848729 DOI: 10.1016/j.transproceed.2005.01.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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: 11/25/2022]
Abstract
In this study we monitored mixed chimerism in 36 patients with various hematologic disorders. All of them underwent a classic conditioning regimen, 31 patients for related bone marrow transplantation (BMT) and 5 patients for unrelated BMT. DNA was isolated from peripheral blood, and samples were polymerase chain reaction (PCR) amplified for 5 short tandem repeat (STR) loci (TH01, VWA31, FES/FPS, F13A01, and SE33) and for one variable number of tandem repeats locus (D1S80). Samples were run on a 6% polyacrylamide gel in an automated ALFexpress sequencer. In all 36 donor-recipient pairs we found differences for at least two STR loci. In most cases the difference was observed for SE33 and D1S80 loci. Mixed chimerism (MC) was detected in 18 patients: 4 with unrelated BMT and 14 with related sibling donors. In 11 patients MC was detected in the early period after BMT, but was soon followed by full donor chimerism (FDC) in peripheral blood. In 5 cases patients MC appearing after FDC was established, and was predictive for the relapse. One patient showed alternating MC and FDC, but at the end showed only recipient cells and graft rejection. In conclusion, the PCR-STR analysis is a highly informative, fast, and simple screening method for monitoring chimerism in a BMT program.
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Affiliation(s)
- Z Grubic
- National Referral Organ Transplantation and Tissue Typing Centre, University Hospital Centre Zagreb, Croatia.
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36
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Labar B, Rudan I, Ivankovic D, Biloglav Z, Mrsic M, Strnad M, Fucic A, Znaor A, Bradic T, Campbell H. Haematological malignancies in childhood in Croatia: investigating the theories of depleted uranium, chemical plant damage and 'population mixing'. Eur J Epidemiol 2004; 19:55-60. [PMID: 15012023 DOI: 10.1023/b:ejep.0000013400.65418.60] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [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: 11/12/2022]
Abstract
Some of potential causes proposed to explain the reported increase of haematological malignancies in childhood during or after the war period in several countries include depleted uranium, chemical pollution and population mixing theory. The aim of this study was to define the population of Croatian children aged 0-14 years who were potentially exposed to each of those risks during the war and to investigate any possible association between the exposure and the incidence of haematological malignancies. The authors analyzed the data reported by the Cancer Registry of Croatia during the pre-war period (1986-1990), war period (1991-1995) and post-war period (1996-1999). In the group of 10 counties potentially exposed to depleted uranium and two counties where chemical war damage occurred, no significant difference in incidence of the studied haematological malignancies was noted in comparison to pre-war period. The incidence of lymphatic leukaemia significantly increased in four counties where population mixing had occurred during the war period, supporting the 'mixing theory'. In those counties, the incidence of Hodgkin's lymphoma decreased during and after the war. In Croatia as a whole, decreases in incidence of myeloid leukaemias during war and non-Hodgkin lymphoma after the war were noted.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Blood Cell Count
- Croatia/epidemiology
- Environmental Exposure/adverse effects
- Female
- Hazardous Substances/toxicity
- Hematologic Neoplasms/chemically induced
- Hematologic Neoplasms/diagnostic imaging
- Hematologic Neoplasms/epidemiology
- Humans
- Incidence
- Leukemia, Lymphoid/chemically induced
- Leukemia, Lymphoid/diagnostic imaging
- Leukemia, Lymphoid/epidemiology
- Leukemia, Myeloid/chemically induced
- Leukemia, Myeloid/diagnostic imaging
- Leukemia, Myeloid/epidemiology
- Lymphoma, Non-Hodgkin/chemically induced
- Lymphoma, Non-Hodgkin/diagnostic imaging
- Lymphoma, Non-Hodgkin/epidemiology
- Male
- Middle Aged
- Population Dynamics
- Prevalence
- Radioactive Pollutants/toxicity
- Radionuclide Imaging
- Registries
- Uranium/chemistry
- Uranium/toxicity
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Affiliation(s)
- B Labar
- Faculty of Medicine, University of Zagreb, Croatia.
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37
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Golubić-Cepulić B, Budimir A, Plecko V, Plenković F, Mrsić M, Sarlija D, Vuk T, Skrlin J, Kalenić S, Labar B. Morganella morganii causing fatal sepsis in a platelet recipient and also isolated from a donor's stool. Transfus Med 2004; 14:237-40. [PMID: 15180816 DOI: 10.1111/j.0958-7578.2004.00506.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [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: 11/28/2022]
Abstract
Bacterial contamination of blood products causes significant patient morbidity and mortality. Contaminated platelet transfusion is a frequent cause of bacteraemia and sepsis because of the storage conditions of platelets. A fatal case of Morganella morganii platelet transfusion associated with sepsis is described, along with procedures traced back to the isolation of M. morganii from a donor's stool. Molecular typing was performed, and the same M. morganii strain was found in blood and post-mortem organ cultures of platelet recipient and platelet bag and in the donor's stool. The route of contamination is unknown. The contamination could be due to either insufficient venipuncture site disinfection or the donor's transient bacteraemia. Patient died 5 days after the transfusion.
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Affiliation(s)
- B Golubić-Cepulić
- Department of Transfusion Medicine, Clinical Hospital Centre Zagreb, Zagreb, Croatia.
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38
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Oosterveld M, Suciu S, Verhoef G, Labar B, Belhabri A, Aul C, Selleslag D, Ferrant A, Wijermans P, Mandelli F, Amadori S, Jehn U, Muus P, Zittoun R, Hess U, Anak O, Beeldens F, Willemze R, de Witte T. The presence of an HLA-identical sibling donor has no impact on outcome of patients with high-risk MDS or secondary AML (sAML) treated with intensive chemotherapy followed by transplantation: results of a prospective study of the EORTC, EBMT, SAKK and GIMEMA Leukemia Groups (EORTC study 06921). Leukemia 2003; 17:859-68. [PMID: 12750698 DOI: 10.1038/sj.leu.2402897] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This report used the framework of a large European study to investigate the outcome of patients with and without an HLA-identical sibling donor on an intention-to-treat basis. After a common remission-induction and consolidation course, patients with an HLA-identical sibling donor were scheduled for allogeneic transplantation and patients lacking a donor for autologous transplantation. In all, 159 patients alive at 8 weeks from the start of treatment were included in the present analysis. In total, 52 patients had a donor, 65 patients did not have a donor and in 42 patients the availability of a donor was not assessed. Out of 52 patients, 36 (69%) with a donor underwent allogeneic transplantation (28 in CR1). Out of 65 patients, 33 (49%) received an autograft (27 in CR1). The actuarial survival rates at 4 years were 33.3% (s.e. = 6.7%) for patients with a donor and 39.0% (s.e. = 6.5%) for patients without a donor (P = 0.18). Event-free survival rates were 23.1% (s.e. = 6.2%) and 21.5% (s.e. = 5.3%), respectively (P = 0.66). Correction for alternative donor transplants did not substantially alter the survival of the group without a donor. Also, the survival in the various cytogenetic risk groups was not significantly different when comparing the donor vs the no-donor group. This analysis shows that patients with high-risk myelodysplastic syndrome and secondary acute myeloid leukemia may benefit from both allogeneic and autologous transplantation. We were unable to demonstrate a survival advantage for patients with a donor compared to patients without a donor.
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Affiliation(s)
- M Oosterveld
- 1University Medical Centre, Nijmegen, The Netherlands
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Rozman P, Karas M, Kosir A, Labar B, Madrigal A, Middleton D, Navarrete C, Oudshoorn M, Schennach H, Vitek A, Bohinjec M. Are human platelet alloantigens (HPA) minor transplantation antigens in clinical bone marrow transplantation? Bone Marrow Transplant 2003; 31:497-506. [PMID: 12665847 DOI: 10.1038/sj.bmt.1703854] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The role of human platelet alloantigens (HPA) in clinical bone marrow allotransplantation was investigated. The leading hypothesis was that HPA alloepitopes act as minor histocompatibility antigens and aggravate graft-versus-host disease (GVHD). To exclude the effect of MHC disparity, only HLA identical donor-recipient pairs were entered into the study. The influence of HPA compatibility on overall survival, occurrence of relapses and haematopoietic recovery was also investigated. A total of 223 patients who received a graft from an HLA-identical sibling, genotyped for HPA -1, -2, -3, -4 and -5, were observed over a post-transplant period of 24 months following the protocol recommended by EBMT. The data from patients having received grafts from HPA compatible donors were compared to data from patients having received grafts that were mismatched in HPA allotypes in the GVH direction. Analysis of the incidence of acute and chronic (GVHD), overall survival, relapse incidence, haematopoietic recovery and some other clinical parameters did not reveal any significant difference between the HPA-matched and -mismatched groups of patients, regardless of their age. Our results give no evidence that HPA-1, -2, -3 and -5 alloantigens should be considered minor transplantation antigens in clinical bone marrow transplantation.
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Affiliation(s)
- P Rozman
- Blood Transfusion Centre of Slovenia, Ljubljana, Slovenia
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40
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Basić-Jukić N, Kes P, Labar B. Myeloma kidney: pathogenesis and treatment. Acta Med Croatica 2002; 55:169-75. [PMID: 12398020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
Renal failure frequently complicates the course of multiple myeloma. Factors that determine the development of myeloma kidney include a high rate of light chain excretion, biochemical characteristics of light chain, and concurrent volume depletion. There are two main pathogenetic mechanisms; i.e. direct tubular toxicity and intratubular cast formation. Therapeutic measures include chemotherapy, bone marrow or peripheral blood stem cell transplantation, hyperhydration, plasmapheresis, dialysis, solving of hypercalcemia, treatment of anemia with erythropoietin, and avoidance of nephrotoxic drugs and radiocontrast agents. Experimental approach includes administration of colchicines and alkalinization of the urine.
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Affiliation(s)
- N Basić-Jukić
- Department of Medicine, Zagreb University Hospital Center, Kispatićeva 12, 10000 Zagreb, Croatia.
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Radman I, Basić N, Labar B, Kovacević J, Aurer I, Bogdanić V, Zupancić-Salek S, Nemet D, Jakić-Razumović J, Mrsić M, Santek F, Grgić-Markulin L, Boban D. Long-term results of conventional-dose salvage chemotherapy in patients with refractory and relapsed Hodgkin's disease (Croatian experience). Ann Oncol 2002; 13:1650-5. [PMID: 12377656 DOI: 10.1093/annonc/mdf271] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The aim of this study was to analyze outcome of patients with Hodgkin's disease (HD) in whom first-line chemotherapy with mustine/vincristine/procarbazine/prednisone (MOPP) had failed. PATIENTS AND METHODS From January 1982 to December 1989 among 210 patients treated with MOPP and radiotherapy to initial bulky sites, 65 patients were primary refractory to or relapsed after initial treatment. RESULTS Twenty-nine of 65 patients (44%) were primary refractory to initial chemotherapy, 20 relapsed within 12 months after complete remission (CR) and 16 relapsed after CR that lasted more than 12 months. Patients with primary refractory HD and early relapse (<12 months after CR) were treated with doxorubicin/bleomycin/vinblastine/darcarbazine. In patients with late relapse (>12 months after CR) MOPP was repeated. The median follow-up for all patients was 115 months. The overall response rate was 63%. Thirty-three patients (51%) achieved a second CR and eight patients (12%) partial response. Remission rate was greatest in patients with late relapse (CR >12 months) (75 versus 55% for early relapse versus 35% for primary refractory HD) (P <0.01). At 10 years, overall and failure-free survival rates were 21 and 16%, respectively. Patients who were in first remission longer than 12 months had a superior overall survival (37 versus 18% for early relapse) and failure-free survival (24 versus 10% for early relapse). No patient with primary refractory HD was alive beyond 52 months after initial treatment failure (P <0.01). Main prognostic factors were duration of the first remission and tumor bulk at relapse. CONCLUSIONS Our results confirm previous observations that a significant proportion of patients with HD who experience induction treatment failure cannot be cured with conventional treatment and probably need more aggressive therapy.
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Affiliation(s)
- I Radman
- Department of Internal Medicine, Division of Hematology, Clinical Hospital Center Rebro, Zagreb, Croatia
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Oosterveld M, Muus P, Suciu S, Koller C, Verhoef G, Labar B, Wijermans P, Aul C, Fière D, Selleslag D, Willemze R, Gratwohl A, Ferrant A, Mandelli F, Cortes J, de Witte T, Estey E. Chemotherapy only compared to chemotherapy followed by transplantation in high risk myelodysplastic syndrome and secondary acute myeloid leukemia; two parallel studies adjusted for various prognostic factors. Leukemia 2002; 16:1615-21. [PMID: 12200672 DOI: 10.1038/sj.leu.2402591] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.2] [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: 10/01/2001] [Accepted: 04/11/2002] [Indexed: 11/09/2022]
Abstract
Comparisons of the effectiveness of chemotherapy and transplantation in AML in first complete remission (CR) have focused almost exclusively on patients with de novo disease. Here we used Cox modelling to compare these strategies in patients with MDS and s-AML treated by the Leukemia Group of the EORTC or at the MD Anderson Cancer Center. All patients were aged 15-60. The 184 EORTC patients received conventional dose ara-C + idarubicin + etoposide for remission induction, and after one consolidation course, were scheduled to receive an allograft, or an autograft if a sibling donor was unavailable. The 215 MDA patients received various high-dose ara-C containing induction regimens, and in CR, continued to receive these regimens at reduced dose for 6-12 months. CR rates were 54% EORTC and 63% MDA (P = 0.09). Sixty-five of the 100 EORTC patients who entered CR received a transplant in first CR. Disease-free survival in patients achieving CR was superior in the EORTC cohort, the 4-years DFS rates were 28.9% (s.e. = 4.8%) EORTC vs 17.3% (s.e. = 3.7%) MDA (P = 0.017). Survival from CR was not significantly different in the EORTC and MDA groups, as was survival from start of treatment. After accounting for prognostic factors the conclusions were unchanged. Despite various problems with the analysis discussed below, the data suggest that neither transplantation nor chemotherapy, as currently practised, can be unequivocally recommended for these patients in first CR and that questions as to the superior modality may be less important than the need to improve results with both.
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Affiliation(s)
- M Oosterveld
- University Medical Centre Nijmegen, The Netherlands
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Huić D, Ivancević V, Aurer I, Dodig D, Nemet D, Labar B, Poropat M, Munz DL. Bone marrow immunoscintigraphy in haematological patients with pancytopenia: preliminary results. Nucl Med Commun 2002; 23:757-63. [PMID: 12124481 DOI: 10.1097/00006231-200208000-00009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [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: 12/16/2022]
Abstract
The aim of this study was to assess the clinical value of bone marrow immunoscintigraphy using the (99m)Tc labelled anti-NCA-95 antigranulocyte antibodies (AGAb) and of AGAb bone marrow uptake ratio (UR) in the initial diagnostic work-up of diseases with depression of the bone marrow. Twenty-four whole-body bone marrow scans were performed in 23 patients (11 women, 12 men; median age 46 years, range 17-74 years) 5 h after i.v. injection of 370 MBq of AGAb. The UR was calculated from the posterior view drawing an irregular region of interest around the sacroiliac and a background areas. The mean UR in pancytopenic patients was 2.3+/-1.5 (range 0.3-5.8), thus being significantly lower (P=0.45 x 10(-6)) than the mean UR in a control group of 50 patients (mean UR 7.3+/-2.3; range 4.4-12.6) obtained previously. Considering patient age, there was no overlap between UR of pancytopenic patients and the respective normal ranges. The bone marrow appearance on scans seemed to be characteristic for the different haematological diseases investigated. In six patients with myelofibrosis, bone marrow scans demonstrated diffusely decreased bone marrow activity and prominent splenic uptake, possibly related to extramedullary haematopoiesis. In aplastic anaemia, highly reduced and patchy marrow uptake was observed in four patients (five scans), in one of them persisting even after blood cell counts had recovered to the near-normal range. In another two patients with aplastic anaemia, diffusely decreased bone marrow uptake was obtained. In patients with myeloid leukaemia, bone marrow patterns were almost normal probably because the target antigen is often expressed on neoplastic myeloid cells, too. Bone marrow extension was a common finding in these patients. There is an obvious differentiation between haematological patients with pancytopenia and normal subjects by means of AGAb bone marrow uptake ratio. The distinct patterns of AGAb distribution may be indicative for particular haematological diseases.
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Affiliation(s)
- Drazen Huić
- Clinical Department of Nuclear Medicine and Radiation Protection, University Hospital Rebro, Kispatićeva 12, 10000 Zagreb, Croatia.
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44
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Basić-Jukić N, Basić-Koretić M, Radman I, Labar B. Reed-Sternberg cells in the pathogenesis of Hodgkin's disease. Acta Med Croatica 2002; 55:115-21. [PMID: 11852730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Hodgkin/Reed Stemberg (HRS) cells mediate the classical features of Hodgkin's disease. However, because of their rarity in tumor tissue, little is known about their origin and function. Recent advances in biotechnology, including the single cell manipulation, enabled the insight into the biology of HRS cell. It has been demonstrated that in the great majority of cases they are of germinal center B cell origin, with highly developed interactive network with adjacent cells via expression of cell adhesion molecules, tumor necrosis factor receptor superfamily, and elaboration of different cytokines.
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Affiliation(s)
- N Basić-Jukić
- Department of Medicine, Zagreb University Hospital Center, Kispatićeva 12, 10000 Zagreb, Croatia
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45
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Mrsić M, Grgić M, Budisić Z, Podolski P, Bogdanić V, Labar B, Jakić-Razumović J, Restek-Samarzija N, Gosev M. Trastuzumab in the treatment of advanced breast cancer: single-center experience. Ann Oncol 2002; 12 Suppl 1:S95-6. [PMID: 11521730 DOI: 10.1093/annonc/12.suppl_1.s95] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [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: 11/14/2022] Open
Abstract
A significant number of women with advanced breast cancer fail to respond to standard-dose chemotherapy. From the beginning of 1999, 17 women with HER2 positive advanced breast cancer received Herceptin as monotherapy or in combination with paclitaxel or other non-anthracyclines. Eight (47%) women previously received high-dose chemotherapy followed by haematopoiesis stem cell rescue. Three women received Herceptin alone, eleven Herceptin plus paclitaxel and three Herceptin and some of the other non-anthracyclines (CCNU, cisplatin and gemcitabine). In the group of patients who received Herceptin monotherapy, one has partial response (PR), one stable disease (SD) and in the third patient the disease progressed. Out of three patients who received Herceptin in combination with other non-anthracyclines, two have SD and one progressed. In the group of 11 women who received Herceptin + Taxol, 7 (64%) patients achieved PR, 2 (18%) SD, and 2 (18%) had disease progression. Grade 3-4 neutropenia has been observed in four (23%) women. Febrile neutropenia was observed in two cases and resolved completely when antibiotics were introduced. Other grade 3 toxicity that has been noted is peripheral neuropathy in three (18%) patients, diarrhoea in four (23%) and onycholysis in one (6%). Serial heart ultrasound showed no significant decline in left ventricular ejection fraction. According to our preliminary experience, Herceptin therapy showed promising results in women with metastatic breast cancer.
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Affiliation(s)
- M Mrsić
- University Hospital Center Zagreb, Croatia.
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46
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de Witte T, Suciu S, Verhoef G, Labar B, Archimbaud E, Aul C, Selleslag D, Ferrant A, Wijermans P, Mandelli F, Amadori S, Jehn U, Muus P, Boogaerts M, Zittoun R, Gratwohl A, Zwierzina H, Hagemeijer A, Willemze R. Intensive chemotherapy followed by allogeneic or autologous stem cell transplantation for patients with myelodysplastic syndromes (MDSs) and acute myeloid leukemia following MDS. Blood 2001; 98:2326-31. [PMID: 11588026 DOI: 10.1182/blood.v98.8.2326] [Citation(s) in RCA: 112] [Impact Index Per Article: 4.9] [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: 11/20/2022] Open
Abstract
This study investigated the feasibility of allogeneic (alloSCT) and autologous stem cell transplantation (ASCT) as postconsolidation therapy for patients with myelodysplastic syndromes (MDSs) or acute myeloid leukemia after MDS. Patients with a histocompatible sibling were candidates for alloSCT and the remaining patients for ASCT. Remission-induction therapy consisted of 1 or 2 courses with idarubicin, cytarabine, and etoposide, followed by one intensive consolidation course with cytarabine and mitoxantrone. Initially, bone marrow cells were used for ASCT. Subsequently, mobilized blood stem cells were used in an attempt to shorten posttransplantation hypoplasia. With a median follow-up of 3.6 years the 184 evaluable patients showed a 4-year survival rate of 26% and a median survival of 13 months. The remission-induction chemotherapy induced complete remission (CR) in 100 patients (54%). The 4-year disease-free survival (DFS) rate was 29% and the median DFS was 12 months. Twenty-eight of 39 patients (72%) with a donor were allografted in CR-1, including 2 patients who underwent transplantation in CR-1 without a consolidation course. Thirty-six of 59 patients (61%) without a donor received ASCT in CR-1. The 4-year DFS rates in the group of patients with or without a donor were 31% and 27%, respectively. The 4-year survival rates from CR were 36% and 33%, respectively. This large prospective study shows the feasibility of both alloSCT and ASCT. This treatment approach leads to a relatively high remission rate, and the majority of patients in remission received the SCT in CR-1. The ongoing study investigates whether this approach is better than treatment with chemotherapy only.
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Affiliation(s)
- T de Witte
- University Medical Center St Radboud, Nijmegen, The Netherlands.
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Janda SS, Boranić M, Skodlar J, Petrovecki M, Nemet D, Labar B. Effect of opioid peptide methionine-enkephalin in long-term cultures of human bone marrow. Acta Med Croatica 2001; 54:99-105. [PMID: 11268793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Methionine enkephalin, an opioid peptide belonging to the family of neuropeptides, has been shown to function as a neurotransmitter, hormone and growth factor. The present work explored its effects in long-term culture of bone marrow cells, harvested from a patient with acute lymphoid leukemia (ALL-L3) in the second complete remission. Nine cultivation flasks were established and maintained for five weeks, with medium renewal once a week. At each re-feeding, methionine-enkephalin was added to the cultures in final concentrations 10(-8), 10(-10) or 10(-12) M, and granulocyte-macrophage progenitor cells (GM-CFU) were determined among the harvested, nonadherent cell populations. The total number of nonadherent cells was 8% to 42% higher in the treated cultures than in the control, nontreated cultures, and the GM-CFU counts were three to four times higher. Those changes, although evident, did not reach statistical significance because of the small group sizes. In 1 of 9 cultures the adherent cell layer was atypical, the cell population consisted of small cells resembling the lymphoblasts, and the cell count was 2-8 times higher than in the controls. That aberrant culture has presumably arisen from residual leukemic cells remaining in the bone marrow after chemotherapy. The findings support the idea that opioid peptides, including methionine-enkephalin, participate in regulation of hematopoiesis. Two mechanisms may have accounted for the observed effects of enkephalin on cultured bone marrow cells: an indirect action, via interleukins secreted from the stromal cells upon stimulation of the opioid receptors, or a direct action on hematopoietic precursors.
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Affiliation(s)
- S S Janda
- Department of Molecular Medicine, Ruder Bosković Institute, POB 180, Bijenicka 54 10002 Zagreb, Croatia.
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Stanović Janda S, Boranić M, Sucić M, Petrovecki M, Golubić-Cepulić B, Aurer I, Labar B. Effects of a membrane-metallopeptidase blocking agent thiorphan in long-term cultures of human bone marrow. Haematologia (Budap) 2001; 30:289-302. [PMID: 11204028 DOI: 10.1163/156855900300109530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Thiorphan [(DL-3-mercapto-2-benzylpropanoyl)-glycine], a drug blocking the activity of membrane metalloendopeptidase EC 3.4.24.11 (CD10, CALLA), was added to long-term cultures of human bone marrow. Progression of the cultures was assessed by cell counts, cytology and clonogenic (GM-CFU) ability of the non-adherent cells in the supernatant and by morphology of the adherent stromal layer. A stimulatory effect on hematopoiesis was noted.
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Affiliation(s)
- S Stanović Janda
- Ruder Bosković Institute, Department of Molecular Medicine, Zagreb, Croatia.
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Stanović S, Boranić M, Petrovecki M, Batinić D, Skodlar J, Nemet D, Labar B. Thiorphan, an inhibitor of neutral endopeptidase/enkephalinase (CD10/CALLA) enhances cell proliferation in bone marrow cultures of patients with acute leukemia in remission. Haematologia (Budap) 2001; 30:1-10. [PMID: 10841318 DOI: 10.1163/15685590051129814] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Thiorphan, (DL-mercapto-2-benzylpropanoyl)-glycine is a potent and specific inhibitor of membrane metallo-endopeptidase (EC 3.4.24.11, CD10). We explored its effects in short-term clonal cultures of the bone marrow from 10 patients with acute leukemia in remission. The cell suspensions were incubated with thiorphan (10(-13) to 10(-5) M) and seeded for the granulocyte/macrophage-colony forming unit (GM-CFU) assay. In normal bone marrow samples the median seeding efficiency was 119 colonies and clusters per 10(5) cells and thiorphan caused slight stimulation of the clonal growth in concentrations above 10(-9) M. In the leukemic samples, the median seeding efficiency varied from 10 to 366 colonies and clusters per 10(5) seeded cells. Meaningful alterations of the clonal growth were noted in 32 out of 83 thiorphan-treated cultures (39%). In those 32 cultures the stimulatory effects outnumbered the inhibitory effects (24 versus 8). Thus, thiorphan stimulated the progenitor cell proliferation in bone marrow samples from the normal donor and from the patients with acute leukemia in remission. Thiorphan binding to CD10 might interfere with the processing of neuropeptide hemoregulatory factors and thus influence the progenitor cell proliferation.
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Affiliation(s)
- S Stanović
- Department of Molecular Medicine, Ruder Bosković Institute, Zagreb, Croatia
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Mrsić M, Grgić M, Budišić Z, Podolski P, Bogdanić V, Labar B, Jakić-razumović J, Restek-samaržija N, Gošev M. Ann Oncol 2001; 12:95-96. [DOI: 10.1023/a:1011116224931] [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: 11/12/2022] Open
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