Advances in Hematopoietic Stem Cell Transplantation and by Priv.-Doz. Dr. med. Rainer Haas, Dr. med. Ralf Kronenwett,

By Priv.-Doz. Dr. med. Rainer Haas, Dr. med. Ralf Kronenwett, Priv.-Doz. Dr. rer. nat. Georg Sczakiel (auth.)

This publication supplies an summary of the present state-of-the-art in peripheral blood stem cellphone transplantation and up to date advancements in molecular prognosis and gene healing methods. the point of interest is at the function of peripheral blood stem mobilephone transplantation within the remedy of hematological malignancies akin to non-Hodgkin lymphomas, continual myelogenous leukemia and a number of myeloma. present molecular organic concepts for detecting genetic defects in tumors and minimum residual disorder also are provided. additional themes contain new gene healing suggestions in hematology and oncology: using viral vectors for transduction of hematopoietic cells is mentioned in addition to healing options in accordance with antisense nucleic acids, ribozymes, and immunological approaches.

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1991). Sharp et al. (1996) reported that the frequency of relapse after bone marrow or peripheral blood stem cell transplantation is correlated with the presence of lymphoma cells which will grow in appropriate in vitro assays. Although these results must be confirmed in prospective studies, they suggest that the use of purged bone marrow or PBPC may be beneficial. However, these procedures were effective in only half of the cases (Gribben et al. 1991); thus, the relapse rate in autologous transplants may be related in part to the reinfusion of malignant cells.

Blood 82:1929-1936 Cross NCP, Melo IV, Goldman IM (l994a) An optimized multiplex polymerase chain reaction (PCR) for detection of BCR-ABL fusion mRNAs in haematological disorders. Leukemia 8:186-189 Cross NCP, Feng L, Zhang IG, Goldman IM (1994b) Competitive PCR to monitor residual disease after bone marrow transplantation for chronic myeloid leukaemia. In: Borden EC, Goldman IM, Grignani F (eds) Molecular diagnosis and monitoring of leukaemia and lymphoma. Ares-Serono Symposia Publications, pp 119-126 De Klein A, Hagemeijer A, Bartram CR, Houwen R, Hoefsloot L, Carbonell F, Chan L, Barnett M, Greaves M, Kleihauer E et al (1986) bcr rearrangement and translocation of the c-abl oncogene in Philadelphia positive acute lymphoblastic leukemia.

By nested RT-PCR, CML cells remaining after treatment can be No. of leukemia cells 10 13 10 12 10 11 Ph+, Southern blot +, Western blot + 10 10 PCR positive Cytogenetic remission PCR negative Molecular remission 10 9 10 8 10 7 10 6 10 5 10 4 10 3 10 2 10 Fig. 1. Levels of remission. Patients in conventional (cytogenetic, Southern blot, western blot) remission may harbor up to 1010 residual leukemic cells. Nested RT-PCR is able to detect minimal residual disease up to a level of 106 cells in the body 40 A.

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