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  • 1.
    Abelsson, J.
    et al.
    NU Hospital Organization, Uddevalla.
    Merup, M.
    Karolinska Universitetssjukhuset, Huddinge.
    Birgegård, G.
    Uppsala University.
    WeisBjerrum, O.
    Rigshospitalet, University of Copenhagen.
    Brinch, L.
    Rikshospitalet, Oslo University Hospital.
    Brune, M.
    Sahlgrenska Universitetssjukhuset, Göteborg.
    Johansson, P.
    NU Hospital Organization, Uddevalla.
    Kauppila, M.
    Turku University Hospital, Finland.
    Lenhoff, S.
    Skåne University Hospital.
    Liljeholm, M.
    Norrlands Universitetssjukhus, Umeå.
    Malm, Claes
    Linköping University, Department of Clinical and Experimental Medicine, Oncology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Surgery, Orthopaedics and Cancer Treatment, Department of Haematology UHL.
    Remes, K.
    Turku University Hospital, Finland.
    Vindelöv, L.
    Rigshospitalet, University of Copenhagen.
    Andréasson, Björn
    NU Hospital Organization, Uddevalla.
    The outcome of allo-HSCT for 92 patients with myelofibrosis in the Nordic countries2012In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 47, no 3, p. 380-386Article in journal (Refereed)
    Abstract [en]

    Between 1982 and 2009 a total of 92 patients with myelofibrosis (MF) in chronic phase underwent allo-SCT in nine Nordic transplant centers. Myeloablative conditioning (MAC) was given to 40 patients, and reduced intensity conditioning (RIC) was used in 52 patients. The mean age in the two groups at transplantation was 46±12 and 55±8 years, respectively (P<0.001). When adjustment for age differences was made, the survival of the patients treated with RIC was significantly better (P=0.003). Among the RIC patients, the survival was significantly (P=0.003) better for the patients with age <60 years (a 10-year survival close to 80%) than for the older patients. The type of stem cell donor did not significantly affect the survival. No significant difference was found in TRM at 100 days between the MAC- and the RIC-treated patients. The probability of survival at 5 years was 49% for the MAC-treated patients and 59% in the RIC group (P=0.125). Patients treated with RIC experienced significantly less aGVHD compared with patients treated with MAC (P<0.001). The OS at 5 years was 70, 59 and 41% for patients with Lille score 0, 1 and 2, respectively (P=0.038, when age adjustment was made). Twenty-one percent of the patients in the RIC group were given donor lymphocyte infusion because of incomplete donor chimerism, compared with none of the MAC-treated patients (P<0.002). Nine percent of the patients needed a second transplant because of graft failure, progressive disease or transformation to AML, with no significant difference between the groups. Our conclusions are (1) allo-SCT performed with RIC gives a better survival compared with MAC. (2) age over 60 years is strongly related to a worse outcome and (3) patients with higher Lille score had a shorter survival.Bone Marrow Transplantation advance online publication, 9 May 2011; doi:10.1038/bmt.2011.91.

  • 2. Axdorph, Ulla
    et al.
    Stenke, Leif
    Grimfors, Gunnar
    Carneskog, Jan
    Hansen, Jan
    Linder, Olle
    Ljungman, Per
    Löfvenberg, Eva
    Malm, Claes
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Hematology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Haematology UHL.
    Simonsson, Bengt
    Turesson, Ingemar
    Vilén, Lars
    Udén, Anne-Marie
    Björkholm, Magnus
    Intensive chemotherapy in patients with chronic myelogenous leukaemia (CML) in accelerated or blastic phase - A report from the Swedish CML Group2002In: British Journal of Haematology, ISSN 0007-1048, E-ISSN 1365-2141, Vol. 118, no 4, p. 1048-1054Article in journal (Refereed)
    Abstract [en]

    In attempting to restore the chronic phase (CP) of chronic myelogenous leukaemia (CML), the Swedish CML group utilized an intensive chemotherapy protocol for 83 patients (aged 16-79 years) in accelerated (AP, n = 22) or blastic phase (BC, n = 61). Most patients received a combination of mitoxantrone (12 mg/m2/d) and etoposide (100 mg/m2/d) together with cytosine arabinoside (1 g/m2 b.i.d) for 4 d. Overall, 39 patients (47%) achieved a second CP (CP2)/partial remission (PR). Responding patients <65 years were eligible for ablative chemotherapy followed by an allogeneic (SCT) or a double autologous stem cell transplant (ASCT). Seventeen of 34 responders <65 years failed to proceed to transplantation as a result of early disease progression (n = 15) or disease-related complications (n = 2). The remaining 17 patients underwent SCT (n = 9, including four unrelated donor SCT) or ASCT (n = 8). Only one of the eight ASCT patients had a second ASCT, the remaining seven failed because of progression (n = 5) or hypoplasia (n = 2). The median duration of CP2/PR was 6 months (range 1-72 months). Five patients achieved a longer CP2/PR than CP1. The 1 year survival was 70% for SCT/ASCT patients (median survival 21 months), 50% for responding patients overall, but only 7% for non-responders (P < 0.001). Three SCT/ASCT patients are long-term survivors (65+, 66+ and 73+ months). In conclusion, approximately half of the patients achieved a CP2/PR after intensive chemotherapy, with a clear survival advantage for responders vs non-responders. Subsequent SCT/ASCT was feasible for half of the responders (<65 years), and one individual underwent double ASCT. Novel therapeutic options for CML patients in AP/BP are needed.

  • 3.
    Baron, F
    et al.
    University of Liege, Belgium .
    Labopin, M
    Hop St Antoine, France .
    Niederwieser, D
    University of Leipzig, Germany .
    Vigouroux, S
    University Hospital, France University of Bordeaux 2, France .
    Cornelissen, J J.
    Erasmus University, Netherlands .
    Malm, Claes
    Östergötlands Läns Landsting, Centre for Surgery, Orthopaedics and Cancer Treatment, Department of Haematology UHL.
    Vindelov, L L.
    Rigshosp, Denmark .
    Blaise, D
    CHU Marseille, France .
    Janssen, J J W M
    Vrije University of Amsterdam, Netherlands .
    Petersen, E
    University of Medical Centre Utrecht, Netherlands .
    Socie, G
    Hop St Louis, France .
    Nagler, A
    Tel Aviv University, Israel .
    Rocha, V
    Eurocord, France EBMT ALWP, France .
    Mohty, M
    Hop St Antoine, France EBMT ALWP, France University of Nantes, France INSERM, France .
    Impact of graft-versus-host disease after reduced-intensity conditioning allogeneic stem cell transplantation for acute myeloid leukemia: a report from the Acute Leukemia Working Party of the European group for blood and marrow transplantation2012In: Leukemia, ISSN 0887-6924, E-ISSN 1476-5551, Vol. 26, no 12, p. 2462-2468Article in journal (Refereed)
    Abstract [en]

    This report investigated the impact of graft-versus-host disease (GVHD) on transplantation outcomes in 1859 acute myeloid leukemia patients given allogeneic peripheral blood stem cells after reduced-intensity conditioning (RIC allo-SCT). Grade I acute GVHD was associated with a lower risk of relapse (hazards ratio (HR) 0.7, P = 0.02) translating into a trend for better overall survival (OS; HR 1.3; P = 0.07). Grade II acute GVHD had no net impact on OS, while grade III-IV acute GVHD was associated with a worse OS (HR 0.4, P andlt; 0.0.001) owing to high risk of nonrelapse mortality (NRM; HR 5.2, P andlt; 0.0001). In time-dependent multivariate Cox analyses, limited chronic GVHD tended to be associated with a lower risk of relapse (HR 0.72; P = 0.07) translating into a better OS (HR 1.8; P andlt; 0.001), while extensive chronic GVHD was associated with a lower risk of relapse (HR 0.65; P = 0.02) but also with higher NRM (HR 3.5; P andlt; 0.001) and thus had no net impact on OS. In-vivo T-cell depletion with antithymocyte globulin (ATG) or alemtuzumab was successful at preventing extensive chronic GVHD (P andlt; 0.001), but without improving OS for ATG and even with worsening OS for alemtuzumab (HR 0.65; P = 0.001). These results highlight the role of the immune-mediated graft-versus-leukemia effect in the RIC allo-SCT setting, but also the need for improving the prevention and treatment of severe GVHD. Leukemia (2012) 26, 2462-2468; doi: 10.1038/leu.2012.135

  • 4.
    Baron, Frederic
    et al.
    ULg, Liege, Belgium .
    Labopin, Myriam
    University of Paris 06.
    Mohty, Mohamad
    CHU Hotel Dieu, Nantes, France .
    Basara, Nadezda
    University of Leipzig.
    Niederwieser, Dietger
    University of Leipzig.
    Milpied, Noel-Jean
    CHU Bordeaux.
    Cornelissen, J J
    Erasmus University.
    Malm, Claes
    Linköping University, Department of Clinical and Experimental Medicine, Oncology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Haematology UHL.
    Sengeloev, Henrik
    Rigshosp, Copenhagen, Denmark .
    Blaise, Didier
    CHU Marseille.
    Janssen, Jeroen J W M
    Vrije University Amsterdam.
    Petersen, Eefke
    University Medical Centre Utrecht.
    Socie, Gerard
    St Louis Hospital, Paris, France .
    Rocha, Vanderson
    St Louis Hospital, Paris, France .
    Graft-Versus-Leukemia (GVL) Effect After Reduced Intensity Conditioning (RIC) Allogeneic Stem Cell Transplantation (allo-SCT) as Treatment for Acute Myeloid Leukemia (AML): a Survey From the Acute Leukemia Working Party of the EBMT in BLOOD, vol 114, issue 22, pp 1284-12852009In: BLOOD, American Society of Hematology , 2009, Vol. 114, no 22, p. 1284-1285Conference paper (Refereed)
    Abstract [en]

    n/a

  • 5.
    Bjorkholm, M.
    et al.
    Karolinska University Hospital Solna, Karolinska Institutet, Stockholm, Sweden, Swedish Chronic Myeloproliferative Neoplasm Study Group, Stockholm, Sweden.
    Derolf, A.R.
    Karolinska University Hospital Solna, Karolinska Institutet, Stockholm, Sweden.
    Hultcrantz, M.
    Karolinska University Hospital Solna, Karolinska Institutet, Stockholm, Sweden, Swedish Chronic Myeloproliferative Neoplasm Study Group, Stockholm, Sweden.
    Kristinsson, S.Y.
    Karolinska University Hospital Solna, Karolinska Institutet, Stockholm, Sweden.
    Ekstrand, C.
    Karolinska University Hospital Solna, Karolinska Institutet, Stockholm, Sweden.
    Goldin, L.R.
    National Cancer Institute, National Institutes of Health, Bethesda, MD, United States.
    Andreasson, B.
    Swedish Chronic Myeloproliferative Neoplasm Study Group, Stockholm, Sweden.
    Birgegard, G.
    Swedish Chronic Myeloproliferative Neoplasm Study Group, Stockholm, Sweden.
    Linder, O.
    Swedish Chronic Myeloproliferative Neoplasm Study Group, Stockholm, Sweden.
    Malm, Claes
    Linköping University, Department of Clinical and Experimental Medicine, Oncology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Surgery, Orthopaedics and Cancer Treatment, Department of Haematology UHL.
    Markevarn, B.
    Swedish Chronic Myeloproliferative Neoplasm Study Group, Stockholm, Sweden.
    Nilsson, L.
    Swedish Chronic Myeloproliferative Neoplasm Study Group, Stockholm, Sweden.
    Samuelsson, J.
    Swedish Chronic Myeloproliferative Neoplasm Study Group, Stockholm, Sweden.
    Granath, F.
    Karolinska University Hospital Solna, Karolinska Institutet, Stockholm, Sweden.
    Landgren, O.
    Karolinska University Hospital Solna, Karolinska Institutet, Stockholm, Sweden, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States.
    Treatment-related risk factors for transformation to acute myeloid leukemia and myelodysplastic syndromes in myeloproliferative neoplasms2011In: Journal of Clinical Oncology, ISSN 0732-183X, E-ISSN 1527-7755, Vol. 29, no 17, p. 2410-2415Article in journal (Refereed)
    Abstract [en]

    Purpose: Patients with myeloproliferative neoplasms (MPNs), including polycythemia vera, essential thrombocythemia, and primary myelofibrosis, have a propensity to develop acute myeloid leukemia (AML) and myelodysplastic syndromes (MDSs). Using population-based data from Sweden, we assessed the role of MPN treatment and subsequent AML/MDS risk with special focus on the leukemogenic potential of hydroxyurea (HU). Methods: On the basis of a nationwide MPN cohort (N = 11,039), we conducted a nested case-control study, including 162 patients (153 and nine with subsequent AML and MDS diagnosis, respectively) and 242 matched controls. We obtained clinical and MPN treatment data for all patients. Using logistic regression, we calculated odds ratios (ORs) as measures of AML/MDS risk. Results: Forty-one (25%) of 162 patients with MPNs with AML/MDS development were never exposed to alkylating agents, radioactive phosphorous (P32), or HU. Compared with patients with who were not exposed to HU, the ORs for 1 to 499 g, 500 to 999 g, more than 1,000 g of HU were 1.5 (95% CI, 0.6 to 2.4), 1.4 (95% CI, 0.6 to 3.4), and 1.3 (95% CI, 0.5 to 3.3), respectively, for AML/MDS development (not significant). Patients with MPNs who received P32 greater than 1,000 MBq and alkylators greater than 1 g had a 4.6-fold (95% CI, 2.1 to 9.8; P = .002) and 3.4-fold (95% CI, 1.1 to 10.6; P = .015) increased risk of AML/MDS, respectively. Patients receiving two or more cytoreductive treatments had a 2.9-fold (95% CI, 1.4 to 5.9) increased risk of transformation. Conclusion: The risk of AML/MDS development after MPN diagnosis was significantly associated with high exposures of P32 and alkylators but not with HU treatment. Twenty-five percent of patients with MPNs who developed AML/MDS were not exposed to cytotoxic therapy, supporting a major role for nontreatment-related factors. © 2011 by American Society of Clinical Oncology.

  • 6. Hallböök, Helene
    et al.
    Simonsson, Bengt
    Ahlgren, Thomas
    Björkholm, Magnus
    Carneskog, Jan
    Grimfors, Gunnar
    Hast, Robert
    Karlsson, Karin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Hematology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Haematology UHL.
    Kimby, Eva
    Lerner, Richard
    Linder, Olle
    Linderholm, Mats
    Löfvenberg, Eva
    Malm, Claes
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Hematology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Haematology UHL.
    Nilsson, Per-Gunnar
    Paul, Christer
    Stenke, Leif
    Stockelberg, Dick
    Tidefelt, Ulf
    Turesson, Ingemar
    Uden-Blome, Ann-Marie
    Vilen, Lars
    Wahlin, Anders
    Winquist, Ingemar
    Smedmyr, Bengt
    High-dose cytarabine in upfront therapy for adult patients with acute lymphoblastic leukaemia2002In: British Journal of Haematology, ISSN 0007-1048, E-ISSN 1365-2141, Vol. 118, p. 748-754Article in journal (Refereed)
  • 7.
    Hoglund, Martin
    et al.
    University of Uppsala Hospital, Sweden .
    Sandin, Fredrik
    Regional Cancer Centre, Sweden .
    Hellstrom, Karin
    Regional Cancer Centre, Sweden .
    Bjoreman, Mats
    University Hospital, Sweden .
    Bjorkholm, Magnus
    Karolinska University Hospital, Sweden .
    Brune, Mats
    Sahlgrens University Hospital, Sweden .
    Dreimane, Arta
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Ekblom, Marja
    Skåne University Hospital, Sweden .
    Lehmann, Soren
    Karolinska University Hospital, Sweden .
    Ljungman, Per
    Karolinska University Hospital, Sweden .
    Malm, Claes
    Linköping University, Department of Clinical and Experimental Medicine, Oncology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Haematology.
    Markevarn, Berit
    Umeå University Hospital, Sweden .
    Myhr-Eriksson, Kristina
    Sunderby Luleå Hospital, Sweden .
    Ohm, Lotta
    Karolinska University Hospital, Sweden .
    Olsson-Stromberg, Ulla
    University of Uppsala Hospital, Sweden .
    Sjalander, Anders
    Umeå University, Sweden .
    Wadenvik, Hans
    Sahlgrens University Hospital, Sweden .
    Simonsson, Bengt
    University of Uppsala Hospital, Sweden .
    Stenke, Leif
    Karolinska University Hospital, Sweden .
    Richter, Johan
    Skåne University Hospital, Sweden .
    Tyrosine kinase inhibitor usage, treatment outcome, and prognostic scores in CML: report from the population-based Swedish CML registry2013In: Blood, ISSN 0006-4971, E-ISSN 1528-0020, Vol. 122, no 7, p. 1284-1292Article in journal (Refereed)
    Abstract [en]

    Clinical management guidelines on malignant disorders are generally based on data from clinical trials with selected patient cohorts. In Sweden, more than 95% of all patients diagnosed with chronic myeloid leukemia (CML) are reported to the national CML registry, providing unique possibilities to compile population-based information. This report is based on registry data from 2002 to 2010, when a total of 779 patients (425 men, 354 women; median age, 60 years) were diagnosed with CML (93% chronic, 5% accelerated, and 2% blastic phase) corresponding to an annual incidence of 0.9/100 000. In 2002, approximately half of the patients received a tyrosine kinase inhibitor as initial therapy, a proportion that increased to 94% for younger (andlt;70 years) and 79% for older (andgt;80 years) patients during 2007-2009. With a median follow-up of 61 months, the relative survival at 5 years was close to 1.0 for patients younger than 60 years and 0.9 for those aged 60 to 80 years, but only 0.6 for those older than 80 years. At 12 months, 3% had progressed to accelerated or blastic phase. Sokal, but not European Treatment and Outcome Study, high-risk scores were significantly linked to inferior overall and relative survival. Patients living in university vs nonuniversity catchment areas more often received tyrosine kinase inhibitors up front but showed comparable survival.

  • 8.
    Höglund, M
    et al.
    Uppsala University Hospital.
    Bjoreman, M
    Örebro University Hospital.
    Björkholm, M
    Karolinska Institutet.
    Brune, M
    Sahlgrenska University Hospital.
    Ekblom, M
    Lund University Hospital.
    Hellström, K
    Regional Oncology Centre Uppsala.
    Lehmann, S
    Karolinska Institutet .
    Ljungman, P
    Karolinska Institutet.
    Malm, Claes
    Linköping University, Department of Clinical and Experimental Medicine, Oncology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Haematology UHL.
    Markevarn, B
    Umeå University Hospital.
    Sandin, F
    Regional Oncology Centre Uppsala.
    Stenke, L
    Karolinska Institutet.
    Wadenvik, H
    Sahlgrenska University Hospital.
    Wahlin, A
    Umeå University Hospital.
    Richter, J
    Lund University Hospital.
    Simonsson, B
    REAL WORLD DATA ON CHRONIC MYELOID LEUKEMIA - A REPORT FROM THE SWEDISH POPULATION BASED CML-REGISTRY in HAEMATOLOGICA-THE HEMATOLOGY JOURNAL, vol 95, issue , pp 337-3382010In: HAEMATOLOGICA-THE HEMATOLOGY JOURNAL, Pensiero Scientifico / Ferrata Storti Foundation , 2010, Vol. 95, p. 337-338Conference paper (Refereed)
    Abstract [en]

    n/a

  • 9.
    Juliusson, Gunnar
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Hematology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Haematology UHL.
    Celsing, Fredrik
    Turesson, Ingemar
    Lenhoff, Stig
    Adriansson, Magnus
    Malm, Claes
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Hematology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Haematology UHL.
    Frequent good partial remissions from thalidomide including best response ever in patients with advanced refractory and relapsed myeloma2000In: British Journal of Haematology, ISSN 0007-1048, E-ISSN 1365-2141, Vol. 109, no 1, p. 89-96Article in journal (Refereed)
    Abstract [en]

    Twenty-three patients with advanced and heavily pretreated myeloma were treated with thalidomide. Starting dose was 200 mg/d, and 20 patients had dose escalations up to 400 (n = 5), 600 (n = 12) or 800 mg/d (n = 3), usually in divided doses. Nineteen patients were refractory to recent chemotherapy, and four had untreated relapse after prior intensive therapy. Ten out of 23 patients (43%) achieved partial response (PR, nine with refractory and one with relapsed disease), six patients had minor response or stabilization of the disease and four had disease progression. Another three patients died early from advanced myeloma at less than 3 weeks of thalidomide therapy. Of the 10 patients with PR, seven had a better response than after any prior therapy, despite vincristine-doxorubicin-dexamethasone (VAD)-based treatment in all but one and high-dose melphalan with autologous stem cell support in four. Time to achieve PR was rapid in patients receiving thalidomide in divided doses (median 31 d). Responses also included reduced bone marrow plasma cell infiltration and improved general status. Normalized polyclonal gammaglobulin levels were seen in four cases. Six out of 10 patients with PR remained in remission with a median time on treatment of 23 weeks (range 15- 50 weeks). Sedation was common but usually tolerable, and some patients continued full- or part-time work. Four patients had skin problems, three patients had pneumonia, one hypothyrosis, one sinus bradycardia and one minor sensory neuropathy. Thalidomide may induce good partial remissions in advanced refractory myeloma with tolerable toxicity, and should be evaluated in other settings for myeloma patients. Divided thalidomide doses seem to reduce time to achieve remission and may improve response rate.

  • 10.
    Juliusson, Gunnar
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Oncology . Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Haematology UHL.
    Karlsson, K
    Frodin, U
    Backstrom, G
    Malm, Claes
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Oncology . Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Haematology UHL.
    Subcutaneous Campath1H instead of thymoglobulin in nonmyeloablative allogeneic transplantation: Reduced acute toxicity, but delayed lymphocyte recovery leading to more mixed chimerism, more fatal infections and impaired long-term survival2002In: Blood, ISSN 0006-4971, E-ISSN 1528-0020, Vol. 100, no 11, p. 1665-Conference paper (Other academic)
  • 11.
    Juliusson, Gunnar
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Hematology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Haematology UHL.
    Karlsson, Karin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Hematology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Haematology UHL.
    Malm, Claes
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Hematology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Haematology UHL.
    More potent graft-versus-myeloma effect than graft-versus-renal cell cancer effect2002In: Leukemia and Lymphoma, ISSN 1042-8194, E-ISSN 1029-2403, Vol. 43, no 11, p. 2233-2234Article in journal (Refereed)
    Abstract [en]

    [No abstract available]

  • 12.
    Juliusson, Gunnar
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Hematology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Haematology UHL.
    Karlsson, Karin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Hematology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Haematology UHL.
    Malm, Claes
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Hematology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Haematology UHL.
    Frödin, U
    Mollen, AS
    Backström, G
    Söderkvist, Peter
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Cell biology.
    Adjusted conditioning for allogeneic transplantation in a single center setting: Mixed chimerism heralds relapse2003In: Leukemia and Lymphoma, ISSN 1042-8194, E-ISSN 1029-2403, Vol. 44, no 4, p. 669-679Article in journal (Refereed)
    Abstract [en]

    The role of mixed chimerism on subsequent relapse was prospectively evaluated in an allotransplant program. Sixty-six patients with median age of 54 and mainly high-risk hematologic disease and/or solid tumors had individually adjusted non-myeloablative conditioning. Thirty-nine donors were siblings and 27 unrelated. Frequent chimerism analyses supported immune manipulation including donor lymphocyte infusions. The need for transfusions, iv fluids, and antibiotics, and weight loss was less than in a control cohort. Most patients had immediate full and consistent donor chimerism, one-third required immune manipulation. Eight of ten evaluable CML patients were BCR/ABL-negative at days 14-58 post-transplant. Mixed chimerism frequently preceded relapse, and the relapse rate was 38% in 26 patients with mixed chimerism vs. 11% among 35 with consistent full donor chimerism (p = 0.015). The current transplant- and disease-related mortality were 11 and 9%, respectively, among 35 non-high-risk patients, and 35 and 10% for 29 high-risk patients with hematologic malignancy. With a median follow-up of 15 months the 2-year overall survival is 73% for non-high-risk, and 46% for high-risk patients. Adjusted conditioning reduces early toxicity and resource requirements without impairing tumor control, probably due to a rapid establishment of the graft-versus-cancer effect. Mixed chimerism heralded relapse, and tumor-related mortality is not greater with adjusted than with conventional conditioning.

  • 13.
    Juliusson, Gunnar
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Oncology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Haematology UHL.
    Theorin, Niklas
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Oncology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Haematology UHL.
    Karlsson, Karin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Oncology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Haematology UHL.
    Frödin, U
    Malm, Claes
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Oncology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Haematology UHL.
    Subcutaneous alemtuzumab vs ATG in adjusted conditioning for allogeneic transplantation: Influence of Campath dose on lymphoid recovery, mixed chimerism and survival2006In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 37, no 5, p. 503-510Article in journal (Refereed)
    Abstract [en]

    Sixty-nine consecutive patients (median age 54 years) were prospectively enrolled in a single-institution protocol for allogeneic transplantation with adjusted non-myeloablative fludarabine-melfalan-based conditioning including cyclosporin A and MMF, and one of three modes of serotherapy. Thirty-one donors (45%) were unrelated. The first cohort of 29 had ATG (Thymoglobulin 2 mg/kg × 3 days), the subsequent 26 had Campath 30 mg × 3 days subcutaneously, and the final cohort of 14 had 30 mg Campath once. The groups were similar as regards age, diagnosis and risk factors. Campath-patients had no acute toxicity, fewer days with fever and antibiotics, and required fewer transfusions than ATG-treated patients. 3-d-Campath patients showed lower lymphocyte counts from day + 4, and CD4 +, CD8 +, CD19 + and NK cells recovered slower than in ATG-treated patients. More Campath patients developed mixed chimerism that required DLI. 3-d-Campath induced more serious and opportunistic infections than ATG, which resulted in a greater non-relapse mortality and an impaired overall survival despite a low tumor-related mortality. The change of the Campath dosing schedule to one dose abrogated the deleterious effect of 3-d-Campath on immune recovery, severe infections and survival. Subcutaneous Campath is simple and provides strong immune suppression with no early toxicity, but dose limitation to 30 mg once is recommended. © 2006 Nature Publishing Group. All rights reserved.

  • 14.
    Lazarevic, V.L.
    et al.
    Department of Hematology, University Hospital Lund, Lund University, Lund, Sweden.
    Remberger, M.
    Department of Hematology, University Hospital Lund, Lund University, Lund, Sweden.
    Hagglund, H.
    Department of Hematology, University Hospital Lund, Lund University, Lund, Sweden.
    Hallbook, H.
    Department of Hematology, University Hospital Lund, Lund University, Lund, Sweden.
    Juliusson, G.
    Department of Hematology, University Hospital Lund, Lund University, Lund, Sweden.
    Kimby, E.
    Department of Hematology, University Hospital Lund, Lund University, Lund, Sweden.
    Malm, Claes
    Linköping University, Department of Clinical and Experimental Medicine, Oncology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Surgery, Orthopaedics and Cancer Treatment, Department of Haematology UHL.
    Wahlin, A.
    Department of Hematology, University Hospital Lund, Lund University, Lund, Sweden.
    Omar, H.
    Department of Hematology, University Hospital Lund, Lund University, Lund, Sweden.
    Johansson, J.-E.
    Department of Hematology, University Hospital Lund, Lund University, Lund, Sweden.
    Letter: Myeloablative allogeneic stem cell transplantation for lymphoblastic lymphoma in Sweden: A retrospective study2011In: American Journal of Hematology, ISSN 0361-8609, E-ISSN 1096-8652, Vol. 86, no 8, p. 709-710Article in journal (Other academic)
    Abstract [en]

    [No abstract available]

  • 15.
    Lazarevic, Vladimir
    et al.
    Lund University.
    Remberger, Mats
    Karolinska Institute.
    Hagglund, Hans
    Karolinska University Hospital.
    Juliusson, Gunnar
    Lund University.
    Omar, Hamdy
    Karolinska University Hospital.
    Halbook, Helene
    University of Uppsala Hospital.
    Kimby, Eva
    Karolinska University Hospital.
    Malm, Claes
    Linköping University, Department of Clinical and Experimental Medicine, Oncology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Surgery, Orthopaedics and Cancer Treatment, Department of Haematology UHL.
    Wahlin, Anders
    Umeå University Hospital.
    Johansson, Jan-Erik
    Sahlgrens University Hospital.
    Letter: Long-term survival after allogeneic stem cell transplant for relapsed large B cell lymphomas: a retrospective study2012In: Leukemia and Lymphoma, ISSN 1042-8194, E-ISSN 1029-2403, Vol. 53, no 3, p. 503-505Article in journal (Other academic)
    Abstract [en]

    n/a

  • 16.
    Lj Lazarevic, Vladimir
    et al.
    Lund University.
    Hagglund, Hans
    Karolinska University.
    Remberger, Mats
    Karolinska Institute.
    Wahlin, Anders
    Umeå University Hospital.
    Hallbook, Helene
    Uppsala University Hospital.
    Juliusson, Gunnar
    Lund University.
    Kimby, Eva
    Karolinska University.
    Malm, Claes
    Linköping University, Department of Clinical and Experimental Medicine, Oncology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Haematology UHL.
    Omar, Hamdy
    Karolinska University.
    Johansson, Jan-Erik
    Sahlgrens University Hospital.
    Long-term survival following allogeneic or syngeneic stem cell transplant for follicular lymphoma in Sweden2011In: LEUKEMIA and LYMPHOMA, ISSN 1042-8194, Vol. 52, no 1, p. 69-71Article in journal (Refereed)
    Abstract [en]

    n/a

  • 17.
    Machaczka, Maciej
    et al.
    Karolinska University Hospital Huddinge, Sweden Karolinska Institute, Sweden .
    Johansson, Jan-Erik
    Sahlgrens University Hospital, Sweden .
    Remberger, Mats
    Karolinska Institute, Sweden .
    Hallbook, Helene
    University of Uppsala Hospital, Sweden .
    Malm, Claes
    Linköping University, Department of Clinical and Experimental Medicine, Oncology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Surgery, Orthopaedics and Cancer Treatment, Department of Haematology UHL.
    Lj Lazarevic, Vladimir
    Skåne University Hospital, Sweden Lund University, Sweden .
    Wahlin, Anders
    Umeå University, Sweden .
    Omar, Hamdy
    Karolinska University Hospital Huddinge, Sweden Karolinska Institute, Sweden .
    Juliusson, Gunnar
    Skåne University Hospital, Sweden Lund University, Sweden .
    Kimby, Eva
    Karolinska University Hospital Huddinge, Sweden Karolinska Institute, Sweden .
    Hagglund, Hans
    Karolinska University Hospital Huddinge, Sweden Karolinska Institute, Sweden .
    Allogeneic hematopoietic stem cell transplant with reduced-intensity conditioning for chronic lymphocytic leukemia in Sweden: does donor T-cell engraftment 3 months after transplant predict survival?2012In: Leukemia and Lymphoma, ISSN 1042-8194, E-ISSN 1029-2403, Vol. 53, no 9, p. 1699-1705Article in journal (Refereed)
    Abstract [en]

    Thirty-eight adult patients with chronic lymphocytic leukemia (CLL) underwent reduced-intensity conditioning (RIC) allogeneic stem cell transplant (allo-SCT) in Sweden between 1999 and 2007. The cumulative incidences of acute graft-versus-host disease (GVHD) grades II-IV and chronic GVHD were 29% and 47%, respectively. Rates of non-relapse mortality, progression-free survival (PFS) and overall survival (OS) were 18%, 47% and 74% at 1 year, and 21%, 25% and 45% at 5 years, respectively. T-cell chimerism after transplant was measured in 31 out of 34 patients (91%) surviving beyond day + 100. Seventeen patients achieved andgt; 90% donor T-cell engraftment at 3 months after allo-SCT and, compared with the 12 patients with andlt;= 90% donor T-cell engraftment, they showed favorable PFS at 1 year (82% vs. 33%, p = 0.002) and better long-term PFS and OS (p = 0.002 and 0.046, respectively). Donor T-cell engraftment of andgt; 90% at 3 months after RIC allo-SCT for CLL seems to predict favorable short-term and long-term outcome.

  • 18. Merup, M
    et al.
    Lazarevic, V
    Nahi, H
    Andreasson, B
    Malm, Claes
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Oncology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Haematology UHL.
    Nilsson, L
    Brune, M
    LeBlanc, K
    Kutti, J
    Birgegard, G
    Different outcome of allogeneic transplantation in myelofibrosis using conventional or reduced-intensity conditioning regimens2006In: British Journal of Haematology, ISSN 0007-1048, E-ISSN 1365-2141, Vol. 135, no 3, p. 367-373Article in journal (Refereed)
    Abstract [en]

    Allogeneic haematopoietic stem cell transplantation remains the only curative treatment of myelofibrosis with myeloid metaplasia (MMM). Previous reports have indicated significant treatment-related mortality (TRM) for patients transplanted after myeloablative conditioning but superior survival has been reported after reduced-intensity conditioning (RIC). We report the results of a survey of all allogeneic transplantations for MMM performed in Sweden at six transplant units between 1982 and 2004. Twenty-seven patients were transplanted, 17 with a myeloablative conditioning regimen and 10 with RIC. The median age was 50 years (5-63 years) at transplantation. After a median follow up of 55 months, 20 patients are alive. TRM was 10% in the RIC group and 30% in the myeloablative group. There was no difference in survival for high or low-risk patients according to Cervantes score or between sibling and unrelated donor transplantations. © 2006 The Authors.

  • 19.
    Mohty, Mohamad
    et al.
    CHU Nantes.
    Labopin, Myriam
    Hop St Antoine.
    Basara, Nadezda
    University of Leipzig.
    Cornelissen, Jan J
    Erasmus MC Daniel Den Hoed, Rotterdam, Netherlands .
    Tabrizi, Reza
    CHU Bordeaux.
    Malm, Claes
    Linköping University, Department of Clinical and Experimental Medicine, Oncology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Haematology UHL.
    Perez Simon, Jose Antonio
    Hospital University Salamanca.
    Nagler, Arnon
    Chaim Sheba Medical Centre.
    Kroger, Nicolaus
    University of Hamburg Hospital.
    Rio, Bernard
    Hop Hotel Dieu.
    Martino, Rodrigo
    Hospital Santa Creu and Sant Pau.
    Eder, Matthias
    Hannover Medical School.
    Bilger, Karin
    Hop Hautepierre, Strasbourg, France .
    W Bunjes, Donald W
    University of Ulm Klinikum.
    Socie, Gerard
    Institute J Paoli I Calmettes.
    Polge, Emmanuelle
    EBMT Paris Off.
    Rocha, Vanderson
    Hop St Louis.
    Association Between the Hematopoietic Cell Transplantation-Specific Comorbidity Index (CI) and Non-Relapse Mortality (NRM) After Reduced Intensity Conditioning (RIC) Allogeneic Stem Cell Transplantation (allo-SCT) for Acute Myeloid Leukemia (AML) in First Complete Remission (CR1) in BLOOD, vol 114, issue 22, pp 270-2702009In: BLOOD, American Society of Hematology , 2009, Vol. 114, no 22, p. 270-270Conference paper (Refereed)
    Abstract [en]

    n/a

  • 20.
    Mustjoki, Satu
    et al.
    University of Helsinki.
    Richter, Johan
    Lund University Hospital.
    Barbany, Gisela
    Karolinska University Hospital.
    Dybedal, Ingunn
    University of Oslo.
    Fioretos, Thoas
    Lund University Hospital.
    Gedde Dahl, Tobias
    University of Oslo.
    Gjertsen, Bjorn T
    Haukeland Hospital.
    Hovland, Randi
    Haukeland Hospital.
    Jalkanen, Sari
    University of Helsinki.
    Josefsen, Dag
    Norwegian Radium Hospital.
    Koskenvesa, Perttu
    University Helsinki.
    Lassen, Carin
    Lund University Hospital.
    Latvala, Kirsi
    University of Helsinki.
    Majeed, Waleed
    Stavanger University Hospital.
    Malm, Claes
    Linköping University, Department of Clinical and Experimental Medicine, Oncology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Haematology UHL.
    Markevarn, Berit
    Norrland University Hospital.
    Moshfegh, Ali
    Karolinska University Hospital.
    Ohm, Lotta
    Karolinska University Hospital.
    Olofsson, Tor
    Lund University Hospital.
    Olsson Stromberg, Ulla
    University Uppsala Hospital.
    Rapakko, Katrin
    Oulu University Hospital.
    Remes, Kari
    Turku University.
    Stentoft, Jesper
    Arhus University Hospital.
    Stenke, Leif
    Karolinska University Hospital.
    Suominen, Merja
    Kanta Hame Cent Hospital.
    Thunberg, Sara
    Karolinska University Hospital.
    Weiss Bjerrum, Ole
    Rigshosp, Copenhagen.
    Simonsson, Bengt
    University Uppsala Hospital.
    Porkka, Kimmo
    University Helsinki.
    Hjorth Hansen, Henrik
    St Olavs Hospital.
    The Proportion of Ph+CD34(+)CD38(neg) Leukemic Stem Cells In the Bone Marrow of Newly Diagnosed Patients with Chronic Myeloid Leukemia (CML) In Chronic Phase (CP) Is Variable and Correlates with High Sokal Risk, High Leukocyte Count, Low Hemoglobin Concentration, Splenomegaly and Increased Hematological Toxicity During Initial TKI Therapy Data From a Randomized Phase II NordCML006 Study2010In: BLOOD vol 116, issue 21 (ISSN 0006-4971), American Society of Hematology , 2010, Vol. 116, no 21, p. 291-292Conference paper (Refereed)
  • 21.
    Mustjoki, Satu
    et al.
    HUCH.
    Richter, Johan
    Skåne University Hospital.
    Barbany, Gisela
    Karolinska University Hospital.
    Ehrencrona, Hans
    Skåne University Hospital.
    Dybedal, Ingunn
    University of Oslo.
    Fioretos, Thoas
    Lund University.
    Gedde-Dahl, Tobias
    University Hospital, Oslo.
    Gjertsen, Bjorn
    Haukeland Hospital.
    Hovland, Randi
    Haukeland Hospital.
    E Jalkanen, Sari
    HUCH.
    Josefsen, Dag
    Norwegian Radium Hospital.
    Koskenvesa, Perttu
    HUCH.
    Lassen, Carin
    Skåne University Hospital.
    Latvala, Kirsi
    HUCH.
    Majeed, Waleed
    Stavanger University Hospital.
    Malm, Claes
    Linköping University, Department of Clinical and Experimental Medicine, Oncology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Surgery, Orthopaedics and Cancer Treatment, Department of Haematology UHL.
    Markevarn, Berit
    Umeå University Hospital.
    Mosfegh, Ali
    Karolinska University Hospital.
    Ohm, Lotta
    Karolinska University Hospital.
    Olofsson, Tor
    Skåne University Hospital.
    Olsson-Stromberg, Ulla
    University of Uppsala Hospital.
    Rapakko, Katrin
    Oulu University Hospital.
    Remes, Karil
    Turku University.
    Stentoft, Jesper
    Aarhus University Hospital.
    Stenke, Leif
    Karolinska University Hospital.
    Suominen, Merja
    Kanta Hame Central Hospital.
    Thunberg, Sara
    Karolinska University Hospital.
    Weiss Bjerrum, Ole
    University of Copenhagen Hospital.
    Simonsson, Bengt
    University of Uppsala Hospital.
    Porkka, Kimmo
    HUCH.
    Hjorth-Hansen, Henrik
    St Olavs University Hospital.
    Favorable Therapeutic Responses in Newly Diagnosed CML-CP Patients Induced by Dasatinib Are Reflected At the CD34+CD38+Progenitor Cell but Not At the CD34+CD38-Stem Cell Level: Results From Randomized NordCML006 Study in BLOOD, vol 118, issue 21, pp 356-3562011In: BLOOD, American Society of Hematology , 2011, Vol. 118, no 21, p. 356-356Conference paper (Refereed)
    Abstract [en]

    n/a

  • 22.
    Nagler, A
    et al.
    Chaim Sheba Medical Centre.
    Labopin, M
    University of Paris 06.
    Shimoni, A
    Chaim Sheba Medical Centre.
    Mufti, G
    GKT School of Medicine.
    Cornelissen, J J
    Erasmus MC, Netherlands .
    Blaise, D
    Institute J Paoli I Calmettes.
    Janssen, J J W M
    Vrije University Amsterdam.
    Milpied, N
    CHU Bordeaux.
    Vindelov, L
    Rigshospital, Copenhagen.
    Petersen, E
    University Medical Centre, Utrecht.
    Gribben, J
    St Bartholomews and Royal London Hospital.
    Bacigalupo, A
    Osped San Martino Genova.
    Malm, Claes
    Linköping University, Department of Clinical and Experimental Medicine, Oncology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Haematology UHL.
    Niederwieser, D
    University Hospital Leipzig.
    Socie, G
    Hopital St Louis, Paris.
    Arnold, R
    Charite, Campus Virchow Klinikum.
    Brown, P
    St James Hospital.
    Goker, H
    Hacettepe University.
    Mohty, M
    Hematol Clinic, Nantes.
    Rocha, V
    Department Hematology, Paris.
    Mobilized peripheral blood stem cells compared with bone marrow for related reduced-intensity transplantation in acute myeloid leukaemia in complete remission: a retrospective analysis from the ALWP of EBMT in BONE MARROW TRANSPLANTATION, vol 45, issue , pp S21-S222010In: BONE MARROW TRANSPLANTATION, Nature Publishing Group , 2010, Vol. 45, p. S21-S22Conference paper (Refereed)
    Abstract [en]

    n/a

  • 23.
    Nagler, Arnon
    et al.
    Chaim Sheba Medical Centre, Israel .
    Labopin, Myriam
    UPMC University of Paris, France .
    Shimoni, Avichai
    Chaim Sheba Medical Centre, Israel .
    Mufti, Ghulam J
    Kings Coll London, England .
    Cornelissen, Jan J
    Erasmus Medical Centre Daniel den Hoed, Netherlands .
    Blaise, Didier
    Institute J Paoli I Calmettes, France .
    Janssen, Jeroen J W M
    Vrije University of Amsterdam, Netherlands .
    Milpied, Noel
    CHU Bordeaux, France .
    Vindelov, Lars
    Rigshosp, Denmark .
    Petersen, Eefke
    University of Medical Centre, Netherlands .
    Gribben, John
    St Bartholomews and Royal London Hospital, England .
    Bacigalupo, Andrea
    Osped San Martino Genova, Italy .
    Malm, Claes
    Linköping University, Department of Clinical and Experimental Medicine, Oncology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Surgery, Orthopaedics and Cancer Treatment, Department of Haematology UHL.
    Niederwieser, Dietger
    University Hospital Leipzig, Germany .
    Socie, Gerard J
    Hop St Louis, France .
    Arnold, Renate
    Charite, Germany .
    Brown, Paul
    St James Hospital, Ireland .
    Goker, Hakan
    Hacettepe University, Turkey .
    Rocha, Vanderson
    CHU Nantes, France .
    Mohty, Mohamad
    EBMT ALWP, France University of Paris 07, France .
    Mobilized peripheral blood stem cells compared with bone marrow from HLA-identical siblings for reduced-intensity conditioning transplantation in acute myeloid leukemia in complete remission: a retrospective analysis from the Acute Leukemia Working Party of EBMT2012In: European Journal of Haematology, ISSN 0902-4441, E-ISSN 1600-0609, Vol. 89, no 3, p. 206-213Article in journal (Refereed)
    Abstract [en]

    Reduced-intensity conditioning (RIC)-alloSCT is increasingly used for acute myelogenous leukemia. Limited data are available for the comparison of peripheral blood stem cells with bone marrow for RIC-alloSCT. We used the European Group for Blood and Marrow Transplantation (EBMT) ALWP data to compare the outcome of mobilized peripheral blood stem cells (PBSC) (n = 1430) vs. bone marrow (BM) (n = 107) for acute myelogenous leukemia (AML) patients with complete remission that underwent RIC-alloSCT from compatible sibling donors. The leukemia features, the disease status, and the time from diagnosis were similar between the two groups. Engraftment was achieved in 99% and 93% in the PBSC and BM groups, respectively (P andlt; 0.0001). The day of engraftment was significantly earlier for the PBSC vs. the BM group, 15 (159) and 19 (569), respectively (P andlt; 0.001). Acute GVHD, severe GVHD (grade IIIIV) and chronic GVHD did not differ between the groups. leukemia-free survival (LFS), relapse, and non-relapsed mortality (NRM) were 51 +/- 2%, 32 +/- 1%, and 17 +/- 1% vs. 50 +/- 6%, 38 +/- 6%, and 12 +/- 3% for the PBSC and BM groups, respectively. Our results indicate faster engraftment, but no difference in GVHD, LFS, relapse, and NRM when comparing PBSC to BM grafts from sibling donors following RIC conditioning. This is the first study comparing PBSC to BM grafts in the RIC setting, analyzing a homogeneous population of patients with AML in remission. Whether PBSC should be preferred for advanced phases of the disease, where the outcome is dominated by relapse incidences, needs further investigation.

  • 24. Olsson-Strömberg, U
    et al.
    Höglund, M
    Björkholm, M
    Braide, I
    Carlson, K
    Gahrton, G
    Grimfors, G
    Hast, R
    Lerner, r
    Linder, O
    Ljungman, P
    Löfvenberg, E
    Malm, Claes
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Oncology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Haematology UHL.
    Nilsson, PG
    Paul, c
    Rodjer, s
    Stenke, L
    Tidefeldt, U
    Turesson, I
    Uden, AM
    Wahlin, A
    Vilén, L
    Winqvist, I
    Zettervall, O
    Öberg, G
    Simonsson, B
    Successful mobilization of Ph-negative blood stem cells with intensive chemotherapy+ G-CSF in patients with chronic myelogenous leukemia in first chronic phase2006In: Leukemia and Lymphoma, ISSN 1042-8194, E-ISSN 1029-2403, Vol. 47, no 9, p. 1768-1773Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to investigate the feasibility of mobilizing Philadelphia chromosome negative (Ph-) blood stem cells (BSC) with intensive chemotherapy and lenograstim (G-CSF) in patients with CML in first chronic phase (CP1). During 1994-1999 12 centers included 37 patients <56 years. All patients received 6 months' IFN, stopping at median 36 (1-290) days prior to the mobilization chemotherapy. All received one cycle of daunorubicin 50 mg/m2 and 1 hour infusion on days 1-3, and cytarabine (ara-C) 200 mg/m2 24 hours' i.v. infusion on days 1-7 (DA) followed by G-CSF 526 μg s.c. once daily from day 8 after the start of chemotherapy. Leukaphereses were initiated when the number of CD 34+ cells was >5/μ blood. Patients mobilizing poorly could receive a 4-day cycle of chemotherapy with mitoxantrone 12 mg/m2/day and 1 hour i.v infusion, etoposide 100 mg/m2/day and 1 hour i.v. infusion and ara-C 1 g/m2/twice a day with 2 hours' i.v infusion (MEA) or a second DA, followed by G-CSF 526 μg s.c once daily from day 8 after the start of chemotherapy. Twenty-seven patients received one cycle of chemotherapy and G-CSF, whereas 10 were mobilized twice. Twenty-three patients (62%) were successfully (MNC >3.5 × 108/kg, CFU-GM >1.0 × 104/kg, CD34+ cells >2.0 × 106/kg and no Ph+ cells in the apheresis product) [n = 16] or partially successfully (as defined above but 1-34% Ph+ cells in the apheresis product) [n = 7] mobilized. There was no mortality during the mobilization procedure. Twenty-one/23 patients subsequently underwent auto-SCT. The time with PMN <0.5 × 109/l was 10 (range 7-49) and with platelets <20 × 109/l was also 10 (2-173) days. There was no transplant related mortality. The estimated 5-year overall survival after auto-SCT was 68% (95% CI 47-90%), with a median follow-up time of 5.2 years. We conclude that in a significant proportion of patients with CML in CP 1, intensive chemotherapy combined with G-CSF mobilizes Ph - BSC sufficient for use in auto-SCT.

  • 25. Olsson-Strömberg, Ulla
    et al.
    Simonsson, Bengt
    Ahlgren, Tomas
    Björkholm, Magnus
    Carlsson, Karin
    Gahrton, Gösta
    Hast, Robert
    Löfvenberg, Eva
    Linder, Olle
    Ljungman, Per
    Malm, Claes
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Oncology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Haematology UHL.
    Paul, Christer
    Rödjer, Stig
    Turesson, Ingemar
    Udén, Ann-Mari
    Wahlin, Anders
    Killander, Andreas
    Wadman, Bengt
    Westin, Jan
    Vikrot, Olle
    Zettervall, Olle
    Öberg, Gunnar
    Comparison of busulphan, hydroxyurea and allogeneic bone marrow transplantation (BMT) in chronic myeloid leukaemia: BMT prolongs survival2004In: The Hematology Journal, ISSN 1466-4860, E-ISSN 1476-5632, Vol. 5, no 6, p. 462-466Article in journal (Refereed)
    Abstract [en]

    Introduction: Whether busulphan-treated patients develop blastic transformation earlier than hydroxyurea treated has been a controversial issue. In a randomised prospective study, we examined the busulphan versus hydroxyurea influence on time to blast crisis and on survival. When we opened our study in 1984, the clinical benefit of allogeneic bone marrow transplantation (BMT) was not well known, to follow up the long-time outcome of this treatment was therefore of great interest. Materials and methods: Previously untreated CML patients were randomly started on either hydroxyurea (30 mg/kg/day) or busulphan (0.1 mg/kg/day). The end points of the study were overall survival and time to blast crisis. A total of 26 patients subsequently underwent BMT. Results: A total of 179 patients were randomised, 90 to hydroxyurea, and 89 to busulphan treatment. There was no significant difference in survival between hydroxyurea- and busulphan-treated patients (P = 0.46), median survival was 3.5 and 3.2 years, respectively. In all, 85 of the patients were subsequently diagnosed with blast crisis, 41 in the busulphan and 44 in the hydroxyurea group. There was no significant difference between the two groups (P=0.91). The 26 patients who were allotransplanted survived significantly longer than those who were not transplanted (P=0.0001). The 5-year-survival rates were 50 and 22% and the 10-year-survival rates were 46 and 2%, respectively. The median survival was 4.7 years for the transplanted and 3.3 years for the nontransplanted patients. Conclusion: We did not find any difference between hydroxyurea and busulphan treatment, either in overall survival or in blast crisis-free survival, transplanted patients survived significantly longer than nontransplanted patients. © 2004 The European Hematology Association All rights reserved.

  • 26.
    Simonsson, B
    et al.
    University Uppsala Hospital.
    Gedde-Dahl, M
    National Hospital Norway.
    Markevarn, M
    University Uppsala Hospital.
    Remes, P
    Turku University Hospital.
    Stentoft, R
    University Uppsala Hospital.
    Almqvist, S
    Vaasa Cent Hospital.
    Bjoreman, T
    University Uppsala Hospital.
    Flogegard, V
    Falun Cent Hospital.
    Hallman, U
    Cent Finland Cent Hospital.
    Koskenveesa, L
    University of Helsinki.
    Lindblom, A
    Malmö University Hospital.
    Malm, Claes
    Linköping University, Department of Clinical and Experimental Medicine, Oncology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Haematology UHL.
    Mustjoki, S
    University of Helsinki.
    Myhr-Eriksson, K
    Luleå Central Hospital.
    Rasanen, A
    Kymenlaakso Central Hospital.
    Sinisalo, M
    Tampere University Hospital.
    Sippola, R
    Lapland Cent Hospital.
    Sjalander, A
    Sundsvall Cent Hospital.
    Stromberg, U
    University Uppsala Hospital.
    Weiss Bjerrum, O
    Rigshospital, Copenhagen.
    Ehrencrona, H
    Uppsala University.
    Gruber, F
    Akershus University Hospital.
    Kairisto, V
    Reginal Oncology Centre, Uppsala.
    Sandin, F
    Reginal Oncology Centre, Uppsala.
    Nagler, A
    Chaim Sheba Medical Centre.
    Lanng Nielsen, J
    Aarhus University Hospital.
    Hjorth-Hansen, H
    St Olavs Hospital.
    Porkka, K
    University Helsinki.
    MAJOR MOLECULAR RESPONSE RATE AT ONE YEAR IS HIGHER IF PEGYLATED INTERFERON ALPHA-2B IS ADDED TO IMATINIB IN NON-HR CHRONIC MYELOID LEUKEMIA PATIENTS IN IMATINIB INDUCED COMPLETE HEMATOLOGICAL REMISSION in HAEMATOLOGICA-THE HEMATOLOGY JOURNAL, vol 95, issue , pp 457-4572010In: HAEMATOLOGICA-THE HEMATOLOGY JOURNAL, Pensiero Scientifico / Ferrata Storti Foundation , 2010, Vol. 95, p. 457-457Conference paper (Refereed)
    Abstract [en]

    n/a

  • 27.
    Simonsson, Bengt
    et al.
    Uppsala University Hospital.
    Gedde-Dahl, Tobias
    University of Oslo, Rikshospital.
    Markevarn, Berit
    Umeå University Hospital.
    Remes, Kari
    Turku University.
    Stentoft, Jesper
    Aarhus University Hospital.
    Almqvist, Anders
    Vaasa Central Hospital.
    Bjoreman, Mats
    Örebro University Hospital.
    Flogegard, Max
    Falun Central Hospital.
    Hallman, Heikki
    Central Finland Hospital.
    Koskenvesa, Perttu
    University of Helsinki.
    Lindblom, Anders
    Malmö University Hospital.
    Malm, Claes
    Linköping University, Department of Clinical and Experimental Medicine, Oncology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Haematology UHL.
    Mustjoki, Satu
    University of Helsinki.
    Myhr-Eriksson, Kristina
    Luleå Central Hospital.
    Rasanen, Anu
    Kymenlaakso Central Hospital.
    Sinisalo, Marjatta
    Tampere University Hospital.
    Sippola, Risto
    Lapland Central Hospital.
    Sjalander, Anders
    Sunsvall Centtal Hospital.
    Stromberg, Ulla
    Uppsala University Hospital.
    Weiss Bjerrum, Ole
    Rigshospital, Copenhagen.
    Ehrencrona, Hans
    Uppsala University Hospital.
    Gruber, Franz
    Akershus University Hospital.
    Kairisto, Veli
    Turku University.
    Olsson, Karin
    Uppsala University Hospital.
    Nagler, Arnon
    Chaim Sheba Medical Centre.
    Lanng Nielsen, Johan
    Aarhus University Hospital.
    Hjorth-Hansen, Henrik
    St Olavs Hospital.
    Porkka, Kimmo
    University of Helsinki.
    A Randomized Phase II Study Comparing Imatinib and the Combination of Imatinib and Pegylated Interferon Alpha-2b in Newly Diagnosed Non-High Risk Chronic Myeloid Leukemia (CML) Patients in Complete Hematological Remission After Imatinib Induction Therapy. in BLOOD, vol 114, issue 22, pp 1269-12702009In: BLOOD, American Society of Hematology , 2009, Vol. 114, no 22, p. 1269-1270Conference paper (Refereed)
    Abstract [en]

    n/a

  • 28.
    Simonsson, Bengt
    et al.
    Uppsala University.
    Gedde-Dahl, Tobias
    Oslo University Hospital.
    Markevarn, Berit
    Umea University.
    Remes, Kari
    Turku University Hospital.
    Stentoft, Jesper
    Aarhus University Hospital.
    Almqvist, Anders
    Vaasa Central Hospital.
    Bjoreman, Mats
    University Hospital, Hematol Unit, Orebro, Sweden .
    Flogegard, Max
    Falun Central Hospital.
    Koskenvesa, Perttu
    University of Helsinki.
    Lindblom, Anders
    Malmö University Hospital.
    Malm, Claes
    Linköping University, Department of Clinical and Experimental Medicine, Oncology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Surgery, Orthopaedics and Cancer Treatment, Department of Haematology UHL.
    Mustjoki, Satu
    University of Helsinki.
    Myhr-Eriksson, Kristina
    Luleå Centralral Hospital.
    Ohm, Lotta
    Karolinska Hospital.
    Rasanen, Anu
    Kymenlaakso Central Hospital.
    Sinisalo, Marjatta
    Tampere University Hospital.
    Sjalander, Anders
    Sundsvall Central Hospital.
    Stromberg, Ulla
    Uppsala University.
    Weiss Bjerrum, Ole
    University of Copenhagen.
    Ehrencrona, Hans
    Uppsala University.
    Gruber, Franz
    University of Tromso.
    Kairisto, Veli
    Turku University.
    Olsson, Karin
    Reg Oncol Centre, Uppsala.
    Sandin, Fredrik
    Reg Oncol Centre, Uppsala.
    Nagler, Arnon
    Chaim Sheba Medical Centre.
    Lanng Nielsen, Johan
    Aarhus University Hospital.
    Hjorth-Hansen, Henrik
    St Olavs Hospital Trondheim.
    Porkka, Kimmo
    University of Helsinki.
    Combination of pegylated IFN-alpha 2b with imatinib increases molecular response rates in patients with low- or intermediate-risk chronic myeloid leukemia2011In: Blood, ISSN 0006-4971, E-ISSN 1528-0020, Vol. 118, no 12, p. 3228-3235Article in journal (Refereed)
    Abstract [en]

    Biologic and clinical observations suggest that combining imatinib with IFN-alpha may improve treatment outcome in chronic myeloid leukemia (CML). We randomized newly diagnosed chronic-phase CML patients with a low or intermediate Sokal risk score and in imatinib-induced complete hematologic remission either to receive a combination of pegylated IFN-alpha 2b (Peg-IFN-alpha 2b) 50 mu g weekly and imatinib 400 mg daily (n = 56) or to receive imatinib 400 mg daily monotherapy (n = 56). The primary endpoint was the major molecular response (MMR) rate at 12 months after randomization. In both arms, 4 patients (7%) discontinued imatinib treatment (1 because of blastic transformation in imatinib arm). In addition, in the combination arm, 34 patients (61%) discontinued Peg-IFN-alpha 2b, most because of toxicity. The MMR rate at 12 months was significantly higher in the imatinib plus Peg-IFN-alpha 2b arm (82%) compared with the imatinib monotherapy arm (54%; intention-to-treat, P = .002). The MMR rate increased with the duration of Peg-IFN-alpha 2b treatment (andlt; 12-week MMR rate 67%, andgt; 12-week MMR rate 91%). Thus, the addition of even relatively short periods of Peg-IFN-alpha 2b to imatinib markedly increased the MMR rate at 12 months of therapy. Lower doses of Peg-IFN-alpha 2b may enhance tolerability while retaining efficacy and could be considered in future protocols with curative intent.

  • 29. Simonsson, Bengt
    et al.
    Öberg, Gunnar
    Björeman, Mats
    Björkholm, Magnus
    Carneskog, Jan
    Karlsson, Karin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Oncology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Haematology UHL.
    Gahrton, Gösta
    Grimfors, Gunnar
    Hast, Robert
    Karle, Hans
    Linder, Olle
    Ljungman, Per
    Nielsen, Johan L
    Nilsson, Jonas
    Löfvenberg, Eva
    Malm, Claes
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Oncology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Haematology UHL.
    Olsson, Karin
    Olsson-Strömberg, Ulla
    Paul, Christer
    Stenke, Leif
    Stentoft, Jesper
    Turesson, Ingemar
    Udén, Ann-Marie
    Wahlin, Anders
    Vilén, Lars
    Weis-Bjerrum, Ole
    Intensive treatment and stem cell transplantation in chronic myelogenous leukemia: Long-term follow-up2005In: Acta Haematologica, ISSN 0001-5792, E-ISSN 1421-9662, Vol. 113, no 3, p. 155-162Article in journal (Refereed)
    Abstract [en]

    In the present study we combined interferon (IFN) and hydroxyurea (HU) treatment, intensive chemotherapy and autologous stem cell transplantation (SCT) in newly diagnosed chronic myelogenous leukemia patients aged below 56 years, not eligible for allogeneic SCT. Patients who had an HLA-identical sibling donor and no contraindication went for an allogeneic SCT (related donor, RD). After diagnosis, patients not allotransplanted received HU and IFN to keep WBC and platelet counts low. After 6 months patients with Ph-positive cells still present in the bone marrow received 1-3 courses of intensive chemotherapy. Those who became Ph-negative after IFN + HU or after 1-3 chemotherapy courses underwent autologous SCT. Some patients with poor cytogenetic response were allotransplanted with an unrelated donor (URD). IFN + HU reduced the percentage of Ph-positive metaphases in 56% of patients, and 1 patient became Ph-negative. After one or two intensive cytotherapies 86 and 88% had a Ph reduction, and 34 and 40% became Ph-negative, respectively. In patients receiving a third intensive chemotherapy 92% achieved a Ph reduction and 8% became Ph-negative. The median survival after auto-SCT (n = 46) was 7.5 years. The chance of remaining Ph-negative for up to 10 years after autologous SCT was around 20%. The overall survival for allo-SCT RD (n = 91) and URD (n = 28) was almost the same, i.e. ≈ 60% at 10 years. The median survival for all 251 patients registered was 8 years (historical controls 3.5 years). The role of the treatment schedule presented in the imatinib era is discussed. Copyright © 2005 S. Karger AG.

  • 30.
    Söderholm, Johan D
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Surgery. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery in Östergötland.
    Malm, Claes
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Hematology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Haematology UHL.
    Juliusson, Gunnar
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Hematology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Haematology UHL.
    Sjödahl, Rune
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Surgery. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery in Östergötland.
    Long-term endoscopic remission of Crohn disease after autologous stem cell transplantation for acute myeloid leukaemia2002In: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 37, no 5, p. 613-616Article in journal (Refereed)
    Abstract [en]

    A favourable course of Crohn disease has been observed after allogeneic bone marrow transplantation, and there is now mounting evidence that autologous stem cell may be an effective treatment for severe autoimmune diseases. Here, we present the first long-term endoscopic follow-up of a patient with Crohn disease undergoing autologous stem cell transplantation for haematological disease. A 54-year-old woman developed Crohn disease and was submitted to ileocaecal resection. Four months after surgery, the patient contracted acute myeloid leukaemia. She was initially treated with chemotherapy, and subsequently underwent autologous stem cell transplantation. Following transplantation, the patient has remained in clinical remission regarding both diseases, without anti-inflammatory medication. She has undergone ileo-colonoscopy with normal findings at 1, 2, 3 and 5 years after transplantation. This case suggests that autologous stem cell transplantation can change not only the clinical course, but also the natural history of intestinal inflammation in Crohn disease. This has pathophysiological as well as therapeutic implications.

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