With the almost explosive evolution of new data on the nature of tumor
biology, the mandate for cooperative groups in the forseeable future
becomes increasingly more challenging and complex. Information on tumor
biology must be incorporated into the development of feasible group-will
and intra(sub) group phase II/III studies. As a result, protocols designed
for specific subgroups in acute lymphoblastic leukemia must address T-cell
and B-cell subtypes and continue to delve into the nature of pre-B and
pre-T subtypes. In AML, efforts must be made to identify risk factors
whilst utilizing randomized trials of best available "standard" therapy.
In this regard, efforts must be made to evaluate new combinations of proven
therapy utilizing new knowledge of (1) drug-drug interaction, (2) efficacy
of high or mega-dose therapy, and (3) the role of "cleansing" techniques.
Examples of (1) include methotrexate-asparaginase, (2) high dose cytosine
arabinoside, and (3) antibody purging. Bone marrow transplantation as a
major therapeutic arm deserves intensive evaluation. The University of
Florida has developed a most favorable preparative regimen for second
remission ALL, as part of an 8 institution POG study which, which it will
now apply to first remission high risk ALL. A proposal for marrow
transplantation in second remission AML is now available for group use, and
bone marrow transplantation is underway in high risk neuroblastoma, and is
being piloted locally in Hodgkin's disease, Ewing's sarcoma and
non-Hodgkin's lymphoma. Bone marrow cleansing with antibody coated
magnetized microspheres directed against neuroblastoma, cALLa(+), ALL and
T-cell ALL are underway locally. The University of Florida Bone Marrow
Transplantation Unit is also a component of a multi-institution CML
transplantation study. In addition to active participation in whole group
efforts, ongoing programs in pharmacology and pharmacokinetics will
continue in order to design regimens which will address the propitious use
of chemotherapeutic agents. Finally, this division has expanded its
program to include University Hospital of Jacksonville, has submitted
additional institutions for cancer control and has broadened its range of
studies in genetics and long term effects.
Public Health Relevance Statement
Data not available.
NIH Spending Category
No NIH Spending Category available.
Project Terms
cancer registry /resourcecancer rehabilitation mental health servicecancer riskchild (0-11)cooperative studycyclophosphamidedrug metabolismfluorouracilhuman T cell leukemiahuman subjecthuman therapy evaluationlymphomamethotrexateneoplasm /cancer chemotherapyneoplasm /cancer immunologyneoplasm /cancer radiation therapyneoplasm /cancer surgeryneuroblastomaosteosarcomapediatric neoplasm /cancerpediatric pharmacologyretinoblastomarhabdomyosarcoma
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