High-dose Chemotherapy And Bone Marrow Transplant
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High-dose Chemotherapy And Bone Marrow Transplant
High-dose chemotherapy and bone marrow transplant (HDC/BMT), also high-dose chemotherapy with autologous bone marrow transplant (HDC/ABMT or just ABMT), was an ineffective treatment regimen for metastatic breast cancer, and later high-risk breast cancer, that was considered promising during the 1980s and 1990s. With an overall idea that more is better, this process involved taking cells from the person's bone marrow to store in a lab, then to give such high doses of chemotherapy drugs that the remaining bone marrow was destroyed, and then to inject the cells taken earlier back into the body as replacement. It was ultimately determined to be no more effective than normal treatment, and to have significantly higher side effects, including treatment-related death. From its birth in the 1980s to its denouncement in the late 1990s, HDC/BMT transformed clinical practice, activist-driven legislation on healthcare insurance coverage, public health policy and drove a two-decade long per ...
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Metastatic Breast Cancer
Metastatic breast cancer, also referred to as metastases, advanced breast cancer, secondary tumors, secondaries or stage IV breast cancer, is a stage of breast cancer where the breast cancer cells have spread to distant sites beyond the axillary lymph nodes. There is no cure for metastatic breast cancer; there is no stage after IV. Metastases can occur several years after the primary breast cancer, although it is sometimes diagnosed at the same time as the primary breast cancer or, rarely, before the primary breast cancer has been diagnosed. Metastatic breast cancer cells frequently differ from the preceding primary breast cancer in properties such as receptor status. The cells have often developed resistance to several lines of previous treatment and have acquired special properties that permit them to metastasize to distant sites. Metastatic breast cancer can be treated, sometimes for many years, but it cannot be cured. Distant metastases are the cause of about 90% of deaths du ...
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Dana–Farber Cancer Institute
Dana–Farber Cancer Institute (DFCI) is a comprehensive cancer treatment and research center in Boston, Massachusetts. Dana-Farber is the founding member of the Dana-Farber/Harvard Cancer Center, Harvard's Comprehensive Cancer Center designated by the National Cancer Institute, and one of the 15 clinical affiliates and research institutes of Harvard Medical School. As of 2024, Dana-Farber is ranked the #6 cancer hospital in the US. Two Nobel Prize in Physiology or Medicine, Nobel laureates in Physiology or Medicine are among its past and present faculty. In 2024, an investigation revealed evidence of scientific misconduct, research misconduct in dozens of studies authored by Dana-Farber researchers, including then President (corporate title), President and Chief executive officer, CEO Laurie Glimcher, the Vice President, Executive Vice President and Chief operating officer, COO, and the Scientific integrity, Research Integrity Officer. In response to these findings, Dana-Farber ...
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Autologous Blood And Marrow Transplant Registry
Autotransplantation is the organ transplantation, transplantation of Organ (anatomy), organs, Biological tissue, tissues, or even particular proteins from one part of the body to another in the same person (''wikt:auto-, auto-'' meaning "self" in Ancient Greek, Greek). The autologous tissue (also called autogenous, autogeneic, or autogenic tissue) transplanted by such a procedure is called an autograft or autotransplant. It is contrasted with allotransplantation (from other individual of the same species), Syngenic, syngeneic Isograft, transplantation (grafts transplanted between two genetically identical individuals of the same species) and xenotransplantation (from other species). A common example is the removal of a piece of bone (usually from the hip) and its being ground into a paste for the reconstruction of another portion of bone. Autotransplantation, although most common with blood, bone, hematopoietic stem cells, or skin, can be used for a wide variety of organs. On ...
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Health Maintenance Organization
In the United States, a health maintenance organization (HMO) is a medical insurance group that provides health services for a fixed annual fee. It is an organization that provides or arranges managed care for health insurance, self-funded health care benefit plans, individuals, and other entities, acting as a liaison with health care providers (hospitals, doctors, etc.) on a prepaid basis. The US Health Maintenance Organization Act of 1973 required employers with 25 or more employees to offer federally certified HMO options if the employer offers traditional healthcare options. Unlike traditional indemnity insurance, an HMO covers care rendered by those doctors and other professionals who have agreed by contract to treat patients in accordance with the HMO's guidelines and restrictions in exchange for a steady stream of customers. HMOs cover emergency care regardless of the health care provider's contracted status. Operation HMOs often require members to select a primary car ...
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Food And Drug Administration
The United States Food and Drug Administration (FDA or US FDA) is a List of United States federal agencies, federal agency of the United States Department of Health and Human Services, Department of Health and Human Services. The FDA is responsible for protecting and promoting public health through the control and supervision of food safety, tobacco products, caffeine products, dietary supplements, Prescription drug, prescription and Over-the-counter drug, over-the-counter pharmaceutical drugs (medications), vaccines, biopharmaceuticals, blood transfusions, medical devices, electromagnetic radiation emitting devices (ERED), cosmetics, Animal feed, animal foods & feed and Veterinary medicine, veterinary products. The FDA's primary focus is enforcement of the Federal Food, Drug, and Cosmetic Act (FD&C). However, the agency also enforces other laws, notably Section 361 of the Public Health Service Act as well as associated regulations. Much of this regulatory-enforcement work is ...
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ACT UP
AIDS Coalition to Unleash Power (ACT UP) is an international, grassroots political group working to end the AIDS pandemic. The group works to improve the lives of people with AIDS through direct action, medical research, treatment and advocacy, and working to change legislation and public policies. (Comprehensive early history of ACT UP, discussion of the various signs and symbols used by ACT UP). ACT UP was formed on March 12, 1987, at the Lesbian, Gay, Bisexual and Transgender Community Services Center, Lesbian and Gay Community Services Center in New York City. Co-founder Larry Kramer was asked to speak as part of a rotating speaker series, and his well-attended speech focused on action to fight AIDS. Kramer spoke out against the state of the Gay Men's Health Crisis (GMHC), which he perceived as politically impotent. Kramer had co-founded the GMHC but had resigned from its board of directors in 1983. According to Douglas Crimp, Kramer posed a question to the audience: "Do we w ...
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Cancer And Leukemia Group B
Cancer and Leukemia Group B (CALGB; former name: Acute Leukemia Group B, ALGB) is a cancer research cooperative group in the United States. CALGB research is focused on seven major disease areas: leukemia, lymphoma, breast cancer, lung cancer, gastrointestinal malignancies, genito-urinary malignancies, and melanoma. In each of these areas, multi-modality treatment programs are designed by national experts. CALGB is headquartered at the University of Chicago in Chicago, Illinois and maintains its statistical centers at Mayo Clinic in Rochester, Minnesota and Duke University in Durham, North Carolina. History The group that was to become known as the CALGB got its roots when James F. Holland initiated a clinical trial for acute leukemia in 1953 while at the National Cancer Institute. In 1954, before the trial was complete, Holland moved to Roswell Park Comprehensive Cancer Center (then known as Roswell Park Memorial Institute), but the new chief of oncology Gordon Zubrod at t ...
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Randomised Controlled Trial
A randomized controlled trial (or randomized control trial; RCT) is a form of scientific experiment used to control factors not under direct experimental control. Examples of RCTs are clinical trials that compare the effects of drugs, surgical techniques, medical devices, diagnostic procedures, diets or other medical treatments. Participants who enroll in RCTs differ from one another in known and unknown ways that can influence study outcomes, and yet cannot be directly controlled. By randomly allocating participants among compared treatments, an RCT enables ''statistical control'' over these influences. Provided it is designed well, conducted properly, and enrolls enough participants, an RCT may achieve sufficient control over these confounding factors to deliver a useful comparison of the treatments studied. Definition and examples An RCT in clinical research typically compares a proposed new treatment against an existing standard of care; these are then termed the 'experi ...
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Overall Survival
Survival rate is a part of survival analysis. It is the proportion of people in a study or treatment group still alive at a given period of time after diagnosis. It is a method of describing prognosis in certain disease conditions, and can be used for the assessment of standards of therapy. The survival period is usually reckoned from date of diagnosis or start of treatment. Survival rates are based on the population as a whole and cannot be applied directly to an individual. There are various types of survival rates (discussed below). They often serve as endpoints of clinical trials and should not be confused with mortality rates, a population metric. Overall survival Patients with a certain disease (for example, colorectal cancer) can die directly from that disease or from an unrelated cause (for example, a car accident). When the precise cause of death is not specified, this is called the overall survival rate or observed survival rate. Doctors often use mean overall survival ...
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Progression-free Survival
Progression-free survival (PFS) is "the length of time during and after the treatment of a disease, such as cancer, that a patient lives with the disease but it does not get worse". In oncology, PFS usually refers to situations in which a tumor is present, as demonstrated by laboratory testing, radiologic testing, or clinically. Similarly, "disease-free survival" is the length of time after patients have received treatment and have no detectable disease. Time to progression (TTP) does not count patients who die from other causes but is otherwise a close equivalent to PFS (unless there are many such events). The FDA gives separate definitions and prefers PFS. Background PFS is widely used as a surrogate endpoint in oncology. The definition of "progression" generally involves imaging techniques (plain radiograms, CT scans, MRI, PET scans, ultrasounds) or other aspects: biochemical progression may be defined on the basis of an increase in a tumor marker (such as CA125 for epitheli ...
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Doxorubicin
Doxorubicin, sold under the brand name Adriamycin among others, is a chemotherapy medication used to treat cancer. This includes breast cancer, bladder cancer, Kaposi's sarcoma, lymphoma, and acute lymphocytic leukemia. It is often used together with other chemotherapy agents. Doxorubicin is given by injection into a vein. Common side effects include hair loss, bone marrow suppression, vomiting, rash, and inflammation of the mouth. Other serious side effects may include allergic reactions such as anaphylaxis, heart damage, tissue damage at the site of injection, radiation recall, and treatment-related leukemia. People often experience red discoloration of the urine for a few days. Doxorubicin is in the anthracycline and antitumor antibiotic family of medications. It works in part by interfering with the function of DNA. Doxorubicin was approved for medical use in the United States in 1974. It is on the World Health Organization's List of Essential Medicines. Version ...
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Houston
Houston ( ) is the List of cities in Texas by population, most populous city in the U.S. state of Texas and in the Southern United States. Located in Southeast Texas near Galveston Bay and the Gulf of Mexico, it is the county seat, seat of Harris County, Texas, Harris County, as well as the principal city of the Greater Houston metropolitan area, the fifth-most populous metropolitan statistical area in the United States and the List of Texas metropolitan areas, second-most populous in Texas after Dallas–Fort Worth metroplex, Dallas–Fort Worth. With a population of 2,314,157 in 2023, Houston is the List of United States cities by population, fourth-most populous city in the United States after New York City, Los Angeles, and Chicago, and the List of North American cities by population, sixth-most populous city in North America. Houston is the southeast anchor of the greater megaregion known as the Texas Triangle. Comprising a land area of , Houston is the List of United S ...
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