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- Lie, Sverre O, et al.
(författare)
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Treatment stratification based on initial in vivo response in acute myeloid leukaemia in children without Down's syndrome: results of NOPHO-AML trials.
- 2003
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Ingår i: British journal of haematology. - : Wiley. - 0007-1048. ; 122:2, s. 217-25
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Tidskriftsartikel (refereegranskat)abstract
- Three consecutive protocols for childhood acute myeloid leukaemia (AML) have been used in the Nordic countries since 1984: the Nordic Society for Paediatric Haematology and Oncology (NOPHO)-AML84 was of moderate intensity, NOPHO-AML88 of high intensity with upfront loading and aggressive consolidation. NOPHO-AML93 utilized the same treatment blocks as NOPHO-AML88, but after the first block those children with a hypoplastic non-leukaemic bone marrow were allowed to recover from aplasia. Poor responders received intensified induction therapy. Between January 1993 and December 2000, 219 children without Down's syndrome were entered on NOPHO-AML93. Compared with NOPHO-AML88, the event-free survival (EFS) at 7 years increased from 41% to 49% (P = 0.06) and 7-year overall survival increased from 47% to 64% (P < 0.01). Toxic death during induction was reduced from 10% to 3%. Survival was similar in patients receiving stem cell transplantation or chemotherapy only in first remission. The major prognostic factors in NOPHO-AML93 were response to therapy and cytogenetics. A total of 67% of patients achieved remission after the first induction course and showed an EFS of 56% compared with 35% in those not in remission (P < 0.01). Cytogenetic results were obtained in 95% of patients. Patients with t(9;11) (p22;q23) (n = 16) experienced a significantly better EFS (86%) than other cytogenetic groups. The overall outcome was improved by employing the previous toxic protocol with different timings, and through individualizing therapy according to the initial response of the patient.
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| 2. |
- Lindblom, Lars, 1971-, et al.
(författare)
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How agencies inspect : a comparative study of inspection policies in eight Swedish government agencies
- 2003
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- BackgroundThe regulatory approach used by SKI has an impact on the licensee and, therefore, indirectly on the safety of the nuclear facilities. The regulatory policy and its implementation also influences the way SKI is working and the competency needed by the regulator as well as by the industry. One of SKI´s tasks is to be able adjust the regulatory approach to current and future needs.Little research is available on the use of regulatory strategies, methods and activities used by regulatory agencies in their work (to assure safety), as well as their impacts. To address this gap in knowledge, SKI has contracted two separate research projects. This project, where the focus is on comparing inspection policies in Swedish government agencies, and another one where regulatory strategies across selected countries, are studied and compared.SKI´s purpose and goalsThe goal of this research project is to gain knowledge about selected Swedish agencies and their inspection policies. All the selected agencies are working with issues regarding health, environmental protection or safety. A number of persons at each agency have been interviewed about the regulatory work at their organizations. A questionnaire was developed as a first part of the project, and it was used during the interviews.In addition to provide insights as a basis for improvement within SKI, the purpose has been to promote exchange of experience between agencies with similar tasks. By this study SKI also wanted to contribute to the development of competency in this field of research.ResultsA lot of information has been gathered and analyzed during the project. The focus of the research is on comparing agencies and their practices. The report includes an analysis regarding similarities and differences in a number of areas across the agencies. The report also provides information and evidence on the problems related to comparison between agencies, partly due to the difference in the use of definitions. The recommendations resulting from this study focus on improving cooperation among Swedish agencies and on improving inspection methodologies, areas where further analysis is suggested. The conclusions and recommendations in the report belong to the persons participating in this work, and are not necessarily the same as the once drawn by SKI.
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