TY - JOUR A1 - Röllig, C. A1 - Kramer, M. A1 - Gabrecht, M. A1 - Hänel, M. A1 - Herbst, R. A1 - Kaiser, U. A1 - Schmitz, N. A1 - Kullmer, J. A1 - Fetscher, S. A1 - Link, H. A1 - Mantovani-Löffler, L. A1 - Krümpelmann, U. A1 - Neuhaus, T. A1 - Heits, F. A1 - Einsele, H. A1 - Ritter, B. A1 - Bornhäuser, M. A1 - Schetelig, J. A1 - Thiede, C. A1 - Mohr, B. A1 - Schaich, M. A1 - Platzbecker, U. A1 - Schäfer-Eckart, K. A1 - Krämer, A. A1 - Berdel, W. E. A1 - Serve, H. A1 - Ehninger, G. A1 - Schuler, U. S. T1 - Intermediate-dose cytarabine plus mitoxantrone versus standard-dose cytarabine plus daunorubicin for acute myeloid leukemia in elderly patients JF - Annals of Oncology N2 - Background: The combination of intermediate-dose cytarabine plus mitoxantrone (IMA) can induce high complete remission rates with acceptable toxicity in elderly patients with acute myeloid leukemia (AML). We present the final results of a randomized-controlled trial comparing IMA with the standard 7+3 induction regimen consisting of continuous infusion cytarabine plus daunorubicin (DA). Patients and methods: Patients with newly diagnosed AML>60 years were randomized to receive either intermediate-dose cytarabine (1000 mg/m(2) twice daily on days 1, 3, 5, 7) plus mitoxantrone (10 mg/m(2) days 1-3) (IMA) or standard induction therapy with cytarabine (100 mg/m(2) continuously days 1-7) plus daunorubicin (45 mg/m(2) days 3-5) (DA). Patients in complete remission after DA received intermediate-dose cytarabine plus amsacrine as consolidation treatment, whereas patients after IMA were consolidated with standard-dose cytarabine plus mitoxantrone. Results: Between February 2005 and October 2009, 485 patients were randomized; 241 for treatment arm DA and 244 for IMA; 76% of patients were >65 years. The complete response rate after DA was 39% [95% confidence interval (95% CI): 33-45] versus 55% (95% CI: 49-61) after IMA (odds ratio 1.89, P = 0.001). The 6-week early-death rate was 14% in both arms. Relapse-free survival curves were superimposable in the first year, but separated afterwards, resulting in 3-year relapse-free survival rates of 29% versus 14% in the DA versus IMA arms, respectively (P = 0.042). The median overall survival was 10 months in both arms (P = 0.513). Conclusion: The dose escalation of cytarabine in induction therapy lead to improved remission rates in the elderly AML patients. This did not translate into a survival advantage, most likely due to differences in consolidation treatment. Thus, effective consolidation strategies need to be further explored. In combination with an effective consolidation strategy, the use of intermediate-dose cytarabine in induction may improve curative treatment for elderly AML patients. KW - acute myeloid leukemia KW - cytarabine dose KW - elderly Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-226473 VL - 29 IS - 4 ER - TY - JOUR A1 - Tacke, Reinhold A1 - Link, M. A1 - Zilch, H. T1 - Eine neue in situ-Darstellung von (Trimethyl-silyl)trifluormethansulfonat durch thermisch induzierte Umlagerung T1 - A New in situ Preparation of Trimethylsilyl Trifluoromethanesulfonateby Thermally Induced Rearrangement N2 - A new in situ preparation of trimethylsilyl trifluoromethanesulfonate (3) is described: 3 is generated by a thermally induced rearrangement of (dimethylsilyl)methyl trifluoromethanesulfonate (2), which can be prepared by reaction of (CH\(_3\))\(_2\)Si(H)CH\(_2\)OH (1) with (CF\(_3\)SO\(_2\))\(_2\)O. Starting with C\(_6\)H\(_5\)(CH\(_3\))Si(H)CH\(_2\)OH (5), the derivative (methylphenylsilyl)methyl trifluoromethanesulfonate (6) can be obtained by a similar method. Its thermally induced rearrangement Ieads to dimethylphenylsilyl trifluoromethanesulfonate (7). The rearrangements 2---> 3 and 6---> 7 were found to be first-order reactions with half-lifes at 80 oc of 0.75 and 1.7 h, respectively. KW - Anorganische Chemie Y1 - 1985 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-63784 ER - TY - JOUR A1 - Schomburg, D. A1 - Link, M. A1 - Linoh, H. A1 - Tacke, Reinhold T1 - Molekülstruktur der Akarizide Chlortrineophylstannan, Chlortris[(dimethylphenylsilyl)methyl]stannan und Trineophyl(1,2,4-triazol-1-yl)stannan-hemihydrat sowie des 2,5-Dimethyl-2,5-diphenylhexans (Bineophyl) N2 - Die Kristall- und Molekülstrukturen der Akarizide Chlortrineophylstannan (Ia), Chlortris[ ( dimethylphenylsilyl)methyl]stannan (tb) und Trineophyl(1,2,4-triazol-1- yl)stannan-hemihydrat (2a · 0.5H\(_2\)0) wurden durch Einkristall-Röntgenstrukturanalysen bestimmt. Zu V ergleichszwecken wurde ausserdem die Struktur des 2,5-Dimethyl-2,5-diphenylhexans (Bineophyl, 4) untersucht. Die Knüpfung von drei sehr raumerfüllenden N eophyl-Resten an ein Zinnatom führt zu einer deutlichen Verzerrung der tetraedrischen Geometrie [ta: C-Sn-C 117.2°, C-Sn-Cl99.7°; 2a·0.5H20: C-Sn-C 116.9° (Mittelwert), C-Sn-N 100.2° (Mittelwert)]. Austausch der zentralen Kohlenstoffatome in den Neophyt-Substituenten von la durch Siliciumatome führt zu einer Verringerung des Raumbedarfs und dadurch zu einer erkennbaren Angleichung an die tetraedrische Geometrie [lb: C-Sn-C 113.3° (Mittelwert), C-Sn-Cl 105.3° (Mittelwert)]. N2 - The crystal and molecular structures of the acaricides chlorotrineophylstannane (ta), chlorotris[( dimethylphenylsilyl)methyl]stannane (tb ), and trineophyl(1,2,4-triazol- 1-yl)stannane hemihydrate (2a · 0.5H\(_2\)0), have been determined by single-crystal X-ray diffraction studies. The structure of 2,5-dimethyl-2,5-diphenylhexane (4) was also investigated for comparison. Binding of three very bulky neophyl ligands around tin causes serious distortion of the tetrahedral geometry [la: C-Sn-C 117.2°, C-Sn-Cl 99.7°; la · 0.5H20: C-Sn-C 116.9° (mean), C-Sn-N 100.2° (mean)]. Replacement of the central carbon atoms in the neophyl substituents of ta by silicon atoms Ieads to a decrease in steric strain and hence to a much smaller distortion of the tetrahedral geometry [lb: C-Sn-C 113.3° (mean), C-Sn-Cl105.3° (mean)]. KW - Anorganische Chemie Y1 - 1988 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-63840 ER - TY - JOUR A1 - Schlevogt, Bernhard A1 - Boeker, Klaus H. W. A1 - Mauss, Stefan A1 - Klinker, Hartwig A1 - Heyne, Renate A1 - Link, Ralph A1 - Simon, Karl-Georg A1 - Sarrazin, Christoph A1 - Serfert, Yvonne A1 - Manns, Michael P. A1 - Wedemeyer, Heiner T1 - Weight gain after interferon-free treatment of chronic hepatitis C — results from the German Hepatitis C-Registry (DHC-R) JF - Biomedicines N2 - Chronic hepatitis C can be treated very effectively with direct-acting antivirals (DAA) with only minor side effects compared to an interferon-containing treatment regimen. The significance of metabolic comorbidities after HCV cure is not well defined. This study aims to investigate short- and long-term weight change of patients receiving interferon-free antiviral treatment for chronic hepatitis C. The German Hepatitis C-registry (DHC-R) is a national multicenter real-world cohort. A total of 5111 patients were followed prospectively after DAA treatment for up to 3 years. Weight change compared to baseline was analyzed at end of treatment and at years 1, 2, and 3 after completion of antiviral therapy. Regression analysis was performed to identify baseline predictors for weight change. While there was no relevant mean weight change (−0.2 kg, SD 4.3 kg) at the end of antiviral treatment, weight started to increase during long-term follow-up reaching +1.7 kg (SD 8.0 kg, p < 0.001) compared to baseline at 3 years (follow-up year 3, FU3) after completion of antiviral therapy. 48%, 31%, and 22% of patients had a weight gain greater than 1, 3, and 5 kg at FU3, respectively. During follow-up, a body mass index (BMI) <30 proved to be the only consistent predictor for weight gain. DAA treatment is followed by a substantial weight gain (+3 kg or more) in one-third of the patients during long-term follow-up. Non-obese patients seemed to be most vulnerable to weight gain. The body compartment involved in weight gain as well as the mechanism of weight gain remain to be elucidated. KW - chronic hepatitis C KW - direct-acting antivirals KW - interferon-free KW - HCV cure KW - weight gain KW - German Hepatitis C-Registry Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-248476 SN - 2227-9059 VL - 9 IS - 10 ER - TY - JOUR A1 - Heidrich, Benjamin A1 - Wiegand, Steffen B. A1 - Buggisch, Peter A1 - Hinrichsen, Holger A1 - Link, Ralph A1 - Möller, Bernd A1 - Böker, Klaus H. W. A1 - Teuber, Gerlinde A1 - Klinker, Hartwig A1 - Zehnter, Elmar A1 - Naumann, Uwe A1 - Busch, Heiner W. A1 - Maasoumy, Benjamin A1 - Baum, Undine A1 - Hardtke, Svenja A1 - Manns, Michael P. A1 - Wedemeyer, Heiner A1 - Petersen, Jörg A1 - Cornberg, Markus T1 - Treatment of Naive Patients with Chronic Hepatitis C Genotypes 2 and 3 with Pegylated Interferon Alpha and Ribavirin in a Real World Setting: Relevance for the New Era of DAA JF - PLOS ONE N2 - Evidence based clinical guidelines are implemented to treat patients efficiently that include efficacy, tolerability but also health economic considerations. This is of particular relevance to the new direct acting antiviral agents that have revolutionized treatment of chronic hepatitis C. For hepatitis C genotypes 2/3 interferon free treatment is already available with sofosbuvir plus ribavirin. However, treatment with sofosbuvir-based regimens is 10-20 times more expensive compared to pegylated interferon alfa and ribavirin (PegIFN/RBV). It has to be discussed if PegIFN/RBV is still an option for easy to treat patients. We assessed the treatment of patients with chronic hepatitis C genotypes 2/3 with PegIFN/RBV in a real world setting according to the latest German guidelines. Overall, 1006 patients were recruited into a prospective patient registry with 959 having started treatment. The intention-to-treat analysis showed poor SVR (GT2 61%, GT3 47%) while patients with adherence had excellent SVR in the per protocol analysis (GT2 96%, GT3 90%). According to guidelines, 283 patients were candidates for shorter treatment duration, namely a treatment of 16 weeks (baseline HCV-RNA <800.000 IU/mL, no cirrhosis and RVR). However, 65% of these easy to treat patients have been treated longer than recommended that resulted in higher costs but not higher SVR rates. In conclusion, treatment with PegIFN/RBV in a real world setting can be highly effective yet similar effective than PegIFN +/- sofosbuvir/RBV in well-selected naive G2/3 patients. Full adherence to guidelines could be further improved, because it would be important in the new era with DAA, especially to safe resources. KW - peginterferon alpha-2B KW - HCV genotype-2 KW - sofosbuvir KW - infection KW - epidemology Y1 - 2014 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-115149 SN - 1932-6203 VL - 9 IS - 10 ER -