PEDIATRIC ONCOLOGY GROUP PROGRAM

随着关于肿瘤性质的新数据几乎爆炸性的发展， 生物学，在可预见的未来合作小组的任务 变得越来越具有挑战性和复杂性。 肿瘤信息 生物学必须被纳入可行的群体意志的发展中 和组内（亚组）II/III期研究。 因此，设计的协议 对于急性淋巴细胞白血病的特定亚群，必须解决T细胞 和B细胞亚型，并继续深入研究前B细胞的性质， 前T亚型 在AML中，必须努力确定风险因素 同时利用最佳可用的“标准”治疗的随机试验。 在这方面，必须作出努力，以评估新的组合， 利用（1）药物相互作用，（2）疗效的新知识的治疗 高剂量或大剂量治疗的作用，以及（3）“清洁”技术的作用。 （1）的实例包括蛋氨酸-天冬酰胺酶，（2）高剂量胞嘧啶 阿拉伯糖苷，和（3）抗体净化。 骨髓移植作为一种 主要治疗臂值得深入评价。 大学 佛罗里达已经制定了一个最有利的准备方案， 缓解ALL，作为8个机构POG研究的一部分，它将 现在适用于首次缓解的高危ALL。 一个关于骨髓的提议 第二次缓解AML的移植现在可供群体使用， 骨髓移植正在高危神经母细胞瘤中进行， 在当地的霍奇金病，尤因肉瘤和 非霍奇金淋巴瘤 用抗体包被的骨髓净化 针对神经母细胞瘤、cALLa（+）、ALL和 T细胞ALL正在当地进行。 佛罗里达大学骨髓 移植股也是多机构慢性骨髓性白血病的一个组成部分 移植研究 除了积极参与整个团队 努力，正在进行的药理学和药代动力学项目将 继续，以设计方案，这将解决有利的使用 化学治疗剂。 最后，该部门扩大了其 计划包括杰克逊维尔大学医院，已提交 增加了癌症控制机构，并扩大了其范围， 遗传学和长期影响的研究。

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.