PEDIATRIC ONCOLOGY GROUP PROGRAM-UNIVERSITY OF FLORIDA

列入下一代合作小组的任务规定 努力是需要扩展之前的POG研究，以及来自 其他机构和团体，关于肿瘤的性质和分类 并将这种努力扩展到可行的第二/第三阶段研究中。 急性胰腺炎的组织学、免疫学和自然病史分类 淋巴细胞性白血病使研究人员能够开发出治疗方法 为解决这方面的具体实体而量身定做的努力，即 风险(WBC>50,000/mm，T细胞)，低风险，隐匿性疾病， 髓外复发。对于某些类别和子分类，它 显然，这样的治疗努力已经导致了戏剧性的 改善，如Wilms瘤和横纹肌肉瘤；在其他方面，结果 令人失望，如尤文氏肉瘤，III/IV期神经母细胞瘤， 脑瘤、骨肉瘤、高危急性淋巴细胞白血病和急性髓细胞白血病。药代动力学 大剂量治疗的研究和移植生物学的数据 相关的第二阶段研究提供了到目前为止还不容易提供的机会 可采用具有临时药物监测的高剂量方案 动力学，以便利用药物抢救方案，如在大剂量 甲氨蝶呤联合亚叶酸抢救或消融后骨髓输注 心理治疗。佛罗里达大学的骨髓移植小组将 继续(1)进行高风险的同种异体移植研究 ALL和AML，首次缓解旨在询问以下问题 调节方案和免疫恢复，以及(2)利用自体 大剂量治疗后的骨髓挽救与药代动力学数据相结合 适用于复发/耐药实体瘤，如尤文肉瘤、神经母细胞瘤、 非霍奇金淋巴瘤、脑瘤、霍奇金病和肾母细胞瘤。 研究工作将包括将组织学和免疫学联系起来 急性淋巴细胞白血病和神经母细胞瘤的治疗反应特点。整体 团队努力将包括积极参与正在进行的和新的 开发了包括多机构成骨肉瘤在内的方案 学习。在科学参与方面的努力也得到了回报 包括外科医生和放射治疗师在内的调查以及确定 额外卫星，可进一步增加35-40颗 病人/年，建立农村转诊，以维持家庭护理和 医疗中心沟通，建立全面的心理社会 支持系统。

Included in the mandate for the next generation of cooperative group efforts is the need to extend prior POG studies, as well as those from other institutions and groups, on the nature and classification of tumor biology and to expand such efforts into feasible phase II/III studies. Histologic, immunologic and natural history classifications of acute lymphoblastic leukemia have enabled investigators to develop therapeutic efforts tailored to address specific entities in this regard, i.e., high risk (WBC greater than 50,000/mm., T-cell), low risk, occult disease, extramedullary relapse. For certain categories and subclassifications, it is apparent that such therapeutic efforts have resulted in dramatic improvement, as in Wilms' tumor and rhabdomysarcoma; in others, the results have been disappointing, i.e., Ewing's sarcoma, stage III/IV neuroblastoma, brain tumors, osteogenic sarcoma, high risk ALL, and AML. Pharmacokinetic studies of megadose therapy and data derived from transplantation biology and related phase II studies provides opportunities heretofore not readily available to employ high-dosage regimens with temporal monitoring of drug kinetics so as to utilize pharmacologic rescue regimens, as in high dose MTX with folinic acid rescue, or marrow infusion following ablative therapy. The bone marrow transplant unit at the University of Florida will continue (1) to conduct allogeneic transplantation studies of high risk ALL, and AML, in first remission designed to ask questions concerning conditioning regimens and immune recovery, and (2) to utilize autologous marrow rescue following megadose therapy coupled with pharmacokinetic data for relapsing/resistant solid tumors, i.e., Ewing's sarcoma, neuroblastoma, non-Hodgkin's lymphoma, brain tumor, Hodgkin's Disease and Wilms' tumor. Research endeavors will include correlating histologic and immunologic characteristics with therapy responses as in ALL and neuroblastomas. Whole group endeavors will consist of active participation in ongoing and newly developed protocols including a multi-institution osteogenic sarcoma study. Efforts have also been rewarding in scientifically involved investigation including surgeons and radiotherapists as well as identifying additional satellites representing a further accrual of 35-40 patients/year, establishing a rural referral for maintaining home care and medical center communication, and establishing a comprehensive psychosocial support system.