BackgroundStimulation parameters in deep brain stimulation (DBS) of the subthalamic nucleus for Parkinson's disease (PD) are rarely tested in double‐blind conditions. Evidence‐based recommendations on optimal stimulator settings are needed. Results from the CUSTOM‐DBS study are reported, comparing 2 pulse durations.MethodsA total of 15 patients were programmed using a pulse width of 30 µs (test) or 60 µs (control). Efficacy and side‐effect thresholds and unified PD rating scale (UPDRS) III were measured in meds‐off (primary outcome). The therapeutic window was the difference between patients’ efficacy and side effect thresholds.ResultsThe therapeutic window was significantly larger at 30 µs than 60 µs (P = ·0009) and the efficacy (UPDRS III score) was noninferior (P = .00008).InterpretationSubthalamic neurostimulation at 30 µs versus 60 µs pulse width is equally effective on PD motor signs, is more energy efficient, and has less likelihood of stimulation‐related side effects. © 2017 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.

Effective anodic stimulation requires a higher charge injection into the tissue, but may provide a better reduction of off-period motor symptoms within the individual therapeutic window. Therefore, a programming change to anodic stimulation may be considered in patients suffering from residual off-period motor symptoms of PD despite reaching the adverse effect threshold of cathodic stimulation in the subthalamic nucleus.

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Summary:Advances in therapy of intermediate-or high-grade nonHodgkin's lymphomas (NHL) and Hodgkin's disease (HD) are one of the most important breakthroughs in oncology. Patients with relapsed or refractory non-Hodgkin's lymphomas (NHL) and Hodgkin's disease (HD) withUsing CHOP or newer second-and third-generation regimens, about 30-50% of patients with advanced NHL will recurrences after an anthracyclin-containing regimen only have a chance of cure of below 10% with convenachieve long-term disease-free survival (DFS). 1,2 Nevertheless, the outcome of the remaining 50-70% of patients who tional chemotherapy. In order to improve their prognosis, we started a phase I/II trial using high-dose therdo not achieve complete remission (CR) or who relapse is dismal. The 2-year disease-free survival with conventional apy comprising carboplatin, together with etoposide and ifosfamide (CEI), followed by autologous stem cell salvage chemotherapy regimens is less than 15% in most studies. [3][4][5] Therefore, several approaches have been made rescue (ASCR) as consolidation after salvage treatment. Since September 1990, 40 patients with intensively preto increase CR and DFS rates, most of them using highdose chemotherapy (HDT) regimens Ϯ total body treated advanced NHL (n = 24) or HD (n = 16) received one cycle of high-dose therapy (HDT) consisting of carirradiation (TBI) with autologous stem cell support. Widely used chemotherapeutic agents have been cyclophosphamboplatin 1500 mg/m 2 , ifosfamide 10 g/m 2 and etoposide in escalating doses from 1200 mg/m 2 to 2400 mg/m 2 folide, cytosine arabinoside, etoposide and BCNU. Combinations of three or four drugs in high dosages have regulowed by ASCR. Thirty-nine patients were assessable for toxicity and response. The following doses appeared larly shown substantial toxicitiy. [6][7][8] One possible way to improve results of HDT is with nonto be safe: carboplatin 1500 mg/m 2 , etoposide 2400 mg/m 2 and ifosfamide 10 g/m 2 . All patients developed crossresistant drugs which were not used during first-line and salvage treatment. They should have low non-hematograde 3 nausea and grade 3 or 4 mucositis. Granulocytopenic fever occurred in 100% with grade 4 infeclogic toxicity even in escalated doses. The topoisomerase II inhibitor etoposide has become one of the most effective tions in 15%. Mild transient kidney toxicity was noted in 36% and liver toxicity in 20% of patients. One toxic drugs for the treatment of NHL. Its synergism with alkylating agents and its limited non-hematologic toxicity makes death occurred (2.5%). Objective responses were obtained in 36 of 39 patients (92%) with complete it useful for combination in HDT. 9,10 Ifosfamide is an oxazaphosphorine alkylating agent with a broad spectrum of remissions (CR) in 24 patients (61.5%) and partial remissions (PR) in 12 (30.7%). Median observation antineoplastic activity producing favorable response rates, for example, in germ cell cancer, ovarian carcinoma, NHL time for surviving patients was 23.3 months (range 3.4-52.3). The ...

Summary:Donor lymphocyte infusions (DLI) are an effective treatment of leukemia relapse after allogeneic bone marrow transplantation. Undesired side-effects are the development of graft-versus-host disease (GVHD) and the occurrence of pancytopenia in some patients. In a pilot study, we investigated if unmanipulated G-CSF-mobilized peripheral blood stem cells which naturally contain large numbers of T lymphocytes (D-PBSC/LI) would be equally effective or even superior than DLI in generating a graft-versus-leukemia reaction (GVL) but could mitigate or prevent the development of pancytopenia. We treated 12 patients with CML chronic phase (n = 5), CML blast crisis (n = 2), AML (n = 2), ALL (n = 1), CLL (n = 1) and multiple myeloma (n = 1). In five patients with acute leukemia or CML blast crisis D-PBSC/LI followed intensive chemotherapy (group A), in seven patients D-PBSC/LI were given without any prior chemotherapy (group B). In group A two patients were evaluable for hematologic toxicity. Leukopenia Ͻ1000/ l lasted for 10 and 19 days, and thrombocytopenia Ͻ20 000/l for 11 and 13 days, respectively. In group B leukopenia Ͻ1000/l and thrombocytopenia Ͻ20 000/l was observed in only one patient. Moderate cytopenia developed in four of five evaluable patients. A complete remission could be achieved in all seven patients with CML who all developed acute and/or chronic GVHD. None of the remaining five patients achieved a complete remission despite acute and/or chronic GVHD in two of them. Four patients died from disease progression, one patient from a secondary lymphoma, and one patient as a result of uncontrolled GVHD. In conclusion, D-PBSC/LI is effective in inducing GVL reaction but it does not prevent pancytopenia in each case. It remains unclear if it mitigates the incidence and severity of pancytopenia.