Summary. Newly diagnosed chronic myelogenous leukaemia (CML) patients (n 65) were treated with interferon (IFN)-a2b (5´10 6 IU/d s.c.) combined with monthly courses of cytarabine (20 mg/d s.c. for 14 d). Median age of patients enrolled was 45 years. The endpoints of the study were clinical ef®cacy and toxicity. The survival rates at 3 years and 5 years were 77% and 56%, respectively. The rate of complete haematological response was 60%. Evaluation of cytogenetic response was available in 29/65 patients. A complete cytogenetic response was seen in 3/29 patients (10%). W.H.O. toxicity grade 3±4 occurred in only 22/523 evaluable treatment cycles. Since the study protocol required intermittent or de®nitive discontinuation of cytarabine in case of moderate leucopenia (white blood cells (WBC) <5´10 9 /l), combined cytopenia (WBC < 5´10 9 /l, platelets <100´10 9 /l), and isolated moderate thrombocytopenia (<100´10 9 /l), the drug had to be discontinued temporarily or de®nitively in 200 cycles and the dose of cytarabine had to be reduced in 35 cycles. Thus, only 25% of the planned dose of cytarabine could be administered. At this dosage it would appear that cytarabine had no effect on survival and did not improve remission rates.We conclude that a clinical bene®t for the addition of cytarabine to the treatment of CML with IFN might only be achieved by the administration of a higher cumulative dose of cytarabine, suggesting that lower leucocyte counts of 2±4´10 9 /l have to be tolerated.

Abstract. The actual predictive value of oestrogen receptor (ER) ß for treatment decisions in breast cancer is still unclear. Retrospective studies using preoperative systemic therapy (PST) revealed that chemotherapy but also endocrine therapy can lead to alterations in expression levels of ER· and progesterone receptor (PR). The main purpose of this study was to compare ERß expression levels before and after neoadjuvant chemotherapy or endocrine therapy and to explore a possible predictive value of ERß. Matching 'baseline' biopsies and post-therapy surgical specimens of 69 breast cancer patients treated with neoadjuvant anthracycline-or taxane-based chemotherapy or with aromatase inhibitors were analyzed for expression levels of ER·, PR, total ERß (ERßt), ERß1, ERß2 and the proliferation-related antigen Ki-67 using immunohistochemistry. A marked expression of ERßt significantly correlates with low proliferation rates after PST (p=0.0013) and with response to it. Further most tumours decreased ERß1 expression with PST. A marked ERß2 expression was observed predominantly in responders and significantly decreased during chemotherapy (p=0.047). Results on ER· and PR corroborate findings of previous studies. Our data demonstrate that changes of ERß expression occur during PST and that total ERß expression and ERß2 may have a predictive value for PST.

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