Ann Transpl
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Alcoholic liver disease is the leading cause of end-stage liver disease and the second most common indication for liver transplantation (OLT) in the United States and Europe, with the number of patients receiving transplants each year representing about 5% of the estimated deaths from alcoholic cirrhosis. Long-term patient survival rates compare favorable with those for other chronic liver diseases. ⋯ Furthermore, pre-transplant evaluation and selection of potential candidates are discussed and guidelines are given to clarify the role of OLT in the management of patients suffering from alcoholic cirrhosis. It appears very important to mention that alcoholism is not a fault but represents a disease, and provided that the underlying disease can be treated, consequent disease (end-stage liver disease) should be treated, too.
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The treatment of multiple myeloma still remains under investigation. Conventional chemotherapy with currently used agents (i.e., Melphalan) effects complete remission in no more than 5% of patients. High dose chemotherapy followed by hematopoietic stem cells transplantation results in complete remission rates between 25% and 75% and a 3-year probability of event-free survival between 40% and 60% but is not curative since most patients relapse after 1.5 to 3 years. ⋯ Several regimens have been proposed for stem cells mobilization including: High-dose cyclophosphamide and G or GM-CSF, G-CSF alone, and cyclophosphamide and etoposide with G-CSF... ect.. Further attempts to improve the results of autotransplantation have included intensification with tandem transplantations (double transplants) and reduction of tumor cells in stem cell infusion. The aim of this review is to summarize the current knowledge about the treatment of multiple myeloma with high dose chemotherapy with autologous hematopoietic stem cell transplantation.