Battered into Nothingness Gratification Through Castration. Wretched Stagnant Blood Soaking wet in rancid fetor Initiation of pointless life Fighting through lose tissue To impregnate the lungs with air Unborn killing the mother to seek life Womb inner walls reduced to shreds Contractions swell hemorrhaging Around the fragmenting tumorous mass Still living inside the dying carcass Immersed in wretched stagnant blood Decrepit mother life bled out of her The comforting wish to see her child A futile dream, her legs lay still Extended, divaricated but corpselike Eyes fixed on a spray of brown droplets Trailed along the gray walls of the ward Loosing focus as she's drained of life Behind the masking smell of disinfectant A morbid odor brews: wretched stagnant blood Tiny prisoner evading the death bound confinement Twisting and churning finding anchor through the scraps Gripping hands tugging at the fragile form Emerging enshrouded in wretched stagnant blood Amid resounding tortured screams Void eyes go blind as she surrenders to her fate 5.
Lurid Iniquity Far away from civilization In a desert were he dragged them from which there is no escape Some of them are still alive For hours there he sits watching this bloody orgy of human shit He laughs as they slowly rot and die rejects they deserve to die Watching the greedy crow Picking at their bones Bleeding eyes are torn out A sight of Lurid Iniquity Those of them who are still alive Beg him for mercy But he's deaf to their suffering Hypnotized by the sinuous motions Created by the mass of gnawing worms Feeding upon their butchered corpses Rotting shreds scattered all around Drying in the sun Their unearthly pain satisfics His sadistic fantasies For hour and hours there he sitis Surrounded by an aura of death watching their worthless lives slowly expire 9.
Battered into Nothingness The time elapsed now As I turn my back At the dark season That's just gone by I lay my feet on The scorched ground and Slowly walk on Through the endless grey Stretching beyond the bleak horizon Serene Obscurity Scenes of surreal tranquility Seemingly impossible Nocturnal noiselessness I'm entangled further more In increasing frustration With every step I take By which I can never reach The border to this place I'm imprisoned In a cage without bars Briffa Bass Wayne Vella R.
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Please read the disclaimer. This study will investigate the safety and effectiveness of a modified stem cell transplant procedure for treating cancers of the blood and immune system. Patients with cancers and pre-cancerous conditions originating in blood or immune system cells can sometimes benefit greatly from, and even be cured by, transplants of stem cells cells produced by the bone marrow that mature into blood cells.
In addition to producing new bone marrow and restoring normal blood production and immunity, the donated cells fight any residual tumor cells that might have remained in the body, in what is called a graft-versus-tumor effect.
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However, severe problems, and sometimes death, may follow these transplants as a result of the high-dose chemotherapy and radiation that accompany the procedure. Also, donated immune system cells called T cells sometimes attack healthy tissues in a reaction called graft-versus-host-disease GVHD , damaging organs such as the liver, intestines and skin. This study will use the following strategies to try to reduce these risks:.
Patients between 12 and 75 years of age with non-Hodgkin s lymphoma, Hodgkin s lymphoma, multiple myeloma, chronic lymphocytic leukemia, chronic myelogenous leukemia, acute myelogenous leukemia, acute lymphocytic leukemia, myelodysplasia, idiopathic myelofibrosis, polycythemia vera, or chronic myelomonocytic leukemia may be eligible for this study. Candidates will have a medical history, physical and dental examinations, blood and urine tests including a blood test for genetic match with the donor , lung and heart function tests, and X-ray studies.
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A bone marrow biopsy may be done to evaluate disease status. Patients with lymphoma may have a nuclear medicine test called a positron emission tomography PET scan. Participants will have a central venous line large plastic tube placed into a major vein. This tube can stay in the body and be used during the entire treatment period to deliver the donated stem cells and give medications, including chemotherapy and other drugs, antibiotics and blood transfusions, and to withdraw blood samples.
Treatment will start with induction chemotherapy, which will include the drugs fludarabine, cyclophosphamide, etoposide, doxorubicin, vincristine, and prednisone. Some patients may also receive an antibody called rituximab. Patients will receive one to three cycles of this treatment, depending on their response to the drugs. One cycle consists of 5 days on drug therapy followed by a day rest period. Several days before the transplant procedure, patients will start conditioning chemotherapy with cyclophosphamide and fludarabine.
Three days after the conditioning therapy is completed, the stem cells will be infused. To help prevent GVHD, patients will take four doses of methotrexate by vein shortly after the transplant, and cyclosporine by mouth or by vein for about 6 months after the transplant. The average hospital stay for stem cell transplantation is 3 to 4 weeks.
After discharge, patients will return for frequent follow-up visits for 3 months. Monthly visits will be scheduled for the next 3 months, then every 3 months for the next 18 months, and less frequently for a total of at least 5 years post-transplant. These visits will include bone marrow aspirates and biopsies, blood draws, and other tests to monitor disease status. Allogeneic hematopoietic stem cell transplantation HSCT is potentially curative for refractory hematologic malignancies, but its application has been limited historically by morbidity and mortality from conventional transplant preparative regimens and graft-versus-host disease GVHD.
Donor T cells mediate GVHD and also help to eradicate malignancies through an immune-dependent graft-versus-tumor effect. Efforts to decrease preparative regimen toxicity have led to reduced-intensity or 'nonmyeloablative' regimens, facilitating the study of allogeneic HSCT in a broader population. However, a significant proportion of patients failed to achieve satisfactory disease control before transplant, providing a basis for intensifying this induction regimen. Furthermore, the initial 20 patients treated on this study experienced relatively high rates of acute GVHD and considerable morbidity associated with cyclosporine monotherapy for GVHD prevention, indicating that future studies should use more aggressive prophylaxis.
These observations warrant modifying our approach to allogeneic HSCT before undertaking a randomized study of donor Th2 cells. This regimen will be evaluated for toxicity and disease control before transplantation. The relationships between these cytokines and lymphocyte subpopulations have not been studied in the setting of allogeneic HSCT; such analysis may enhance our understanding of engraftment kinetics, graft-versus-host disease, and immune reconstitution.
Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies. Patients with hematologic malignancies, myelodysplasia, or myeloproliferative disorders, as summarized below:. Disease: Acute Myelogenous Leukemia; Disease Status: a In Complete Remission 1, with high-risk cytogenetics [abnormalities other than t 8;21 , t 15;17 , or inv 16 ], b In Complete Remission 2 or greater; Age: 18 to Disease: Acute Lymphocytic Leukemia; Disease Status: a In Complete Remission 1, with high-risk cytogenetics [t 9;22 or bcr-abl rearrangement; t 4;11 , 1 1;19 , t 8;14 ], b In Complete Remission 2 or greater; Age: 18 to Disease: Myeloproliferative disorders; Disease Status: a Idiopathic myelofibrosis, b Polycythemia vera, c Essential thrombocytosis, d Chronic myelomonocytic leukemia; Age: 18 to Patients years of age.
Patients older than 75 years of age will be considered on an individual basis.
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Patient or legal guardian must be able to give informed consent. All previous therapy must be completed at least 2 weeks prior to study entry, and any grade 3 or 4 non-hematologic toxicity of previous therapy must be resolved to grade 2 or less, unless specified elsewhere. The cumulative dose of doxorubicin received by patients will not be considered, as the cardiac ejection fraction appears to indicate the safe cumulative doxorubicin dose in the setting of EPOCH-based chemotherapy. Creatinine less than or equal to 1.
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Serum total bilirubin less than 2. Values above these levels may be accepted, at the discretion of the PI or study chairman, if such elevations are thought to be due to liver involvement by malignancy. If these values do not normalize during induction chemotherapy, such patients will not be eligible for the transplant phase of the protocol, and will thus be taken off study.
Ability to give informed consent. For donors under 18 years of age, the donor must complete an assent form, and the donor s legal guardian must complete an informed consent form. Age years. As the potential cerebrovascular and cardiac complications may potentially increase with age, age 75 has been chosen arbitrarily as the upper age limit.
However, if it is determined after initial accrual of patients in this upper age range that this procedure is relatively safe, the age range may be extended. Adequate venous access for peripheral apheresis, or consent to use a temporary central venous catheter for apheresis. Donors must be HIV negative, hepatitis B surface antigen negative, and hepatitis C antibody negative.
This is to prevent the possible transmission of these infections to the recipient. A donor who is lactating must substitute formula feeding for her infant during the period of cytokine administration.
Filgrastim may be secreted in human milk, although its bioavailability from this source is not known. Limited clinical data suggest that short-term administration of filgrastim or sargramostim to neonates is not associated with adverse outcomes. Active infection that is not responding to antimicrobial therapy. HIV infection. There is theoretical concern that the degree of immune suppression associated with the treatment may result in progression of HIV infection.
Chronic active hepatitis B. Patients may be hepatitis B core antibody positive but must be surface antigen negative and without evidence of active infection.