ROR1 - Become An Master In 6 Uncomplicated Tasks
Two further courses of chemotherapy were given at four?wk post-transplant. From 1991 to 1996, the immunosuppressive regime was cyclosporin A (Sandimmune?, Novartis Pharmaceuticals UK Ltd, Camberley, Surrey, UK) azathioprine, and corticosteroids. From November 1996, Sandimmune was changed to Neoral? (Novartis). From February 1998, tacrolimus MK-2206 concentration was introduced to patients with a body weight >20?kg (exclusions were due to preparation available, that is, no liquid preparation at this time). Target plasma cyclosporin A trough levels were first three?months after transplant 180�C230?��g/L, three?months to one?yr 100�C160?��g/L, second year 70�C110?��g/L and third year onwards 60�C90?��g/L. Target plasma tacrolimus trough level: first two?wk post-transplant 10�C15?ng/mL, third and fourth weeks 8�C12?ng/mL, second and third months 5�C8?ng/mL and thereafter 3�C5?ng/mL. Acute rejection was treated with methylprednisolone 15 mgs/kg IV daily for three?days. A slightly modified immunosuppressive regime ABT263 was used from 1999 onwards. The doses of cyclosporin A and tacrolimus were reduced by 30% to target trough levels of 150?��g/L and 5?ng/mL, respectively. Liver biopsy was undertaken where rejection was suspected on clinical or biochemical grounds. Acute and chronic rejections were diagnosed using conventional histological criteria (RAI score >4) [7]. Statistical methods used were to assess significance of data including Student's t-test, and survival analysis for freedom from rejection. Mean duration of follow-up was seven?yr and six?months. Mean age at transplant was 3.25?yr in the hepatoblastoma group and 3.28?yr in the EHBA group. There were no significant differences between the two groups in terms of age, gender, and weight or height pre-/post-transplant. Median length of survival in the hepatoblastoma group is 11?yr (range 0�C20?yr), median survival in the EHBA group is nine?yr (range 0�C21?yr). Overall two-yr survival was 75% for the hepatoblastoma group compared with 88.3% in the biliary atresia group (p?=?0.5). Deaths in the hepatoblastoma group were predominantly due to malignancy (including recurrence and progression) or sepsis (60% and 20%, respectively). Acute rejection, as defined by the rejection activity index (RAI?>?4) was found to be less common in the hepatoblastoma ROR1 group (50% vs. 75%, respectively p?
