정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

조혈모세포이식 환자에서 발생한 Cytomegalovirus 질환의 특징 : 일개 대학변원에서 최근 10년간의 경험

최수미,이동건,박선희,김시현,김유진,민창기,김희제,이석,최정현,유진홍,김동욱,이종욱,민우성,신완식,김춘추 대한감염학회 2009 감염과 화학요법 Vol.41 No.1

Background : Studies on cytomegalovirus (CMV) diseases in Korean hematopoietic stem cell transplant (HSCT) recipients are lacking and do not reflect the recent trends of advances and changes. Therefore, we tried to analyze the clinical features of CMV diseases in HSCT recipients over the past 10 years at a tertiary university hospital in Korea. Methods : Retrospective review of medical records was done for all adult HSCT patients who received transplant at the Catholic HSCT Center from January 1998 to January 2008. Results : Forty-four cases (2.2%) of CMV diseases were identified. CMV pneumonia was diagnosed in 17 patients, retinitis in 16 patients, enterocolitis in 7 patients, esophagitis 1 patient, gastritis in 1 patient, duodenitis in 1 patient, and hepatitis in 1 patient. The median onset of symptom was 90 days after transplantation. Late CMV diseases accounted for 47.7%. CMV related death varied from 0 to 58.8% according to the involved organ. CMV retinitis was diagnosed relatively later in the course of transplantation mostly in patients who had chronic graft versus host disease (GVHD). On the contrary, CMV enterocolitis mainly occurred in patients who suffered from acute GVHD. The overall concurrent CMV reactivation was documented to be 63.6%: the concurrent CMV reactivation was observed only in 37.5% of patients with retinitis. Conclusions : We observed some differences in the pattern of CMV disease manifestation according to the involved organ and reconfirmed the fact that CMV pneumonia is the most common and fatal disease in HSCT recipients. Additionally, CMV retinitis was not uncommon in HSCT recipients. Since specific marker does not exist in predicting retinitis, regular ocular examination should be done thoroughly, especially in patients with chronic GVHD.

조혈모세포이식 환자에서 침습성 진균 감염에 대한 Micafungin의 예방 효과 및 안전성

김시현,이동건,최수미,권재철,박선희,최정현,유진홍,이성은,조병식,김유진,이석,김희제,민창기,조석구,김동욱,이종욱,민우성,박종원 대한감염학회 2010 감염과 화학요법 Vol.42 No.3

Background: Micafungin, a potent inhibitor of 1,3-β-D-glucan synthase, is a novel antifungal agent of the echinocandin class. In vitro study showed that micafungin was effective against Aspergillus species as well as Candida species, but clinical data on the prophylactic efficacy against invasive fungal infections (IFIs) other than candidiasis are still lacking. Materials and Methods: We identified 60 consecutive adult hematopoietic stem cell transplantation (HSCT) recipients who received at least 3 doses of micafungin during neutropenic period. Micafungin was started as an alternative in patients who were intolerant or had adverse events (AEs) to primary prophylactic antifungal agents. We retrospectively reviewed the medical records and analyzed the efficacy and safety of micafungin for prophylaxis against IFIs. Results: The patients either had autologous (n=9) or allogeneic (n=51: 1 syngeneic, 24 sibling, 26 unrelated donor) HSCT. Itraconazole oral solution (n=58) was the most frequently used first line antifungal agent for prophylaxis and was administered for median 11 days. The most frequent cause of switch to micafungin was vomiting (n=42). The duration of neutropenia and micafungin administration was median 13 and 12 days, respectively. A successful outcome was achieved in 45 (75%) patients. Empirical antifungal therapy was initiated in 13 (22%) patients. There were 2 cases (3.3%) of breakthrough fungal infections which comprised a probable invasive pulmonary aspergillosis and a possible invasive fungal sinusitis. There was no case of invasive candidiasis. A total of 53 (88%) patients experienced at least one AE regardless of causality during micafungin administration. The most frequent AEs were hypokalemia, vomiting, diarrhea, and elevated serum aspartate aminotransferase or alanine aminotransferase. Among the aforementioned AEs, only 1 case of diarrhea could be classified as a probable relation with micafungin when causality was assessed. There was no AEs that caused discontinuation of micafungin. Conclusions: Micafungin seems to be a safe and effective agent for prophylaxis of IFIs including aspergillosis as well as candidiasis in HSCT recipients. However, further large, prospective, and randomized comparative studies are warranted for aspergillosis.

서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1998)

김재홍,김준호,반재용,이정우,황성주,정준규,정성태,강진문,조흔정,홍창의,정혜신,이한승,김이선,이봉길,이종호,선영우,한기덕,윤성필,이성훈,안종성,박석범,문승현,조항래,김형섭,류지호,황재영,박준홍,손상욱 한양대학교 의과대학 2001 한양의대 학술지 Vol.21 No.1

In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. For the detection of a more effective therapeutic regimen and assessing the prevalence of Penicillinase Producing Neisseria gonorrhoeae(PPNG), we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by menas of the chromogenic cephalosporin method. In 1998, 93 strians of N. genorrhoeae were isolated, among which 60(64.5%) were PPNG. The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 64.5% in 1998.

근로자들의 직종별 직무스트레스

이승욱,이종태,손혜숙,김성준 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.5

Objective : This study was conducted to evaluate the Job stress among workers by tasks. Methods and Material : This is a cross-sectional study consisting of self-administered qestionnaire survey. These study subjects were 983 persons in total; elementary school teachers 282, taxi-drivers 72, container terminal workers 199 and hair dressers 430. Through the questionnaire, socio-demographic characteristics, stress-related behaviors and daily sleeping hours were surveyed, and through the JCQ(Job Content Questionnaire), Job characteristic scores were assessed and through the PWI(Psychological Well being Index), psychosocial distress level was assessed. Results : Psychological job demand and decision latitude by hairdressers were the highest among 4 jobs. So, in the job strain levels, the rate of between active group and high strain group was higher than of other jobs. On taxi-drivers, psychological job demand was high in some degree but decision latitude and social support were low. In case of contain terminal workers, psychological job demand and social support were high in some degree but decision latitude was the lowest among 4. On elementary school teachers, social support was high in some degree. but decision latitude was low and psychological job demand was lowest among 4. Accordingly, in Job strain, the rate of passive group was the highest, but the rate of high strain group was the lowest. On hairdressers, the job strain by each rank was very various; in case of staff, the rate of passive group and high strain group was the highest and in case of designers and directors, the rate of active group and strain group was high(P<0.01). The psychosocial distress of taxi-drivers(PWI; 90.1) and container terminal workers(PWI; 88.3) were very serious. It was thought that the common job characteristics caused works by turns, night workers, irregular break and mealtime, and strain against accidents as job stressors. Only on hairdressers, the difference of PWI levels by each rand was statistically significant; staffs(46.9) and designers(44.9) were higher than directors(34.8)(P<0.01). Comparing the results of PWI between low strain group and high strain group, only about hairdressers, the PWI was high(P=0.0001) and high strain group odds ratio about low strain group was statistically significant. Conclusion : It could be evaluated the job stress among workers by tasks. To lower the job strain levels and to raise the rate of active group in container terminal workers and elementary school teachers, the decision latitude should be guaranteed. On taxi-drivers and hairdressers, social support should be consolidated. Especially to decrease psychosocial distress among workers, an effective and systematic job stress management programs should be needed.

연속 드레싱을 이용한 CNC Creep Feed 연삭기의 개발 및 연삭 평가에 관한 연구

이영욱,정재운,김종관,정윤교 한국공작기계학회 2006 한국공작기계학회 추계학술대회논문집 Vol.2006 No.-

The method of creep feed grinding is an effective technology process. It is used to improve the productivity & efficiency in form grinding. However there are some inherent difficulties throughout the grinding process. The progress of abrasive wear around the cutting edge is remarkable. The grinding force become intense and burn marks occur frequently. To grind a work piece of large length is clearly a tremendously difficult task. Also, domestically, creep feed grinding is a scarce development. We crucially depend on the imports of goods from abroad. Therefore, the purpose of this research is that developing the localization creep feed grinding with continuous dressing device and we must research more into this complex technology to discover the most efficient dressing conditions and dresser to wheel speed ratio(qd).

『삼국사기』에 나타난 초기 백제와 풍납토성

이종욱 西江大學校 人文科學硏究所 2000 서강인문논총 Vol.12 No.-

한국산 잠자리과(잠자리목) 5종의 세포분류학적 연구

李鐘郁,愼鏞直,朴元學,金德勳 嶺南大學校附設 基礎科學硏究所 1988 基礎科學硏究 Vol.8 No.-

The chromosome study was performed in some species on the Korean Libellulidae by using squash techniques and lactopropionic orcein stain in order to define species relationship between them. The numerical and morphological differences were shown in the chromsome between the species of the stages of spermatocyte metaphase. The results obtained were summarized as follows: 1. The pattern of standard chromosome number in these species is divided into two groups; Orthetrum albistylum speciosum (UHLER), Orthetrum triangrlare melanina (SELYS), Rhyothemis fulignosa HAGEN are 13 in the haploid chromosome number. But, Crocothemis servilia servilia DRURY and Synoetrum eroticum (SELYS) are 12. 2. The shape of chromosome in these specie in divided into two groups; O. albistylum, S. eroticum eroticum, R. fulignosa, O. triangulare melania are bar or clover in shape at the spermatocyte metaphase. These species seem to be holocentric chromosome. On the other hand, C. servilia servilia is gloval and this species has monocentric chromosome. 3. The sex chromosome of five species ( O. albistylum speciosum, O. Triangulare melania, R. fulignosa, C. servilla servilia, S. eroticum eroticum ) are XO type. 4. Three species ( O. albistylum speciosum, O. Triangulare melania, S. eroticum eroticum ) shows the fragment chromosome in the spermatocyte metaphase. As the results, five species on the Korean Libellulidae (O. albistylum speciosum, O. triangulare melania, R. fulignosa, C. servilla servilia, S. eroticum eroticum ) is similar to each other in the external morphology, But, in the analysis of chromosome, these species is different to some degree.

한국산 나비목(Lepidoptera)의 발향린(Androconia)에 관한 주사 전자현미경적 연구 Ⅰ. 뱀눈나비과

이종욱,차진열,류성만 嶺南大學校附設 基礎科學硏究所 1988 基礎科學硏究 Vol.8 No.-

한국산 Satyridae 에서 보고된 35종 중 북한산 11종과 채집하지 못한 3종을 제외한 21종을 재료로 광학현미경으로 발향린의 유무 및 분포를 확인하였다. 이중 발향린이 관찰된 9종을 대상으로 주사전자현미경으로 그 형태를 비교 연구하였다. 1. 발향린이 관찰된 종은 Coenonympha ammaryllis Cramer, Erebia wanga Bremer, Eumenis antonoe Esper, Lopinga achine Scopoli, Minois dryas Scopoli, Pararge deidamia Eversmann, Ypthima argus Buttler, Ypthima amphithea Menetries, Ypthima mojschulsk Bremer et Grey 9종 이었다. 2. 발향린은 암컷에서는 발견되지 않았고 수컷의 앞·뒷날개 표면(dorsal surface)에서 관찰되었다. 3. 발향린의 분포는 주로 앞날개의 둔맥과 경맥사이, 뒷날개는 주맥을 중심으로 분포하였으며, 종에 따라서 상당한 차이를 보였다. 4. Satyridae 9종의 발향린은 나발막(fimbriae), neck, 잎새(laminar), 자루병반(foot stalk)등을 갖추었으나, 부속반(accessory disk)은 가지지 않았다. 5. Satyridae 9종의 발향린은 같은 종 내의 다른 개체간, 부위에 따른 변이는 관찰되지 않았다. 6. 발향린의 성유인 물질의 분비는 샘(gland)의 생성물이 자루병반의 강(cavity)내로 들어가서 잎새(laminar), neck, 나발막(fimbrae)의 말단개구부등 발향린 전면에 걸쳐있는 구멍(pore)을 통해 분산되는 것으로 여겨진다. This paper observed through microscope the existance and the distribution of the androconia of the 21 species of Satyride among 35 ones which have been reported in Korea, excluding 11 species in north Korea and 3 one's not in collection. 9 species which were observed the androconia among these were chifely compared and studied through Scanning Electron Microscope. 1. The species observing androconia are ? Coenonympha ammaryllis Cramer, Erebia wanga Bremer, Eumenis antonoe Esper, Lopinga achine Scopoli, Minois dryas Scopoli, Pararge deidamia Eversmann, Ypthima argus Buttler, Ypthima amphithea ? Menetries, Ypthima mojschulsk Bremer et Grey. 2. The androconia was not found at the females, but only at the dorsal surface of the fore and hind wings of males. 3. The androconia was mainly distributed between the anal vein and the radius of the fore wings and at the cubitus of the hind wings, and made differences among the species. 4. The androconia of 9 species Satyridae fimbriae, nack, laminar,foot stalk, but no accessory disk. 5. The androconia of 9 species Satyridae was observed no variation at the sections and among the inviduals of the same species. 6. The secretion of the sexual attractant at the androcnia was through to be diffused into the pores at the surface of the androconia of laminar, neck, and fimbriae through the cavirty of the foot stalk of the gland.

성인 급성 림프구성백혈병 고위험군에서 일차관해시 동종 및 자가 조혈모세포이식의 성적 비교 : 단일기관 치료경험 A Single Center Experience

이석,민우성,민창기,김동욱,이종욱,김유진,박은정,박윤희,김춘추 대한조혈모세포이식학회 2000 대한조혈모세포이식학회지 Vol.5 No.2

배경:성인 ALL에서 동종 조혈모세포이식은 전처치요법 및 이식편대백혈병 효과에 의한 효과적인 백혈병세포의 제거가 가능하다는 측면에서 활발히 시행되고 있으나 자가 조혈모세포이식과 화학요법과의 비교 연구에서는 대상환자의 다양성 등으로 인하여 상이한 결과가 보고되었다. 그러나 최근 진단당시 환자의 임상적·세포생물학적 특성 및 관해유도요법 후의 백혈병세포의 제거 속도 등을 기준으로 한 위험인자가 정의되면서 이를 근간으로 위험도에 따른 관해 후 치료방침의 결정이 타당성 있는 접근방법으로 제시되고 있고, 특히 고위험군에서의 동종 조혈모세포이식의 역할이 강조되고 있다. 방법: 성인 ALL 고위험군에서 일차 완전관해시 동종 조혈모세포이식의 역할을 규명하기 위해 최근 5년간 가톨릭의대 조혈모세포이식센터에서 ALL로 진단 후 일차 완전관해 상태에서 동종 및 자가 조혈모세포이식을 시행받고 임상적 특성과 세포면역학적 특성 및 세포유전학적 검사결과가 모두 확인 가능하였던 환자 중 고위험군에 해당된 50례를 대상으로 후향적 분석을 시행하였다. 고위험군은 진단시 연령이 30세 이상인 경우, 백혈구수가 30,000/μL 이상인 경우, 관해유도기간이 30일 이상 소요된 경우, Ph 혹은 t(4;11)이 동반된 경우 중 하나 이상의 인자를 갖고 있는 경우로 정의하였다. 결과: 대상환자의 중앙연령은 30세(15~43세)이었고, 남녀 비는 27:23이었다. FAB 분류상 L1 29례(58.0%), L2 21례(42.0%)였으며, precursor B-lineage 항원이 양성인 경우는 36례(72.0%), T-세포 항원이 양성인 경우는 9례(18.0%), 골수구계 항원이 동시에 발현된 경우는 5례(10.0%)였다. 세포유전학적 검사상 23례(46.0%)에서 불량한 염색체유형 [Ph 19례, t(4;11) 4례]이 동반되었다. 전체 환자 중 31례에서 동종 조혈모세포이식을 시행하였으며, 19례에서는 자가 조혈모세포이식이 시행되었다. 동종 및 자가 조혈모세포이식 환자군간의 임상적 특성은 양군간의 유의한 차이가 없었다. 대상환자의 중앙 추적관찰기간은 27개월(7~72개월)이었고, 전체 환자의 2년 무병생존율 및 전체생존율은 각각 59.0±7.6%, 68.2±7.1%이었다. 조혈모세포이식에 따른 치료성적을 비교한 결과 전체생존율은 동종 조혈모세포이식군 71.4±8.6%, 자가 조혈모세포이식군 62.7±12.4%로 양군간의 유의한 차이가 없었던 반면, 재발율은 동종 조혈모세포이식군에서 유의하게 낮은 빈도를 보였으며(25.8% vs 52.6%, P=0.05), 무병생존율에 있어서도 각각 70.6±9.0%, 42.1±12.2%로 동종 조혈모세포이식군에서 보다 높은 경향을 보였다(P=0.07). 이식 후 생존율에 영향을 주는 위험인자를 분석한 결과, 진단시 연령, 백혈구수, 관해유도기간에 따른 차이는 관찰되지 않았다. 다만 Ph 혹은 t(4;11)이 동반된 경우에서 무병생존율이 동종(28.5±16.0% vs 94.4±5.4%, P=0.0002) 및 자가 조혈모세포이식군(18.1±11.6% vs 80.0±17.8%, P=0.0046) 모두에서 유의하게 감소되었다. 결론: 본 연구를 통하여 일차관해시 조혈모세포이식을 시행받은 고위험군 성인 ALL에서는 관해 후 치료법으로써 동종 조혈모세포이식이 우선적으로 고려될 수 있는 치료법임을 확인할 수 있었다. 이는 추후 국내에서도 보다 장기간의 추적관찰을 통한 전향적 임상연구를 시행하여 보다 정립된 관해 후 치료방침의 결정 필요성을 제시하였다는 측면에서 임상적 의의가 있을 것으로 사료된다. Background:Optimal postremission therapy remains controversial in adult patients with acute lymphoblastic leukemia (ALL). In this study, we compared allogeneic bone marrow transplantation (alloBMT) with autologous peripheral blood stem cell transplantation (autoPBSCT) using the result of the human leukocyte antigen typing (HLA). Methods:Patients were eligible if they were in first remission (CR1) and had either: adverse cytogenetics [Philadelphia chromosome (Ph), t(4;11)], age >30 years, required more than 1 induction course to achieve remission (time-to-CR1 >30 days) or presenting WBC >30,000/μL. From July 1994 to June 1999, 50 consecutive adult patients with high-risk ALL underwent HLA-matched alloBMT (n=31) or autoPBSCT (n=19) at the Catholic Hemopoietic Stem Cell Transplantation Center. Results:There were 27 males and 23 females with median age 30 (range, 15~43) years. The distribution of phenotype was as follows: L1 (n=29), L2 (n=21), precursor B (n=36), T (n=9), myeloid marker coexpression (n=5). Adverse cytogenetic abnormalities at diagnosis were shown in 23 (46.0%) cases. All pretransplant characteristics were well balanced between these two groups. Most patients were treated with total body irradiation containing regimen as part of the conditioning. With a median follow-up of 27 months in both groups, disease-free survival (DFS) and overall survival probabilities at 2 years were 59.0±7.6% and 68.2±7.1%, respectively. The relapse rates were significantly different between alloBMT and autoPBSCT groups (25.8% vs 52.6%, P=0.05). There was no significant difference in overall survival between the two groups. However, alloBMT had a trend toward better DFS (70.6±9.0% vs 42.1±12.2%, P=0.07). None of the pretransplant characteristics significantly affected outcome after transplantation, except adverse cytogenetics. Prognosis of ALL with Ph or t(4;11) was significantly poorer than that of the remaining high-risk ALL patients (P<0.01). Conclusion: We conclude that alloBMT appears to be more effective than autoPBSCT in prolonging initial CR for high-risk ALL patients. Prospective studies addressing additional clinical variables are needed to guide clinical decision making about transplant choices for adult patients with ALL. New therapeutic strategies for the management of ALL with adverse cytogenetics will be also required.