[Phoneme discrimination test material for preschool children: development and preliminary assessment]. / Zur Entwicklung eines Testmaterials für die Uberprüfung der Lautdiskriminationsfähigkeit im Vorschulalter.

BACKGROUND: Several tests have been developed to probe phoneme discrimination. However, little is known about the reliability and validity of discrimination abilities in preschool children as assessed by these tests. Based on previous results we now developed a test material based on minimal pair presentation. METHODS: Prospective study; 30 preschool children (5;1 to 6;3 years old, 17 boys, 13 girls); descriptive statistics and correlational analysis; items: 60 minimal pairs consisting of real words and nonsense words. RESULTS: Empirical testing confirmed prediction of normal distributed phoneme discrimination errors. No gender specific effects were found. Results correlated with the degree of phoneme opposition and with phonological loop capacity. DISCUSSION: These results indicate that the test material developed is suitable for testing phoneme discrimination in preschool children. However other normative assessments using larger test populations are warranted. Phoneme discrimination tasks appear to include testing of sensory as well as linguistic-cognitive functioning.

[Stability of phoneme discrimination in preschool children]. / Zur Stabilität der Lautdiskriminationsfähigkeit im Vorschulalter.

BACKGROUND: Several tests have been developed to probe phoneme discrimination. However, little is known about the stability of discrimination abilities in preschool children. We investigated the test-retest reliability of a newly developed test material. METHODS: In a prospective study, 30 preschool children (5.1-6.3 years old) were tested with a time lag between test 1 and test 2 of 1 month. Correlational analysis was carried out using 60 minimal pairs consisting of real words and nonsense syllables. The choice of items took into consideration their frequency in the basic vocabulary as well as phoneme properties such as contrast and position. RESULTS: High Cronbach's alpha were found for all subscales. For the whole item list, Cronbach's alpha was 0.994. No significant gender specific differences were found. DISCUSSION: These data indicate a high stability of phoneme discrimination abilities in preschool children. Based on these results, the test material can be reliably used to evaluate therapeutic strategies to improve discrimination ability.

Outcome of peripheral blood stem cell mobilization in advanced phases of CML is dependent on the type of chemotherapy applied.

High-dose chemotherapy with autologous transplantation of in vivo purged PBSC is a novel investigational approach to treating chronic myelogenous leukemia (CML) patients not responsive to conventional therapy with interferon-alpha (IFN-alpha) and not eligible for allogeneic transplantation. PBSC mobilization using either '5+2/7+3'-type chemotherapy or 'mini-ICE/ ICE' chemotherapy was investigated in 43 patients with advanced phases of Philadelphia (Ph)-positive CML. Thirty patients were in late chronic phase (>12 months post diagnosis) and 13 patients in accelerated phase (AP) or blast crisis (BC). Contamination with Ph-positive cells was evaluated in harvests from 37/43 patients. The outcome of PBSC mobilization was dependent on the type of chemotherapy administered: a complete or major cytogenetic response (<35% Ph-positive metaphases) in leukapheresis collections was obtained in ten of 15 patients treated with 'mini-ICE/ICE' but in only three of 28 patients treated with '5 + 2/7 + 3' chemotherapy. One patient (1/43) in blast crisis died during mobilization therapy (2%). Twenty-five patients underwent PBSC transplantation and all of them engrafted successfully. Transplantation-related mortality was 0%. The data show that in advanced phases of CML the chance of harvesting Ph-negative peripheral blood stem cells depends on the type of chemotherapy used for mobilization.

Chemotherapy-induced mobilization of karyotypically normal PBSC for autografting in CML.

High-dose chemotherapy with autologous transplantation of in vivo purged PBSC is a new and interesting therapeutic option for CML patients not eligible for allogeneic transplantation. We investigated the feasibility and toxicity of this approach in 57 patients with Ph-positive CML. For mobilization of Ph-negative PBSC, patients were treated either with '5 + 2/7 + 3'- type chemotherapy or with 'mini-ICE/ICE' chemotherapy followed by administration of G-CSF. Fourteen patients were in early chronic phase, 30 patients in late chronic phase and 13 patients in accelerated phase (AP) or blast crisis (BC). Cytogenetic responses in the PBSC harvests were dependent on both disease stage and type of chemotherapy: in late chronic phase and AP/BC, a complete or major cytogenetic response could be obtained in nine out of 13 patients treated with 'mini-ICE/ICE' but only in three out of 23 patients treated with '5 + 2/7 + 3' chemotherapy. However, in early chronic phase a Ph-negative autograft could be obtained in three out of eight patients upon mobilization with '5 + 2' chemotherapy. Thirty-one patients underwent PBSC transplantation and all of them successfully engrafted. Post-transplant cytogenetic analysis was available on 21 cases, of whom seven achieved a complete or major cytogenetic response, with two minor cytogenetic remissions. One patient (1/57) in blast crisis died during mobilization therapy (1.8%). Transplantation related mortality was 0%. This study demonstrates that mobilization of Ph-negative PBSC after myelosuppressive chemotherapy is feasible in CML patients and is associated with acceptable toxicity. Autologous transplantation of in vivo purged PBSC is a safe procedure with rapid and complete hematopietic recovery.