摘要:

AbstractNinety patients with solid tumors or lymphomas were immunized with a polyvalent pneumococcal vaccine. Pre‐ and postimmunization antibody titers were determined by radioimmunoassay. Treated patients with lymphoma had poor antibody response whether on or off chemotherapy. Patient with chronic lymphocytic leukemia had the lowest antibody titers of all patients groups. Patients with solid tumors had antibody responses which were similar to those of the control population. Those patients who received sequential chemotherapy and immunization had a tendency for higher postimmunization titers than those patients who received simultaneous chemotherapy and immunization, but the difference was not significant. This study suggests that patients with solid tumors would be expected to benefit from pneumococcal immunization, whereas patients with lymphoma immunized after receiving treatment initially would not be expected to develop protective antibody levels. Recovery of antibody formation in patients with non‐Hodgkin lymphoma, which may occur in patients with Hodgkin disease, remains to be determi

ISSN:0098-1532    

DOI:10.1002/mpo.2950110502

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1983

数据来源: WILEY

摘要:

AbstractFifty‐one children with acute lymphoblastic leukemia on a common protocol of treatment were classified according to presence or absence of chromosomal abnormalities found at the time of diagnosis in bone marrow and/ or blood. Twenty‐two or 43% had normal karyotypes while 29 (57%) had clonal abnormalities using the Giemsa‐trypsin banding technique. Thirteen of the 29 (45%) chromo‐somally abnormal patients relapsed while only three of 21 (14%) with normal karyotypes have relapsed with a median follow‐up of 49.5 months (42‐76 months). (One child with a normal karyotype did not respond to therapy.) Several hypotheses have been offered to attempt to explain the significantly better prognosis of patients with no observable initial chromosomal

ISSN:0098-1532    

DOI:10.1002/mpo.2950110503

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1983

数据来源: WILEY

摘要:

AbstractTwenty‐five patients with evaluable histologically confirmed inoperable metastatic sarcomas were treated once every four weeks with cyclophosphamide, doxorubicin, and cisplatin in doses of 400, 40, and 60 mg/m2, respectively. Cyclophosphamide and doxorubicin were given by rapid intravenous injection followed immediately by cisplatin by slow intraveneous infusion (2‐6 hr) in 1 liter of 0.45% saline with mannitol added. Leukopenia, alopecia, and vomiting were common side effects and three patients refused further treatment because of vomiting following their initial courses. No drug‐related deaths occurred and we removed no one from the study because of toxicity problems. Among the 9 patients who experienced objective tumor regression were 2 of 2 with hemangio‐sarcoma, 3 of 5 with malignant fibrous histiocytoma, 3 of 5 with osteosarcoma, and 1 of 1 with pleomorphic liposarcoma of bone. Although not therapeutically gratifying, these results appear to be better than any previously observed at our inst

ISSN:0098-1532    

DOI:10.1002/mpo.2950110504

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1983

数据来源: WILEY

摘要:

AbstractEighteen children with Hodgkin disease (16 previously untreated; two relapsed) were treated with MOPP chemotherapy (nitrogen mustard, vincristine, prednisone, procarbazine) only. Ten had clinical stage I and II disease, four had stage III, and four had stage IV. In ten patients, the clinical stage was confirmed by staging laparotomy. Six courses of MOPP were given to eight stage I and II patients and two stage IV patients. Between 7 and 12 courses were given to two stage I and II, and six stage III and IV patients. Dose reduction of 75‐50% was required in 13% and delay of treatment in 22% of the first six courses of MOPP. Hematologic toxicity, minor and major viral infections, and nausea and vomiting were the major complications. Complete remission (CR) was obtained in 17 patients. Of these 17, there has been one death in CR, and one relapse. Sixteen patients have discontinued treatment and have been observed off treatment for 8 months to 7.5 years. The actuarial disease‐free survival with a median follow‐up of 28 months is 80% and overall survival i

ISSN:0098-1532    

DOI:10.1002/mpo.2950110505

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1983

数据来源: WILEY

摘要:

AbstractOne hundred four children with acute lymphoblastic leukaemia were diagnosed at the University Hospital, Kuala Lumpur, Malaysia, between 1976 and 1982; 87 were evaluable with respect to treatment. They were divided into good prognosis (GP) and bad prognosis (BP) groups based on their initial total white cell count, their treatment differing only during the maintenance phase. Remission was achieved in 82 patients (94%) of whom ten (12%) subsequently died in remission from infection. Twenty‐eight (34%) relapsed while on treatment and three while off therapy. Eleven patients ceased treatment after 3 yr of continuous complete remission (CCR). Three of these later relapsed, two within the first year. Survival in CCR was significantly better in the GP group up to 30 months, after which the difference diminished. There was no difference in survival between boys and girls. The overall disease‐free survival at 3 yr and 5 yr was 40% and 25%, respectively, with a median follow‐up period of 20 months (range 4‐69 months). The reasons for the relatively low survival rates as compared with those in developed countries are di

ISSN:0098-1532    

DOI:10.1002/mpo.2950110506

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1983

数据来源: WILEY

摘要:

AbstractThe ability to administer a complex chemo‐therapy regimen, adriamycin and cis‐platinum, was evaluated in two different settings, inpatient and outpatient. On comparison, outpatient administration proved superior. This resulted from the interest and experience of the staff administering the medications. It is recommended that outpatient administration of chemotherapy, even with complex protocols, be employed whenever feasi

ISSN:0098-1532    

DOI:10.1002/mpo.2950110507

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1983

数据来源: WILEY

摘要:

AbstractA 9‐year‐old boy with a myocardiac angiosarcoma is described; the tumor was diagnosed by echocardiography and the boy underwent surgery followed by radio and chemotherapy. Death occurred 5 months after surgery, probably due to abdominal hemorrhage from metastases. The young age of the patient, the acute and reversible hepatic damage, the use of echocardiography for diagnosis and the possible role of the extracorporeal circulation in determining the metastases are emphasi

ISSN:0098-1532    

DOI:10.1002/mpo.2950110508

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1983

数据来源: WILEY

摘要:

AbstractRelapse in children with acute lymphoblastic leukemia (ALL) on therapy may be due to development of a resistant clone of blast cells. Seven children who presented initially with the ‘common’‐type, L1 lymphoblast relapsed with a morphologically different and more undifferentiated blast cell. All were male, with a median age of 12 years at initial presentation. One child who relapsed while off therapy was successfully reinduced and remains in hematologic remission on therapy. The remaining 6 children died within 10 months of relapse. Selection of a resistant clone of lymphoblasts by chemotherapy may be responsible for relapse in children with ALL and should be studied in hopes of controlling the di

ISSN:0098-1532    

DOI:10.1002/mpo.2950110509

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1983

数据来源: WILEY

摘要:

AbstractBased on the concept of “>Based on the concept of” hypertransfusion has been shown to attenuate the leucopenia associated with chemotherapy in children with leukemia. We conducted a randomized, controlled study of hypertransfusion in 25 patients with inoperable lung cancer who received combination chemotherapy consisting of methotrexate, adriamycin, cyclophosphamide, and CCNU (Lomustine) (MACC scheme). Twelve patients in the hypertransfusion group were given red cell transfusion to a hemoglobin value greater than or equal to 17 gm/dl prior to each chemotherapy cycle. The two groups of patients were comparable in age, cell type, extent of disease, performance status, and initial hemoglobin level and blood counts. The mean fall in granulocyte count was greater for control group (3.76 × 109/liter) than for hypertransfusion group (3.27 × 109/liter), and the mean fall in platelet count was greater for control group (53.84 × 109/liter) than for hypertransfusion group (35.83 × 109/liter), although the differences did not reach statistical significance (p>0.05) partly because our MACC scheme was probably not sufficiently myelosuppressive to bring about a difference in the two groups. Granulocytopenia‐associated infections were infrequent in both groups: two episodes in 37 cycles of chemotherapy in the hypertransfusion group and three episodes in 43 cycles in the control group. Hypertransfusion was simple and safe, and the encouraging trend towards less marked myelosuppression in our hypertranfused group would warrant further studies using more intensive and myelosuppressive combination chemotherapy

ISSN:0098-1532    

DOI:10.1002/mpo.2950110510

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1983

数据来源: WILEY

摘要:

AbstractEpidural spinal cord compression from metastatic disease is a common neurological complication of cancer. The incidence is probably increasing owing to continual advancements in the treatment of cancer that have led to prolongation of life and a greater probability of secondary involvement of the spinal cord.A problem often encountered by the oncologist treating patients with epidural spinal cord compression is the recurrence of compression by metastatic tumor both in and out of the original treatment field. Radiotherapists are often presented with the difficult task of trying to determine the optimal dose/time fractionation with the hope of improving the therapeutic ratio.We have examined the charts of 80 patients treated at the Rhode Island Hospital during the last five years (1975‐1980) with myelographic evidence of cord compression in order to determine 1) the recurrence rate of cord compression by metastatic tumor after radiotherapy treatment both in and out of the original treatment field; 2) the influence of various dose/fractionation schedules on the disease‐free interval; 3) the percentage of recurrence out of the treatment field that might represent “skipped lesions” at the original time of diagnosis.Our results show 1) that 9 patients (11.3%) experienced recurrence within the original treatment field; 2) that 21 (26.3%) experienced recurrence within the spinal canal, but out of the original treatment field; 3) that 9 of the 21 (42%) cases of recurrence out of the original treatment field occurred within 1 week and thus were determined to be “>Our results show 1) that 9 patients (11.3%) experienced recurrence within the original treatment field; 2) that 21 (26.3%) experienced recurrence within the spinal canal, but out of the original treatment field; 3) that 9 of the 21 (42%) cases of recurrence out of the original treatment field occurred within 1 week and thus were determined to be” at the time of diagnosis; and 4) that there appears to be a dose‐response relationship for those patients treated successfully without recurrences who did not have presenting symptoms of comple

ISSN:0098-1532    

DOI:10.1002/mpo.2950110511

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1983

数据来源: WILEY