摘要:

AbstractTherapy for acute leukemia in children has improved dramatically in recent years so that early death is rare. A subset of patients with extreme elevation of the WBC at diagnosis have been noted to have a higher rate of early death. We reviewed our experience with acute leukemia in children retrospectively over a 10 year period to assess the incidence and outcome of this problem. Nine early deaths occurred in a total of 185 cases (4.9%). One hundred and sixty patients presented with WBC less than 100,000/mm3at diagnosis and four (2.5%) early deaths occurred. Twenty‐five patients presented with WBC greater than 100,000/mm3at diagnosis and five (20%) early deaths occurred (p<0.001). While early death in acute leukemia in children is uncommon (4.9%), patients with extremely elevated WBC at diagnosis have a significantly higher risk of early deat

ISSN:0098-1532    

DOI:10.1002/mpo.2950110403

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

年代:1983

数据来源: WILEY

摘要:

AbstractA case of a nine‐year‐old boy who presented with central nervous system leukemia is described. This case was unusual because he presented without initial bone marrow involvement. Bone marrow involvement was documented 15 months after central nervous disease was diagnosed. Immunologic marker studies revealed that the spinal fluid blasts lacked definable B‐cell, pre‐B cell, T‐cell, and pre‐T cell surface markers. The marker studies helped to define the nature of the dise

ISSN:0098-1532    

DOI:10.1002/mpo.2950110404

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

年代:1983

数据来源: WILEY

摘要:

AbstractSubpopulations of spleen cells of mice bearing virus‐induced mammary tumors were assessed for responsiveness to Concanavalin A (Con A) under in vitro xenogeneic and syngeneic culture conditions. When cultured with human A+ plasma (xenogeneic), spleen cells of normal, nontumor‐bearing BALB/c mice exhibited a high degree of synthesis as compared to unstimulated cells in response to Con A. Spleen cells of mice inoculated with tumor exhibited response exceeding that of their normal counterparts by 59%. When normal BALB/c sera (syngeneic) was used as the supplement, no response of normal spleen cells was observed upon stimulation by Con A; however, spleen cells from tumor bearing individuals demonstrated heightened activity. Tumor‐bearer spleen cell response to Con A of mice inoculated with 1 × 106viable cells was biphasic. The peak of the first phase appeared as early as 10 days postinoculation and declined within 3 days after its appearance. The peak of the second phase appeared within 6 days following decline of the first and declined drastically within 3 days after its appearance. Coincidental with the onset of the second phase, the tumor became ulcerated, purulent, and necrotic. Both phases were predominantly T‐cell

ISSN:0098-1532    

DOI:10.1002/mpo.2950110405

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

年代:1983

数据来源: WILEY

摘要:

AbstractAcquired ichthyosis is very likely to be associated with a malignancy, especially with Hodgkins disease. The association of congenital ichthyosis with malignant tumors has been so far reported only in two instances. Herein we report on a third case. Due to the small number of cases, no conclusion can be drawn about the correlations between the two diseases.

ISSN:0098-1532    

DOI:10.1002/mpo.2950110406

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

年代:1983

数据来源: WILEY

摘要:

AbstractRhabdoid tumor of the kidney (RTK), originally described as a monophasic sarcomatous variant of Wilms' tumor, is now recognized as a highly malignant, non‐Wilms' tumor possibly of neuroectodermal origin. Twenty‐one National Wilms' Tumor Study patients with this tumor were treated in the years 1969 through 1978. Mean patient age was 18 months with 16 of the 21 younger than 2 years at diagnosis. Two patients were Stage I, 10 Stage II, 5 Stage III, and 4 Stage IV. One patient only is continuously disease free and another is surviving disease free following excision of bilateral pulmonary metastases. One patient died of sepsis early during therapy. Thus 18 of the 19 patients who relapsed died, 15 within 1 year of diagnosis, all with progressive tumor growth. The rapid appearance of metastases (mean 4 months), often to multiple sites, and short subsequent survival signal a very malignant tumor resistant to current treatment stratag

ISSN:0098-1532    

DOI:10.1002/mpo.2950110407

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

年代:1983

数据来源: WILEY

摘要:

AbstractTen patients with refractory acute leukemia were treated with high‐dose cytosine arabinoside (Ara‐C) infusions. Nine patients had previously achieved at least one complete remission using standard chemotherapy protocols that include cytosine arabinoside. Eight of the ten had been on maintenance therapy. Twelve courses of treatment were given, with the cytosine arabinoside infused over 1‐2 hours in a dose of 3 gm/m2. Each course consisted of 12 to 16 doses given at 12‐hour intervals.The drug was generally well tolerated but five patients developed central nervous system symptoms characterized by ataxia, dysphasia, nystagmus, dysdiadochokinesis, and a decreased level of consciousness. These changes began 3 to 34 days after the initiation of therapy and were severe at the time of death in two of the patients. One complete and one partial remission, lasting 2.5 months and 1 month, respectively, were documented. This experience suggests that high‐dose AraC is of limited usefulness in refractory acute leukemia and may be frequently associated with significant neur

ISSN:0098-1532    

DOI:10.1002/mpo.2950110408

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

年代:1983

数据来源: WILEY

摘要:

AbstractTwenty‐eight evaluable patients with clinical stage I‐II of non‐Hodgkin's lymphoma were treated with primary chemotherapy followed by involved field radiotherapy. The frequency of the follicular versus diffuse histological pattern was 14.3 versus 85.7%, and 24/28 (86%) of patients were in stage II. No lymphoma examined was identified as T‐cell in origin. A complete response was obtained in 21 (78%) of 27 patients with measurable disorder. [Gastrectomy rendered one patient disease‐free survival, and one partially responded showing a complete reponse after radiotherapy.] Sixteen (76%) of the 21 employed for complete response. After 36 months, elapsed disease‐free survival was rated at 100% together with actuarial survival of all patients at 81%. Chemotherapy contributed to reduce the radiation dosage to 3000 rads and to control the areas infiltrated with preexisting tumors. These findings, although the median follow‐up time in our study remains short (28 months), provide a strong rationale for further clinical trials of primary chemotherapy, followed by regional radiotherapy for localized stages of non‐Hodg

ISSN:0098-1532    

DOI:10.1002/mpo.2950110409

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

年代:1983

数据来源: WILEY

摘要:

AbstractA patient with IgA‐k multiple myeloma is presented. There was initially a good response to chemotherapy but the patient later developed small intestinal obstruction. This was due to multiple polypoid plasmacytomas. The mesenteric nodes were also involved, and were found on immunofluorescence microscopy and flow cytometry with double fluorescent labelling to be composed of two separate populations of cells (IgA‐k and IgG‐k), one population having a diploid content of DNA and the other tetraploid. These two distinct cell populations differed in both proliferative characteristics and size. The findings are discussed and the literature relating to gastrointestinal involvement in plasma cell dyscrasias rev

ISSN:0098-1532    

DOI:10.1002/mpo.2950110410

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

年代:1983

数据来源: WILEY

摘要:

AbstractDuring 1967‐78, cancer was diagnosed in 870 children living in the Province of Torino. Survival until the end of 1978 is reported separately for cases diagnosed in 1967‐70, in 1971‐74, and in 1975‐78. Comparisons between the three series indicate a statistically significant (p<0.05) increase in survival rates for children with leukemia and cancer of the central nervous system as well as a nonstatistically significant increase for children with lymphoma (both Hodgkin's and non‐Hodgkin's). No consistent changes in time were noticed for neuroblastomas, nephroblastomas, soft tissue sarcomas, and retinoblastomas. Survival rates for both types of lymphomas and for leukemias (at least for cases diagnosed after 1975) were very similar to corresponding population‐derived data from the U.S. and other Western countries. Rates for other cancers were relatively poor in the Province of Torino. It is suggested that relatively high care standards are easier to achieve in the case of childhood cancers requiring chemotherapy than in cancers commonly treated through radiotherapy and

ISSN:0098-1532    

DOI:10.1002/mpo.2950110411

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

年代:1983

数据来源: WILEY

摘要:

AbstractNewly diagnosed children with leukemia and their families were subjects of a longitudinal study to describe coping behaviors, to determine adequacy of coping, and to discover predictors of healthy coping with leukemia.Families were followed for six months during which time they were interviewed, completed tests and scales, and were rated by physicians, nurses, and psychosocial staff. Families showed a wide variety of reactions and coping behaviors. The data supported the hypothesis that most families cope well despite the stresses of the first six months post‐diagnosis. Based on physicians' ratings, psychosocial intervention appeared to be effective for mothers during the early outpatient phase of treatment. Age of child, previous coping, coping of other family members, a good support system, and lack of additional stresses were significantly correlated with healthy coping. The need for longitudinal assessment of coping was stresse

ISSN:0098-1532    

DOI:10.1002/mpo.2950110412

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

年代:1983

数据来源: WILEY