ISSN:0098-1532    

DOI:10.1002/mpo.2950130602

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

年代:1985

数据来源: WILEY

摘要:

AbstractVisual‐evoked potentials (VEPs) were studied in 55 asymptomatic children with leukemia or solid tumors in remission in order to detect subclinical demyelination of the optic pathway after CNS prophylaxis. In group I (11 patients with ALL studied prospectively), VEP latency was increased in ten after cranial radiation (CR) as compared with previous values. Group II (18 patients with ALL in maintenance) and group III (16 patients with ALL off therapy) were studied retrospectively and VEP latency was found above normal limits in 33 and 31%, respectively. In group IV (four patients with solid tumors and six with leukemia, all of whom received no CR), VEP latency was normal despite periodical intrathecal methotrexate administrations to five of them. We conclude that CR determines a slowing of conduction on VEP test, probably due to demyelination of the optic pathway, in a high proportion of patients. The future clinical significance of these findings must be established throughout a prolonged follow‐up per

ISSN:0098-1532    

DOI:10.1002/mpo.2950130603

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

年代:1985

数据来源: WILEY

摘要:

AbstractTwenty‐six children with primary brain tumors were studied prospectively with regard to their sensorimotor, intellectual, academic, and emotional status. Serial evaluations were conducted after surgery (pre‐irradiation) and six months after the completion of radiation therapy. The timing of the second evaluation was chosen so as to antedate the late effects of irradiation. Children over 6 years old displayed significant improvement of intellectual function over time, with only 11% exhibiting deterioration on one or more cognitive parameters. In contrast, 68% of younger children clinically deteriorated in one or more areas of intellectual functioning, with prominent difficulties in memory and selective attention for age. Children under 6 years old with supratentorial tumors were less likely than those with posterior fossa tumors to improve their cognitive performance. At the second evaluation, 23% of the patients were functioning below normal (IQ<80) intellectually, with 50% of the younger children and 11% of the older children receiving special educational assistance. Approximately 40–50% of the patients manifested emotional adjustment problems at each evaluation. The results are discussed in terms of the clinical need to follow similar patient populations with formal psychological assessments over time, and in terms of the difficulties involved in defining factors that determine the functional status of children surviving brain t

ISSN:0098-1532    

DOI:10.1002/mpo.2950130604

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

年代:1985

数据来源: WILEY

摘要:

AbstractSixteen patients with multiple myeloma refractory to alkylating agents were treated with vincristine 0.25 mg/m2i.v. on days 1 to 4 and prednisone 1 gm/m2on days 1 and 3. Chemotherapy was repeated every 2 weeks. Of 15 evaluable patients, five achieved a partial response and four stable disease. Three patients with partial response and three with stable disease relapsed at 6, 7, and 16 and at 5, 9, and 10 months, respectively. The median survival for all patients was 10 1/2 months and it ranged from 1 to 21 + months. The median survival in responders was not reached at 13 months. Onset of antitumor effect was observed within the first 2 weeks. Symptomatic relief of bone pain was noted within 48 hours in responders and nonresponders. Improvement in bone marrow cellularity and decrease in plasma cell infiltration was documented in more than one‐half of the responders. Tolerance to the treatment was good. No hematologic or other significant toxicity was observe

ISSN:0098-1532    

DOI:10.1002/mpo.2950130605

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

年代:1985

数据来源: WILEY

摘要:

AbstractAmong the 114 children with retinoblas‐toma seen at St. Jude Children's Research Hospital 1962–1984, 11 have received treatment with chemotherapy for measurable extraocular disease which was present at diagnosis (seven patients) or developed later during the subsequent course of their disease (four patients). Metastatic disease involved the brain and spinal fluid of four persons, the orbit of five, the bone marrow of five, lymph nodes of four, and soft tissues of three individuals at the time of their treatments. Single agents or combinations were used. Two patients with orbital extension of primary retinoblastoma developed complete responses following chemotherapy and subsequently received orbital irradiation, and have had long‐term disease‐free survival. Additional responses developed in patients who received vincristine, cyclophosphamide, adriamycin, cisplatin, VM‐26, and ifosfamide, singly or in combination. With future identification of effective chemotherapy, new studies may be focused upon patients with localized disease to reduce radiation dosage or the need for immediate surgical resection of all invo

ISSN:0098-1532    

DOI:10.1002/mpo.2950130606

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

年代:1985

数据来源: WILEY

摘要:

AbstractSeventy‐two successfully treated patients with acute lymphocytic leukemia, all in first complete remission and all off therapy, who had received CNS prophylaxis (radiotherapy, 2,400 rad, plus intrathecal methotrexate), were studied by computed tomography (CD of the brain, EEGs, and neurologic evaluations 3 to 9 years after the end of prophylaxis. Thirty‐five patients showed CT brain scan abnormalities: intracranial calcifications (twelve); widening of the subarachnoid spaces (eight); isolated dilatation of ventricular spaces (three) and with frontal periventricular hypodensity (two); dilatation of ventricular and subarachnoid spaces (nine); and a hypodense area (one). Only 17 patients showed aspecific EEC abnormalities which were never linked to CT scan findings. None of our patients presented major motor deficits at the neurologic examination.A stepwise logistic regression technique showed that age less than 5 years at the time of prophylaxis was the most important risk factor (p = 0.008) of CT brain scan abnormalities followed by neurets (p = 0.037) and sex (p = 0.10). Furthermore, the multivariate analysis pointed out that the interactions between these variables were not significant and the effects were only of the first or

ISSN:0098-1532    

DOI:10.1002/mpo.2950130607

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

年代:1985

数据来源: WILEY

摘要:

AbstractThe drug combination of mitomycin‐C, cis‐platin, and vinblastine was administered to 30 patients with stage III non‐small‐cell lung cancer. All patients had a performance status of 50% or greater, had evaluable disease, and had not received previous chemotherapy. The overall response rate was 37% with responses seen in 7 of 18 (39%) squamous cell and 3 of 11 (27%) patients with adenocarcinoma of the lung. Mean survival was greater by 2 months in those patients with an objective response to chemotherapy (8.1 vs 5.5). Drug‐associated gastrointestinal toxicity was the most common side effect observed. This three‐drug combination appears to be an active regimen in the treatment of non‐small‐cell broncho‐genie carcinoma; however, altered dosage schedules should be examined in order to decrease drug

ISSN:0098-1532    

DOI:10.1002/mpo.2950130608

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

年代:1985

数据来源: WILEY

摘要:

AbstractEarly and effective Cytoreduction for high peripheral white blood cell counts in pediatric patients with acute leukemia may be helpful in preventing complications secondary to hyperviscosity. It also may be a useful adjunct to systemic chemotherapy. As an alternative to automated apheresis for this purpose, manual exchange transfusion is efficacious and does not require hemapheresis instrumentation and disposables and the related special staff. Two patients, a neonate with acute myeloblastic leukemia and a white blood cell count of 422.2 k/μl as well as a 2 1/2‐year‐old with an admission diagnosis of acute promyelocytic leukemia and a white blood cell count of 617.4 k/μl, underwent manual exchange hemotherapy for acute cytoreduction. The procedures were tolerated well, and significant leukocyte removal was achieved, with the respective leukocyte reductions being 81.1 and 68.7%. The techniques available for pediatric cytoreduction are compared, with emphasis on their efficiency and safety and appropriateness for very small chi

ISSN:0098-1532    

DOI:10.1002/mpo.2950130609

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

年代:1985

数据来源: WILEY

摘要:

AbstractA 12‐year‐old Caucasian boy developed leukemic hyphema with iris infiltration as the only relapse site during the third complete remission of his acute lymphoblastic leukemia. With high‐dose methotrexate, high‐dose cytosine‐arabinoside plus teniposide, and a 5‐week course of vincristine, prednisolone, and L‐asparaginase, a complete remission could be achieved. Maintenance treatment was reinstituted for 1 year. However, after stopping the treatment, the iris infiltrate reappeared, and this time the eye was irradiated after chemotherapeutic reinduction. Seven months later, the boy remains in complete remission. The pathogenesis of leukemic iris infiltration is disc

ISSN:0098-1532    

DOI:10.1002/mpo.2950130610

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

年代:1985

数据来源: WILEY

摘要:

AbstractThree patients with widely disseminated Merkel cell tumors of the skin are presented. In all three cases, neuron‐specific enolase (NSE) was demonstrated in neoplastic tissue by immunohistochemical staining, and serum NSE levels were also elevated in all three patients. Serum NSE may prove to be a useful tumor marker in this and other malignancies of neuroendocrine origi

ISSN:0098-1532    

DOI:10.1002/mpo.2950130611

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

年代:1985

数据来源: WILEY