摘要:

AbstractOne hundred fourteen children with acute lymphoblastic leukemia were treated with allogeneic marrow transplantation from HLA‐identical siblings after conditioning with cy‐clophosphamide and total body irradiation. Methotrexate was given posttransplantation for prophylaxis of graft‐versus‐host disease. The minimum follow‐up after transplantation was 2 years. Sixteen of 51 patients transplanted in marrow remission survive from 2.1 to 8.9 years (median 2.7), 13 in continuous remission, one in remission following testicular relapse, and two after marrow relapse. Sixty‐three were transplanted in relapse and eight survived 3–10 years (median 5.7), five in continuous remission, and three in remission following testicular relapse. In a multivariate analysis, factors significantly related to increased survival were marrow remission at transplant (p<0.007) and chronic graft‐versus‐host disease (p<0.005). Factors associated with increased relapse were marrow relapse at transplant (p<0.002) and absence of significant graft‐versus‐host disease (p<0.004). The development of acute graft‐versus‐host disease was associated with high marrow cell doses (p<0.04). These data suggest that some children with acute lymphoblastic leukemia and a poor prognosis with conventional chemotherapy may be cured wi

ISSN:0098-1532    

DOI:10.1002/mpo.2950130402

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

年代:1985

数据来源: WILEY

ISSN:0098-1532    

DOI:10.1002/mpo.2950130403

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

年代:1985

数据来源: WILEY

摘要:

AbstractOne hundred and eighty cases of neuro‐blastomas from the four child oncology clinics are reviewed. The overall cure rate was 24%. During the 38‐year period, there was a significant increase in survival from 0% during the period of 1943–1950 to 32% during the period of 1971–1980. This improved survival rate is most likely a result of adjuvant chemotherapy. Forty percent of the patients appear chronically ill, which reflects the fact that nearly 60% have metastases when they are first seen. In localized disease (stages I–II), the prognosis was favourable (cure rate 69%), while the prognosis for disseminated disease (stage III–IV) was poor (cure rate 5%). A favourable outcome was seen in patients under 1 year (survival rate 46%), and in patients with primary tumours located in the neck or mediastinum (survival rate 48%). When related to stage, however, the survival rates for the former tumours were not significantly better in patients below 1 year or in patients with cervical or thoracic tumours. As is the case in other studies, we found that survival is significantly poor

ISSN:0098-1532    

DOI:10.1002/mpo.2950130404

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

年代:1985

数据来源: WILEY

摘要:

AbstractNine of 11 patients with hepatoblastoma treated with cisplatin (DDP) based chemotherapy had a complete (CR) or partial (PR) remission. Five of these patients had measurable pulmonary disease and four achieved a CR of pulmonary lesions. The average interval of disease control following DDP was three times that of Adriamycin (ADR). DDP is an effective agent in the treatment of hepatoblastoma.

ISSN:0098-1532    

DOI:10.1002/mpo.2950130405

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

年代:1985

数据来源: WILEY

摘要:

AbstractEight patients with histologically‐documented malignant pleural effusions received a total of ten courses of intrapleurally administered chemotherapy with cisplatin (100 mg/m2) and cytarabine (10−2M). Sodium thiosulfate was simultaneously administered intravenously to protect against cisplatin‐induced nephrotoxicity. There was no local toxocity observed and the only significant systemic toxicity (bone marrow depression) developed in a patient with poor marrow reserve prior to the initiation of therapy. Six of seven evaluable patients exhibited major reductions (>75%) in the size of their effusions lasting for 2 to 10 plus months (median: 4 months). We conclude that the intrapleural administration of this chemotherapy regimen results in objective and subjective improvement in patients with malignant pleural effusions with minimal local and systemic toxicity (except for cisplatin‐induced emesis) and does not require chest tube drainage or prolonged hospital

ISSN:0098-1532    

DOI:10.1002/mpo.2950130406

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

年代:1985

数据来源: WILEY

摘要:

AbstractAmong children over 1 year of age with Evans Stage IV neuroblastoma, there appears to be a small group with a relatively favorable prognosis. These patients have extensive lymph node metastases (cervical/axillary/thoracic/abdominal/pelvic), but no extranodal metastases. Three of six such patients (50%) are long‐term disease‐free survivors, compared with none of 40 patients with extranodal metastatic disease (p<0.0002). Patients with only lymph node metastases (Stage “IV‐N”) may have a biologically more favorable tumor that is curable with conventional, intensive multimodalit

ISSN:0098-1532    

DOI:10.1002/mpo.2950130407

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

年代:1985

数据来源: WILEY

摘要:

AbstractSix children with refractory acute lymphocytic leukemia were treated with vincristine combined with diltiazem. In four of five children who took the drug as scheduled, a cytolytic effect was observed. One child showed massive cell destruction which caused hyperuricemic nephropathy. The only adverse effect was atrioventricular block in two children, which was completely reversible. Increased neurotoxicity was not observed in any child.

ISSN:0098-1532    

DOI:10.1002/mpo.2950130408

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

年代:1985

数据来源: WILEY

摘要:

AbstractThe incidence of acute and chronic liver damage and its relation to hepatitis B virus (HBV) infection was evaluated in 164 consecutive children with acute leukemia seen in ten Italian hemato‐pediatric units. Thirteen out of 164 children (7.9%) had acute hepatitis (AH) during treatment, while 8/90 (8.8%) showed an acute exacerbation of liver damage within 6 months after therapy withdrawal. Seven of the 13 children with AH while on therapy were HBsAg positive. In 12/13 cases, liver disease progressed to chronicity. Five of eight children who developed AH after completion of treatment were HBsAg positive. Eighty‐nine patients (54.2%) developed biochemical evidence of chronic hepatitis during therapy; 48/89 were followed after cessation of treatment and 33 of them showed persisting evidence of liver cell necrosis. Thirty‐three out of 133 children (24.8%) tested for serum HBsAg were found positive: 26 (78.7%) of them developed chronic hepatitis. Sixty‐four out of 133 patients were evaluated after cessation of treatment: Chronic hepatitis persisted in 16/22 HBsAg‐positive (72.7%) and in 17/42 HBsAg‐negative (40.4%) children during follow‐up. The outcome of these liver diseases after treatment withdrawal did not differ significantly in relation to HBV serology, suggesting that viral rather than toxic agents were responsible for liver damage also in most HBsAg‐negative patients. The high incidence of chronic HBV infection in children with leukemia found in this multicentric study could suggest a need for active immunization with HBV vaccine, but the efficacy of such approach in this clinical setting is still

ISSN:0098-1532    

DOI:10.1002/mpo.2950130409

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

年代:1985

数据来源: WILEY

摘要:

AbstractAmong 31 consecutive patients who developed acute nonlymphocytic leukemia following treatment with chemotherapy or radiation therapy, 17 were treated with intensive chemotherapy aimed at inducing a complete remission. Seven of these 17 patients (41%) obtained a complete remission that ranged in duration from 2 to 11 (median 3) months. Two additional patients who failed to develop normal peripheral blood counts despite postinduction bone marrows that were normocellular and free of leukemia were classified as nonresponders. The median time to complete remission and median duration of leukopenia (WBC<1,000/μ1) were 34 days and 23 days, respectively. Induction chemotherapy was complicated by fever in all patients, documented infection in six patients, and death secondary to sepsis in three. Survival of the 17 patients ranged from<1 to 39 (median 4) months. Patients achieving a complete remission had a median survival time of 10 months compared to 2 months for the nonresponders. The other 14 patients received only supportive care and had a median survival of 2 months. These findings indicate that therapy‐associated acute nonlymphocytic leukemia (t‐ANLL) can frequently respond to chemotherapy and that achieving a complete remission is associated with longer survival. Although these results are encouraging, patients with t‐ANLL still have a relatively poor prognosis and efforts directed at improving treatment outcome need to be con

ISSN:0098-1532    

DOI:10.1002/mpo.2950130410

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

年代:1985

数据来源: WILEY

摘要:

AbstractIn order to reduce the subjective errors in subtyping leukemic lymphoblasts using the French‐American‐British (FAB) classification, computer‐assisted morphometry was used. Bone marrow smears obtained at diagnosis from 99 children with acute lymphoblastic leukemia (ALL) were analysed by this method and compared with the subjective FAB classification. The results confirm that lymphoblast morphology, as a single variable, is a very significant predictor of survival in ALL. This computer‐assisted morphometric analysis would be of great value in large‐scale clinical tria

ISSN:0098-1532    

DOI:10.1002/mpo.2950130411

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

年代:1985

数据来源: WILEY