摘要:

ABSTRACTA controlled clinical study in children with acute lymphoblastic leukemia was conducted to measure the potential benefit of time sequencing vincristine and cyclophosphamide. Vincristine and cyclophosphamide were utilized in a maintenance regimen in children after a remission had been obtained. Patients received vincristine either 24 hours before cyclophosphamide or simultaneously with cyclophosphamide. The median time to relapse and the number of continued remissions was significantly increased for patients receiving vincristine 24 hours before cyclophosphamide when compared to those patients receiving both drugs simultaneously. The results of this comparative study indicate that the sequential use of vincristine and cyclophosphamide for maintenance of a second relapse in childhood ALL produces a greater duration of remission than when both are used simultaneously.

ISSN:0192-8562    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

ABSTRACTThe parents of eight children who had died of malignant diseases were interviewed about their experiences concerning the medical and social care of the children. There was a great need for repeated and thorough information about the disease and the therapy to all in the family. The risk of isolation of the family could be diminished by active measures. There was a great need for continuity with only a few key people involved in the care. It proved important to recognize at an early stage the economical and social problems of the family and to help the family to solve them.

ISSN:0192-8562    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

ABSTRACTThis paper presents the results of a preliminary evaluation of a home visitation program for families of children with cancer. The visitation program has been well received by the parents and a statistical comparison of visited and nonvisited families suggested favorable effects of the program with respect to helping parents control feelings of anger and in enhancing or maintaining positive interaction with spouse, children, and grandparents. Comments by the parents indicated that the visits create an atmosphere which facilitates communication between members of the health care team and the family. Interviews with parents of deceased children revealed that a particularly important aspect of the program is the contact maintained with the familyafterthe child has died. Overall, the results indicated that the visits can be a valuable addition to the total program of care for the chronically ill child.

ISSN:0192-8562    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

ABSTRACTFrom 1940 to 1977, a total of 152 children aged 15 years or less with the histological diagnosis of Hodgkin's disease were treated in Argentina. For analysis, these patients were placed into three periods which displayed the most outstanding changes in diagnostic workup and therapy. The periods are as follows: (1) 1940 to 1966 (43 children), (2) 1967 to 1972 (35 children), and (3) 1973 to 1977 (74 children). The patients were treated with extended field radiation therapy and followed by courses of cyclophospha mide-vinblastine-procarbazine-prednisone. with CCNU added (CCVPP) or not added (CVPP) in a randomized trial.The mean age of the whole group was 7.5 years (range 2 to 15 years) and there was a predominance of males (79%). Crude 6-year survival for the three periods were as follows: 1940 to 1966, 34%; 1967 to 1972, 50%; and 1973 to 1977, 79%.We concludé that (1) survival of Hodgkin's disease in childhood has shown a rather marked improvement during the last decade and this progress is probably due to the use of combined multidrug chemotherapy administered under collaborative controlled clinical trials; (2) preliminary evaluation of the results of CVPP and CCVPP therapy shows that the latter combination (CCVPP) neither increases the percent of patients achieving complete remission nor prolongs relapse-survival in Hodgkin's disease of childhood; and (3) all stages of childhood Hodgkin's disease can be successfully managed with multidrug chemotherapy alone.

ISSN:0192-8562    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

ABSTRACTVincristine (VCR), cyclophosphamide (CP), and BCNU have antineoplastic activity in acute lymphocytic leukemia. In animal tumor systems, and in a clinical controlled study, vincristine and cyclophosphamide have been demonstrated to be more effective when given sequentially. In animal models, cyclophosphamide and BCNU have a synergistic effect if given simultaneously. In order to evaluate this potentially synergistic schedule in man, children with ALL in their second or greater remission were randomized to receive either a standard vincristine cyclophosphamide regimen (VCR 2 mg/m2on day 1 and CP 450 mg/m2on days 2 and 3) or this same regimen with the addition of 50 mg of BCNU given with the CP given on days 2 and 3. The standard two-drug regimen was given every 3 weeks and the potentially synergistic combination was given on a 4-week schedule. The median duration of remission (MDR) for the 18 children receiving the two-drug combination was 13.5 weeks, and for the 20 children receiving the potentially synergistic three-drug regimen combination, 15 weeks. With 95% confidence, the population MDR for the two-drug combination is from 63% to 125% of the population with the three-drug regimen. The toxicities of both regimes was tolerable. No statistically significant synergistic benefit was demonstrated in these patients with the addition of BCNU to cyclophosphamide.

ISSN:0192-8562    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

ABSTRACTGlucocorticoid receptor sites were measured in lymphoblasts of six patients with childhood acute lymphocytic leukemia in relapse who were resistant to glucocorticoid therapy and compared to the number of receptor sites found in the lymphoblasts of 12 patients with acute lymphocytic leukemia who achieved initial complete remissions on glucocorticoid-containing chemotherapy regimens. Resistant patients as a group were found to have lower receptor site levels. This data supports the hypothesis that reduction in the number of receptor sites per cell is one mechanism by which cells become resistant to glucocorticoids. However, the clinical usefulness of these measurements to prospectively select glucocorticoid-resistant patients appears limited because four of the six resistant patients had measurements within one standard deviation of the mean for the 12 patients who achieved remission.

ISSN:0192-8562    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

ABSTRACTA boy with acute lymphocytic leukemia (ALL) associated with a pre-B-cell phenotype and the Ph‘ chromosome is described. The Ph’-positive blasts with L3 morphology contained intracytoplasmic IgM but lacked surface immunoglobulins. The child's response to intensive chemotherapy was unsatisfactory. The short survival of our patient suggests that childhood leukemias expressing the pre-B-cell phenotype and Ph‘ chromosome may carry a poor prognosis. For that reason, the usefulness of cytogenetic and immuno-logic characterization of leukemic blasts at diagnosis is emphasized.

ISSN:0192-8562    

出版商:OVID    

年代:1981

数据来源: OVID

ISSN:0192-8562    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

ABSTRACTWith the exception of hemangiomas, neoplasms occur in newborn infants once per 15,000 births. These tumors are mostly derived from embryonic mesenchymal or neural crest tissues and consist of teratomas, neuroblastomas, and tumors of the kidneys and soft tissues. Many of these neoplasms are very malignant in older children, while the same tumor type in the newborn is generally well circumscribed and has a benign biological behavior. Therefore, the surgical treatment should be conservative. The operation is conducted with attention to the minute details that support the metabolic needs of the infant. The manager ment of specific tumors encountered in the neonate are described.

ISSN:0192-8562    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

ABSTRACTRadiation therapy (RT) is frequently used in the management of children with cancer, but neonatal neoplasms are rare. Newborns represent 1.5% of the children with malignant diseases in the Tumor Registry at the Children's Hospital of Philadelphia over the last 30 years. Thus, occasionally the pediatric radiation therapist must consider treating the very young infant. The specific radiation effects on growth and development must be weighed in reaching a therapeutic decision. All‘ children are vulnerable to the late effects of radiation therapy, but the neonate may be more susceptible because of the immaturity of important organs such as the brain, lung, liver, kidney, and bone.In general, radiation therapy should be avoided during the first several weeks of life because of the potential increased sensitivity of the liver and kidneys during that period. If radiation therapy is used at all during infancy, the benefits must be weighed against the possibility of significant late effects. Increasing knowledge of pediatric neoplasms has shown that some tumors (such as mesoblastic nephroma) require no treatment except for surgical excision; and other tumors, such as Stage IV-S neuroblastoma, may require very little treatment. In those tumors that require radiation therapy, the use of chemotherapy may allow reduction of the radiation dose. Furthermore, alterations of time-dose-fractionation schemes and careful attention to tumor volume with the use of special techniques, such as “shrinking fields,” may decrease the late adverse effects of treatment.

ISSN:0192-8562    

出版商:OVID    

年代:1981

数据来源: OVID