摘要:

AbstractTo date, median duration of second and subsequent remissions in childhood acute lymphocytic leukemia (ALL) has been short, with most studies reporting median remission duration less than 6 months. In May 1979, the Childrens Cancer Study Group (CCSG) undertook a pilot study to assess the efficacy of a vincristine, methotrexate, and L‐asparaginase regimen (modified Capizzi) for maintenance in children with ALL in second or subsequent remission. Thirty patients were treated with this maintenance regimen. By life table analysis, predicted median duration of hematologic remission was 57 weeks. Ten patients (33%) were in continuous hematologic remission at 1 year and three (10%) continue in remission>2 years from maintenance onset. Major toxicity included leukoencephalopathy in four patients, three of whom had experienced at least one central nervous system relapse prior to study entry. Allergic reactions toEscherichia coliL‐asparaginase were common. Nine of 30 patients experienced at least one CNS relapse during therapy. We conclude that a modified Capizzi regimen is the most effective regimen reported to date for maintaining second and subsequent remission in childhood ALL. CCSG is currently utilizing this regimen in an ongoing open st

ISSN:0098-1532    

DOI:10.1002/mpo.2950110102

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

年代:1983

数据来源: WILEY

摘要:

AbstractA 25‐year‐old man presented with a malignant teratoma of the right testicle. After orchidectomy, the results of the surgical staging procedure were negative. Although pulmonary metastasis did not occur, massive bone marrow involvement with a bleeding tendency and hypercalcemic nephropathy developed. The response to chemotherapy was excellent, but after the attainment of a complete remission the patient developed carcinomatous leptomeningitis, which was confirmed at autopsy as cause of de

ISSN:0098-1532    

DOI:10.1002/mpo.2950110103

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

年代:1983

数据来源: WILEY

摘要:

AbstractTwenty‐six patients with advanced squamous cell cancer of the head and neck were treated with bleomycin, Oncovin, mitomycin C, and methotrexate (BOMM) for ten weeks. Partial and non responders then received adriamycin, cisplatin, and cyclophosphamide (APC) in a planned sequential program. The response rate to BOMM was 65% (19% complete remission, CR). The overall response rate to APC was 20%. Only three of eight nonresponders to BOMM could receive APC and none responded. Six of seven partial responders received APC and only one responded. One complete responder to BOMM received APC at relapse and attained a partial response. The major side effects of BOMM were mucositis and myelosuppression. Patients receiving methotrexate 60–72 hours following the bleomycin infusion had less myelo‐suppression than patients who were treated 36–42 hours after bleomycin. The toxicities with APC included nausea, vomiting, and myelosuppression. Including a prior series, a total of 45 patients have been treated with BOMMwith a 71% response rate (69% in previously irradiated patients). Twenty‐eight percent of previously treated patients achieved complete remission, and two of these patients are disease free at 31 and 37 months. Methotrexate dose‐rate alteration to low dose twice weekly followed by a single dose of oral leucovorin did not improve the complete or partial response rate when compared to weekly methotrexate administration. The complete remission rate and response duration were also not improved by the planned sequential use of this cisplatin‐conta

ISSN:0098-1532    

DOI:10.1002/mpo.2950110104

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

年代:1983

数据来源: WILEY

摘要:

AbstractA 52‐year‐old female presented with Philadelphia chromosome‐positive acute nonlymphocytic leukemia and a morphologically benign‐appearing histiocytosis with intramedullary cytophagocytosis of formed blood elements. No cause of the reactive histiocytosis could be found. Despite initial successful therapy of the acute nonlymphocytic leukemia with induction of a cytological remission, pancytopenia with marked cytophagocytosis persisted. Therapy aimed at reducing the degree of cytophagocytosis by the histiocytes, in the form of vinblastine‐treated platelets and, subsequently, prednisone, was instituted. There was no significant clinical response to either therapeutic maneuver. Cytophagocytosis persisted until leukemic relapse and dea

ISSN:0098-1532    

DOI:10.1002/mpo.2950110105

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

年代:1983

数据来源: WILEY

摘要:

AbstractTwo patients with extrapulmonary small cell carcinoma localized in the neck survived for more than two‐years without systemic therapy. This suggests that there may be a subset of small cell carcinomas characterized by slow growth, resulting in an indolent clinical course. By light and electron microscopy, we were unable to identify features of this indolent form which differ from those of the aggressive form of pulmonary or extrapulmonary small cell carcinom

ISSN:0098-1532    

DOI:10.1002/mpo.2950110106

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

年代:1983

数据来源: WILEY

摘要:

AbstractThis report describes two children with lymphoblastic lymphoma who relapsed more than 21/2years from diagnosis. Relapses occurred at seven and 20 months after completion of treatment. Their therapy consisted of an intensive pulse chemotherapy program combined with radiation therapy. Initial relapse after two years' treatment has been extremely rare in patients receiving contemporary chemotherapy programs, and two‐year survival without disease has been considered a cure. These cases illustrate that late relapses can occur after intensive chemotherapy and that two‐year disease‐free survival must not be interpreted as a complete

ISSN:0098-1532    

DOI:10.1002/mpo.2950110107

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

年代:1983

数据来源: WILEY

摘要:

AbstractThirty‐five patients with acute nonlymphocytic leukemia (ANNL) entered complete remission (CR) and survived 16 weeks following induction therapy with high‐dose timed sequential chemotherapy without maintenance therapy. These patients were analyzed to test the hypothesis that acute posttransfusion hepatitis (APTH) has a beneficial influence on the course of ANNL. Ten patients developed evidence of APTH while 25 did not. Median length of CR was 22 weeks for both groups while median survival was longer in patients not developing APTH (75 weeks vs 58 weeks) (P>0.5). Possible explanations for the discrepancy between these results and those previously reported are discus

ISSN:0098-1532    

DOI:10.1002/mpo.2950110108

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

年代:1983

数据来源: WILEY

摘要:

AbstractWe have studied 127 children from 5 participating institutions as to the effect of acute lymphoblastic leukemia (ALL) or the therapy used in the treatment of ALL on growth, growth hormone concentrations, and somatomedin activity. The study (SWOG No. 7581) was initiated in December 1975 and was closed to new entry in September 1979 and to data collection in February 1981. Heights, weights, and blood samples for growth hormone and somatomedin activity were obtained at the time of initial diagnosis and at intervals during the 55 months of observation. The percentage of boys<4 years of age below the 50th percentile is significantly greater than the expected 50% for both initial and final height (P<0.01). Girls<4 years appeared to have significantly different percentile height distribution from the normal for their final height measurement (P<0.05) but not for their initial height measurement. No other significant differences in the percentile height distribution were found. When growth rate, since time of diagnosis of ALL, is compared to the expected growth of normal children of the same age by linear regression analysis, there is a difference in the slope of the lines. Children with ALL are significantly shorter. The mean initial growth hormone and somatomedin concentration, 6.2 ng/ml and 1.3 μg/ml, respectively, vs mean remission growth hormone and somatomedin of 2.5 ng/ml and 1.1 μg/ml, respectively, were different. This was significant at P<0.01. The slope of the computed regression lines for multiple analysis of growth hormone and somatomedin were negative for more than 60% of the patients when compared to the initial concentration. These data suggest that a significant number of the children<4 years of age are short prior to the onset of therapy, and this persists throughout the course of their disease. Second, there is a reduction in growth rate during intensive therapy or the first year of the disease, with a normal growth rate thereafter. Third, growth hormone and somatomedin concentrations appear to be higher at the time of onset of the disease and decrease while on therap

ISSN:0098-1532    

DOI:10.1002/mpo.2950110109

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

年代:1983

数据来源: WILEY

ISSN:0098-1532    

DOI:10.1002/mpo.2950110110

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

年代:1983

数据来源: WILEY

摘要:

AbstractSixteen children with high risk acute lymphoblastic leukemia (ALL) who had one or more of the following risk factors: white cell count over 50 × 109/liter, mediastinal mass, age under 2 or over 10 years, extramedullary involvement, or T‐cell markers, were treated by a new protocol. All attained complete remission and 11 are still in their continuous first remission for 6‐53 months. High activity of adenosine deaminase (ADA) in the leukemic cells seems to be an independent risk factor, as in the high ADA level group, 4 out of 7 patients relapsed and died, while none of the 8 patients with low ADA levels relapsed or

ISSN:0098-1532    

DOI:10.1002/mpo.2950110111

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

年代:1983

数据来源: WILEY