摘要:

AbstractSeventeen children born to mothers with acute leukemia who received chemotherapy during pregnancy were examined for physical health, growth, and development. The hematologic and neurologic status and school performance were also evaluated. Chromosomal studies were done in the long‐term survivors ranging in age from 4 to 22 years. The children had thorough history and physical examinations to detect any abnormal symptoms or signs. The mothers' previous treatment was documented. In each child growth and development, school performance, intelligence testing, neurologic examination, and hematologic evaluation including bone marrow were normal. Bone marrow cytogenetic studies were also normal. Chemotherapy was given during the pregnancy in each case, including 11 cases during the first trimester. No fetal malformations were found and no late side effects could be demonstrated. The results of this study indicate that pregnancy is not a counterindication for treatment of patients with acute leukemia, and in the cases described here chemotherapy is not associated with excessive risk to the fetu

ISSN:0098-1532    

DOI:10.1002/mpo.2950160102

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

年代:1988

数据来源: WILEY

摘要:

AbstractThis descriptive epidemiology study of 1,040 children with Wilms' tumor (WT) registered in the International Society of Paediatric Oncology (SIOP) clinical trials confirms the findings reported by the National Wilms' Tumor Study. The male:female rate was 0.89:1. The mean age at diagnosis of the 43 bilateral cases was significantly younger than children with unilateral renal involvement (32.4 vs 45 months). However, the mean ages at diagnosis for unilateral multicentric and for unicen‐tric WT were very similar. On the other hand, the mean age at diagnosis of children with sporadic aniridia and hypospadias was younger than the mean age of patients with or without other congenital malformations. Thus aniridia as well as hypospadias could be indices of the first mutation, according to the Knudson and Strong hypothesis. WT was reported in two members of each of five families. However, these familial cases were comparable in terms of demographic and clinical features to the nonfamilial ones. These data suggest that the heritable fraction of WT is relatively small and that genetic and environmental factors interact in the development of W

ISSN:0098-1532    

DOI:10.1002/mpo.2950160103

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

年代:1988

数据来源: WILEY

摘要:

AbstractBetween 1983 and 1985, we conducted a phase II clinical trial using VP‐16, ifosfamide, and cisplatin (VIP) in patients with refractory lymphoma. Twenty‐eight patients with bidimensional measurable disease were treated with VP‐16 (75 mg/m2), ifosfamide (1.2 g/m2), and cisplatin (20 mg/m2) as daily intravenous infusions for 5 consecutive days. N‐Acetyl‐cystein, 2 g orally every 6 h, was given as a uroepithelial protective agent. All patients had received extensive combination chemotherapy prior to beginning VIP (median number of regimens = 2). Of the 25 patients evaluable for response, 2 patients achieved complete remission and 7 achieved partial remission for an overall objective response rate of 36%. The length of responses ranged from 2 months to 13 months. The predominant toxicity of VIP was myelosuppression. Of 23 patients receiving more than one course of VIP, 17 (73%) had dose reductions or delays related to poor hematologic tolerance of therapy. Uroepithelial and renal toxicity were mild. VIP demonstrates therapeutic activity in refractory lymphoma and appears comparable to other ifosfamide/VP‐16 based salva

ISSN:0098-1532    

DOI:10.1002/mpo.2950160104

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

年代:1988

数据来源: WILEY

摘要:

AbstractSeveral cytotoxic agents when used in vitro in very low concentrations have been shown to induce differentiation of leukemic cells. We treated 18 patients with myelodysplastic syndromes with low‐dose oral 6‐thioguanine (6‐TG; 20 to 60 mg daily). Four patients demonstrated significant improvement in peripheral blood counts. An additional three patients had significant reductions in the percentage of leukemic myeloblasts in the marrow without a corresponding improvement in peripheral counts. With the exception of a fall in the peripheral neutrophil count in four patients requiring dose reductions, no toxicity was observed. Low‐dose oral 6‐TG gives a response rate in myelodysplastic syndromes similar to that of parenteral agents such as cytosine arabinoside. Given the ease of administration and lack of toxicity, oral 6‐TG may be a useful treatment modality for these syndromes either alone or in combination with other differentiation‐enh

ISSN:0098-1532    

DOI:10.1002/mpo.2950160105

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

年代:1988

数据来源: WILEY

摘要:

AbstractCyclic combination chemotherapy was administered to 26 patients with acute lymphoblastic leukemia who had relapsed in the bone marrow ≥ 6 months after elective cessation of therapy. Each patient had been in initial continuous complete remission for 36‐111 months (median, 47 months). Prednisone, vincristine, and doxorubicin induced second complete remissions in all patients within 1 month. Continuation therapy consisted of alternating 6‐week courses of 6‐mercaptopurine/methotrexate and vincristine/cyclo‐phosphamide with intervening reinforcement courses of prednisone/doxorubicin, for a total of 18 months. All patients received 4 weeks of late intensification therapy with the same agents used for remission reinduction. Periodic intrathecal methotrexate was given as reprophylaxis for subclinical central nervous system leukemia. The estimated rate of continuous failure‐free survival at 5 years is 31% ± 17% (2 SE). Eight patients remain free of leukemia for 42+ to 65+ months after completing therapy a second time. Adverse second events included 11 hematologic, 1 testicular, and 3 meningeal relapses. Patients who relapsed at more than 12 months after the completion of initial treatment have had significantly longer second remissions than patients whose first remissions were shorter (p = .04). None of the other six factors we analyzed showed predictive strength. These end results indicate that intensive cyclic continuation chemotherapy, as described here, will secure durable second remissions in approximately one‐third of the children with late bone m

ISSN:0098-1532    

DOI:10.1002/mpo.2950160106

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

年代:1988

数据来源: WILEY

摘要:

AbstractEighty‐seven patients with histologically or cytologically proven non‐small‐cell carcinoma of the lung were treated with 4′‐deoxydoxo‐rubicin (DxDx) 30 mg/m2every 3 weeks. Three responses (4%), all partial, were observed. All responses occurred in patients with large‐cell anaplastic lung cancer and none in squamous or adenocarcinoma histologies (P<0.01). The durations of partial response for these three responders were 70, 198+ and 209+ days. The side effects noted were predominantly neutropenia, anemia, and weight loss. In three patients, declines in cardiac ejection fraction of 7%, 12%, and 23% occurred after cumulative drug doses of 150 mg/m2, 150 mg/m2, and 233 mg/m2, respectively. 4′‐Deoxydoxorubicin had little activity in non‐small‐cell lung cancer at the do

ISSN:0098-1532    

DOI:10.1002/mpo.2950160107

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

年代:1988

数据来源: WILEY

摘要:

AbstractEighteen patients with advanced non‐small‐cell lung cancer (NSCLC) received recombinant beta interferon, 90 million units three times weekly. No complete or partial responses were seen. Five patients had stable disease for several months. Most patients experienced some toxicity, most commonly fever and chills. No dose reduction of interferon had to be made due to toxicity. Tachyphylaxis to symptoms of fever and chills occurred in most patients. While 33% of patients developed beta‐interferon‐binding antibodies, the incidence of interferon‐neutralizing activity was 0%. This dose and schedule of beta interferon did not result in significant anti‐tumor effects in advanced NSCLC. Stabilization of disease for up to 9 months in patients with previously progressive disease was of interest. Tachyphylaxis of symptoms should allow for dose escalation within patients. A dose‐escalating study has been initiated to evaluate the efficacy of beta interferon when given at each patient's maximally t

ISSN:0098-1532    

DOI:10.1002/mpo.2950160108

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

年代:1988

数据来源: WILEY

摘要:

AbstractCongenital anomalies were identified in 37 of 115 (32%) children and adolescents autop‐sied with rhabdomyosarcoma. An analysis of sex, age, site, and histology of cases with or without congenital anomalies showed no significant differences. Of the 45 identified anomalies, 14 were considered major and 31 minor. The distribution of the anomalies by system included central nervous (9), genitourinary (10), gastrointestinal (13), and cardiovascular systems (4). Ten patients had complex or miscellaneous anomalies. There was one child with each of the following: Rubinstein‐Taybi syndrome, neurofibromatosis, single horseshoe kidney, hemihypertrophy, and Arnold‐Chiari malformation. Aniridia was not noted in any case of rhabdomyosarcoma. Individuals with rhabdomyosarcoma have an increased incidence of genitourinary anomalies similar to that in Wilms' tumor. Recent molecular genetic investigations have suggeted that rhabdomyosarcoma, Wilms' tumor, and he‐patoblastoma share a common pathogenetic mechanism involving chromosome 11. The uniquely increased association of central nervous system anomalies with rhabdomyosarcoma and absence of aniridia would support a different gene locus operative on chromosome 11 for individuals with rhabdomyosarcoma compared to Wilms' tumor. Extensive epidemiologic studies now in progress in patients with rhabdomyosarcoma should provide the incidence of congenital anomalies and potential linkage with prenatal

ISSN:0098-1532    

DOI:10.1002/mpo.2950160109

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

年代:1988

数据来源: WILEY

摘要:

AbstractA survey of 24 pediatric oncologists from 21 institutions not performing bone marrow transplants found that 156 patients were referred for transplants in the years 1984/85; only 10 of these patients were not transplanted. No patient in good clinical condition whose disease was under control was denied transplantation after evaluation at a transplant center. The decision for transplantation was made by the families and the referring pediatric oncologists, almost always before the patient was seen at a transplant center. The fact that almost all patient and family evaluations at transplant centers take place after a family has decided to have a marrow transplant has obvious implications regarding informed consent. Referring pediatric oncologists must attempt to provide the best possible information to families when decisions regarding marrow transplantation are actually being made.

ISSN:0098-1532    

DOI:10.1002/mpo.2950160110

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

年代:1988

数据来源: WILEY

摘要:

AbstractAn 11–yr‐old girl, who had been treated with human growth hormone (h‐GH) for 31 months, developed acute myeloblastic leukemia with an inv(3)(q21q26). Since CH has been suggested to influence the genesis of leukemia, and the inversion 3 has been reported only in adult leukemia patients, the GH treatment may have caused the development of leukemia or accelerated the proliferation of the leukemia

ISSN:0098-1532    

DOI:10.1002/mpo.2950160111

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

年代:1988

数据来源: WILEY