摘要:

AbstractTwenty‐one patients with malignant melanoma stage III and IV were treated by intradermal injections of MER ‐ methanol extraction residue of Baccillus Calmette‐Gurin (BCG). Twelve of the patients, all with active disease, received chemotherapy in addition. Tests of skin reactivity to recall antigens and in vitro lymphocyte transformation by phytohemagglutinin (PHA), purified protein derivative (PPD), Canadidine, and Varidase were performed in 19 of the patients before and after the MER therapy. The skin reactivity improved in 8 patients, 5 patients maintained their cutaneous competence, 3 remained incompetent, and in 3 other patients a decrease in reactivity occurred. Improvement or maintenance of cutaneous response was more common in stage III than in stage IV patients. The in vitro lymphocyte stimulation tests have shown that reactivity increased or remained at a high level in 9 of 11 patients in stage III. It dropped or remained low in 2 patients in respect to all antigens used in spite of repeated MER injections. In most patients with stage IV disease no improvement could be detected. MER seems to be a potent immunostimulator in patients in stage III. The side effects were tolerable in all patients and consisted of local reactions and influenza‐like symptoms. In 4 patients treated with MER by intralesional injections, transiet flattening of nodules occurred but no complete regression was o

ISSN:0098-1532    

DOI:10.1002/mpo.2950060102

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

年代:1979

数据来源: WILEY

摘要:

AbstractA patient with a late recurrence (13 years) of Wilms tumor is presented. After relapse with conventional chemotherapy, an objective partial remission was obtained with bleomycin, vinblastine, cyclophosphamide, and cis‐platinum. Stable disease was noted when bleomycin was withheld. Bleomycin in this combination appeared to effect a good response, and further studies of chemotherapy of Wilms tumor should include bleomycin in combination with other active agent

ISSN:0098-1532    

DOI:10.1002/mpo.2950060103

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

年代:1979

数据来源: WILEY

摘要:

AbstractTwo patients developed isolated Candida albicans peritonitis in association with intraabdominal malignancy. Although additional factors predisposing to the development of fungal peritonitis were present, we postulate that tumor‐related local factors permitted fungi to cross the gut wall and to enter the peritoneum, where the host immune status determined whether the infection spread. These two cases are the sixth and seventh reported cancer patients who developed fungal peritonitis, but the first two who had the fungal infection localized to the peritoneum; and this is the first report known to us specifically associating intraabdominal malignancy and fungal peritonitis. Patients who develop fungal peritonitis may have a primary or metastatic intraadbdominal malignancy, and fungi should be considered as a cause of peritonitis in cancer patient

ISSN:0098-1532    

DOI:10.1002/mpo.2950060104

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

年代:1979

数据来源: WILEY

摘要:

AbstractIn 1968 the Cancer and Acute Leukemia Group B (CALGB) demonstrated optimal control of disseminated non‐Hodgkin lymphomas (NHL) with vincristine‐prednisone induction followed by cyclophosphamide maintenance. A study was then begun to determine whether four drugs in combination or sequence could achieve greater control. NHL patients at each participating CALGB institution were randomly assigned to one of three regimens: I) Cyclic vincristine‐streptonigrin alternating every 2 weeks with cyclophosphamide‐prednisone up to 155 days; II) Sequential treatment with the same 4 drugs taken singly up to 182 days; and III) Vincristine‐prednisone induction for 6 weeks followed by cyclophosphamide maintenance. Results are now reported after a 10 year follow‐up period. The 203 evaluable patients are those on whom Rappaport histopathologic classification was available. Frequency of complete response did not differ significantly among the three regimens: I) 38%; II) 30%; and III) 45%. Remission durations were significantly longer among patients receiving maintenance therapy. After ten years, two patients from Regimen I, one from Regimen II, and five from Regimen III remain alive and well. It was concluded that neither of the four‐drug regimens conferred a significant advantage in terms of response rate or survival time over the stand

ISSN:0098-1532    

DOI:10.1002/mpo.2950060105

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

年代:1979

数据来源: WILEY

摘要:

AbstractTwenty 36‐hour infusions of high‐dose methotrexate were given preoperatively to 10 patients with head and neck cancer. Plasma methotrexate levels of greater than 1 × 10−5M were maintained for 36 hours and declined with primary and secondary plasma half‐lives of 1.7 and 9.2 hours following the end of the infusion. Toxicity of this infusion regimen was minimal (10% incidence of significant (WBC<2000/mm3) myelosuppression; no renal toxicity) and all patients underwent surgical resection within 3 weeks of therapy without obvious increase in operative complications. Four of ten patients responded to chemotherapy. Further comparison of the therapeutic efficacy of this prolonged preoperative infusion regimen with surgery alone or schedules employing conventional doses or 6‐hour infusions of high‐dose methotrexate appea

ISSN:0098-1532    

DOI:10.1002/mpo.2950060106

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

年代:1979

数据来源: WILEY

摘要:

AbstractA patient with long‐standing chronic lymphocytic leukemia with both humoral and cellular immunodeficiency had lymph node receptor evidence of a B lymphocyte disorder. He was also found to secrete the Epstein–Barr virus and, late in his illness, developed a markedly positive antinuclear antibody. Interrelationship of these findings may be important in the ultimate determination of the etiology and functional mechanisms in lymphocyte malignanc

ISSN:0098-1532    

DOI:10.1002/mpo.2950060107

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

年代:1979

数据来源: WILEY

摘要:

AbstractFull skeletal survey was performed on 193 consecutive children presenting over a 6‐year period with acute lymphoblastic leukaemia (ALL). A record was made of the degree of bone pain in these patients and 60 others presenting immediately prior to the availability of skeletal surveys. Bone pain was present in 76 out of 253 patients (30%) and radiological bone changes characteristic of leukaemia in 125 out of 193 (65%). A significant correlation was found between the severity of bone pain and the number of bones involved on × ray (r = 0.25, P =<0.001), but not between initial white cell counts and bone score (r =‐0.14, P = 0.08). There was no significant correlation between the degree of bone pain and survival or length of first remission (P = 0.29 and 0.86). Similarly, the extent of radiological bone disease was of no prognostic significance with relation to survival (P = 0.41) or length of first remission (P = 0

ISSN:0098-1532    

DOI:10.1002/mpo.2950060108

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

年代:1979

数据来源: WILEY

摘要:

AbstractClosed trephine needle biopsy of the bone marrow has become an established procedure in the evaluation of many malignant and benign diseases in adults; however, its role in pediatric pathology has not yet been defined.In the period from February 1974 to April 1978 we have performed 164 such biopsies in 111 children under 15 years of age. A representative specimen has been obtained in over 80% of cases. This series included, in order of frequency, non‐Hodgkin lymphomas, Hodgkin lymphomas, aplastic anemias, rhabdomyosarcomas, neuroblastomas, miscellaneous solid tumors, and single cases of histiocytosis X, malignant histiocytosis, sarcoidosis, malignant histiocytoma, and Castleman lymphoma of the hyaline‐vascular type.Histology has been found superior to cytology in the detection of neuroblastoma invasion; the evaluation of the true cellularity in aplastic anemia, and the detection of granulomatous tissue in the only case of sarcoidosis. In other diseases histology and cytology gave similar information, except for the few cases of acute leukemia in partial relapse, which has been better defined in the aspirate smears than in the core specimen.Further evaluation of this technique in other patient series appears advisa

ISSN:0098-1532    

DOI:10.1002/mpo.2950060109

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

年代:1979

数据来源: WILEY

摘要:

AbstractThirty‐six febrile neutropenic episodes were treated by granulocyte transfusions in 33 children. Septicemia and mucous membrane ulcerations were most commonly associated with the fever. Infection cleared in 81% of the episodes, eight per cent ended in death from bacterial infections, 11% from nonbacterial infections or hemorrhage. The median number of polymorphonuclear leukocytes given was 1.1 × 1010/m2/transfusion. Two to twenty‐eight (median 8.5) transfusions were given over 3–34 days (median 10.5). The source of cells (parental or random) and the method of collection did not seem to affect the outcome. None of the 23 patients whose marrow recovered during the transfusions died of bacterial infections. Infection cleared even without marrow recovery in 62% of the patients, but then only 25% lived for more than two months after clearing of sepsis. In a subgroup of patients with nonlymphoblastic leukemia on the same chemotherapy and antibiotic treatment protocol, 8/11 (73%) survived bacteremia when white cell support was available; only 2/11 (18%) of a historical control group survived when such support was not available. Granulocyte support appears to be a valuable tool in helping neutropenic patients overcome their infections or, at the very least, helping them survive long enough for normal marrow recovery to

ISSN:0098-1532    

DOI:10.1002/mpo.2950060110

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

年代:1979

数据来源: WILEY

摘要:

AbstractTwo patients who had severe carcinoid syndrome are presented. In one patient prednisone relieved symptoms for 20 months, and in the second patient chemotherapy appears to have precipitated fatal carcinoid crisis. Changes in mentation, increased frequency and intensity of flushing, and hypotension indicate increased risk of a chemotherapy induced carcinoid crisis. Since prednisone may produce relatively long control of carcinoid syndrome, it should be tried before chemotherapy in patients who have increased risk of carcinoid crisis. If chemotherapy is given, doses should be decreased by 50%, and patients should be followed closely.

ISSN:0098-1532    

DOI:10.1002/mpo.2950060111

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

年代:1979

数据来源: WILEY