摘要:

AbstractThirty-three patients with symptomatic Waldenström's macroglobulinemia have been treated with the M-2 protocol (BCNU, cyclophosphamide, vincristine, melphalan, and prednisone). Therapy was administered every 5 weeks for 2 years and every 10 weeks for an additional 1–3 years. Median clinical and laboratory parameters included age 70 years (range 52–87), performance status 1 (1–3), prior therapy 7, weight loss 12, symptomatic hyperviscosity 13, splenomegaly 22, lymphadenopathy 7, hemoglobin 9.6 g/dl (6.7–14.6), IgM paraprotein level 200 mg% (340–11,600), and serum viscosity 2.1 (1.4–6.0). Responses were observed in 27 patients, of whom 21 were partial responses. Survival ranges from 1 to 120+ months with 58% of patients projected to be alive at 10 years. Twenty-one patients remain alive, of whom 10 are≥6 years from initiation of therapy with M-2. Treatment has been well tolerated with usually only mild to moderate hematologic toxicity. Median nadir white blood cells during the first cycle was 3000/mm3(1000–5500). Peripheral neuropathy was seen in 54% secondary to vincristine. Nausea/vomiting, anemia requiring transfusions, and alopecia were each noted in approximately 25% of patients. Sepsis was observed in 2 patients. Two characteristics, age and prior therapy, were found to be of borderline statistical significance (p = 0.03) using univariate analysis but were not significant with multivariate analysis. The M-2 protocol may be able to produce prolonged survival in the majority of patients with Waldenström's macroglobulinemia. Additional trials are needed to develop recommendations for therapy as well as factors predictive for survival and suitability for treatment.

ISSN:0735-7907    

DOI:10.3109/07357909109032794

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

AbstractWe undertook a retrospective study of all lung cancer patients diagnosed between 1978 to 1982 and seen at the University of California San Diego affiliated hospitals. There were 390 evaluable patients; the vast majority were men. Overall median survival was 8 months and was similar for all histologic types. Completely asymptomatic patients had a median survival of 20.1 months while symptomatic patients had a median survival of 5–8 months. Retrospective application of the new clinical staging system for lung cancer increased the survival distinction between clinical Stage I and Stage II disease. Median survival for small cell carcinoma of the lung was 10 months: 16.6 months for disease limited to the chest, and 5.8 months for metastatic disease. Median survival for Stage III nonsmall cell lung cancer patients was only 5 months. Only those asymptomatic patients with small lesions which were detected incidentally or by screening chest x-ray had any likelihood of long-term, disease-free survival with more than 60% alive two years after diagnosis. This study suggests that screening and early detection programs in existence during the period of observation were not effective in detecting early disease, and that no therapy of advanced diseases [Stages II through IV] was sufficiently efficacious to be considered standard.

ISSN:0735-7907    

DOI:10.3109/07357909109032795

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

AbstractIn an attempt to address the schedule of adjuvant chemotherapy in surgically resected T1 or T2NOMO small cell lung cancer, 12 patients were randomized to receive 6 courses of either single-agent (high-dose epirubicin) or combination (cyclophosphamide, epirubicin, and etoposide) chemotherapy, at 3-week intervals. No thoracic radiotherapy was administered while prophylactic cranial irradiation (30 Gy/10 fractions/2 weeks) was given. With a 25-month median followup, overall estimated 2-year and median survival were 83% and 26.5 months (range 16–34+), respectively. Ten patients are currently alive and disease free. No significant difference in 2-year survival was observed between the two adjuvant treatment modalities and median survival was 28 months (range 13–34+) for combination and 21 months (range 14–29+) for single-agent chemotherapy. Although at high doses, epirubicin resulted in a moderate clinical and histological cardiotoxicity and a remarkably reduced incidence of severe (WHO grades 3 and 4) treatment-related morbidity compared with the combination regimen. These preliminary results suggest that comparable survival and reduced toxicity might be expected with an active single-agent as adjuvant chemotherapy in TI or T2NOMO small cell lung cancer.

ISSN:0735-7907    

DOI:10.3109/07357909109032796

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

AbstractForty four patients who had documented progression of mestastatic colorectal cancer while receiving 5-fluorouracil (5-FU) monotherapy were treated with continuous infusion 5-FU, 300 mg/mg2/day, plus weekly low-dose cisplatin, 20 mg/m2. Treatment was given in 12-week cycles, consisting of 8 weeks of chemotherapy followed by a 4-week rest period, and was well tolerated. Three of 23 patients (13%) who had failed bolus 5-FU but not been exposed previously to infusional 5-FU responded. Of 21 patients who had failed infusional 55-FU monotherapy, only one (5%) responded. Time to progression (5.7 vs. 1.8 months) and survival (12 vs. 5.5 months) were significantly longer for patients who had not previously received infusional 5-FU but who had failed bolus schedules, compared with patients who had previously failed infusional 5-FU (p<.001).

ISSN:0735-7907    

DOI:10.3109/07357909109032797

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

AbstractPreliminary studies involving small numbers of patients have suggested that interleukin-2 (IL-2) administered by continuous infusion in repetitive weekly cycles using doses of 3 X 106U/M2/day is immunologically active and can induce tumor responses in patients with renal cell carcinoma. This study was designed to examine both the immunological and clinical effects of prolonged infusion IL-2 given by repetitive weekly cycles; first at moderate doses for 4 weeks as an inpatient followed by lower doses of IL-2 for up to 5 months. Prolonged IL-2 treatment was investigated because previous studies revealed that patients had a return to their baseline immune status within 4 weeks after completing IL-2 treatment. Twenty-five patients (including 18 with renal cell carcinoma) were treated with one of two regimens utilizing IL-2 as sole therapy. These regimens were designed to induce augmented and prolonged immune activation based upon in vitro and in vivo data. Though patients on both arms of the study demonstrated sustained lymphocytosis, increase in numbers of natural killer cells, and induction of lymphokine-activated killer activity with prolonged IL-2 administration, only 1 out of the 18 patients with renal cell carcinoma demonstrated a sustained partial antitumor response to therapy. Furthermore, several patients demonstrated profound immune activation, without any evidence of tumor regression. The lack of clinical responses in these patients showing marked activation of LAK cytotoxicity suggests that other variables must also influence the likelihood of antitumor effects for patients receiving IL-2 therapy.

ISSN:0735-7907    

DOI:10.3109/07357909109032798

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

AbstractA pilot study was performed to evaluate the feasability of administering prolonged continuous infusion 5-fluorouracil with multiple bolus chemotherapeutic agents. Twelve patients with advanced measurable gastric carcinoma were treated with a combination chemotherapy program of continuous infusion 5-fluorouracil, bolus Adriamycin, mitomycin C, and low-dose cisplatin (FAMP). Responses were observed in 5 patients (2 complete and 3 partial). Observed toxicities included leukopenia, thrombocytopenia, mucositis, and hand-foot syndrome. Although the FAMP regimen has activity in advanced gastric carcinoma, the number of patients evaluated was small and significant improvement over currently available regimens could not be demonstrated. Evaluation of toxicities indicates that bolus administration of multiple agents (specifically, Adriamycin, mitomycin C, and cisplatin) can be used in conjunction with continuously infused 5-fluorouracil without excessive toxicity.

ISSN:0735-7907    

DOI:10.3109/07357909109032799

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

ISSN:0735-7907    

DOI:10.3109/07357909109032800

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

ISSN:0735-7907    

DOI:10.3109/07357909109032801

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

AbstractThe use of MAbs directed against B-cell markers has identified considerably more heterogeneity within B-cell neoplasms than was evident by standard morphologic and histochemical techniques. Using markers specific for lineage and state of differentiation, it is possible to correlate malignant B cells to their normal cellular counterparts. Considering the complexity of normal B-cell ontogeny, differentiation, and function, it is not surprising that these malignancies reflect this diversity. Hopefully, with increasing characterization of the normal function of cell surface molecules, as well as the subpopulations of normal cells to which these malignancies correspond, we will have a better understanding of the biologic and clinical behavior of these malignancies.

ISSN:0735-7907    

DOI:10.3109/07357909109032802

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

ISSN:0735-7907    

DOI:10.3109/07357909109032803

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor