bluuebunny/crossref_metadata_2025 huggingface dataset:
Concomitant radiation therapy and cis‐diamminedichloroplatinum (II) in patients with advanced head and neck cancer
Authors: Creagan Edward T. , Fountain Karen S. , Frytak Stephen , Desanto Lawrence W. , Earle John D.
Published: February 2007

Three patients with locally advanced head and neck squamous cell cancer received concomitant radiation therapy (XRT) and cis‐diamminedichloroplatinum (CDDP). The dose of 6,000 rads was to be administered in two 3,000‐rad courses separated by 3 weeks. The CDDP, 30 mg/m2, was to be given intravenously on days 2 and 12 of each half of XRT. We were especially concerned with the occurrence of an abscess in one patient and an abscess with hemorrhage in another. In addition, each patient experienced severe and intractable nausea, vomiting, and a pervasive feeling of ill‐health which seemed out of proportion to that usually observed from either XRT or CDDP alone. If the findings in this pilot study are confirmed, the toxicity of XRT with concurrent CDDP as used in our study may well obviate routine clinical usage.
Religion in patients with advanced cancer
Authors: Yates Jerome W. , Chalmer Bruce J. , James Paul St. , Follansbee Mark , McKegney F. Patrick
Published: February 2007

Data on religious belief, activity, and connections, and ratings of happiness, life satisfaction, and pain level were obtained periodically from 71 patients with advanced cancer. Religious belief showed substantial positive correlation with life satisfaction, and religious activity and connections were significantly correlated with both happiness and life satisfaction. Religious patients also reported significantly lower levels of pain, even though they were no less likely to report the presence of pain. Data from the 36 patients who have since died show no correlation between the religion variables and duration of survival. In general, the patients showed little change in religious belief over time. Religion seems to be an important source of support for many patients.
Progression of methotrexate‐induced leukoencephalopathy in children with leukemia
Authors: Ch'ien Lawrence T. , Aur Rhomes J. A. , Verzosa Manuel S. , Coburn Thomas P. , Goff John R. , Hustu H. Omar , Price Robert A. , Seifert M. Jane , Simone Joseph V.
Published: February 2007

From 1972 ‐ 1974, 228 children began treatment for acute lymphocytic leukemia and were prospectively assessed for neurologic complications. After CNS irradiation (2,400 rad) and intrathecal methotrexate (MTX), they received weekly intravenous maintenance therapy with MTX alone (40–60 mg/m2; 20 patients) or MTX (10‐30 mg/m2) with other drugs (208 patients). Signs of leukoencephalopathy appeared in 11 children (nine without CNS leukemia) after 4‐15 months of IV MTX alone, and included lethargy, seizures, spasticity, paresis, drooling, and dementia. Before or during the clinical onset, EEG frequencies slowed (all ten patients tested). Radionuclide scans showed periventricular accumulation of 99mTc (9/11 patients) and remained abnormal for ≥ six months in eight patients. Cranial computed tomograms or neuropathology findings (five patients each) demonstrated leukoencephalopathy (nine patients) and radiation‐related microangiopathy (ten patients). Severe neurologic and neuropsychologic dysfunctions were present in four long‐term survivors.
Cloning of fresh lymphoma cells
Authors: Nishikori Masaru , Hansen Herbert , Yen Andrew , Clarkson Bayard
Published: February 2007

We attempted to induce in vivo clonal growth of neoplastic lymphoid cells from fresh specimens of involved tissue from 22 patients with non‐Hodgkin lymphoma (NHL). Conditioned media derived from two human B‐lymphocyte tissue culture lines were tested for their ability to promote colony growth. In addition, we compared the incidence of colony induction to the flash‐3H‐thymidine labeling index (LI) of the cells in the tissues cultured. Successful colony induction occurred in three‐tenths of the cases of diffuse histiocytic lymphoma and one‐half of the cases of nodular lymphoma. Cloning efficiencies were low, ranging from 0.0003 to 0.04%. There was no apparent relationship between successful instances of cloning and LI. We have confirmed the observations of Jones et al that lymphoid tumor cells can be cloned from tissues involved by NHL using a soft agar system. The possibility of using such systems for clinical predictive assays of chemotherapeutic drug toxicity toward tumor cells of NHL is discussed. We conclude that further refinements of the assays are desirable before they can be applied to widespread clinical use.
Adriamycin, vincristine, dibromodulcitol, and hexamethylmelamine in advanced previously treated breast cancer: An ECOG pilot study
Authors: Taylor Samuel G. , Wolter Janet
Published: February 2007

A combination of adriamycin, vincristine, dibromodulcitol, and hexamethylmelamine was piloted in patients with advanced breast cancer who had failed prior CMFP chemotherapy, as a part of ongoing trials by the Eastern Cooperative Oncology Group to improve second‐line chemotherapy for this disease. The vincristine was given as an intensive 5 week induction regimen and hexamethylmelamine was administered on days 15–27 of a 28 day cycle, at the time of anticipated nadir peripheral blood counts. The study was terminated early after only 9 patients had been entered because of severe neurotoxicity related to the intensive schedule of vincristine as well as hematologic and gastrointestinal side effects. Three patients responded for 11, 18 and 21 weeks. The limited therapeutic benefit did not justify the toxicity produced, and suggested that intensive dosage schedules of vincristine, and use of low dose hexamethylmelamine during the time of anticipated hematologic nadir counts would not be of substantial benefit.
Psychological late effects of leukemia in children and their prevention
Authors: Schuler D. , Polcz Alaine , Révész T. , Koó Rozália , Bakos Márta , Gál Nóra
Published: February 2007

The psychological and intellectual sequelae of childhood leukemia and its treatment were examined in 48 children with acute leukemia in long remission. Verbal and performance IQ values were determined in addition to full scale IQ. Performance was worse than the verbal IQ in children who were less than six years old at the time of diagnosis. Cranial irradiation even in repeated doses of 2,400 rads had no effect on these children's intellects. Most of the patients, however, showed severe emotional problems when constructing their “world” from given objects. The frequency and severity of these emotional problems could be much alleviated by regular psychological care.
Cis‐dichlorodiammineplatinum (II) and VP 16–213 combination chemotherapy for non‐small cell lung cancer
Authors: Goldhirsch Aron , Joss Rudolf A. , Cavalli Franco , Sonntag Roland W. , Brunner Kurt W.
Published: February 2007

Twenty‐three patients with non‐small cell lung cancer were treated with a combination of cis‐dichlorodiammineplatinum(II) 100 mg/m2 IV on day 1 and VP 16–213 80 mg/m2 IV on days 1–3. Eighteen patients are evaluable for response. Seven partial remissions with a median duration of 3 months (range, 1–13+) have been observed. Three patients exhibit stable disease, and eight patients show tumor progression. Overall survival was 5+ months (range, 1–13+); 7.5 months (range, 3–13+) for responders and 3+ months (range, 1–9+) for non‐responders. Hematologic toxicity was acceptable, but poor subjective tolerance (nausea, vomiting, loss of appetite) was the main factor limiting treatment duration.
5‐fluorouracil and cis‐platinum in the treatment of refractory solid tumors: A pediatric oncology group phase I — II study
Authors: Land Vita J. , Dyment Paul G. , Starling Kenneth , Strandjord Sarah E. , Chan Raphael
Published: February 2007

Eleven patients with osteogenic sarcoma (9), Hodgkin disease (1), and mesenchymal sarcoma (1), were treated with 5‐fluorouracil (5‐FU) and cisplatin (DDP). Myelosuppression and vomiting of variable degrees occurred in all. No responses were seen.
Primary hemangiosarcoma of the spleen: Report of four cases
Authors: Sordillo Emilia Mia , Sordillo Peter P. , Hajdu Steven I.
Published: February 2007

Four cases of primary splenic hemangiosarcoma are described. The most common presenting symptoms were recurrent fever, malaise, and abdominal pain. Three patients also had complaints referable to the urinary tract. Severe hemo‐lytic anemia with bizarre or fragmented red blood cells on peripheral smear was noted in three patients, in two cases, for more than 1 year before diagnosis. Two patients had been treated for mammary carcinoma with ionizing radiation 10 years before developing hemangiosarcoma of the spleen. One patient had multiple congenital hemangiomas present from birth, and is thought to have developed hemangiosarcoma in a previously existing benign hemangi‐oma. None of our patients survived more than 7 months after the diagnosis of hemangiosarcoma. The importance of early detection and treatment of this tumor is discussed.
Histiocytic lymphoma following resolution of sarcoidosis
Authors: Foon Kenneth A. , Filderman Andrew , Gale Robert Peter
Published: February 2007

A 32‐year‐old female who developed respiratory symptoms and hilar and mediastinal lymph node enlargement had a biopsy of a mediastinal lymph node typical of sarcoidosis. The symptoms and lymphadenopathy resolved spontaneously without therapy. Eighteen months later the patient developed recurrent respiratory symptoms and a large anterior mediastinal mass, a biopsy of which showed a diffuse sclerosing histiocytic lymphoma, without evidence of sarcoidosis. The possibility of a common etiologic factor or transformation of sarcoidosis into a histiocytic lymphoma are discussed.
Prevention of infection and bleeding in leukemic patients receiving intensive remission maintenance therapy
Authors: Preisler H. D. , Early A. , Hryniuk W.
Published: February 2007

Leukemic patients were treated with intensive chemotherapy to reduce the number of leukemic cells remaining after complete remission was induced. This therapy resulted in periods of severe granulocytopenia and thrombocytopenia. Considering 13 patients who did not receive antibacterial prophylaxis, documented infection was quite common including four episodes of bacteremia and three urinary tract infections. By contrast, patients who received co‐trimoxazole as antibacterial prophylaxis experienced one half as many febrile episodes and no serious infections. Prophylactic co‐trimoxazole is beneficial for patients with marrow remission in this study. Similar benefit in patients with leukemic marrows remains to be established. All patients received prophylactic platelet transfusions three times a week when their platelet counts were < 20,000/μl. There were no episodes of bleeding other than petechiae.
Clinical data management and analysis using a microcomputer
Authors: Dodge Richard K. , Krakoff Irwin H.
Published: February 2007

In the clinical setting, it is imperative that the medical staff as well as certain support staff have ready access to patients' records and on‐study data. Computerization of the clinical data must not deter non‐computer‐oriented data users from getting at the information they need. In fact, the computer system should be designed for ease of operation by all potential users so that it becomes a valuable and unobtrusive aid to the clinical environment. This paper describes the workings of a microcomputer system at the Vermont Regional Cancer Center.
Myelofibrosis in neuroblastoma
Authors: Labotka Richard J. , Morgan Elaine R.
Published: February 2007

Myelofibrosis, a rare childhood disorder, has been reported as an associated complication of certain hematologic malignancies or as an isolated idiopathic process. In this report, we describe a patient with metastatic neuroblastoma whose initial presentation included the findings of myelofibrosis and leukoery‐throblastosis. The myelofibrosis regressed with chemotherapy and did not recur when the patient's tumor reappeared.
Acute lymphocytic leukemia with microblastosis and near haploidy (26 chromosomes): A case report
Authors: Hoeltge Gerald A. , Dyment Paul G. , Slovak Marilyn L.
Published: February 2007

A three‐year‐old acute lymphocytic leukemia (ALL) patient had a modal chromosome count of 26 in her bone marrow metaphases. The leukemia was “common” ALL by cytochemical and immunologic studies. Five other cases had been reported previously, and all have had a near haploidy varying from 26 to 32 chromosomes. Disomy of chromosomes 18 and 21 is a consistent feature of this disease. Severe hypodiploidy correlates with microblastosis requiring morphologic separation from non‐neoplastic small lymphocytes.
Cytogenetic studies on four cases of non‐endemic burkitt lymphoma
Authors: Slater Rosalyn M. , Behrendt Henk , Van Heerde Peter
Published: February 2007

Cytogenetic studies carried out on four children with non‐endemic Burkitt lymphoma showed: 1) Two with the typical translocation t(8;14)(q24;q32); 2) one with a variant t(2;8)(p11;q24); and 3) one with apparently normal chromosomes 8 and 14. Additional chromosomal variation was present in all four patients. Two were shown to have a duplication of part of the long arm of chromosome 1 (1q23→1q32 and 1q23→1q42). Epstein Barr virus studies on two patients showed that one was positive and the other negative. A comparison of these results with other non‐endemic cases in the literature has been made revealing a wider range of chromosomal variation than has been hitherto reported for endemic cases. The finding that chromosome 8 is also involved in the variant translocations in Burkitt lymphoma suggests that its changes may contribute more to the tumour development than the 14q +.
A prospective randomized clinical trial of total parenteral nutrition in children with cancer
Authors: Donaldson Sarah S. , Wesley Margaret N. , Ghavimi Fereshteh , Shils Maurice E. , Suskind Robert M. , Dewys William D.
Published: February 2007

A prospective randomized clinical trial was undertaken to test the efficacy of total parenteral nutrition (TPN) among previously untreated children receiving abdominal/pelvic irradiation with or without adjuvant chemotherapy who were at risk for weight loss, malnutrition, and complications from treatment. Children were evaluated by weight/height determinations, anthropomorphic measurements, and laboratory studies. TPN was associated with an improved nutritional status during therapy as compared with control patients on ad libitum intake. However, when TPN was discontinued, weight declined and there were no differences among treated and control patients detected at three‐month follow‐up. Likewise there was no obvious effect from TPN on tolerance to therapy in the adequately nourished child. TPN as initial supportive therapy should be reserved for those children who are malnourished or marginally malnourished at the time of presentation. Close nutritional assessment during treatment is essential since approximately 25% of children undergoing abdominal/pelvic radiotherapy with chemotherapy can be expected to become malnourished during an initial course of therapy.
Lymphocyte responsiveness to thymosin in angioimmunoblastic lymphadenopathy with lymphomatous transformation
Authors: Taylor Samuel G.
Published: February 2007

Lymphocytes from a patient with angioimmunoblastic lymphadenopathy with lymphomatous degeneration were tested in vitro for thymosin responsiveness. The percentage of lymphocytes forming spontaneous (E) rosettes to sheep red blood blood cells (SRBC) was 37 and 32% in the absence of thymosin on two separate occasions. Lymphocytes incubated with thymosin formed rosettes in 55 and 43% when incubated with 0.1 μ/ml and 66 and 63% when incubated with 100 μ/ml, respectively. The patient subsequently received thymosin while in a preterminal condition. No clinical response to thymosin was apparent and lymphocytes tested 8 days after starting thymosin treatment demonstrated reduced thymosin responsiveness (31% without thymosin vs 37% with 100/μ/ml). The failure to respond clinically to thymosin treatment may be related to the preterminal condition. The in vitro responsiveness to thymosin suggests that thymosin effect should be examined earlier in the course of this disease process.
Combination chemotherapy plus BCG in the treatment of disseminated malignant melanoma: A southwest oncology group study
Authors: Costanzi John J. , Al‐Sarraf Muhyi , Groppe Carl , Bottomley Richard , Fabian Carol , Neidhart James , Dixon Dennis
Published: February 2007

The Southwest Oncology Group performed a randomized study comparing combination chemotherapy alone versus combination chemotherapy plus BCG versus DTIC plus BCG in the treatment of disseminated malignant melanoma. A 31% response rate was noted with combination chemotherapy alone, a 27% response rate with combination chemotherapy plus BCG, and an 18% response rate with DTIC plus BCG. Survival was not influenced by type of therapy, but the responders had significantly longer survival than the nonresponders. There appeared to be some significant differences in response as related to age wherein those patients between the ages of 30 and 60 years had a higher response rate to combination chemotherapy as compared to DTIC plus BCG. Those patients older than 60 years of age had a higher response rate in the BCG groups. Furthermore, in those patients older than 60 years of age who responded, their duration of response was longer if they received BCG than those who did not receive BCG. It should be emphasized that those differences noted in various age groups could occur by chance alone. These differences should be studied in the future, by appropriate pretreatment stratifications. Patients with higher peripheral lymphocyte counts had significantly better response rates and those patients with higher numbers of positive delayed hyper‐sensitivity skin tests had significantly greater survival. A significant improvement in survival was noted in patients whose PPD converted from negative to positive during therapy.
Pancreatic carcinoma in a ten‐year survivor of acute myeloblastic leukemia
Authors: McLaughlin Peter , Bennetts Roland W.
Published: February 2007

Adenocarcinoma of the pancreas developed in a young man who was a 10‐year survivor of acute myeloblastic leukemia (AML). His extensive cytotoxic chemotherapy for AML is reviewed along with a discussion of its possible oncogenic effects. Other case reports of second malignant neoplasms (SMN) following acute leukemia are cited; available data suggest that the overall risk of SMN in AML may be in the range of 6%. While our patient's second malignancy may have been a chance association, his and other cases of pancreatic carcinoma in young survivors of hematologic neoplasia suggest that the cytotoxic treatment may have had a role in the pathogenesis of the pancreatic carcinoma.
Sex differences in prognosis of childhood T‐cell leukemia
Authors: Penchansky Lila , Whiteside Theresa L. , Wollman Michael R. , Albo Vincent C.
Published: February 2007

Bone marrows of 41 untreated children and adolescents with acute lymphocytic leukemia were studied by combined immunologic and histochemical methods at the time of diagnosis. Eleven were classified as T‐cell lymphoblastic leukemias (27%) on the basis of cytochemical stains and E‐rosette assay. The patients in this group had low median age of 8 years, relatively low median WBC of 13.4 × 103/cc, 6/11 were female, and only 2/5 males had a mediastinal mass. The girls had a lower median age than boys (7 vs 9 years), none had mediastinal masses or extramedullary involvement, and their survival was >27 months compared to 14 months for the boys (P < 0.01). All patients were enrolled and treated on the (then) currently active CCSG protocols for ALL. This study emphasizes the fact that not all patients with T‐cell ALL have poor prognosis, that sex could be an important factor affecting survival, and that the difference in survival could not be adequately explained by differences in the initial WBC.
A content validity analysis of neoplastic items of the national board of medical examiners part II examination
Authors: Goetzel Ronnie Z. , Croen Lila G. , Lan Sam , Bases Robert E.
Published: February 2007

As part of its evaluation of the Clinical Cancer Education Program (CCEP) at the Albert Einstein College of Medicine, the Office of Educational Research and Evaluation analyzed student performance on neoplastic items of the National Board of Medical Examiners (NBME) Examination Part II. The evaluation provided a successful application of the American Association for Cancer Education (AACE) coding schema for analysis of neoplastic items. Two examinations were analyzed in order to determine the frequency with which specific disease sites, treatment modalities, and question emphasis items appeared. With reference to disease site, the greatest number of questions on both examinations dealt with gynecological issues while the fewest dealt with lung and hematologic‐related disease. A breakdown of questions into various treatment modalities indicated that of items that could be categorized, most dealt with surgical treatment, while other therapeutic modalities were given little or no emphasis. Looking at question emphases, the most frequently asked questions referred to diagnostic tests and stratagems, whereas the least amount of emphasis was placed on rehabilitative and psychosocial aspects of the disease. These findings corroborate those reported by Ruckdeschel and his associates and point out several limitations to the content validity of the neoplastic items on NBME Part II.
Vm‐26 with prednisone and vincristine for treatment of refractory acute lymphocytic leukemia
Authors: Rivera Gaston , Bowman W. Paul , Murphy Sharon B. , Dahl Gary V. , Aur Rhomes J. , Kalwinsky David K. , Wood Adynel , Stagner Shirley , Avery Thomas L.
Published: February 2007

Fifty‐six children with refractory acute lymphocytic leukemia (ALL) were assessed for remission‐induction responses to VM‐26 (250 mg/m2 per week) in combination with prednisone (40 mg/m2 per day) and vincristine (1.5 mg/m2 per week). Each child had been treated intensively with steroids, vincristine, daunorubicin and L‐asparaginase. In fact, all patients had failed to respond to previous reinduction therapy with prednisone‐vincristine or had relapsed while receiving vincristine. Our intent in this study was to test whether or not addition of VM‐26 to prednisone‐vincristine would overcome clinical resistance to these established agents. Complete remissions were induced in 17 patients (0.30) over 4 to 6 weeks. Five of these children, all clinically unresponsive to prednisone‐vincristine alone, had complete remissions that lasted longer than 1 year; two remain in remission for 2 1/2 years and both are now off therapy. Myelosuppression, the most serious treatment complication, was documented in 20 of 26 evaluable patients. The median time to recovery of normal marrow function was 15 days. These results demonstrate further the potential of VM‐26 in combined‐drug treatment of refractory ALL. Whether the effectiveness of this combination represents potentiation of prednisone and vincristine activity by VM‐26 or some other, as yet unidentified interaction, remains to be determined.
Transfusion of granulocyte rich buffy coats to neutropenic patients
Authors: Reiss R. F. , Reiss R. F. , Waldman A. A. , Raju M. , Kulpa J.
Published: February 2007

Granulocyte rich buffy coats were transfused to infected neutropenic patients when leukapheresis donors were not available. Efficacy of transfusions was evaluated from data supplied by hospitals administering them. Buffy coats separated from ACD blood contained a mean of 4.9 × 108 granulocytes. Fifty‐seven patients received a course consisting of a mean of 3.8 transfusions. Of these, 27 received a mean of 17.5 units per transfusion and had a survival rate of 44.4%, which was not significantly different from the 50.0% found in 30 who received a mean of 11.1 units per transfusion. No significant difference in survival rate was found between 31 patients with acute leukemia and 26 with other disorders or 38 patients with positive and 19 with negative cultures. Finally, no significant difference in survival rate was noted between patients who received a course of ≫ four transfusions or ≪ three transfusions in any of the above groups. Survival rates were less than those generally reported following similar courses of leukapheresis units. Buffy coat transfusions consisting of a mean of approximately 17.5 units as produced during this study have therefore been shown to be not generally beneficial. The increased survival seen in some studies utilizing leukapheresis products may relate in part to the larger number of granulocytes they contained. Greater benefit from buffy coat transfusions might result if the number of granulocytes infused were increased. Evaluation of possible efficacy associated with transfusions of increased numbers of buffy coat units further enriched with granulocytes may be justified when leukapheresis donors are not available.
Coarctation of the aorta from a mediastinal germ cell tumor: A case report
Authors: Davis Thomas J. , Davis Thomas J. , Carbone Paul P. , Crummy Andrew B.
Published: February 2007

A 20‐yr‐old male had compression of the thoracic aorta by a large malignant mediastinal germinoma. The symptoms and signs that simulated coarctation of the aorta included hypertension, markedly decreased femoral pulses, and a systolic murmur that radiated to the back. Following X‐ray therapy, the femoral pulses were palpable and the blood pressure became normal. To our knowledge, compression of the aorta by a malignant teratocarcinoma with manifestations mimicking coarctation of the aorta has not been reported.
Spontaneous improvement of pneumocystis carinii pneumonia in childhood acute lymphocytic leukemia
Authors: Ettinger Lawrence J. , Torrisi John , Wood Beverly P. , Anderson Virginia M.
Published: February 2007

Until recently, Pneumocystis carinii pneumonitis was the most common cause of death in patients with leukemia in remission. Prior to the advent of effective antimicrobial agents, this disease was virtually 100% fatal in the cancer patient undergoing immunosuppressive therapy. The spontaneous improvement of P carinii pneumonitis in a child with acute lymphocytic leukemia suggests a higher incidence of P carinii pneumonitis in immunocompromised patients than is commonly realized.
The treatment of acute lymphoblastic leukaemia (ALL) in childhood, Ukall III: The effects of added cytosine arabinoside and/or asparaginase, and a comparison of continuous or discontinuous mercaptopurine in regimens for standard risk ALL
Authors: Rothwell Miss D.
Published: February 2007

In a comparison of treatments for standard‐risk acute lymphoblastic leukaemia in children (UKALL III), there were no differences in remission lengths between regimens with or without second‐line drugs (cytosine arabinoside and asparaginase) and with continuous or discontinuous mercaptopurine. The number of infections was significantly lower when maintenance followed the less immunosuppressive modified induction period and when there were 1‐week gaps each month in the administration of mercaptopourine. As in the previous trial, a higher rate of relapse in boys was found to be due partly to testicular and partly to bone marrow relapse. Cell‐typing by the FAB system showed that the proportion of patients still in their first remission at 5 years was very much higher in LI than in L2 cases.
Safe and effective induction chemotherapy without cisplatin for squamous cell carcinoma of the head and neck: Impact on complete response rate and survival at five years, following local therapy
Authors: Price L. A. , Hill Bridget T.
Published: February 2007

One hundred forty‐seven patients were given a kinetically based combination of vincristine, bleomycin, methotrexate, 5‐fluorouracil, and hydrocortisone as initial treatment. Chemotherapy was given on days 1 and 14 before local “curative” therapy with radiation and/or surgery was started on day 28. Response to chemotherapy was assessed in 136 patients. In 89 stage III or IV patients, 57 (64%) responded and 32 (36%) did not. The complete remission (CR) rate following local therapy in patients responding to initial chemotherapy was 74% (42 patients). In patients not responding to initial chemotherapy the CR rate following local therapy was only 40%. This difference is highly significant (P < 0.001). In 39 stage II patients, 28 (72%) responded to initial chemotherapy and 11 (28%) did not. After local therapy in this group the figures for CR were 70% (19 patients) and 73% (8 patients), respectively. This difference is not significant. Side effects from chemotherapy were minimal and patient compliance was 100%. Of the original 96 eligible patients studied, 1 patient was not assessed and 66 (69%) responded to initial chemotherapy; of these 48 (73%) had a CR following local therapy. Only 15 of the 29 chemotherapy nonresponders (52%) achieved CR following local therapy. This difference is significant (P=0.03). The overall 5‐year survival for these 96 patients is 36%, with chemotherapy responders having the longest median duration of survival.
Cure of ommaya reservoir associated staphylococcus epidermidis ventriculitis with a simple regimen of vancomycin and rifampin without reservoir removal
Authors: Connors Joseph M.
Published: February 2007

Staphylococcus epidermidis ventriculitis developed in a patient undergoing treatment for meningeal lymphoblastic lymphoma via Ommaya subcutaneous reservoir. Treatment with a regimen of intravenous and intraventricular vancomycin and oral rifampin resulted in prompt cure of the infection without removal of the reservoir. The antiobiotic therapy, guided by CSF bacteriocidal levels, was convenient to administer, nontoxic, and well tolerated. No interruption of lymphoma treatment was necessary.
Intermittent combined chemotherapy with doxorubicin in recurrent childhood acute lymphoblastic leukemia
Authors: Platt M. P. Ward , Mott M. G. , Eden O. B.
Published: February 2007

A series of 14 children with bone marrow or testicular recurrence of acute lymphoblastic leukemia (ALL) and treated with pulsed combined chemotherapy incorporating doxorubicin is reviewed. All had been previously adequately treated according to established leukemia protocols. Median disease‐free survival for the series is 46 weeks, overall survival 62 weeks, and the toxicity of the therapy relatively low. This compares favorably with other reports of treatment of relapsed ALL and supports the formulation of prospective trials to evaluate anthracyclines in initial induction and consolidation phases of treatment of childhood ALL.
Prolonged second remissions in childhood acute lymphocytic leukemia: A report from the childrens cancer study group
Authors: Baum E. , Nachman J. , Ramsay N. , Weetman B. , Neerhout R. , Littman P. , Griffin T. , Norris D. , Sather H.
Published: February 2007

To 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 to Escherichia coli L‐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 study.
Therapeutic leukapheresis for hyperleukocytosis in acute myelocytic leukemia
Authors: Cuttner Janet , Holland James F. , Norton Larry , Ambinder Edward , Button Gail , Meyer Richard J.
Published: February 2007

Twenty‐two patients with newly diagnosed acute myelocytic leukemia (AML) and white cell counts (WBC) greater than 100,000/μl received one, two, or three leukaphereses prior to induction chemotherapy with cytosine arabinoside (Ara‐C) and daunorubicin (DNR). Fifteen of 22 (68%) achieved a complete remission. Greater than a 30% decrease in initial WBC was found to be an important predictor of response. Fifteen of 17 patients (88%) with greater than 30% reduction of initial WBC achieved remission, while none of 5 patients with less than a 30% reduction responded (P = 0.001).
Histiocytosis X in children: Patterns of disease and results of treatment
Authors: Matus‐Ridley Monica , Raney R. Beverly , Thawerani Hasina , Meadows Anna T.
Published: February 2007

The pathologic materials and clinical courses of 36 children aged 1 month‐22 years, with histiocytosis × (H‐X) seen at the Philadelphia Children's Cancer Research Center from 1970 to 1979 were reviewed. The pathologic subtype of H‐X was favorable (type II) in 31 patients, unfavorable (type I) in one patient, and unclassified in four patients whose specimens were limited to a skin biopsy. Sixteen patients had localized H‐X involving bone (14 patients), soft tissue (1 patient), or skin only (1 patient); all are alive and well after treatment with surgery alone (12 patients), radiation therapy (RT) (3 patients), or observation (1 patient); only 1 of the 16 developed recurrent H‐X. The other 20 patients presented with multifocal H‐X involving the skeleton alone (3 patients); the skeleton and soft tissues other than liver (7 patients); soft tissue exclusive of the liver (3 patients); soft tissue including the liver (4 patients); or soft tissues, skeleton, and liver or multiple drugs ± RT (15 patients). Seven of the 20 patients are alive and well without recurrence at a median of 4 years after diagnosis. Nine of the 20 patients, including 3 with liver dysfunction, responded completely to initial therapy but developed recurrence; each was retreated with drugs and is alive and well at a median of 4 years. The remaining 4 patients had widespread disease with dysfunction of the liver and/or hematopoietic system at diagnosis, failed to respond, and died. We conclude that (1) patients with multiple bony lesions with or without associated soft tissue disease or skin involvement have a favorable outlook and do not require systemic chemotherapy; (2) systemic treatment also is unnecessary for patients with localized H‐X since recurrence is rare; (3) drugs can benefit patients with multifocal H‐X, although the optimal duration of therapy is unclear; and (4) favorable response to treatment indicates high probability of disease‐free survival. However, organ dysfunction at diagnosis is ominous: four of seven patients with liver dysfunction are dead, as are all three patients who prsented with peripheral blood count depression.
Adriamycin, BCNU, and cyclophosphamide in drug‐resistant adenocarcinoma of the ovary
Authors: Presant Cary A. , Bartolucci Alfred
Published: February 2007

Because of an encouraging response rate in a pilot study of adriamycin, BCNU, and cyclophosphamide (ABC), the Southeastern Cancer Study Group conducted a phase II study of ABC in patients with melphalan‐resistant ovarian carcinoma. Of 36 evaluable patients, there were only 4 partial responses to therapy, for a partial response rate of 11%. Durations of response were 4 to 50 + weeks, and the overall median survival was 29 weeks. No complete responses were seen. Dose‐limiting toxicity was granulocytopenia. We conclude that ABC is generally ineffective in management of alkylator‐resistant ovarian adenocarcinoma.
Asymptomatic intracardiac metastasis from osteosarcoma: A case report with literature review
Authors: Das Lakshmi , Farooki Zia Q. , Hakimi Mehdi N. , Philippart Arvin I. , Watts Frederick B. , Arciniegas Eduardo , Cushing Barbara , Ryan James
Published: February 2007

Osteosarcoma very rarely metastasizes to the heart. Thirteen cases have been reported in the literature so far. Diagnosis in some of these cases was made during investigation for severe cardiac failure and in most of them at autopsy. Our patient, a 13‐year‐old girl, showed right pulmonary metastases on chest x‐ray 1 year after above knee amputation for osteosarcoma of the distal femur. Routine preoperative computerized axial tomography (CT Scan) revealed a calcified lesion in the heart in addition to the pulmonary metastases. She was very active and completely asymptomatic. Two‐dimensional echocardiography, angiography, and right and left heart catheterizations were done. This revealed a large mobile metastatic lesion in the right ventricle. The intraventricular tumor was successfully removed, and 12 days later she had a second thoracotomy for removal of pulmonary metastases. Nine months after her intraventricular metastasis was removed she developed a solitary right pulmonary metastasis. This was successfully resected. Now, 10 months later, she is disease free and completely asymptomatic.
Brief communication: Legionnaire's disease successfully treated in acute myelocytic leukemia during severe neutropenia
Authors: Guthrie Troy H. , Mahizhnan Palarmalai
Published: February 2007

A patient with acute nonlymphocytic leukemia developed progressive lung infiltrates and unremitting fevers during a profound neutropenic state. Legionnaire's disease was diagnosed by simple immunologic studies and successfully treated with erythromycin.

This index case alerts physicians toward a treatable infection which would not normally be susceptible to the empiric antibiotic regimens given neutropenic patients with fevers.
Clinical aspects of the rhabdoid tumor of the kidney: A report of the national wilms' tumor study group
Authors: Palmer Nigel F. , Sutow Wataru
Published: February 2007

Rhabdoid tumor of the kidney (RTK), originally described as a monophasic sarcomatous variant of Wilms' tumor, is now recognized as a highly malignant, non‐Wilms' tumor possibly of neuroectodermal origin. Twenty‐one National Wilms' Tumor Study patients with this tumor were treated in the years 1969 through 1978. Mean patient age was 18 months with 16 of the 21 younger than 2 years at diagnosis. Two patients were Stage I, 10 Stage II, 5 Stage III, and 4 Stage IV. One patient only is continuously disease free and another is surviving disease free following excision of bilateral pulmonary metastases. One patient died of sepsis early during therapy. Thus 18 of the 19 patients who relapsed died, 15 within 1 year of diagnosis, all with progressive tumor growth. The rapid appearance of metastases (mean 4 months), often to multiple sites, and short subsequent survival signal a very malignant tumor resistant to current treatment stratagems.
Central nervous system toxicity of high‐dose cytosine arabinoside
Authors: Grossman L. , Baker M. A. , Sutton D. M. C. , Deck J. H. N.
Published: February 2007

Ten patients with refractory acute leukemia were treated with high‐dose cytosine arabinoside (Ara‐C) infusions. Nine patients had previously achieved at least one complete remission using standard chemotherapy protocols that include cytosine arabinoside. Eight of the ten had been on maintenance therapy. Twelve courses of treatment were given, with the cytosine arabinoside infused over 1‐2 hours in a dose of 3 gm/m2. Each course consisted of 12 to 16 doses given at 12‐hour intervals.

The drug was generally well tolerated but five patients developed central nervous system symptoms characterized by ataxia, dysphasia, nystagmus, dysdiadochokinesis, and a decreased level of consciousness. These changes began 3 to 34 days after the initiation of therapy and were severe at the time of death in two of the patients. One complete and one partial remission, lasting 2.5 months and 1 month, respectively, were documented. This experience suggests that high‐dose AraC is of limited usefulness in refractory acute leukemia and may be frequently associated with significant neurotoxicity.
Primary chemotherapy followed by radiotherapy for localized non‐hodgkin's lymphomas: A preliminary report
Authors: Sampi Kazumi , Takeoda Syozi , Hattori Masao
Published: February 2007

Twenty‐eight evaluable patients with clinical stage I‐II of non‐Hodgkin's lymphoma were treated with primary chemotherapy followed by involved field radiotherapy. The frequency of the follicular versus diffuse histological pattern was 14.3 versus 85.7%, and 24/28 (86%) of patients were in stage II. No lymphoma examined was identified as T‐cell in origin. A complete response was obtained in 21 (78%) of 27 patients with measurable disorder. [Gastrectomy rendered one patient disease‐free survival, and one partially responded showing a complete reponse after radiotherapy.] Sixteen (76%) of the 21 employed for complete response. After 36 months, elapsed disease‐free survival was rated at 100% together with actuarial survival of all patients at 81%. Chemotherapy contributed to reduce the radiation dosage to 3000 rads and to control the areas infiltrated with preexisting tumors. These findings, although the median follow‐up time in our study remains short (28 months), provide a strong rationale for further clinical trials of primary chemotherapy, followed by regional radiotherapy for localized stages of non‐Hodgkin's lymphomas.
Phase II evaluation of galactitol in head and neck cancer: A southwest oncology group study
Authors: Haas Charles D. , Lehane Daniel , Bottomley Richard
Published: February 2007

A phase II evaluation of DAG in head and neck cancer patients produced one partial response and one patient with prolonged stable disease from nine fully evaluable patients with squamous carcinomas. One partial response was produced in a patient with anaplastic thyroid carcinoma. No drug deaths or life‐threatening toxicity were reported. Further evaluation of DAG in thyroid tumors is warranted.
Brief communication: Hexamethylmelamine in adenocarcinoma of the pancreas and liver
Authors: Oldham Dwight S. , Wampler Galen L.
Published: February 2007

Ten patients with advanced adenocarcinoma of the pancreas were treated with hexamethylmelamine 8 mg/kg/day in oral, divided doses. One of the five patients with measurable disease had a partial response which lasted 5 months. One of the five patients with no measurable disease treated for 52 months with hexamethylmelamine survived a total of 59 months. This experience suggests that hexamethylmelamine may be an active drug in the treatment of pancreatic cancer.
Antibody Response to Pneumococcal Vaccine in Patients With Solid Tumors and Lymphomas
Authors: Shildt Richard A. , Boyd James F. , McCracken Joseph D. , Schiffman Gerald , Giolma John Paul
Published: February 2007

Ninety patients with solid tumors or lymphomas were immunized with a polyvalent pneumococcal vaccine. Pre‐ and postimmunization antibody titers were determined by radioimmunoassay. Treated patients with lymphoma had poor antibody response whether on or off chemotherapy. Patient with chronic lymphocytic leukemia had the lowest antibody titers of all patients groups. Patients with solid tumors had antibody responses which were similar to those of the control population. Those patients who received sequential chemotherapy and immunization had a tendency for higher postimmunization titers than those patients who received simultaneous chemotherapy and immunization, but the difference was not significant. This study suggests that patients with solid tumors would be expected to benefit from pneumococcal immunization, whereas patients with lymphoma immunized after receiving treatment initially would not be expected to develop protective antibody levels. Recovery of antibody formation in patients with non‐Hodgkin lymphoma, which may occur in patients with Hodgkin disease, remains to be determined.
Prognosis in Acute Lymphoblastic Leukemia of Childhood as Determined by Cytogenetic Studies at Diagnosis
Authors: Morse Helvise G. , Odom Lorrie F. , Tubergen David , Hays Taru , Blake Marilyn , Robinson Arthur
Published: February 2007

Fifty‐one children with acute lymphoblastic leukemia on a common protocol of treatment were classified according to presence or absence of chromosomal abnormalities found at the time of diagnosis in bone marrow and/ or blood. Twenty‐two or 43% had normal karyotypes while 29 (57%) had clonal abnormalities using the Giemsa‐trypsin banding technique. Thirteen of the 29 (45%) chromo‐somally abnormal patients relapsed while only three of 21 (14%) with normal karyotypes have relapsed with a median follow‐up of 49.5 months (42‐76 months). (One child with a normal karyotype did not respond to therapy.) Several hypotheses have been offered to attempt to explain the significantly better prognosis of patients with no observable initial chromosomal aberrations.
Treatment of childhood acute lymphoblastic leukaemia in Malaysia, 1976‐1982
Authors: Lin Hai‐Peng , Sinnah D. , Menaka N. , Cherian R. , Singh P.
Published: February 2007

One hundred four children with acute lymphoblastic leukaemia were diagnosed at the University Hospital, Kuala Lumpur, Malaysia, between 1976 and 1982; 87 were evaluable with respect to treatment. They were divided into good prognosis (GP) and bad prognosis (BP) groups based on their initial total white cell count, their treatment differing only during the maintenance phase. Remission was achieved in 82 patients (94%) of whom ten (12%) subsequently died in remission from infection. Twenty‐eight (34%) relapsed while on treatment and three while off therapy. Eleven patients ceased treatment after 3 yr of continuous complete remission (CCR). Three of these later relapsed, two within the first year. Survival in CCR was significantly better in the GP group up to 30 months, after which the difference diminished. There was no difference in survival between boys and girls. The overall disease‐free survival at 3 yr and 5 yr was 40% and 25%, respectively, with a median follow‐up period of 20 months (range 4‐69 months). The reasons for the relatively low survival rates as compared with those in developed countries are discussed.
Can hypertransfusion attenuate myelosuppression associated with combination chemotherapy in patients with inoperable bronchogenic carcinoma? A report of a randomised, controlled study
Authors: Lam W. K. , So S. Y. , Ng R. P. , Yu D. Y. C.
Published: February 2007

Based on the concept of “>Based on the concept of” hypertransfusion has been shown to attenuate the leucopenia associated with chemotherapy in children with leukemia. We conducted a randomized, controlled study of hypertransfusion in 25 patients with inoperable lung cancer who received combination chemotherapy consisting of methotrexate, adriamycin, cyclophosphamide, and CCNU (Lomustine) (MACC scheme). Twelve patients in the hypertransfusion group were given red cell transfusion to a hemoglobin value greater than or equal to 17 gm/dl prior to each chemotherapy cycle. The two groups of patients were comparable in age, cell type, extent of disease, performance status, and initial hemoglobin level and blood counts. The mean fall in granulocyte count was greater for control group (3.76 × 109/liter) than for hypertransfusion group (3.27 × 109/liter), and the mean fall in platelet count was greater for control group (53.84 × 109/liter) than for hypertransfusion group (35.83 × 109/liter), although the differences did not reach statistical significance (p > 0.05) partly because our MACC scheme was probably not sufficiently myelosuppressive to bring about a difference in the two groups. Granulocytopenia‐associated infections were infrequent in both groups: two episodes in 37 cycles of chemotherapy in the hypertransfusion group and three episodes in 43 cycles in the control group. Hypertransfusion was simple and safe, and the encouraging trend towards less marked myelosuppression in our hypertranfused group would warrant further studies using more intensive and myelosuppressive combination chemotherapy regimens.