bluuebunny/crossref_metadata_2025 huggingface dataset:
Renal cell carcinoma in children
Authors: Raney R. Beverly , Palmer Nigel , Sutow Wataru W. , Baum Edward , Ayala Alberto
Published: February 2007

Data from four pediatric hospitals concerning 20 children treated for renal cell carcinoma (RCC) from 1964‐1978 were reviewed. Median age of the patients (pts) was 11.8 years (range, 14 months‐19 years). Twelve were male and eight female; 17 were white and three black. Most patients presented with pain and hematuria with or without a palpable mass. An intrarenal tumor was detected at IV urography (17 pts), arteriography (2 pts), or at surgery (1 pt). Treatment consisted of nephrectomy in 15 pts, renal biopsy (4 pts), or no surgery (1 pt), followed by chemotherapy (5 pts), radiation therapy (1 pt), or both (7 pts). Ten pts died of distant metastases at a median of one year (range, 0.2 to two years) after diagnosis. The other 10 pts (50%) survive free of relapse at a median of 4 years (range, two to ten years) from diagnosis. Proportions surviving free of recurrent disease two or more years by National Wilms' Tumor Study (NWTS) Group were 5/5 in Group 1, 3/7 in Group 11, 1/3 in Group III, and 1/5 in Group IV; by age at diagnosis, 6/6 in those under 11 years old and 4/14 in those 11 or older; and by type of surgery, 10/15 who had nephrectomy and 0/5 with limited or no surgery. The data indicate that radiation and chemotherapy had only minor if any influences on relapse‐free survival. We conclude that (1) RCC in children is similar to its counterpart in adults; (2) RCC has a worse prognosis than Wilms' tumor except for the earliest stage; (3) nephrectomy alone is adequate treatment for Group I RCC, and (4) young age (< 11 years old) may be prognostically favorable.
Combination chemotherapy pneumonitis: A case report of possible synergistic toxicity
Authors: Goedert James J. , Smith Frederick P. , Tsou Edward , Weiss Raymond B.
Published: February 2007

A woman with pancreatic cancer developed acute interstitial infiltrates while receiving modest doses of two potential pulmonary toxins, mitomycin‐C and chlorozotocin. Chemotherapy pneumonitis, confirmed by lung biopsy, responded dramatically to prednisone with negligible sequelae. Comparison with the doses in other reported cases suggested additive or synergistic toxicity between these two alkylating agents.
Treatment of adult acute lymphoblastic leukemia with adriamycin, vincristine, and prednisone
Authors: Aviles Agustin , Sinco Armando , Rivera Raul , Ambriz Raul , Herrera Jose G. , Pizzuto Javier
Published: February 2007

At the present time, it is possible to achieve up to a 95% complete remission in childhood acute lymphoblastic leukemia, using the combination of vincristine and prednisone. Nevertheless, it has not been possible to reproduce these results in the adult. For this reason, a third drug, in this case adriamycin in a low dose, was added to the vincristineprednisone combination in the treatment of adult acute lymphoblastic leukemia (ALL). Complete remission was achieved in 45 of the 50 patients (90%). The median duration of remission was 23 months and the median survival time in this group was 31 months. The complications were minimal and the tolerance was good. From the point of view of our results and others reported in the literature, we consider that the combination of vincristine, prednisone, and adriamycin is a useful method for induction of remission of adult ALL.
Neuroblastoma: Therapy for infants with good prognosis
Authors: Nitschke Ruprecht , Humphrey G. Bennett , Sexauer Charles L. , Smith E. Ide
Published: February 2007

Therapy was designed to achieve a high cure rate and to prevent serious therapeutic side effects for 11 infants younger than one year old with neuroblastoma who had a favorable prognosis (Evans Stages I, II, III, and IV‐S). It consisted of surgery alone if the tumor was totally removed (one infant) and of surgery and low doses of cytoxan and vincristine for a period of 1 year if the tumor was incompletely removed (seven infants). In addition, radiation therapy was applied to unresected dumbbell tumors (three infants). All infants are alive without evidence of disease with the exception of one who died in an accident. The follow‐up time varies from 2‐8 years. The drug combination prevented recurrences in two infants whose tumor was reduced by surgery to less than 10% of the original size. In five infants, chemotherapy reduced the size of large residual tumor masses. Two of these masses were subsequently removed. The tumors of the three other infants recurred while on chemotherapy and were successfully eradicated by surgery or radiation therapy. Two infants were not treated according to this therapeutic plan. Although they had small residual masses after surgery, no chemotherapy was given. They are alive without recurrence of the disease 2 years or more after diagnosis. In summary, cure was achieved in these infants without intensive chemotherapy.
Two sensitive echocardiographic techniques for detecting doxorubicin toxicity
Authors: Goldberg Stanley J. , Hutter John J. , Feldman Linda , Goldberg Susan M.
Published: February 2007

This investigation was designed to evaluate echoes of patients who received a course of doxorubicin (225‐550 mg/m2) by two sensitive indicators of myocardial fibrosis: (1) M‐mode scans of thickening‐thinning curves of the left ventricular posterior wall (LVPW), and (2) two‐dimensional qualitative evaluation of LVPW contraction at three levels of the LV short axis (leaflet, chordal, and papillary). These were compared to standard M‐mode shortening fraction Δ. Eighteen children with cancer were evaluated; 11 had received doxorubicin and 7 were treated with other agents. Echocardiographers were unaware of the treatment category. All controls and 10 of 11 doxorubicin patients had normal. An M‐mode echocardiogram of the expanded LVPW was digitized and wall thickness was evaluated by determining if diastolic relaxation had the normal two phases or only one; six of ten doxorubicin patients and no controls had abnormal relaxation. Qualitative evaluation of LVPW and septal contraction toward the center of the ventricle showed that seven of eleven patients who received doxorubicin and one control (a postthoracotomy patient) had contraction deficits. Six of seven with contraction deficit were the same patients with slowed relaxation. The greatest contraction deficit occurred in the LVPW behind the posterior mitral leaflet. Patients with more extensive involvement had an additional contraction deficit extending to the apex. These tests are more sensitive for detection of doxorubicin toxicity than Δ.
Early death in acute leukemia in children
Authors: Dearth James , Salter Merle , Wilson Edward , Kelly David , Crist William
Published: February 2007

Therapy for acute leukemia in children has improved dramatically in recent years so that early death is rare. A subset of patients with extreme elevation of the WBC at diagnosis have been noted to have a higher rate of early death. We reviewed our experience with acute leukemia in children retrospectively over a 10 year period to assess the incidence and outcome of this problem. Nine early deaths occurred in a total of 185 cases (4.9%). One hundred and sixty patients presented with WBC less than 100,000/mm3 at diagnosis and four (2.5%) early deaths occurred. Twenty‐five patients presented with WBC greater than 100,000/mm3 at diagnosis and five (20%) early deaths occurred (p < 0.001). While early death in acute leukemia in children is uncommon (4.9%), patients with extremely elevated WBC at diagnosis have a significantly higher risk of early death.
Survival of children with cancer in torino, Italy
Authors: Magnani C. , Pastore G. , Cesana B. , Di Prima S. , Stalteri D. , Terracini B.
Published: February 2007

During 1967‐78, cancer was diagnosed in 870 children living in the Province of Torino. Survival until the end of 1978 is reported separately for cases diagnosed in 1967‐70, in 1971‐74, and in 1975‐78. Comparisons between the three series indicate a statistically significant (p < 0.05) increase in survival rates for children with leukemia and cancer of the central nervous system as well as a nonstatistically significant increase for children with lymphoma (both Hodgkin's and non‐Hodgkin's). No consistent changes in time were noticed for neuroblastomas, nephroblastomas, soft tissue sarcomas, and retinoblastomas. Survival rates for both types of lymphomas and for leukemias (at least for cases diagnosed after 1975) were very similar to corresponding population‐derived data from the U.S. and other Western countries. Rates for other cancers were relatively poor in the Province of Torino. It is suggested that relatively high care standards are easier to achieve in the case of childhood cancers requiring chemotherapy than in cancers commonly treated through radiotherapy and/or surgery.
Angiosarcoma of the heart: Report of a case in a 9‐year‐old boy
Authors: Marni Ernesto , Pedroni Elisa , Magrini Umberto , Mariani Paolo , Richichi Italo , Viganó Mario
Published: February 2007

A 9‐year‐old boy with a myocardiac angiosarcoma is described; the tumor was diagnosed by echocardiography and the boy underwent surgery followed by radio and chemotherapy. Death occurred 5 months after surgery, probably due to abdominal hemorrhage from metastases. The young age of the patient, the acute and reversible hepatic damage, the use of echocardiography for diagnosis and the possible role of the extracorporeal circulation in determining the metastases are emphasized.
Morphologic changes in blast cells of children with acute lymphoblastic leukemia in relapse
Authors: Weinblatt Mark E. , Ortega Jorge A. , Kaplan Sophie
Published: February 2007

Relapse in children with acute lymphoblastic leukemia (ALL) on therapy may be due to development of a resistant clone of blast cells. Seven children who presented initially with the ‘common’‐type, L1 lymphoblast relapsed with a morphologically different and more undifferentiated blast cell. All were male, with a median age of 12 years at initial presentation. One child who relapsed while off therapy was successfully reinduced and remains in hematologic remission on therapy. The remaining 6 children died within 10 months of relapse. Selection of a resistant clone of lymphoblasts by chemotherapy may be responsible for relapse in children with ALL and should be studied in hopes of controlling the disease.
Ovarian function after successful bone marrow transplantation in postmenarcheal females
Authors: Sklar Charles A. , Kim Tae H. , Williamson Jeffrey F. , Ramsay Norma K. C.
Published: February 2007

Ovarian function was followed serially in a group of six postmenarcheal females after successful bone marrow transplantation (BMT). The patients were between 13 9/12 and 22 6/12 (median 16 5/12) years of age at the time of BMT and were followed a median of 20 months (range 17‐45 months) posttransplantation. Two subjects received short‐term high‐dose cyclophosphamide combined with single‐dose total lymphoid irradiation (Group I), whereas the remaining four were treated with short‐term, high‐dose chemotherapy plus single‐dose total body irradiation (Group II). Group II subjects also received combination chemotherapy prior to BMT.

One subject from Group I continues to have regular menses and normal gonadotropin levels, 36 months post‐BMT. The remaining five patients have demonstrated persistently elevated plasma concentrations of LH and FSH over a 17‐ to 45‐month period of time. None of the four patients in Group II has menstruated since undergoing BMT.

We conclude that single‐dose radiation combined with short‐term, high‐dose chemotherapy results in profound ovarian damage in the majority of young women undergoing BMT.
Treatment of advanced ovarian carcinoma with hexamethylmelamine, doxorubicin, and cis‐platinum (HAC): Results in both untreated and previously treated patients
Authors: Brower Mark S. , Coleman Morton , Pasmantier Mark W. , Silver Richard T. , Mamaril Aurora P. , Quiguyan Cirila C.
Published: February 2007

Twenty‐two patients with advanced (FIGO stages III and IV) adenocarcinoma of the ovary were treated with 28‐day cycles of hexamethylmelamine, doxorubicin, and cis‐dichlorodiamine‐platinum (II) (HAC). After 45 months, there were 21 evaluable patients. The median survival was 16 months. Response was achieved in 82% (9/11) who had received no prior chemotheraphy, and in 50% (5/10) previously treated. HAC therapy was readily administered on an outpatient basis, with comparatively low major toxicities, primarily hematologic, neurologic, and gastrointestinal. These results indicate that HAC therapy is an effective regimen for patients with advanced ovarian carcinoma, regardless of their prior treatment status.
Pulmonary blastoma associated with cystic lesions in children
Authors: Holland‐Moritz Roxie M. , Heyn Ruth M.
Published: February 2007

A 4‐year‐old boy had a pulmonary blastoma removed from the site of a persistent pulmonary cystic lesion present since 6 weeks of age. Bone metastasis appeared 4 months after diagnosis. Following radiation therapy to the bone and after 15 months of VAC chemotherapy, he developed further metastases which showed little response to adriamycin or radiation therapy. He died 2 years and 2 months after the initial operation. A review of other pulmonary blastomas associated with cystic lesions in children is presented.
Extracranial primitive neuroectodermal tumor
Authors: Womer Richard B.
Published: February 2007

An 11‐year‐old white girl was admitted to The Children's Hospital of Philadelphia in July 1983 for evaluation of metastatic tumor. She had been well until July 1982, when a mass developed over the right scapula. Treatment with warm compresses and antibiotics resulted in no improvement, and incision and drainage were unproductive. A biopsy at another hospital was interpreted as showing a primitive neuroectodermal tumor. There was no evidence of metastatic disease. She then underwent excision of the tumor with the underlying scapula. No further treatment was administered.
IV‐S neuroblastoma: A cooperative study of 30 children
Authors: Mancini Antonia F. , Rosito Pasquale , Vitelli Arnaldo , Paolucci Paolo , Vecchi Vico , Paolucci Guido , de Bernardi Bruno , Calculli Giovanni , Carli Modesto , Castello Manuel , Marchi Antonietta , Massolo Fausta , Mastrangelo Renato , Pastore Guido , Pianca Clotilde , Zanazzo Giulio Andrea
Published: February 2007

The clinical features of 30 children with IVS neuroblastoma have been reviewed. They were treated at 11 Italian pediatric institutions in the period 1970‐1981. Patients with IV‐S neuroblastoma comprise 6.1% of all the neuroblastoma cases observed during that period. The age at diagnosis ranged from birth to 11 months (mean, 3 months). The distribution of “primary” lesions was of interest. The adrenal gland was affected most often (57% of patients), but tumors of the chest and neck were also encountered. No specific “primary” lesion was identified in ten children. The most frequent site of widespread disease was the liver (87%). Neither the size of the “primary” tumor, nor the number or size of subcutaneous nodules was of prognostic significance. Unfavorable features were age less than 2 months and clinical signs of pulmonary, renal, or hepatic embarrassment. These data confirm the need for prompt intervention in the infant who is suffering from compression of these vital structures by the enlarged liver. Radiation therapy is to be preferred for this purpose, because of the often severe toxicity that is associated with chemotherapy in infants. One, and possibly two babies in this series died of chemotherapy‐related complications.
Peptichemio in neuroblastoma at relapse
Authors: Pastore G. , de Bernardi B. , Carli M. , Acquaviva A. , Cordero Montezemolo L. Di , Loiacono G. , Tamaro P.
Published: February 2007

Peptichemio (PTC), a multipeptidic complex of m‐L‐phenyl‐alanine mustard, was administered to 39 children with neuroblastoma at relapse. The compound was given in two 5‐day cycles at dosages varying from 1.0‐1.5 mg/kg/day. We were able to evaluate 29 of the initial 39 children for PTC effect; 21 of them had received PTC as first therapy following diagnosis. Ten patients underwent other chemotherapy for relapse before PTC. Three patients were off therapy when relapse occurred.

Subjective improvement was observed in 18 cases (62%). Eleven patients (38%) experienced an objective regression, which was scored as complete response in three cases, partial response in two, mixed response in six. In ten children no significant disease change was observed; the remaining eight had a progression of their disease while receiving PTC. The incidence of responses has been higher in patients off therapy at moment of relapse, and lower in those pretreated for their relapse. Previous administration of PTC did not reduce the chance of response at relapse.

Major toxic effects were transient, mostly moderate myelodepression and phleboscle‐rosis. Allergic reactions, nausea, and vomiting, occurred in a few patients.

These data indicate that PTC may exert objective antitumor activity in approximately one‐third of neuroblastoma patients at relapse.
Anaphylactic reaction to cytarabine: In vitro evidence that the response is immunoglobulin e mediated
Authors: Markman Maurie , Howell Stephen B. , King Mark , Pfeifle Craig , Wasserman Stephen I.
Published: February 2007

A 48‐year‐old female developed significant bronchospasm on two occasions after being treated with cytarabine (Ara‐C) by the intraperitoneal route. In this report we present the first in vitro evidence that such a reaction to cytarabine can be associated with the release of histamine and therefore might be immunoglobulin E (IgE) mediated. In addition, this report emphasizes the fact that, while uncommon, severe allergic reactions to this useful chemotherapeutic agent do occur and must be considered in the differential diagnosis of anaphylaxis and related symptoms in patients receiving this drug.
Treatment of advanced head and neck cancer: Multiple daily dose fractionated radiation therapy and sequential multimodal treatment approach
Authors: Nissenbaum Michael , Browde Selma , Bezwoda Werner R. , de Moor Norah G. , Derman Dennis P.
Published: February 2007

Fifty‐eight patients with advanced head and neck cancer were entered into a randomised trial comparing chemotherapy (DDP + bleomycin) alone, multiple daily fractionated radiation therapy, and multimodality therapy consisting of chemotherapy plus multiple fractionated radiation therapy. Multimodal therapy gave a significantly higher response rate (69%) than either single‐treatment modality. The use of a multiple daily dose fractionation allowed radiation therapy to be completed over 10 treatment days, and the addition of chemotherapy to the radiation treatment did not significantly increase toxicity. Patients receiving multimodal therapy also survived significantly longer (median 50 weeks) than those receiving single‐modality therapy (median 24 weeks).
Maturation of Wilms' tumor pulmonary metastases to benign fibromas after therapy
Authors: Silván A. M. Alvarez , Gonzalez del Castillo J. , Caro A. Martinez , Vallés M. C. Garcia , Cuevas G. Pineda , Arcega M. A. Maillo , Barrios A. López
Published: February 2007

A 3‐year‐old girl with Wilms' tumor developed pulmonary metastases 5 months after diagnosis. All but one of the visible lesions disappeared after thoracic irradiation and multiple‐agent chemotherapy. Subsequent thoracotomy revealed 17 small nodules in addition to the visible lesion, and all of them proved to be fibromas. It would appear that the Wilms' tumor metastases to the lung were made to mature to benign neoplastic processes after the treatments given.
Pre‐B cell cutaneous lymphoma in infancy: A unique clinical entity
Authors: Meyers Lee , Hakami Nasrollah
Published: February 2007

A case of a young infant with primary cutaneous lymphoma with a pre‐B immunophenotype is presented. Several similar cases from the literature are summarized. Pre‐B cutaneous lymphoma in young children represents a newly recognized clinical entity.
Ascending myelopathy after chemotherapy for central nervous system acute lymphoblastic leukemia: Correlation with cerebrospinal fluid myelin basic protein
Authors: Bates Susan E. , Raphaelson Marc I. , Price Robert A. , McKeever Paul , Cohen Steve , Poplack David G.
Published: February 2007

Ascending myelopathy developed in a previously irradiated 10‐year‐old boy after intra‐ventricular methotrexate and cytosine arabinoside were given for central nervous system relapse of acute lymphoblastic leukemia. The course was fatal in 10 weeks. Cerebrospinal fluid myelin basic protein levels, indicating a demyelinative process, rose prior to the onset of clinical symptoms and remained at very high levels until death. Myelin basic protein may be useful as a predictor of chemotherapy‐associated neurotoxicity.
Leydig cell damage after testicular irradiation for lymphoblastic leukaemia
Authors: Shalet S. M. , Horner Alison , Ahmed S. R. , Morris‐Jones P. H.
Published: February 2007

The effect of testicular irradiation on Leydig cell function has been studied in a group of boys irradiated between 1 and 5 years earlier for a testicular relapse of acute lymphoblastic leukaemia. Six of the seven boys irradiated during prepubertal life had an absent testosterone response to HCG stimulation. Two of the four boys irradiated during puberty had an appropriate basal testosterone level, but the testosterone response to HCG stimulation was subnormal in three of the four. Abnormalities in gonadotrophin secretion consistent with testicular damage were noted in nine of the 11 boys. Evidence of severe Leydig cell damage was present irrespective of whether the boys were studied within 1 year or between 3 and 5 years after irradiation, suggesting that recovery is unlikely. Androgen replacement therapy has been started in four boys and will be required by the majority of the remainder to undergo normal pubertal development.
Pneumococcal vaccination in children with acute lymphocytic leukemia
Authors: Feldman Sandor , Malone W. , Wilbur Richard , Schiffman Gerald
Published: February 2007

Sixty‐three children with ALL in CCR and treated according to a standard therapy protocol were immunized with the 14‐valent pneumococcal vaccine. Forty‐six children were vaccinated 1, 3, or 6 months following initial induction remission; 15 were vaccinated 4–6 weeks following successful completion of 30 months of antileukemia therapy; and two were vaccinated at the time of diagnosis. Response to the vaccine was suboptimal and by the 6‐month follow‐up there were only two serotypes for which more than half the patients tested had > 300 ng antibodies N/ml.
Graft‐versus‐host disease in rhabdomyosarcoma following transfusion with nonirradiated blood products
Authors: Labotka Richard J. , Radvany Ruta
Published: February 2007

Graft‐versus‐host disease is a complication of transfusion of nonirradiated blood products into an immunocompromised patient, and it has been reported in hematologic and lymphoid malignancies as well as in neuroblastoma in children. We report the first case of acute graft‐versus‐host disease in a child undergoing chemotherapy for a rhabdomyosarcoma, who received transfusions during an intercurrent illness. The graft‐versus‐host disease was accompanied by an allogeneic lymphoid graft and was diagnosed on the basis of HLA studies on the patient's and her family's circulating lymphocytes and confirmed by HLA typing of the patient's skin fibroblasts.
Successful treatment of pulmonary and abdominal metastatic osteosarcoma
Authors: Takaue Yoichi , Slopis John M. , Anzai Takashi , Robertson Resa , Jaffe Norman
Published: February 2007

A patient with telangiectatic osteosarcoma of the proximal fibula while receiving adjuvant chemotherapy, developed pulmonary and, later, mesenteric metastases. The pulmonary metastases were resected and the mesenteric metastasis was eradicated with surgery and intra‐arterial cis‐diamminedichloroplatinum II. This represents an additional example of an alteration in the clinical pattern of metastases induced by chemotherapy and the ability to achieve cure with a multidisciplinary approach.
Marrow transplant experience in children with acute lymphoblastic leukemia: An analysis of factors associated with survival, relapse, and graft‐versus‐host disease
Authors: Sanders Jean E. , Flournoy Nancy , Thomas E. Donnall , Buckner C. Dean , Lum Lawrence G. , Clift Reginald A. , Appelbaum Frederick R. , Sullivan Keith M. , Stewart Patricia , Deeg H. Joachim , Doney Kristine , Storb Rainer
Published: February 2007

One hundred fourteen children with acute lymphoblastic leukemia were treated with allogeneic marrow transplantation from HLA‐identical siblings after conditioning with cy‐clophosphamide and total body irradiation. Methotrexate was given posttransplantation for prophylaxis of graft‐versus‐host disease. The minimum follow‐up after transplantation was 2 years. Sixteen of 51 patients transplanted in marrow remission survive from 2.1 to 8.9 years (median 2.7), 13 in continuous remission, one in remission following testicular relapse, and two after marrow relapse. Sixty‐three were transplanted in relapse and eight survived 3–10 years (median 5.7), five in continuous remission, and three in remission following testicular relapse. In a multivariate analysis, factors significantly related to increased survival were marrow remission at transplant (p < 0.007) and chronic graft‐versus‐host disease (p < 0.005). Factors associated with increased relapse were marrow relapse at transplant (p < 0.002) and absence of significant graft‐versus‐host disease (p < 0.004). The development of acute graft‐versus‐host disease was associated with high marrow cell doses (p < 0.04). These data suggest that some children with acute lymphoblastic leukemia and a poor prognosis with conventional chemotherapy may be cured with marrow transplantation.
Response of therapy‐associated acute nonlymphocytic leukemia to intensive induction chemotherapy
Authors: Duane Steven F. , Peterson Bruce A. , Bloomfield Clara D. , Michels Sheryl D. , Hurd David D.
Published: February 2007

Among 31 consecutive patients who developed acute nonlymphocytic leukemia following treatment with chemotherapy or radiation therapy, 17 were treated with intensive chemotherapy aimed at inducing a complete remission. Seven of these 17 patients (41%) obtained a complete remission that ranged in duration from 2 to 11 (median 3) months. Two additional patients who failed to develop normal peripheral blood counts despite postinduction bone marrows that were normocellular and free of leukemia were classified as nonresponders. The median time to complete remission and median duration of leukopenia (WBC < 1,000/μ1) were 34 days and 23 days, respectively. Induction chemotherapy was complicated by fever in all patients, documented infection in six patients, and death secondary to sepsis in three. Survival of the 17 patients ranged from <1 to 39 (median 4) months. Patients achieving a complete remission had a median survival time of 10 months compared to 2 months for the nonresponders. The other 14 patients received only supportive care and had a median survival of 2 months. These findings indicate that therapy‐associated acute nonlymphocytic leukemia (t‐ANLL) can frequently respond to chemotherapy and that achieving a complete remission is associated with longer survival. Although these results are encouraging, patients with t‐ANLL still have a relatively poor prognosis and efforts directed at improving treatment outcome need to be continued.
Sarcoma metastatic to the central nervous system parenchyma: A review of the literature
Authors: Sarno James B. , Wiener Leo , Waxman Marian , Kwee James
Published: February 2007

Sarcoma metastatic to cerebral parenchyma, although rare, occurs more frequently than generally recognized. With increased duration of survival due to multi‐modal therapy, more CNS metastases are being found. A literature search occasioned by a patient with metastatic sarcoma has produced some interesting results.
Neuropsychologic function in children with brain tumors: III. Interval changes in the six months following treatment
Authors: Mulhern Raymond K. , Kun Larry E.
Published: February 2007

Twenty‐six children with primary brain tumors were studied prospectively with regard to their sensorimotor, intellectual, academic, and emotional status. Serial evaluations were conducted after surgery (pre‐irradiation) and six months after the completion of radiation therapy. The timing of the second evaluation was chosen so as to antedate the late effects of irradiation. Children over 6 years old displayed significant improvement of intellectual function over time, with only 11% exhibiting deterioration on one or more cognitive parameters. In contrast, 68% of younger children clinically deteriorated in one or more areas of intellectual functioning, with prominent difficulties in memory and selective attention for age. Children under 6 years old with supratentorial tumors were less likely than those with posterior fossa tumors to improve their cognitive performance. At the second evaluation, 23% of the patients were functioning below normal (IQ < 80) intellectually, with 50% of the younger children and 11% of the older children receiving special educational assistance. Approximately 40–50% of the patients manifested emotional adjustment problems at each evaluation. The results are discussed in terms of the clinical need to follow similar patient populations with formal psychological assessments over time, and in terms of the difficulties involved in defining factors that determine the functional status of children surviving brain tumors.
Secondary polycythaemia associated with large cell lymphoma
Authors: Abdi E. A. , Ding J. C. , Cooper I. A.
Published: February 2007

We describe the case of a 53‐year‐old woman in whom early stage large cell lymphoma appears to be associated with secondary erythrocytosis. A haemogram obtained six months earlier had been normal, but at the time lymphoma was diagnosed, investigations showed haemoglobin 20.5 gm/dl, total red cell count 6 1012/liter, haematocrit 0.60 liters/liter, whole blood volume 81.1 ml/kg, red cell volume 43.2 ml/kg, and plasma volume 37.8 ml/kg. Other investigations revealed no evidence of any other myeloproliferative disorder, and common causes of tissue hypoxia and other well‐known causes of secondary polycythaemia were excluded. Combination chemotherapy employed to treat lymphoma reverted the abnormal blood counts to normal. We believe this to be the first described case of an association of lymphoma and secondary polythaemia.
Steroid receptors in a granulosa cell tumor (GCT) in an infant with precocious puberty
Authors: Leiberman E. , Glezerman M. , Karny N. , Levy J.
Published: February 2007

A granulosa theca cell tumor was found in a 10‐month‐old girl with precocious puberty. Steriod hormone receptors were measured in fractionated tumor cells. Estrogen and progesterone receptors were measured in the cytosol, and estrogen receptors were measured in the nuclear fraction of the tumor. Although high affinity (Kd 0.4 nM) progesterone receptors were present in the cytosol of this tumor—54 fmole/mg protein—no cytosolic estradiol receptors could be detected; however, these receptors were found to be tightly bound to the nuclear fraction of the tumor. The nuclear protein had lower apparent Kd for the hormones—5.4 nM. This tumor produced and released various steroid hormones. The plasma steroid levels before removal of the tumor were 1,200 pg/ml for estradiol, 350 pg/ml for testosterone, and 5 ng/ml for progesterone. All these steroid hormones declined postoperatively to undetectable levels, with total remission of pubertal signs. Plasma‐dehydroepiandrosterione, prolactin, and gonadotropin levels were in the normal range before and after surgery. These results suggest that cytosolic progesterone receptor as an estrogenic marker and/or nuclear estrogen receptors may predict the hormonal dependency of these estrogen‐producing tumors.
Sudden cerebral death in malignant presacral teratoma
Authors: Chan Ka Wah , Fryer Christopher J. H. , Fraser Graham C. , Dimmick James E.
Published: February 2007

A three‐year‐old girl with disseminated malignant teratoma was treated by palliative radiotherapy to her pulmonary metastases. She developed seizure followed by absence of cerebral function and death ensued in 36 hours. Computerized scan of brain was negative prior to death. The main finding at autopsy was occlusion of the carotid and cerebral arteries by necrotic tumour. Widespread cerebral tumour embolization may be an unusual terminal event in cancer patients with pulmonary metastases.
Treatment of advanced ovarian cancer: A randomised trial comparing adriamycin or 4′epi‐adriamycin in combination with cisplatin and cyclophosphamide
Authors: Bezwoda W. R.
Published: February 2007

Fifty‐one patients with ovarian cancer were entered in a randomised trial comparing treatment with cisplatin + adriamycin + cyclophosphamide (PAC) to cisplatin + 4′epi‐adriamycin + cyclophosphamide (PEC). Complete response rates for the two treatment arms were similar (9/27 PAC, 14/24 PEC). Patients with < 2 cm residual disease had significantly higher rate of complete remission than those with > 2 cm residual disease. Cardiotoxicity was significantly less in the PEC‐treated group (0/24) as compared with the PAC‐treated group (6/27, χ2 = 4.09, p < 0.05).
Effects of cyclophosphamide, cis‐platinum, nitrosourea (ACNU), melphalan, and dacarbazine on a cytogenetically highly malignant neuroblastoma xenograft
Authors: Makino Shun‐Ichi , Tsuchida Yoshiaki , Nakajo Toshio , Kanda Naotoshi , Kaneko Yasuhiko
Published: February 2007

The effects of eight different chemotherapeutic agents were studied on a human neuroblastoma xenograft, designated TNB9, according to the standard Battelle Columbus Laboratories protocol. Cytogenetically and molecular‐cytogenetically, this xenograft is known to have a homogeneously staining region (HSR) on chromosome 20 and to exhibit 60‐ to 80‐fold amplification of clone #8 (1.75 kb) and N‐myc (2.1 kb) in the HSR. Our previous analyses of cytogenetic and phenotypic characteristics on nine human neuroblastoma xenografts demonstrated that TNB9 is one of the most malignant strains of neuroblastoma. The in vivo chemotherapeutic sensitivity assessment disclosed that cyclophosphamide, cis‐platinum, nitrosourea (ACNU), melphalan, and dacarbazine (DTIC) are effective, while aclarubicin, vincristine, and cytosine arabino‐side are quite ineffective against this neuroblastoma xenograft.
Statistical evaluation of prognostic factors in ALL and treatment results
Authors: Sather Harland N.
Published: February 2007

Prognostic factor evaluation is a frequent and desirable investigative activity in clinical trials. Nevertheless, a number of errors in the evaluation of such factors occur quite commonly. Many of these problems are due to inappropriate statistical interpretation of the analyses that are conducted. A detailed discussion of several problem areas is given. In the area of childhood ALL trials, issues related to the appropriate choice of disease end‐points for analysis of prognostic factors are discussed.
Methotrexate infusions in poor prognosis acute lymphoblastic leukemia: II. High‐dose methotrexate (HDM) in acute lymphoblastic leukemia in childhood: A pilot study from April 1981
Authors: Moe Peter Johan , Wesenberg Finn , Kolmannskog Svein
Published: February 2007

The pilot study using HDM in all cases of ALL in childhood had been run for 41/2 years as of September 1985. Fourteen (23%) of all 62 diagnosed cases of ALL had WBC above 50 × 109/L, all 14 achieved CR. Three of them were below one year of age, two also had WBC above 400 × 109/L, the third infant had B‐cell‐leukemia. The remaining 11 children received our new HDM protocol (Fig. 1), one of them had relapsed (BM) as of September 1985.
Extrarenal rhabdoid sarcoma
Authors: Blatt Julie , Russo Pierre , Taylor Suzanne
Published: February 2007

Rhabdoid sarcoma is a tumor of unknown etiology that usually occurs in the kidneys of infants and small children. We report an adolescent with a rhabdoid sarcoma of the chest wall, In addition to the patient's age and the site of the tumor, other unusual features of this case were as follows: positive staining of tumor cells with neuron‐specific enolase, the presence of chronic, active, hepatitis that apparently developed coincident with the sar coma, and the presence of widespread hemosiderosis. Two of the patient's siblings died in infancy with degenerative neurologic disease, hepatomegaly, and multiple congenital anomalies. The histochemical findings and family history lend support to previous suggestions that some rhabdoid sarcomas may be of neural crest origin and may be heritable lesions.
Neuro‐ocular damage in pediatric oncology patients: Predictor of long‐term visual disability or tool for limiting toxicity?
Authors: Newman Nancy M. , Donaldson Sarah , De Wit Sharon , King Oscar , Wilbur Jordan R.
Published: February 2007

We present a group of eight pediatric cancer patients with a spectrum of visual afferent pathway abnormalities. Changes include decreased visual acuity, visual field alterations, abnormal visual evoked potentials, changes in the optic disc and nerve fiber layer of the retina, radiation retinopathy, and CNS injury. These changes occur in long term survivors of pediatric malignancy (especially those with prlonged, multimodal, and multicourse therapy), but they may be minimally symptomatic. The changes appear to be analogous to the CNS changes (leukoencephalopathy) described in patients with leukemia and attributed to multimodal therapy.

By taking advantage of opportunities to detect adverse effects earlier in the treatment course, the present excellent cure rate may be improved by refinements in therapy that also improve the quality of survival.
Phase I–II trial of VP‐16 in the treatment of acute nonlymphocytic leukemia and blast crisis of chronic granulocytic leukemia
Authors: Mailliard James A. , Letendre Louis , Dalton Robert J. , Levitt Ralph , Gerstner James B. , Therneau Terry M. , Pierre Robert V.
Published: February 2007

VP‐16 was used to treat newly diagnosed elderly (⩾65 yr) patients with acute nonlymphocytic leukemia (ANLL) and patients with blast crisis of chronic granulocytic leukemia (BI‐CGL). Our pilot study indicated that VP‐16 160 mg/m2 intravenously daily for 5 days was well tolerated and suggested a direct dose‐response correlation. Thirty additional ANLL patients and 11 CGL patients were studied. Among 26 evaluable ANLL patients, we observed ten responses (38%) (seven complete remission and three partial remission), but none of 11 patients with CGL in blast crisis had meaningful responses. In patients who responded to treatment, myelosuppression was always reversed by day 25. Stomatitis was the major nonhematologic toxicity and appeared more severe with advancing age. We conclude that VP‐16 is active against ANLL and is well tolerated at doses higher than have been previously described. It remains to be shown that the present schedule is superior to the intermittent high‐dose or continuous low‐dose infusion schedules, which have been recently described.
Effect of transfusions on serologic testing for antibody to varicella
Authors: Taylor‐Wiedeman Jean , Brunell Philip A. , Geiser Clementina , Shehab Ziad M. , Frierson Lisa S.
Published: February 2007

Serologic testing of patients with acute lymphocytic leukemia for susceptibility to varicella was confounded by prior administration of blood products. Packed red cell transfusions produced fewer problems than plasmarich transfusions. Seronegative individuals may be transiently seropositive for several weeks. Specimens submitted for serologic testing should be accompanied by information on recent receipt of blood products.
Fat embolization and pulmonary infiltrates after bone marrow transplantation
Authors: Lipton J. H. , Russell J. A. , Burgess K. R. , Hwang W. S.
Published: February 2007

Pulmonary interstitial infiltrates developed in a 22‐year‐old female after bone marrow transplantation (BMT) for acute lymphoblastic leukemia (ALL) in second remission. She was receiving prednisone for graft versus host disease (GvH). There was some evidence of cardiac failure, but the primary diagnosis was that of cytomegalovirus (CMV) pneumonia, which resolved. Recurrent infiltrates were associated with the appearance of fat emboli in the pulmonary capillaries. There was little histological evidence of CMV pneumonitis, although other tests confirmed persistent infection. The patient recovered after further treatment directed at CMV infection and cardiac failure with a modest reduction in steroid dose. Most previous descriptions of pulmonary fat embolization (PFE) in immunocompromised patients have been derived from autopsy studies, and the majority of patients have received steroid therapy. The present case illustrates that PFE may complicate or contribute to the picture of interstitial pneumonitis (IPN) in the BMT recipient and that this syndrome may be reversible.
Treatment of neuroblastoma with 131I‐metaiodobenzylguanidine: The experience of an Italian study group
Authors: Bestagno M. , Guerra P. , Puricelli G. P. , Colombo L. , Calculli G.
Published: February 2007

Eight patients affected by neuroblastoma were treated with 18 courses of 131I‐meta‐iodobenzylguanidine (MIBG). They all had been judged as “nonresponders” to conventional treatments. Six had stage IV disease: of these, five, with massive marrow involvement, had poor results, mainly because of marrow depression; one, whose marrow had been previously purged by chemotherapy, showed a decrease in blood cell counts but not to critical levels, thus allowing repeated treatments and some improvement. Two other cases had stage III disease, without marrow involvement. Both could receive repeated treatments without adverse effects on marrow and circulating blood cells; both could have surgical procedures when a significant neoplastic mass reduction had been induced by MIBG treatments.

Almost all patients experienced reduction or disappearing of pain. Treatments were well tolerated.
Retroperitoneal sarcomas: The role of diagnostic imaging and multimodal management
Authors: Silberman Allan W. , Steckel Richard J. , Kagan A. Robert
Published: February 2007

Retroperitoneal sarcomas are a varied group of malignancies which have a high rate of recurrence following surgery alone. The majority of the initial recurrences are local in nature, and new therapeutic approaches are clearly needed. Diagnostic imaging and “interventional radiology” have important roles to play in the management of these malignancies, as well as in investigational approaches to therapy. Two cases are presented which illustrate some recent advances in diagnosis and staging of this group of tumors which can be attributed to new cross‐sectional imaging techniques, when used in concert with “conventional” imaging methods. The latter include arteriography to guide the placement of intra‐arterial catheters for local infusion chemotherapy. CT‐guided needle biopsies can be performed to secure a preoperative diagnosis and also to obtain viable tissue for in vitro chemosensitivity assays. A judicious combination of local and systemic chemo therapy, radiation, and surgery may hold promise for better control of this malignancy, similar to the therapeutic advances which have already been obtained with limb sarcomas.
Catching up with history: Treatment of Wilms' tumor in a developing country
Authors: De Camargo Beatriz , De Andrea Maria Lydia M. , Franco Eduardo L. F.
Published: February 2007

I Despite the tremendous progress that pediatric oncology has achieved in the treatment of Wilms' tumor over the last several decades, survival rates in our institution before 1970 did not exceed 8%. In order to correct the problem standardized therapy was instituted in 1970 through a multimodal oncological team. Results using the new approach were reviewed in 1979 (50 patients) and showed an overall 34% 2‐year survival rate. Although encouraging, these results were still far below the ones reported in the literature. This prompted us to use a vigorous professional and lay educational program in the city. Treatment methods were replaced by those advocated by the Second National Wilms' Tumor Study. A second evaluation period initiated in 1979 and extended through 1984 (35 patients) yielded an overall 83% survival rate. A retrospective study of the two periods by univariate and multivariate survival analysis revealed that, although much of the improvement in survival could be attributed to a shift in stage distribution towards earlier disease, the admission period itself had an important additional explanatory effect with respect to survival. This was probably due to the improvement in treatment protocols used in the latter period. Age was a prognostic variable only for patients admitted during the 1979‐1984 period.
Precocious puberty associated with malignant thoracic teratoma and malignant histiocytosis in a child with Klinefelter's syndrome
Authors: Beasley S. W. , Tiedemann K. , Howat A. , Werther G. , Auldist A. W. , Tuohy P.
Published: February 2007

A 10‐year‐old boy with precocious puberty of 2 1/2 years' duration presented with a malignant thoracic teratoma with elevated levels of beta human chorionic gonadotrophin (β‐HCG) and alpha fetoprotein (αFP). The mediastinal tumor was completely excised and adjuvant chemotherapy commenced. Within 3 weeks of commencing chemotherapy he developed hematologic abnormalities that, with the subsequent clinical illness, led to a diagnosis of malignant histiocytosis. Death occurred a few days after start of therapy for malignant histiocytosis. Cytogenic studies showed the somatic karyotype to be that of Klinefelter's sydrome, while the malignant cells in marrow and lymph node carried an additional marker chromosome. This case, with others reported, suggest that the XXY karyotype may influence the development of mediastinal germ cell tumors, which in themselves appear to be associated with the early onset of a malignancy of the hemopoietic system.
Salvage chemotherapy for lymphoma with VP‐16, ifosfamide, and cisplatin
Authors: Nichols Craig R. , Loehrer Patrick J. , Greist Anne , Kubilis Paul S. , Hoffman Ronald
Published: February 2007

Between 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 salvage regimens.