bluuebunny/crossref_metadata_2025 huggingface dataset:
Radiation myelitis following craniospinal irradiation with concurrent actinomycin‐D therapy
Authors: Littman Philip , Rosenstock Jeffrey G. , Bailey Clifford
Published: February 2007

Two patients are presented who developed radiation myelitis as a complication of treatment for medulloblastoma. These patients had been entered onto a pilot study to evaluate the therapeutic efficacy of combined treatment with radiation therapy and actinomycin‐D (AMD). AMD is a known radiation enhancer in all tissues but the nervous system. Both of these patients received a full course of cranio‐spinal irradiation plus AMD 15 mcg/kg for the first five days of therapy. One patient developed myelitis at 4 months, and the other at 12 months after treatment. Both patients are surviving three years posttreatment without any evidence of recurrent disease. The myelitis in one patient has improved, and it is stable in the other patient. It is concluded that AMD enhances the effect of radiation therapy on the central nervous system. This has never been reported but is important to note now, since radiation enhancers are included in multimodal treatment regimens for a variety of malignant conditions. Reduction of radiation dose may be necessary when large volumes of the nervous system are treated.
Septicemia in acute leukemia
Authors: Cesario T. C. , Slater L. M. , Armentrout S. A. , Thrupp L. D. , Tilles J. G.
Published: February 2007

We have surveyed septicemic episodes occurring in individuals with acute leukemia and have found two factors favorably influencing survival, mainly granulocyte counts over 1,000 mm3 and gram‐positive bacteremias. In contrast, blood cultures persistently positive for longer than 48 hours were a bad prognosticator. Significantly, patients with gram‐positive bacteremia had received less antibiotics. in the week prior to septicemia than had patients with gram‐negative bacteremia.
The prognostic significance of radiological and symptomatic bone involvement in childhood acute lymphoblastic leukaemia
Authors: Hann Ian M. , Gupta Subash , Palmer Michael K. , Morris‐Jones Patricia H.
Published: February 2007

Full skeletal survey was performed on 193 consecutive children presenting over a 6‐year period with acute lymphoblastic leukaemia (ALL). A record was made of the degree of bone pain in these patients and 60 others presenting immediately prior to the availability of skeletal surveys. Bone pain was present in 76 out of 253 patients (30%) and radiological bone changes characteristic of leukaemia in 125 out of 193 (65%). A significant correlation was found between the severity of bone pain and the number of bones involved on × ray (r = 0.25, P = <0.001), but not between initial white cell counts and bone score (r =‐0.14, P = 0.08). There was no significant correlation between the degree of bone pain and survival or length of first remission (P = 0.29 and 0.86). Similarly, the extent of radiological bone disease was of no prognostic significance with relation to survival (P = 0.41) or length of first remission (P = 0.21).
Management of carcinoid syndrome
Authors: Bonomi Philip , Hovey Charlotte , Dainauskas John R. , Slayton Robert , Wolter Janet
Published: February 2007

Two patients who had severe carcinoid syndrome are presented. In one patient prednisone relieved symptoms for 20 months, and in the second patient chemotherapy appears to have precipitated fatal carcinoid crisis. Changes in mentation, increased frequency and intensity of flushing, and hypotension indicate increased risk of a chemotherapy induced carcinoid crisis. Since prednisone may produce relatively long control of carcinoid syndrome, it should be tried before chemotherapy in patients who have increased risk of carcinoid crisis. If chemotherapy is given, doses should be decreased by 50%, and patients should be followed closely.
Chromosomes and causation of human cancer and leukemia: XXXVI. The 14q+ anomaly in an american burkitt lymphoma and its value in the definition of lymphoproliferative disorders
Authors: Kakati Surabhi , Barcos Maurice , Sandberg Avery A.
Published: February 2007

A case of a 10‐year‐old boy with American Burkitt lymphoma is presented in whom a 14q+ due to t(8;14)(q23;q32) was shown to exist in the ascitic lymphoma cells. This appears to be the first demonstration of such a translocation in uncultured material. In addition, another translocation involving the × chromosome, hitherto not observed in Burkitt tumors, was demonstrated. The karyotypic findings have been related to the cytogenetic experience in Burkitt and other lymphomas, with emphasis being put on the importance of the 14q+ anomaly in lymphoproliferative diseases.
Localized bone marrow relapse in acute lymphoblastic leukemia
Authors: Golembe Sarry , Ramsay Norma K. C. , McKenna Robert , Nesbit Mark E. , Krivit William
Published: February 2007

Localized bone marrow relapse is rare in acute lymphoblastic leukemia. Discordant bone marrow specimens were found in an 11‐year‐old asymptomatic girl who had been in remission for six years and off chemotherapy for 2 1/2 years. One bone marrow sample showed marked leukemic infiltration, whereas marrow from another site was normal. Three months later, with normal peripheral blood counts, she developed severe back pain and x‐ray evidence of vertebral collapse and periosteal changes in the public bone. At that time three of the four areas of bone marrow sampled showed leukemic involvement. Reinduction therapy was begun, and she is now in remission on maintenance chemotherapy. At this time, it is unclear whether routine performance of marrow aspirations and biopsies from multiple sites, in periodic follow‐up examinations of patients with acute leukemia would allow earlier detection of relapse frequently enough to justify the procedure. The issue of localized bone marrow involvement, if more common than previously reported, should be addressed at the time a decision is being made to discontinue therapy.
Childhood non‐Hodgkin malignant lymphomas: A clinicopathologic retrospective study
Authors: Gasparini Marco , Fossati‐Bellani Franca , Lombardi Fabrizio , Lattuada Angelo , Pilotti Silvana , Rilke Franco
Published: February 2007

Between 1968 and 1975, 44 evaluable children under 16 years of age with the histologic diagnosis of non‐Hodgkin malignant lymphoma (ML) were treated at the Istituto Nazionale Tumori of Milan. Histologic diagnoses were reclassified as follows: 13 lymphoblastic (others) ML, 15 convoluted cell type lymphoblastic ML, 9 Burkitt type ML, and 7 immunoblastic ML. Only 36% of the patients had stage I and II disease. At diagnosis 25% showed malignant cells in the bone marrow smears. Bone marrow infiltration was particularly frequent in the convoluted cell type lymphoblastic ML and in the lymphoblastic (others) ML subgroups. Burkitt type ML frequently was associated with abdominal lesions and subsequently a high incidence of central nervous system involvement. Patients with stage I and II ML were encountered mostly in the immunoblastic ML subgroup. After 1973 more intensive chemotherapy plus radiotherapy seems to have slightly improved the survival of the patients, except in the Burkitt type ML subgroup.
Adenocarcinoma of unknown primary site: A clinico‐pathological study
Authors: Snyder R. D. , Mavligit G. M. , Valdivieso M.
Published: February 2007

An analysis of the clinico‐pathological findings in 49 patients with adenocarcinoma of unknown primary origin indicates a short survival time. No factors were identified that influenced survival. Thromboembolic episodes and second primary tumors commonly complicate the clinical course. Metastases in widespread organs are common autopsy findings. Immunological mechanisms may explain these findings.
Wilms tumor with extension to the right atrium
Authors: Kolmannskog Svein , Moe Peter J. , Besigye Emmanuel , Sørlie Dag
Published: February 2007

A seven‐year‐old boy had cardiac symptoms for five months before the diagnosis of Wilms tumor was made. The tumor extended into the inferior vena cava through the renal vein and protruded into the right atrium. All demonstrable tumor masses could be removed at a one‐step surgical procedure without using cardiopulmonary bypass. Intensive postoperative chemotherapy has been given, and 15 months after surgery he was without signs of relapse.
Cutaneous lymphoma in an infant: Case report
Authors: Kukreja Suresh , Zarkowsky Harold
Published: February 2007

A case of lymphoma in an infant in whom the skin was the only apparent organ involved is reported. Response to combination chemotherapy was excellent and no recurrence has been observed in the 13 months since diagnosis.
Long‐term survival in childhood acute leukemia: “Late” relapses
Authors: Land Vita J. , Berry Daisilee H. , Herson Jay , Miale Thomas , Ried Hubert , Silva‐Sosa Mario , Starling Kenneth ,   A Southwest Oncology Group Study
Published: February 2007

The “late” relapse patterns of childhood acute leukemia were studied in 83 children in their first continuous complete remission for more than three years prior to randomization for stopping therapy (40 patients) or continuing therapy (43 patients) for a total of six years. Twenty of 83 (22.9%) have relapsed: Ten in the bone marrow, one in the central nervous system, and nine in the testes. The testes relapse rate of 41.1% (7/17) in males discontinuing therapy at three years was much higher than that of 8.7% (2/23) in males continuing therapy. This difference is significant at P = 0.01 (Wilcoxon test).
Chronic lymphocytic leukemia in association with a second lymphoproliferative disorder: Response to chemotherapy in two cases
Authors: Gordon Leo I. , Hrushesky William , Oken Martin M. , Kay Neil E. , Rydell Robert E.
Published: February 2007

The development of either histiocytic lymphoma or Hodgkin disease in association with pre‐existing chronic lymphocytic leukemia has been described in the literature as a terminal event. We describe two patients in whom the diagnosis of a second malignant lymphoma was made during life and who achieved objective clinical response after a change in therapy to a more aggressive combination of drugs. We conclude that patients with chronic lymphocytic leukemia who have had a sudden change in their clinical course should have thorough reevaluation, looking specifically for the development of a second lymphoproliferative disorder. If this is discovered, more aggressive therapy should be initiated.
Patient recall of informed consent
Authors: Kennedy B. J. , Lillehaugen Anne
Published: February 2007

The protection of human subjects in research is a shared responsibility. The informed consent procedure was introduced to implement protection of the subjects. The contents of consent forms have been in dispute, and the impact of the procedure on the human subject has caused concern. It was demonstrated that patients with cancer have poor recall of the contents of a signed consent form.
Pyomyositis in acute lymphocytic leukemia heralded by cutaneous vasculitis: Brief communication
Authors: Blatt Julie , Reaman Gregory , Pizzo Philip A.
Published: February 2007

We have observed two cases of staphylococcal myositis in patients with acute lymphocytic leukemia which are distinguished from previously reported cases by a history of cutaneous vasculitis overlying the area of subsequent infection.
Combination radiotherapy and chemotherapy for small cell carcinoma of the lung
Authors: Goldberg R. S. , Joss R. A. , Bedwinek J. , Yates J. W. , Krakoff I. H.
Published: February 2007

Twenty previously untreated patients with small cell carcinoma of the lung were treated with cyclophosphamide, 400 mg/m2, and Adriamycin, 40 mg/m2 IV on day 1, followed by cytosine arabinoside, 20 mg/m2, every 12 hours subcutaneously on days 5–9; this regimen was repeated every 28 days. On days 14–28 of the first cycle, each patient received 3,000 rads to the primary tumor and whole brain. Following eleven courses, Adriamycin was discontinued and patients received cyclophosphamide, 800 mg/m2 IV on day 1 and methotrexate, 15 mg/m2 IV on days 5–7. This regimen was repeated every 28 days. Toxicity included nausea, vomiting, alopecia, leukopenia, thrombocytopenia, and esophagitis. Overall response rate was 65%. Median survival in limited disease was 14.5 months, and in extended disease it was 4.5 months. This combination is active in localized small cell carcinoma but provides no superiority over other regimens.
Combination chemotherapy of colorectal cancer with 5‐fluorouracil, methyl‐1,3‐cis(2‐chloroethyl)‐1‐nitrosourea, and vincristine
Authors: Joss Rudolf A. , Goldberg Ronald S. , Yates Jerome W.
Published: February 2007

The combination of 5‐fluorouracil (5‐FU), methyl‐1,3‐cis(2‐chlorethyl)‐1‐nitrosourea (methylCCNU), and vincristine (VCR) has been reported to produce a 43.5% response rate in metastatic colorectal cancer, although subsequent studies did not produce such good response rates. The clinical trial reported here was undertaken to assess the reported results. In 52 evaluable patients the overall response rate was 11%. No complete remissions were observed. Six patients with colon carcinoma had a partial remission lasting for a median of ten months, with a median survival of 15 months. No responses were observed in rectosigmoid cancer. The median survival for nonresponders was 7.5 months. Thirty‐three percent of the patients had significant hematological toxicity (white count ≤ 1,000/mm3, platelets ≤ 50,000/mm3); 58% of the patients experienced nausea and vomiting; and 32% experienced some degree of neurotoxicity. In our hands the combination of 5‐FU, methylCCNU, and VCR produced a response rate of 11% in metastatic colorectal cancer with a considerable amount of toxicity.
Inflammatory fibrous histiocytoma: Response to non‐surgical therapy: A case report
Authors: Smith David K. , Poon Man‐Chiu , Flint Andrew
Published: February 2007

A case of inflammatory fibrous histiocytoma arising in soft tissue near the sacrum is presented. The patient's mode of presentation, clinical course, and tumor histology were typical of this disease. The tumor was inoperable, and radiotherapy combined with doxorubicin, cyclophosphamide, and intermediate‐dose oral methotrexate produced a dramatic complete response lasting over 27 months. Favorable results with nonsurgical therapy have not previously been reported for this disease. The gratifying result obtained, although of relatively short duration to date, indicates that combined modality therapy may provide significant back‐up to aggressive surgery. The use of these agents in an adjuvant setting merits study.
Remission induction in acute nonlymphocytic leukemia: Comparison of a seven‐day and ten‐day infusion of cytosine arabinoside in combination with adriamycin
Authors: Preisler H. , Bjornsson S. , Henderson E. S. , Hryniuk W. , Higby D. , Freeman A. , Naeher Carl
Published: February 2007

Forty‐six previously untreated patients with acute nonlymphocytic leukemia were treated with a remission induction regimen consisting of three daily doses of Adriamycin (30 mg/m2/day) and a ten‐day continuous infusion of cytosine ara binoside (ara C) (100 mg/m2/day). The overall remission rate was 72%, with 88% of the patients < 50 and 62% of patients > 50 years old achieving complete remission status. Thirty‐one of the 33 complete remissions occurred after a single course of chemotherapy. Retrospective comparison of this regimen with its predecessor (identical, except that a seven‐day infusion of ara C was administered) demonstrated that the increase in duration of ara C administration resulted in greater antileukemic effectiveness without an increase in hematologic toxicity to the patient.
Acute mxyeloblastic leukemia two years after diagnosis of non‐Hodgkin lymphoma
Authors: Harris Richard E. , Seo In Sook , Provisor Deborah , Otter Marlene , Baehner Robert L.
Published: February 2007

The 18‐year‐old white male developed acute myeloblastic leukemia (AML) 25 months after diagnosis of poorly differentiated lymphocytic lymphoma, diffuse pattern (PDLL‐D), involving cervical, supraclavicular, and mediastinal lymph nodes as well as bone marrow. Treatment of the lymphoma consisted of 2,000 rads to the mantel area and 18 months of chemotherapy with intravenous (IV) methotrexate (400 mg/m2), vincristine, and prednisone, alternating every two weeks with IV cyclophosphamide (1,000 mg/m2), vincristine, and prednisone plus monthly intrathecal methotrexate. Thereafter, a complete remission was maintained without therapy until the onset of AML. Several pseudodiploid clones containing multiple structural rearrangements and a hypodiploid clones were identified in the circulating blood at the time of diagnosis of AML. Induction therapy consisting of cytosine arabinoside, 5‐aza‐cytidine, vincristine, and prednisone was unsuccessful, and the patient died of sepsis two months after diagnosis. This case calls attention to the increased risk for subsequent acute nonlymphocytic leukemia in patients previously treated for nonhodgkin lymphoma.
Malignant pheochromocytoma in childhood: Report of a case with familial neurofibromatosis
Authors: Quissel Barbara , Mohammad Akbar , Bauer John H. , Hakami Nasrollah
Published: February 2007

A 14‐year‐old male with familial neurofibromatosis and widely disseminated malignant pheochromocytoma is described. Current criteria for the diagnosis and management of this rare malignancy are discussed.
Implementation of adjuvant therapy for breast cancer in the St. Louis metropolitan area: 1976–1977
Authors: Van Amburg Albert , Oppenheim Judith , Presant Cary A. , Oliver Joel
Published: February 2007

In order to determine the extent of implementation of adjuvant chemotherapy for stage II carcinoma of the breast in the St. Louis area, records of all patients with stage II carcinoma of the breast treated with standard or modified radical mastectomy in five different St. Louis hospitals were reviewed. Between July 1, 1976, and July 1, 1977 (17 months after publication of preliminary L‐PAM results and 4 months after publication of preliminary CMF results), 73% of 24 premenopausal patients and 55% of 58 postmenopausal patients received adjuvant chemotherapy. Ten percent of premenopausal and 31% of postmenopausal patients received therapy other than CMF or L‐PAM. Compared to premenopausal patients in university‐affiliated hospitals, premenopausal patients in community hospitals tended to receive radiation therapy more commonly and chemotherapy alone less often (P < 0.1). Compared to postmenopausal patients in university‐affiliated hospitals, postmenopausal patients in community hospitals more commonly received chemotherapy alone, and less often received no adjuvant therapy (P < 0.05). We conclude that results of adjuvant chemotherapy trials can be rapidly implemented into standard practice both in university‐affiliated and community hospitals. Since 12 of 52 patients receiving adjuvant chemotherapy in fact received non‐standard, unpublished regimens, improvements in phase IV drug development may be required to prevent potentially deleterious modifications of published recommendations.
Reduced antithrombin III levels during L‐asparaginase therapy
Authors: Buchanan George R. , Holtkamp Christine A.
Published: February 2007

Antithrombin III levels were measured in serum before, during, and after therapy with three different dosage regimens of L‐asparaginase in 11 children with acute lymphoblastic leukemia. Levels determined by both functional and immunologic methods were transiently reduced during alternate‐day or daily L‐asparaginase treatment but not affected when the drug was administered only every 10 days. The probable mechanism of this effect is impaired hepatic synthesis of antithrombin III, resembling the acute and transient deficiency of other asparagine‐rich proteins during L‐asparaginase administration.
Adriamycin and splenectomy in the treatment of histiocytic medullary reticulosis
Authors: Pizzuto Javier , Aviles Agustin , Conte Guillermo , Morales Manuel , Ambriz Raul , Butron Luis
Published: February 2007

Histiocytic medullary reticulosis (HMR) is a rare, malignant disorder with unsatisfactory response to various chemotherapeutic agents that have been used up to the present time.

The purpose of this communication is to describe the first patient with this disease in whom an immediate, complete remission was obtained using only adriamycin. Four months after institution of this treatment, a staging laparotomy and splenectomy revealed residual disease in the spleen only. Adriamycin was continued as the sole agent, to the full calculated dose, followed by maintenance therapy consisting of cyclophosphamide. The patient continues to be in complete remission 35 months after diagnosis was established.
Cancer of the extrahepatic bile ducts
Authors: Bedikian A. Y. , Valdivieso M. , De La Cruz A. , Martin R. , Luna M. , Guinee V. F. , Bodey G. P.
Published: February 2007

Case histories of 47 patients with histologically confirmed carcinoma of extra‐hepatic bile ducts presenting to M. D. Anderson Hospital and Tumor Institute over a 30‐year period were studied. The disease was more common in males during the sixth and seventh decades of life. A third of the patients had history of cholelithiasis. Four patients had prior history of chronic ulcerative colitis and one patient had congenital choledochal cyst prior to development of cancer of the bile duct. Jaundice was the earliest and the most common presenting sign. The tumor was located in the common bile duct more often than in the hepatic ducts. The overall median survival was eight months with two‐year and five‐year survival rates of 15% and 3%, respectively. The respective values for patients who had resectable tumors were 21.7 months, 57% and 20%. Ascending cholangitis was a frequent complication in patients treated with dilation and intubation and, overall, hepatic failure and systemic infection were more frequent causes of death than distant metastases.
A clinical trial of hyperalimentation in children with metastatic malignancies
Authors: Van Eys J. , Copeland E. M. , Cangir A. , Taylor G. , Teitell‐Cohen B. , Carter P. , Ortiz C.
Published: February 2007

In a controlled, randomized prospective clinical trial the utility of intravenous hyperalimentation (IVH) in the administration of and tolerance to chemotherapy was tested. The conclusions reached were 1) IVH is safe with a tolerable infection rate; 2) infectious complications correlate significantly with the nutritional status of the patient, with the presence of IVH being only a secondary factor; 3) IVH may be used to rehabilitate patients nutritionally, even those on intensive chemoterhapy; 4) the ability to deliver chemotherapy to patients seems to be improved by IVH, especially in malnourished patients in a late stage of disease.
Utility of density gradient centrifugation for fractionation of leukemic bone marrow
Authors: Bakkeren J. A. J. M. , De Vaan G. A. M.
Published: February 2007

Comparison of the distribution pattern of leukemic and normal bone marrow cells, obtained by density gradient centrifugation, may give information about the location of the blockade in the differentiation pathway from stem cell to mature leukocyte, as is supposed to exist in acute leukemia.

As a control group 12 children with acute lymphoblastic leukemia (ALL), in complete remission and after cessation of all antileukemic therapy, were studied. By centrifugation over a discontinuous bovine serum albumin (BSA) density gradient, good reproducibility of the partition of the bone marrow cell population was obtained, with a peak in the more dense region. The cells capable of incorporation of [3H] thymidine in vitro were present predominantly in the lower density range.

In 9 patients with lympho‐ or myeloproliferative malignancies (3 with o‐cell ALL, 2 with T‐cell malignant lymphoma, 1 with B‐cell malignant lymphoma, 3 with various malignancies of the myeloid‐monocytoid series) similar fractionation on the BSA gradient revealed a different cell partition pattern as compared with the control group. The peak of the distribution curve was located in the less dense region. Highest [3H] thymidine incorporation values were measured in vitro with cells from the lower density region.

At last the importance of purely practical considerations in the choice of material for density gradient fractionation is stressed. Application of density gradient centrifugation methods could probably be helpful in attributing to cells from acute leukemia a place in the normal differentiation pathway.
Eosinophilic Granuloma of Bone
Authors: Slater James M. , Swarm Orval J.
Published: February 2007

Eosinophilic granuloma of bone is an uncommon granulomatous process for which therapy recommendations vary considerably. Consequently, a survey of the world literature from 1940 to 1974 was undertaken in an attempt to develop more concrete guidelines. This survey revealed that the disease manifests itself primarily in males under 20 years of age of all races. The most common symptom is pain, with or without swelling. Multiple sites in a single case are frequent. The clinical course is generally benign, unlike Letterer‐Siwe disease or Hand‐Schuller‐Christian disease. A remission rate of 95% was noted, with relapses usually occurring as distant disease within the first year. Simple excision or curettage was the most common surgical procedure utilized, and radiotherapy doses varied widely. Excellent local control of the disease can be provided using conservative surgery, low‐dose irradiation, or both. Morbidity secondary to pathologic fracture or to overly aggressive treatment are the major concerns, not failure to control the disease.
Aminoglutethimide in the management of metastatic breast cancer
Authors: Savaraj Niramol , Troner Michael B.
Published: February 2007

Aminoglutethimide (AG) with Dexamethasone has been utilized in 26 patients with metastatic breast cancer who had prior response to hormonal manipulation and/or positive estrogen receptor. Objective tumor response (CR + PR) has been achieved in 13 of 26 patients. Responses were seen in soft tissue, bone, and pleura. Six of 26 patients had stable disease and seven of 26 patients had progressive disease. The median duration of response is 12.8 months. The median survival for the responders has not been reached. Non‐responding patients had a median survival of five months. Side effects were minimal, including mild lethargy, rash, fever, and weight gain. This regimen is well tolerated and can be used effectively in metastatic hormone‐receptor‐positive breast cancer.
Adjuvant chemotherapy in nonmetastatic osteosarcoma: A southwest oncology group study
Authors: Herson Jay , Sutow Wataru W. , Elder Karin , Vietti Teresa J. , Falletta John M. , Crist William M. , Vats Tribhawan S. , Miale Thomas
Published: February 2007

This report updates experience with the CONPADRI‐I, COMPADRI‐II, and COMPADRI‐III adjuvant chemotherapy programs for the treatment of nonmetastatic osteosarcoma. A total of 200 patients received one of the three regimens. The analysis of response to treatment is based on disease‐free survival time (DFS time). The effect of treatment, age, sex, site of disease involvement, and race on DFS time were investigated. Cox's life‐table regression analysis found only sex to have a significant effect on DFS time with males having 1.8 times the risk of recurrence or death per unit time as female patients (P = 0.004). An analysis of the 81 patients still alive and disease‐free 18 months after the start of treatment shows significantly longer DFS time for CONPADRI‐I than COMPADRI‐II patients (P = 0.01). This trend is true for both male (P = 0.12) and female (P = 0.08) patients.
Acute promyelocytic leukemia in children
Authors: Chan Ka Wah , Steinherz Peter G. , Miller Denis R.
Published: February 2007

Sixteen children (ages 2–17) with acute promyelocytic leukemia (APL) were studied retrospectively. Diagnosis was based on clinical features and morphological criteria of the FAB classification. Bleeding diathesis was the predominant presenting symptom (>85%), associated with laboratory findings of disseminated intravascular coagulation (DIC). Extramedullary manifestations included skin rash in six patients, gum infiltration in two, and meningeal leukemia in two. Induction therapy consisted of cytosine arabinoside and an anthracycline, with or without other agents. Prophylactic heparinization was given to 12 patients. Six patients (37.5%) failed to achieve remission and died, secondary to hemorrhage in three, and secondary to infection in the remaining three patients. The median duration of remission was 14 months, and the median survival for responders was 21 months. One meningeal leukemia preceded bone marrow relapse despite intermittent intrathecal chemotherapy for prophylaxis. Three patients remain in continuous complete remission 3 years after initial diagnosis.

Although childhood APL shares many features of its adult counterpart, the high frequency of extramedullary manifestations and mortality secondary to neutropenia deserves separate attention.
Physical function assessment in patients with advanced cancer
Authors: Wood Carol A. , Anderson Judith , Yates Jerome W.
Published: February 2007

Accepted physical therapy assessment techniques were compared with the Karnofsky Performance Status scores in a group of patients with advanced cancer. Assessment of patients' physical functioning by physical therapy evaluation techniques was highly correlated with the Karnofsky Performance Status score. The KPS has been demonstrated to be a reliable assessment tool and is a good indicator of those patients most likely to maintain independent physical function. Extensive physical therapy measures in this patient population appear to offer no advantage over the KPS as an evaluation tool for studies.
Eosinophilic granuloma of the palatal mucosa in a nine‐week‐old infant
Authors: Roper Maryann , Kelly David , Parmley Richard T. , Kheir Sonia M. , Hicks Julius N.
Published: February 2007

Histiocytosis commonly presents as a disseminated disease in children under one year of age and is rare in infants less than three months of age. This case describes a nine‐week‐old infant with unifocal eosinophilic granuloma without bone involvement. One year after surgical excision the child is free of disease by roentgenographic and laboratory studies and is growing and developing normally. Thus our patient demonstrates several unique features, which include a young age at presentation without disease dissemination and an unusual site of tissue involvement without bone extension.
Rhabdoid tumor of the kidney: Complete remission induced by cis‐platinum and adriamycin
Authors: Roper Maryann , Parmley Richard T. , Crist William M. , Kelly David R. , Hyland Caryl H. , Salter Merle
Published: February 2007

A 4‐month‐old male infant with Stage I rhabdoid tumor of the kidney at presentation subsequently developed pulmonary metastatic disease shortly after diagnosis and initiation of Vincristine and Actinomycin D chemotherapy. The patient was then treated with cis‐platinum and Adriamycin. Within 28 days he achieved a complete remission which was maintained for 5 months. Subsequent recurrent pulmonary lesions failed to regress with radiotherapy and high‐dose cyclophosphamide when used as single sequential agents. Further clinical trials with cis‐platinum and Adriamycin seem warranted since prognosis with this tumor is poor and successful chemotherapy after metastatic dissemination has not been previously reported.
Intraperitoneal infusion of doxorubicin in the treatment of gynecologic carcinomas
Authors: Roboz John , Jacobs Allan J. , Holland James F. , Deppe Gunter , Cohen Carmel J.
Published: February 2007

Intraperitoneally administered doxorubicin yields high local concentrations that are expected to deliver higher doses to clinically important peritoneal and lymphatic metastatic sites. Two infusions of 20 mg and 30 mg in a patient with residual microscopic intraperitoneal ovarian cancer eradicated her disease. Quantification of serum doxorubicin by HPLC revealed significant levels of the drug and its major metabolite lasting 72 hours. A 50‐mg infusion induced complete remission in endometrial carcinoma; the patient died in 6 months without evidence of abdominal tumor. Complications due to subcutaneous infiltration of doxorubicin and possible systemic effects of sustained high levels of the drug need further investigation to enable the full exploitation of this modality.
Phase I trial of rubidazone (NSC 164011) in children with cancer
Authors: Tan Charlotte T. C. , Mitta Swatantra K. , Steinherz Laurel , Miller Denis R.
Published: February 2007

Rubidazone was administered to 24 children with advanced solid tumors or leukemia. The dose ranged from 80 to 150 mg/m2/IV daily to a total dose of 160 to 450 mg/m2/course. This course was repeated at intervals of approximately three weeks. Eighteen of 24 patients (75%) had received adriamycin and daunomycin as part of prior chemotherapy. The major toxic effects observed were myelosuppression, nausea, vomiting, mucositis, and skin rash. Four patients developed abnormal echocardiograms following the rubidazone therapy, 2 manifested clinical cardiac failure, of which one had anthracycline cardiomyopathic changes on autopsy. One of 7 adequately treated ALL patients achieved M2 marrow and improved peripheral counts for 3 weeks. One of the 2 neuroblastoma patients had subjective improvement of bone pain for 2 months. Rubidazone, in a previously heavily treated group of patients used in this study, had dosages of 360 and 450 mg/m2 which produced marrow hypoplasia to aplasia, with only minimal responses.
Phase II evaluation of mitomycin C (MMC) in children with refractory solid tumors using the single high‐intermittent‐dose schedule
Authors: Gutierrez Manuel L. , Evans Audrey , Rohrbaugh Thomas , Belasco Jean , Lee Francis H. , Crooke Stanley T.
Published: February 2007

Nine evaluable patients with refractory solid tumors received mitomycin C as a single intravenous injection at a dose of 20 mg/m2 at 6‐ to 8‐week intervals. Toxicity was tolerable. One patient with Wilms'tumor had a transient decrease in liver size. Pharmacokinetic data on three patients have suggested that the disposition of mitomycin C were comparable to those obtained in adults.
Cardiac changes with cyclophosphamide
Authors: Steinherz Laurel J. , Steinherz Peter G. , Mangiacasale Deborah , O'Reilly Richard , Allen Jeffrey , Sorell Michael , Miller Denis R.
Published: February 2007

Serial echocardiographic (ECHO) studies were obtained on 40 pediatric patients (pts) treated with ≥ 80 mg/kg cyclophosphamide (CPM) (range 80–200 mg/kg) in 1 week. Patients were treated for solid tumors and prior to marrow transplant. Echo changes ocurred in 10/13 pts who received CPM ≥ 170 mg/kg over four days, and in 11/19 pts who received 120–140 mg/kg dose over two days and who had previously received ≥ 100 mg/m2 anthracyclines with or without radiation. No changes were seen in eight pts who had 80–160 mg/kg CPM and < 100 mg/m2 anthracyclines. The observed changes occurred approximately 1 week after CPM and persisted for days to weeks. Pericardial effusion seen in 15 pts was successfully treated with furosemide in 13. Two died with hemorrhagic pancarditis. Other changes seen were increased end diastolic left ventricular diameter, decreased fractional shortening and abnormal left ventricular preejection period/ejection time ratios. Thus, cardiac effects of high dose CPM are not rare in children. Patients receiving ≥ 170 mg/kg CPM in 1 week or 120 mg/kg in 1 week after ≥ 100 mg/m2 anthracyclines are at particular risk.
Marrow transplantation for children with acute nonlymphoblastic leukemia in first remission
Authors: Sanders Jean E. , Thomas E. Donnall
Published: February 2007

Thirteen children between the ages of two and 17 years with acute nonlymphoblastic leukemia in first remission were transplanted from HLA matched sibling donors. They were transplanted at a median of four months [2–8] following diagnosis. The preparative regimen of cyclophosphamide and total body irradiation was well tolerated. Two patients died of pneumonia 66 and 94 days following transplant. One patient relapsed at 431 days, and died of leukemia at 490 days. Ten are living in remission 20–53 months following transplantation. None are on maintenance chemotherapy, and all lead normal lives. As yet, growth is not impaired.
Myocardial injury immediately following adriamycin administration
Authors: Oster Martin W. , Rakowski Thomas J.
Published: February 2007

A patient is described who developed chest pain during adriamycin administration given for the first time for small cell carcinoma of the lung. This was associated with the acute onset of atrial fibrillation with a rapid ventricular response. Although no electrocardiographic changes of myocardial ischemia developed, serum isoenzyme studies suggested that myocardial injury had occurred. The patient recovered but died suddenly three weeks later. Physicians should be aware of possible life‐threatening arrhythmias developing during or shortly after adriamycin administration.
Neuroblastoma in a pair of identical twins
Authors: Mancini Antonia F. , Rosito Pasquale , Faldella Giacomo , Serra Luigi , Vallicelli Roberto , Vecchi Vico , Vivarelli Franca , Paolucci Guldo
Published: February 2007

Hereditary neuroblastoma in a pair of identical twins is reported. In one of the twins the tumor occurred in fetal life and caused death of the twin before birth; in the other one, the tumor occurred at two months of life as IV‐S neuroblastoma in the liver with primary tumor undetected. The unusual clinical course of the latter case is described: twice there was tumor regression, but in spite of treatment, fatal uncontrolled growth occurred. The family history, characterized by neoplasms of dissimilar cell types but without additional cases of neuroblastoma, is also detailed.
Major bone lesions in acute lymphoblastic leukaemia
Authors: Hughes R. G. , Kay H. E. M.
Published: February 2007

The records of 1471 patients with ALL entered into UKALL trials II‐V (1972–1977) were studied, and major bone lesions at diagnosis were recorded in 47 (3.2%). These were found predominantly in young patients (median age 5 years), equally in both sexes, and were seen to be associated with a low blood leucocyte count and prolonged remissions.
Transitional cell carcinoma of the bladder metastatic to the breast
Authors: Berkman Aron W. , Markman Maurie , Murphy Joseph B. , Lenhard Raymond E.
Published: February 2007

This report is the first described case of transitional cell carcinoma of the bladder metastatic to the female breast. The patient is a 42‐year‐old woman who underwent radical cystectomy three months prior to presentation with two asymptomatic right breast masses as the first evidence of widely metastatic bladder carcinoma. The mode of presentation is similar to that seen with other tumors metastatic to the breast and requires the clinician and pathologist to be able to distinguish this diagnosis from primary breast carcinoma.
Hydrogen ion dynamics and cancer: An appraisal
Authors: Harguindey S.
Published: February 2007

The concentration of hydrogen ions plays a critical role in all biochemical processes, including multiple enzymatic reactions, and in the regulation of metabolism. The acid‐base aspects of metabolism as applied to cancer are considered. Preliminary data are presented. The primary concept of hydrogen ion dynamics is related to prevention, development, and etiology of carcinogenicity, as well as to the regression of certain malignant tumors. The present overview summarizes, in terms of H+ dynamics, many related concepts in oncologic research and associates and integrates a variety of basic and clinical observations toward better understanding of cancer cell behavior, biology, and host‐tumor relationships.
Induction of neuroblastoma maturation by a new chemotherapy protocol
Authors: Raaf John H. , Cangir Ayten , Luna Mario
Published: February 2007

Five patients, 1.5 to 9 years old, were treated at M.D. Anderson Hospital for Stage III or IV neuroblastoma. Each was entered into a chemotherapy protocol which included cyclophosphamide, vincristine, 5‐trifluoromethyl‐2′‐deoxyuridine (F3TdR), and papaverine, and each responded with marked reduction in size of the abdominal tumor mass. All patients then underwent exploratory laparotomy and resection or biopsy of residual tumor. In three cases, histological examination of the treated tumor showed ganglioneuroblastoma with predominance of mature cells; one patient had a mature ganglioneuroma, whereas only necrotic tissue was obtained from the fifth patient. These findings support the hypothesis that this chemotherapy protocol can induce neuroblastoma maturation.
Adolescent adjustment to amputation
Authors: Boyle Michele , Tebbi Cameron K. , Mindell Eugene R. , Mettlin Curtis J.
Published: February 2007

We investigated the psychological effects of amputation on adolescent patients by interviewing 27 persons who had a limb amputation because of cancer during their adolescence and compared them to data obtained from eight patients with amputations due to trauma at similar ages. In cancer patients, mobility‐related activities and social matters including relations with peers and the opposite sex and self‐consciousness were of paramount concern. All cancer patients considered themselves functionally independent and 67% had little or no concern for the future. While malignancy and amputation had a significant impact on the patients' lives, the vast majority had a positive view of life and 85% were found to have what we assessed as adequate overall adjustment. Individual variables examined included marital and child‐bearing patterns, educational attainments, vocational attainments, perceived parental and peer support, adaptation to prosthesis, and variables relating to general outlook on life and psychological adjustment. Our results suggest that the patients who have had amputations due to malignancy differ from traumatic amputees in their adjustment to amputation, with cancer patients showing, in many instances, evidence of better adaptation to disability. This may in part be due to different backgrounds and social orientation of traumatic amputees. We found the majority of cancer amputees to adjust well to their circumstances and to report leading full and productive lives.
Immune evaluation of 50 children with neuroblastoma at onset
Authors: Rosanda Cristina , De Bernardi Bruno , Pasino Mirella , Bisogni Maria Cristina , Maggio Angelo , Haupt Riccardo , Tonini Gian Paolo , Ponzoni Mirco
Published: February 2007

Several studies document the importance of immunity in the host‐tumor relationship in neuroblastoma patients, evidentiating a correlation between clinical compromission and immune impairment.

In this study we evaluated some aspects of cellular and humoral immune capacity in 50 neuroblastoma patients at onset. The aim of this investigation was to define, if any, the common immune pattern of these patients, and to evidentiate a possible correlation with prognosis.

Immune tests performed were serum immunoglobulin quantitation, absolute value of total T and B lymphocytes, and lymphocyte reactivity to phytohemagglutinin (PHA), Concanavalin A (ConA), and Pokeweed mitogen (PWM). In patients with localized or regional disease, diminished values of lymphocytes were observed in 4/16 cases, a datum highly correlated to a poor final outcome (P <0.01). Mitogen response and serum immunoglobulin levels were frequently altered, but no prognostic value was evidentiated.

Thirty‐one children with disseminated disease presented more frequent and extended abnormalities: No parameter was found to correlate with prognosis, except for an impaired PHA response that paradoxically assumed a favourable prognostic meaning.

Our results suggest that only the total lymphocyte number can contribute to predict the survival ratio in patients with regional disease.
Congenital primitive neuroectodermal tumor (neuroepithelioma) of the chest wall
Authors: Das Lakshmi , Chang Chung‐Ho , Cushing Barbara , Jewell Patrick
Published: February 2007

Primitive neuroectodermal tumor (neuroepithelioma) is a relatively common central nervous system tumor in children. Those arising from a peripheral nerve are extremely rare in childhood. There is only one reported case in a 6‐year‐old where the tumor arose from the sciatic nerve. A case of neuroectodermal tumor of the chest wall, arising from the intercostal nerve, in a newborn is presented. The tumor metastasized to the brain. Prominent Homer‐Wright rosettes, with central eosinophilic fibrillar substance similar to that seen in neuroepithelioma of the central nervous system, were present in the primary tumor and brain metastases. Ultrastructure, as revealed by transmission electron microscopy, is also described.
Late recurrence of wilms tumor
Authors: Clausen Niels
Published: February 2007

Three patients with Wilms tumors recurring after nine years in an organized abdominal hematoma, after ten years in the lung, and after eleven years in the central nervous system, respectively, are presented. It is proposed that the nephroblastoma cells have survived in a latent or a very slowly growing state. The reactivation mechanisms are briefly discussed. A review of the literature indicates a rate of recurrence of nonmetastasizing Wilms tumors later than 24 months of 1.4‐3.9%.
Primary hepatic lymphoma: Two case reports and a review of the literature
Authors: Leahy Michael F. , Ibrahim Ezzeldin M. , Worth Ann J.
Published: February 2007

This report describes the clinical and pathological features of two cases of primary hepatic lymphoma. Both cases presented with nonspecific symptoms and hepatomegaly. In each case the diagnosis was made at laparatomy. Both responded well to combination chemotherapy. Case 1 achieved a partial remission and Case 2 a complete remission. A review of the literature reveals only five cases of primary hepatic lymphoma; none of these had been successfully treated.
Intensive sequential chemotherapy with bleomycin, oncovin, mitomycin C, and methotrexate followed by adriamycin, cisplatin, and cyclosphosphamide in squamous cell cancer of the head and neck
Authors: Wheeler Richard H. , Baker Shan R. , Liepman Marcia K. , Ensminger William D.
Published: February 2007

Twenty‐six patients with advanced squamous cell cancer of the head and neck were treated with bleomycin, Oncovin, mitomycin C, and methotrexate (BOMM) for ten weeks. Partial and non responders then received adriamycin, cisplatin, and cyclophosphamide (APC) in a planned sequential program. The response rate to BOMM was 65% (19% complete remission, CR). The overall response rate to APC was 20%. Only three of eight nonresponders to BOMM could receive APC and none responded. Six of seven partial responders received APC and only one responded. One complete responder to BOMM received APC at relapse and attained a partial response. The major side effects of BOMM were mucositis and myelosuppression. Patients receiving methotrexate 60–72 hours following the bleomycin infusion had less myelo‐suppression than patients who were treated 36–42 hours after bleomycin. The toxicities with APC included nausea, vomiting, and myelosuppression. Including a prior series, a total of 45 patients have been treated with BOMMwith a 71% response rate (69% in previously irradiated patients). Twenty‐eight percent of previously treated patients achieved complete remission, and two of these patients are disease free at 31 and 37 months. Methotrexate dose‐rate alteration to low dose twice weekly followed by a single dose of oral leucovorin did not improve the complete or partial response rate when compared to weekly methotrexate administration. The complete remission rate and response duration were also not improved by the planned sequential use of this cisplatin‐containing regimen.