bluuebunny/crossref_metadata_2025 huggingface dataset:
Follow‐up of patients resected for gastric cancer
Authors: Javier Lacueva F. , Calpena Rafael , Medrano Justo , Compañ Antonio F. , Andrada Encarnación , Moltó Mario , Ferrer Rafael , Diego Manuel
Published: February 2007

In this study we used a cost‐outcome analysis to evaluate our follow‐up protocol for patients who had been resected for gastric cancer. We designed a descriptive cross‐sectional trial through consecutive sampling of patients who had undergone resection of gastric carcinoma and were followed in our outpatient department during 1991. Serological (CEA) and or imaging procedures were pathologic at least two months prior to the onset of symptoms in 33% of recurrences. No significant correlation was found between serum CEA levels and CEA tumor tissue staining in patients who recurred. Only 17% of patients who relapsed underwent further treatment (surgery and chemotherapy) with no improvement found in terms of survival. The overall cost per year has been estimated at US$ 6118. Our results show that serological levels of CEA and available imaging techniques for routine follow‐up provide little advantage in diagnosing gastric cancer recurrence over clinical surveillance alone. © 1995 Wiley‐Liss, Inc.
Intraoperative histologic assessment of surgical margins and lymph node metastasis in breast‐conserving surgery
Authors: Noguchi Masakuni , Minami Masahide , Earashi Mitsuharu , Taniya Takao , Miyazaki Itsuo , Mizukami Yuji , Nonomura Akitaka
Published: February 2007

The diagnostic value of intraoperative histologic examination of frozen sections of surgical margins and axillary lymph nodes (AX) was investigated in 95 patients with breast cancer who underwent breast‐conserving surgery. The periphery of the excised breast tissue was peeled like an orange and examined histologically by frozen section. The results were compared with examination by permanent section. Evaluation of surgical margins by frozen section resulted in a diagnostic accuracy of 87%, a sensitivity of 96%, and a specificity of 84%. Enlarged or hardened AXs were sampled from the axillary pad which was derived from a complete AX dissection. Histologic examination using frozen section was performed during surgery. After the operation, the remaining AXs were removed from the axillary pad by hand dissection and histologically examined on permanent section. A diagnostic accuracy of 97%, a sensitivity of 77%, and a specificity of 100% were achieved in the diagnosis of AX involvement on frozen section. It was therefore concluded that intraoperative histologic examination of frozen sections may be useful in the determination of involvement of the surgical margins and the AXs in patients with breast cancer. © 1995 Wiley‐Liss, Inc.
Familial adenomatous polyposis and lung cancer
Authors: Wong Ralph P. , Hwang Wel‐Sek , Field Stephen K.
Published: February 2007

A 43‐year‐old man presented with a lung nodule 19 years after undergoing a total colectomy for familial adenomatous polyposis (FAP). There had been no evidence of malignant transformation in the colectomy specimen, and current gastrointestinal investigation did not reveal evidence of tumor. Pathological analysis of the lung nodule demonstrated adenocarcinoma of the lung of the fetal type. This is the first reported case of a lung neoplasm in a patient with FAP. The development of an unusual lung tumor in a patient with FAP, a condition associated with other extracolonic tumors, suggests that there may be an association between the two conditions. © 1995 Wiley‐Liss, Inc.
Adjuvant six cycles of high‐dose adriamycin, cyclophosphamide, methotrexate, 5‐fluorouracil (ACMF) vs. 12 cycles of low‐dose acmf with tamoxifen for premenopausal, node‐positive breast cancer patients: Results of a prospective randomized study
Authors: Fukutomi Takashi , Akashi Sadako , Nanasawa Takeshi , Yamamoto Hiroshi
Published: February 2007

A prospective randomized study was conducted to compare the adjuvant efficacy of six cycles of high‐dose ACMF (Adriamycin, ADM; cyclophosphamide, CPA; methotrexate, MTX; 5‐fluorouracil, 5‐FU) with that of 12 cycles of low‐dose ACMF in premenopausal, node‐positive breast cancer patients. The six‐cycle ACMF group (93 patients) received, intravenously (iv), 130 mg/m2CPA, 26 mg/m2MTX, and 600 mg/m25‐FU on days 1 and 8, and 26 mg/m2ADM on day 1 of each cycle. The 12‐cycle ACMF group (97 patients) received, iv, 65 mg/m2CPA, 13 mg/m2MTX, and 300 mg/m25‐FU on days 1 and 8, and 13 mg/m2ADM on day 1 of each cycle. These treatments were repeated every 4 weeks, and all the patients took tamoxifen (30 mg/day) for 2 years. The background factors of the two groups were comparable. There were non‐significant trends toward better disease‐free and overall survival rates in the high‐dose, six‐cycle ACMF group. Both treatments were well tolerated, but more patients in the low‐dose, 12‐cycle group refused to continue to receive chemotherapy. These data suggest that escalating doses of ACMF over a shorter period, even with doses within the conventional range, are superior to low‐dose, prolonged therapy. © 1995 Wiley‐Liss, Inc.
Malignant tumors metastatic to the ovaries
Authors: Ayhan Ali , Sel Tuncer Z. Çuk , Bükülmez Orhan
Published: February 2007

One hundred sixty‐eight patients treated at Hacettepe Hospital between 1969–1993 with metastatic ovarian tumors constituted 21.5% of all malignant ovarian neoplasms. Primary tumors were endometrial (51), breast (27), colorectal (18), and stomach cancer (17), lymphoma (14), sarcoma of the uterus (13), undetermined (11), tumors of the appendix (6) and ileum (4), carcinoma of the cervix (4), and gestational trophoblastic neoplasia (3). Overall 5‐year and median survivals were 20.0% and 26.8 months, respectively. While worse prognoses were seen in gastric cancer and undetermined tumors followed by colorectal cancer, best survival figures were observed in endometrial cancer patients. A trend toward a better survival was seen with the advancement of the operation from bilateral salpingooophorectomy and/or biopsy to total abdominal hysterectomy, bilateral salpingooophorectomy, total omentectomy and pelvic and paraaortic lymphadenectomy with debulking. Multivariate analysis identified the primary site, grade, laterality of involvement, type of surgery and adjuvant therapy status as significant prognostic parameters. Maximal surgical effort followed by adjuvant therapy might at least have short term survival benefit in certain types metastatic to the ovaries. © 1995 Wiley‐Liss, Inc.
Synchronous cancers of the esophagus and the ampulla of vater after distal gastrectomy: Successful removal of the esophagus, gastric remnant, duodenum, and pancreatic head
Authors: Mafune Ken‐ichi , Tanaka Yoichi , Ma Yan‐Yan , Takubo Kaiyo
Published: February 2007

A case of synchronous squamous cell carcinoma of the esophagus and adenocarcinoma of the ampulla of Vater after previous gastrectomy is presented. The coexistence of these two lesions has never been reported in the English literature. We performed a subtotal esophagectomy, total residual gastrectomy, and pancreaticoduodenectomy with lymph node dissection in a one‐stage procedure. An operation of this magnitude could be safely performed with attention to meticulous surgical technique and intensive postoperative care.

Histologic examination of the ampulla lesion showed adenocarcinoma with Paneth‐cell differentiation. This is a rare lesion, and a review of the literature revealed only one other case. Neoplastic Paneth cells were also found in a lymph node metastasis that originated from the ampulla tumor. This case confirms that cells with Paneth‐cell differentiation can be a significant component in invasive carcinoma. © 1995 Wiley‐Liss, Inc.
Spatial variability and temporal dynamics analysis of soil erosion due to military land use activities: uncertainty and implications for land management
Authors: Wang G. , Gertner G. , Anderson A. B. , Howard H. , Gebhart D. , Althoff D. , Davis T. , Woodford P.
Published: February 2007

Human activities, such as military off‐road vehicular traffic, disturb ground and vegetation cover of landscapes and increase potential rainfall related runoff and soil erosion. On military lands, soil erosion is of major concern in order to sustain training lands and thus there is a need for land condition maps for planning training activities and land management. In this study, we presented a conditional co‐simulation algorithm to generate annual time series maps of soil erosion status from 1989 to 2001 for an army installation. The spatial variability and temporal dynamics of land condition were analyzed. This algorithm modeled soil erosion as realizations of a random function by combining a set of permanent plot data and Landsat Thematic Mapper (TM) images. In addition to estimation maps of soil erosion status, we obtained the maps of uncertainties including the variance of each pixel estimate and the probability of poor land condition. The results and maps are useful tools for land managers and decision‐makers to guide military training programs and to generate management plans for sustaining training lands. Copyright © 2007 John Wiley & Sons, Ltd.
Farmers' perceptions of soil erosion and soil fertility loss in Southern Ethiopia
Authors: Moges Awdenegest , Holden N. M.
Published: February 2007

Data and information about farmers' perceptions of soil degradation were collected using household survey, focus group discussion and field observations. The results indicate that farmers in the Sidama zone of southern Ethiopia are able to identify soil erosion and fertility loss indicators, take a holistic view of soil degradation and have a broad knowledge of the reasons for soil degradation. They perceive soil degradation mainly by reduced yields, soil changing in appearance and becoming stoney or coarse. The most frequently mentioned soil erosion indicator was soil becoming coarse and stony, followed by rill formation, dissection of fields and gullies and topsoil removal. The most important perceived indicator of soil fertility loss was reduced crop yield, followed by poor crop performance and yellowing of the crop. Farmers also have knowledge of solutions; however, participation in soil conservation activities is minimal because of the immediate threat of food insecurity. Any programme designed to address soil degradation in the region will have to be cognisant of farmers' knowledge and holistic view of soil degradation, and be integrated with aid measures to guarantee food security. Copyright © 2007 John Wiley & Sons, Ltd.
Correlation between collagen solubility and skin optical clearing using sugars
Authors: Hirshburg Jason , Choi Bernard , Nelson J. Stuart , Yeh Alvin T.
Published: February 2007

Background and Objective

Light scattering from collagen within skin limits light‐based therapeutics while increasing the risk of epidermal thermal injury. Specific chemicals show the ability to reduce light scattering by reversibly altering the optical properties of skin. This study examines the correlation between collagen solubility and the optical clearing potential (OCP) of sugars and sugar‐alcohols using in vitro rodent skin.

Materials and Methods

Collagen solubility in dextrose, fructose, sucrose, and sorbitol was measured using near‐UV spectroscopy. Light transmittance, reflectance, and rodent skin thickness were measured (giving skin reduced scattering coefficient) before and after exposure of the dermal surface to sugars and sugar‐alcohols. OCP was calculated as the ratio of reduced scattering coefficients before and after exposures.

Results

Dextrose, fructose, sucrose, and sorbitol had at least twice the collagen solubility and twice the OCP as compared to glycerol. In general, collagen solubility correlated with each agent's ability to optically clear rodent skin.

Conclusion

These results demonstrate that sugar and sugar–alcohol interaction with collagen are a primary event in tissue optical clearing. Lasers Surg. Med. 39:140–144, 2007. © 2007 Wiley‐Liss, Inc.
Clinical and echographic analysis of photodynamic therapy using methylaminolevulinate as sensitizer in the treatment of photodamaged facial skin
Authors: Zane Cristina , Capezzera Rossana , Sala Raffaella , Venturini Marina , Calzavara‐Pinton Piergiacomo
Published: February 2007

Background and Objective

Photodynamic therapy (PDT) using aminolevulinic acid (ALA) has been previously investigated in the treatment of photodamaged skin. The aim was to assess efficacy and tolerability of methylaminolevulinate (MAL) as a substitute for ALA in PDT treatment of actinic keratosis (AK) and photoaging.

Study Design/Materials and Methods

Twenty patients with multiple (n = 137) AKs and severe photodamage of the face were treated. Metvix® (Galderma, France) was applied under occlusion for 3 hours before exposure to 37 J/cm2 of red light (Aklilite® CL 128, Photocure, Norway). Two treatments were given at monthly intervals.

Results

The clearance rate of AKs was 88.3%, and global score which we use to rate photoaging, mottled hyperpigmentation, fine lines, roughness, and sallowness of the skin showed improvement, but deep wrinkles, teleangiectasia, facial erythema, and sebaceous gland hypertrophy did not change. The treatments were well tolerated. High‐resolution echography showed an increase in skin thickness, pixels count and area, as well as a reduction of the subepidermal low‐echogenic band (SLEB) thickness.

Conclusion

MAL‐PDT is an effective treatment for multiple AKs. In addition, it improves clinical signs of photodamage of the surrounding skin. Lasers Surg. Med. 39:203–209, 2007. © 2007 Wiley‐Liss, Inc.
CCNU and bleomycin in the treatment of cancer: A southwest oncology group study
Authors: Hoogstraten Barth , Haas Charles D. , Haut Arthur , Talley Robert W. , Rivkin Saul , Isaacs Bertha L.
Published: February 2007

CCNU and Bleomycin, alone or in combination, were used to treat 397 evaluable cases of advanced cancer. Responses defined as 50% or greater reduction in all tumor masses occurred in 13/35 lymphomas, 8/50 brain cancers, and 28/312 other solid tumors. Hematologic toxicity of a life‐threatening degree occurred in 33/298 patients evaluable for CCNU toxicity; in an additional 50 it was considered severe. Pulmonary toxicity was severe in 4 patients. Drug‐associated deaths (4) included one each due to leukopenia and thrombocytopenia after CCNU; one due to pulmonary toxicity after Bleomycin; and one due to shock after the 20th dose of Bleomycin. There was no suggestion of synergism or additive activity with the two drugs.
Clinical studies of 5‐fluorouracil + premarin in the treatment of breast cancer
Authors: Taylor Samuel G. , Pocock Stuart J. , Shnider Bruce I. , Colsky Jacob , Hall Thomas C.
Published: February 2007

Sixty patients with metastatic or primary inoperable breast cancer not suitable for hormone alteration therapy were blindly randomized between weekly 5‐fluorouracil, intravenously, and daily physiologic doses of conjugated estrogens by mouth against weekly 5‐fluorouracil, intravenously, and placebo. There was no difference in the survival or the effect on the tumor in the two groups. Numerous factors were analyzed as to their effect on the course of the disease. The number of organ sites of tumor involvement, age of the host, and previous treatment for the disseminated disease were not shown to influence the survival or the results of therapy of either group. However, the duration of the clinical cancer‐free period from primary treatment to recurrence, the sites of organ involvement, and the performance status of the patients at the time of entry into the study significantly did influence the survival. There is no evidence in this study that physiologic doses of conjugated estrogens deleteriously influenced the course of the disease.
The effect of a lymphotoxic factor from patients with multiple sclerosis on acute lymphosarcoma cell leukemia and acute lymphoblastic leukemia
Authors: Armentrout Steven A. , White Gregory , Van Den Noort Stanley
Published: February 2007

Eight patients with acute lymphosarcoma cell leukemia or acute lymphoblastic leukemia received infusions of plasma containing a lymphotoxic factor. The lymphotoxic factor induced a transient fall in the number of “blast” cell forms in the peripheral blood in six of the eight patients but did not produce sustained remissions.

Previous investigations have demonstrated that this lymphotoxic factor, found in the plasma of patients with active multiple sclerosis, is of low molecular weight and does not have the properties normally associated with an antibody. This factor appears to selectively interfere with ribonucleic acid synthesis in the thymusderived lymphocyte. Lymphotoxic factor activity was demonstrated in the serum of one patient during a remission in leukemia induced by a viral illness.
The use of low‐dose prednisone and melphalan in the treatment of poor‐risk patients with multiple myeloma
Authors: Cuttner Janet , Wasserman L. R. , Martz Georg , Sonntag Roland W. , Kyle Robert A. , Silver Richard T. , Spurr Charles , Harley John B. , Wiernik Peter M. , Cornwell Gibbons G. , Falkson Geoffrey , Glidewell Oliver , Holland James F.
Published: February 2007

A study was designed to evaluate the effectiveness of prednisone therapy in poor‐risk patients with multiple myeloma. Patients were treated with melphalan alone or in combination with prednisone at doses of either 0.6 mg/kg or 0.3 mg/ kg. The group of patients receiving melphalan and prednisone 0.6 mg/kg had significantly improved responses in hemoglobin, lowering of the M‐protein concentration, and reduction of azotemia. Significant benefits attributable to prednisone were not demonstrated in the group receiving 0.3 mg/kg. Good responses have been shown to produce improved survival. The combination of melphalan and prednisone is effective in producing good responses, but the dose of steroids is important. A dose of prednisone of 0.6 mg/kg in gradually decreasing doses has been found to be effective in production of good responses, especially in the uremic patient.
Non‐Hodgkin's lymphoma in children
Authors: Wollner Norma , Burchenal Joseph H. , Lieberman Philip H. , Exelby Philip R. , d'Angio Giulio J. , Murphy M. Lois
Published: February 2007

In a study of non‐Hodgkin's lymphoma in children, 104 children were treated and followed at Memorial. Sloan‐Kettering Cancer Center from 1964 through June 1974. Forty‐three patients, previously treated and untreated, received a nonspecific group of various chemotherapeutic agents and attained an 11% disease‐free survival rate. A second group of 18 previously untreated patients, who received a chemotherapeutic regimen consisting of cyclophosphamide alone, achieved a 33% disease‐free survival rate. The last group, 43 previously untreated patients (77% of whom had far advanced disease and 86% of whom had diffuse histological types) who received a new and intensive multiple‐drug regimen (the LSA2‐L2 protocol) consisting of induction, consolidation, and maintenance phases, has maintained an 81% disease‐free survival rate after a median observation time of 21+ months. Although nervous system involvement and recurrence or metastases at any time are poor prognostic factors, initial marrow involvement and the amount of bulky disease are no longer considered negative prognosticators when intensive treatment is initiated immediately after diagnosis, is continued for 2 ‐ 3 years, and includes radiation therapy to sites of bulky disease and CNS prophylaxis. The LSA2‐L2 treatment is effective in accomplishing the dual aims of not only increasing the numbers of disease‐free patients but also prolonging their survival.
Pharmacokinetic considerations in the design of optimal chemotherapeutic regimens for the treatment of breast carcinoma: A conceptual approach
Authors: Broder Lawrence E. , Carbone Paul P.
Published: February 2007

Pharmacological data are currently available for a number of antineoplastic agents which have shown clinical activity in advanced breast carcincoma. Preclinical data reveal a relationship between therapeutic response and certain pharmacokinetic parameters such as time of effective cytotoxic exposure (Teff) and the product of concentration with time (Cxt). We have attempted to apply human pharmacologic data to get estimates of these parameters for 6 active agents in breast cancer, to relate them to response rates, and to suggest a method for estimating the role of individual drugs in a multidrug combination.

The response rates for 6 single agents were obtained from literature review and related to estimates of Teff and Cxt. The Cxt‐response relations for single drugs were linear for cyclophosphamide, 5‐fluorouracil, and thiotepa; exponential for vincristine; and relatively flat for methotrexate and cytosine arabinoside. Most Teff values for the active single agents clustered about 15 hr/dose.

From the graphs of response rate vs Cxt, the individual contribution of each agent in a combination study was estimated to arrive at a predicted response rate. The predicted response rates for the combination studies correlated with the actual response rates determined in the clinical study, for 6 of 6 nonrandomized studies and for 12 of 14 randomized studies analyzed. In 2 studies, deviations from the predicted response rate were attributed to differences in study design or analysis. There was no correlation between Teff and predicted response rate. Analyses of pharmacokinetic data may be useful to simulate combination chemotherapy studies to predict the effectiveness of clinical trials in breast cancer. Since the pharmacologic data were not obtained for any of the agents in the actual clinical trials done, we can only speculate on the usefulness of this method. We would encourage the prospective collection of this data in future clinical trails.
Cell kill kinetics with hydroxyurea
Authors: Yataganas Xenophon , Strife Annabel , Perez Amaury , Clarkson Bayard
Published: February 2007

The effects of various concentrations of hydroxyurea (HU) on a human lymphoid cell line in exponential growth phase have been studied using a combination of methods, including determination of the total and viable cell counts; the cells' relative DNA content, measured in a flow microfluorimeter after staining with a fluorescent Feulgen technique; the mitotic index; and the percentage of cells incorporating thymidine‐3 H (TdR‐3 H) during brief and continuous exposure to the isotope both in the presence and absence of colcemid.

A significant redistribution of the cells in the various phases of the cell cycle occurred during the first 24 hr of continuous treatment with 10‐3 M and 10‐2 MHU as follows: (1) division of cells in G2; (2) depletion of mid and late S phase cells due to early cell death; (3) movement of most G1 cells at a normal rate into early S phase where they accumulate; and (4) arrest of the remaining cells in G1, which represented the surviving population after treatment for 96 hr or longer. After removal of the drug, the cell fraction blocked in early S phase progressed semisynchronously through S, but many of the cells were unable to complete division. Their capacity to recover depended on the drug concentration and duration of exposure, but in general the cellular injury caused by HU was more reversible than that caused by “equivalent” concentrations of arabinosylcytosine.
Mitomycin C in large infrequent doses in breast cancer
Authors: Wise Gregory R. , Kuhn Irvin N. , Godfrey Thomas E.
Published: February 2007

Seventy‐one women with far‐advanced breast cancer resistant to standard chemotherapeutic agents were administered mitomycin C using an intermittent high dose schedule. One group consisted of 54 patients with measurable metastatic tumor; a second group consisted of 18 patients with nonmeasurable osseous metastases. Objective response rate in group 1 was 26% for an average duration of 2 1/2 months. Subjective response rate in group 2 was 44% for an average duration of 3 months. Response and toxicity data were similar to those of studies employing the less convenient protracted low‐dose schedule. Prior treatment with other alkylating agents did not adversely affect response. Further investigation into the role of mitomycin in combination chemotherapy programs is recommended.
Development of an effective treatment program for childhood acute lymphocytic leukemia: A preliminary report
Authors: Furman Lorrie , Camitta Bruce M. , Jaffe Norman , Sallan Stephen E. , Cassady J. Robert , Traggis Demetrius , Leavitt Pearl , Nathan David G. , Frei iii E.
Published: February 2007

The development of an effective therapeutic regimen for acute lymphocytic leukemia (ALL) of childhood is described. By careful surveillance of toxicity and efficacy, positive modifications of treatment strategy were achieved without resorting to classically randomized trials. The resultant protocol utilizes vincristine‐prednisone induction followed by asparaginase consolidation, intensive intermittent combination maintenance chemotherapy with adriamycin as a major component, and cranial radiotherapy plus intrathecal methotrexate for central nervous system prophylaxis. Preliminary analysis suggests that this regimen may result in prolonged continuous complete remission in at least 80% of children with ALL.
Sv40 dna sequences as an example of the structure of genes functioning in animal cell nuclei
Authors: Weissman Sherman M. , Subramanian K. N. , Dhar R. , Zain B. , Pan J.
Published: February 2007

Recent studies of the structure of messenger RNA have demonstrated the existence of untranslated sequences of the 3′ and 5′ end of the messages. In addition analysis of transcription in vitro has indicated that the nucleotide sequence U6 purine may be part of a transcription termination signal in prokaryotes. Recently it has been possible to determine the sequence of extensive portions of the DNA of SV40 virus. This article reviews the analogies between certain of these sequences and sequences available from prokaryotic messengers and DNAs. Unusual structures, including blocks of AT‐rich and GC‐rich segment sections and symmetric regions in the DNA near the origin of DNA replication, have been demonstrated and the distribution of stretches of 6 or more deoxyadenylic acids in the DNA of SV40 is consistent with some rho for these sequences in animal cells, either as terminators of transcription or as sites where degradation of transcripts is initiated or sites related to the selective rejection or degradation of transcripts.
Choline antagonism of methotrexate liver toxicity in the rat
Authors: Freeman‐Narrod M. , Narrod S. A. , Yarbro J. W.
Published: February 2007

Because of the frequent reports of hepatic toxicity associated with long‐term administration of methotrexate, a rat model was developed utilizing daily methotrexate administration. This model revealed an incidence of fatty metamorphosis of over 80 percent, atrophy and necrosis of 30 percent, and fibrosis of 10 percent. Fatty liver changes did not differ substantially from control animals in those animals receiving long‐term hydroxyurea, an agent which, like methotrexate, inhibits DNA synthesis but unlike methotrexate, does not impair methylation reactions. Because choline has a lipotropic effect and because its synthesis requires methylation, an attempt was made to block the liver toxicity of methotrexate by simultaneous administration of choline. Animals so treated did not show the pathologic changes in the liver characteristic of methotrexate treatment alone. Furthermore, the accumulation of triglycerides in the liver which was characteristic of methotrexate administration was markedly reduced in those animals receiving choline.

These data strongly suggest that, in the rat model, methotrexate produced liver toxicity by virtue of an effect other than inhibition of DNA synthesis; and that this toxicity can be blocked without impairing methotrexate effect on bone marrow by the administration of choline, a lipotropic agent requiring methylation for its synthesis. It is suggested that these results may have implications for human therapeutic situations involving long‐term administration of methotrexate.
Combination of cyclophosphamide, vincristine, and prednisone, followed by maintenance chemotherapy, with and without radiotherapy, in the management of patients with non‐Hodgkin's lymphomas
Authors: Gorin N. C. , David R. , Stachowiak J. , Najman A. , Duhamel G.
Published: February 2007

Sixty patients with non‐Hodgkin's lymphomas were treated with a cyclophosphamide, vincristine, and prednisone (CVP) induction regimen, either alone (stage IV) or in combination with radiotherapy (stages I, II, III).

The response rates for lymphocytic and histocytic lymphomas were 82 and 86%. The complete remission (CR) rates were 66 and 71% with a median duration of 13 and 5.5 months respectively. Nodular types responded better than diffuse ones in both lymphocytic (CR rate 85% vs 45%; median duration 24+ months vs 2.5 months) and histiocytic lymphoma (CR rate 100% vs 0%).

In lymphocytic lymphomas, survival in the responder group was 90% at 24 months vs only 20% in the nonresponder group (median survival 14.5 months). In the group with nodular lymphocytic lymphoma responding to therapy, there was a 100% survival rate at 24 months. The median survival for patients treated with chemotherapy alone (stage IV) and not responding to therapy, was 22 months vs 14.5 months in the whole nonresponder group (stages I, II, III, IV), suggesting a detrimental effect of radiotherapy in the nonresponder group.

In histiocytic lymphomas, the median survivals in the responder and nonresponder groups were 19 months and 3 months respectively. These results corroborate the excellent efficacy of the CVP regimen. They also indicate that, after CVP induction, 2 major prognostic factors are the histologic type and the nature of the response to therapy.
Post‐hypophysectomy insulin response in patients with advanced breast cancer
Authors: Theologides A. , McHugh R. B. , Lindall A. W. , Hall S. M.
Published: February 2007

Seven postmenopausal women with metastic breast cancer underwent transsphenoidal hypophysectomy. The rate of disappearance, k*, of iv glucose and insulin following iv glucose and 1‐arginine infusion was determined before and after the ablation. The k* was estimated with a linear least squares weighted regression method. The insulin secretory capacity of the pancreas before and after the ablation was evaluated with the index of insulinogenic reserve, the index representing the quantity of insulin secreted per unit of glycemic stimulus.

Following iv glucose and arginine, there was no significant difference in the mean k* for glucose and insulin, before and after the ablation. The insulinogenic index before was lower than the normal. After hypophysectomy, the index decreased further for the first 30 min following iv glucose.

In patients with advanced cancer the index of insulinogenic reserve is lower than normal and is suppressed further by hypophysectomy.
The action of antitumor agents: A double‐edged sword?
Authors: Sieber S. M.
Published: February 2007

Although cytotoxic immunosuppressive agents play an unquestionably useful role in treating many neoplastic and non‐neoplastic disorders, there is accumulating evidence that the toxicity associated with their use is considerable. The therapeutic successes obtained with antitumor agents have led to increases in the life span of cancer patients, but have also provided the opportunity for this toxicity to become manifest. A search of the available literature was carried out, with emphasis on cases in which a malignancy developed in patients following chemotherapy for either neoplastic or non‐neoplastic (e.g., renal transplantation, psoriasis) conditions; particular focus was given to the incidence of acute myelogenous leukemia in various groups of Hodgkin's disease and multiple myeloma patients. That patients with nonmalignant conditions treated with cytotoxic immunosuppressive agents are also at increased risk of developing a malignancy raises the possibility that these agents may have oncogenic potential. Therefore, one may be faced with the paradox that the patients benefiting most from chemotherapy may be at highest risk of suffering its consequences.
Bone marrow polyamines in children with acute leukemia as related to remission status, therapy, and cellularity of specimens
Authors: Miale Thomas D. , Rennert Owen M. , Lawson Daniel L. , Shukla Jayesh B. , Frias Jaime L.
Published: February 2007

Measurements of polyamines have potential practicality as biochemical markers of disease activity in adult cancer patients. On this basis, similar measurements were made in children with leukemia and solid tumors. Fluctuations in blood polyamine concentration were studied in relationship to chemotherapy schematics, cellularity and composition of blood and bone marrow specimens, and remission status of patients. Our results indicate that each of these factors may influence these determinations and consequently their clinical usefulness.
Dissimilar courses of twins with leukemia
Authors: Stewart Stanford J. , Shepherd Dell A. , Steuber C. Philip , Starling Kenneth A. , Falletta John M.
Published: February 2007

Twin girls, genetically identical, probably experienced different leukemogenic events and presented with acute lymphocytic leukemia 6 years apart. Their clinical presentations were similar, but they received significantly different therapy. The first twin died 34 months after diagnosis following multiple remissions and relapses, having received single‐drug maintenance. The second twin remains free of apparent disease 60 months after diagnosis, following vincristine and prednisone induction, 6‐mercaptopurine maintenance, methotrexate and prednisone reinforcement, and central nervous system treatment of occult disease. Their dissimilar clinical courses may have been due to different leukemogenic events and/or markedly different therapeutic programs.
False positive lymphography in Hodgkin's disease: A histologic‐lymphadenographic correlation
Authors: Abt Arthur B. , Murphy W. Linell , O'Connell Michael J. , Wiernik Peter H.
Published: February 2007

A series of 99 consecutive patients having a staging laparotomy for Hodgkin's disease was reviewed. Negative lymph nodes removed during the laparotomy were correlated with lymphograms reported as positive or suspicious. Four patients had large nodes with a prominent hilar area or irregular cortical fat deposits. In two other patients a cluster of small lymph nodes accounted for the radiologic misinterpretation.
Combination Chemotherapy in Histiocytosis X
Authors: Komp Diane M. , Vietti Teresa J. , Berry D. H. , Starling Kenneth A. , Haggard Mary Ellen , George Stephen L.
Published: February 2007

Twenty‐five children with generalized histiocytosis X were treated with a combination of cyclophosphamide, vinblastine, and prednisone: 8 patients experienced complete response, 8 partial response, 2 improvement, and 7 no response. Response rates for children over 1 year of age were higher than those reported for single agents.

Twelve children are now off therapy with no evidence of disease for 10–50 months.

Very poor response rates and high toxicity were seen in children less than 1 year of age. The two infants who eventually achieved CR did so by other therapies.

Further trials in combination chemotherapy must weigh possible long‐term effects of such therapy against the prospect of more rapid disease control.
Clinical and cytokinetic aspects of remission induction of childhood acute lymphoblastic leukemia (ALL): Addition of an anthracycline to vincristine and prednisone
Authors: Sallan Stephen E. , Camitta Bruce M. , Iii Emil Frei , Furman Lorrie , Leavitt Pearl , Bishop Yvonne , Jaffe Norman
Published: February 2007

Fifty‐six untreated patients with childhood with acute lymphoblastic leukemia (ALL) were randomized to receive one of three remission induction regimens: vincristine and prednisone (VP), vincristine, prednisone and daunorubicin (VPD), or vincristine, prednisone and adriamycin (VPA).

The complete remission rate was similar for all three groups. Although the anthracycline regimens caused somewhat more rapid leukemic cell reduction than the VP only group, this difference was not significant. Labeling index reduction between study days 1 and 5 was significantly greater (p < 0.001) with an anthracycline than for the VP group, but there was no difference between the two anthracyclines. Granulocytopenia during induction was significantly increased (p < 0.05) in both the VPD and VPA groups as compared with VP alone. A significantly higher rate of infectious morbidity (p < 0.01) was associated with the addition of either anthracycline, but to date no significant differences in remission duration or survival have been observed.

The addition of anthracyclines to VP for remission induction in childhood ALL has theoretical advantages, but may be undesirable because of increased morbidity.
Leukemia following Reye's syndrome treated with exchange transfusions: Search for type‐C viral infection
Authors: Overturf Gary D. , Powars Darleen R. , McAllister Robert M. , Pegelow Charles , Charman Howard P.
Published: February 2007

A 5‐year‐old child developed acute lymphoblastic leukemia during convalescence from an episode of Reye's syndrome that was treated with multiple exchange transfusions. Routine laboratory, histology, and viral serology were unable to establish a common etiology for the 2 illnesses. Cultural and immunologic methods to search for evidence of infection with type‐C viruses or viral genes in lymphoblasts from the buffy coat and bone marrow failed to reveal these agents. Although no common infectious etiology was defined for the close temporal occurrence of 2 rare diseases, the possibility of an iatrogenically induced malignancy was considered.
A study of antibiotic therapy in fever of unknown origin in neutropenic cancer patients
Authors: Björnsson Sigurdur , Preisler Harvey , Henderson Edward S.
Published: February 2007

Neutropenic cancer patients were given carbenicillin, cephalothin, and gentamicin (CCG) during 51 evaluable episodes of fever of unknown origin. Patients in whom fever persisted despite these antibiotics and in whom infection had not been documented were randomized after 3 days either to discontinue antibiotics or to add chloramphenicol or clindamycin to CCG. During 19 episodes (37%) an infection was documented during the first 3 days, and during an additional 12 episodes (24%) there was a response in 3 days without a focus of infection or an identifiable organism. Two patients died within 3 days, and one developed renal failure. Seventeen febrile episodes (33%) were unresponsive to CCG after 3 days and were randomized. Klebsiella was cultured in 4 of 6 patients randomized to stop antibiotics within a week of cessation, and 3 of these patients died. Of 11 episodes randomized to continue antibiotics, all patients were alive at 2 weeks after randomization and 9 after 4 weeks. This study, albeit small, demonstrates no advantage to withholding treatment in unremitting fever of unknown etiology, and indeed strongly suggests that in this clinical setting, antibiotics once started should be continued until bone marrow recovery.
Phase II study of subcutaneously administered 5‐azacytidine (NSC‐102816) in patients with metastatic malignant melanoma
Authors: Bellet Robert E. , Catalano R. B. , Mastrangelo Michael J. , Berd David
Published: February 2007

Thirty (30) patients with advanced metastatic malignant melanoma refractory to DTIC (NSC‐45388) and a nitrosourea were treated with 5‐azacytidine (NSC‐102816). 5‐Azacytidine was administered subcutaneously at a dosage of 100 mg/m2/day for 10 days. Twenty‐six (26) patients were evaluable for toxicity and response. Major organ toxicities were hematologic, gastrointestinal, and cutaneous; no antitumor activity was noted.
A summer camp for children with cancer
Authors: Hvizdala Eva V. , Miale Thomas D. , Barnard Patricia J.
Published: February 2007

The prognosis for children with cancer has changed significantly over the past 10 years. Currently, it is anticipated that cure can be achieved in approximately 50% of newly diagnosed cases of childhood cancer. The quality of life for these children depends not only on their medical treatment but also on the successful management of the psychological problems related to their diagnosis.

A summer camp was established in Florida as a part of our psychosocial rehabilitation program for pediatric cancer patients. Participating in the day‐today camp life were 26 children with various forms of cancer. Each child not only had the opportunity to enjoy a normal out‐of‐door life style, away from their overprotective parents, but experienced daily contact with other children who shared a similarly stressful existence. It is felt the awareness gained through the realization that they were not alone in their plight and the independence instilled through separation from parents was beneficial to each child.

It is anticipated that future camps with the inclusion of psychological testing will provide us with the opportunity to further assess the need for psychosocial rehabilitation for the child with cancer.
Blastic transformation in chronic myelogenous leukemia: Experience with 50 patients
Authors: Marks Stanley M. , McCaffrey Ronald , Rosenthal David S. , Moloney William C.
Published: February 2007

Fifty consecutive patients with blastic chronic myelogenous leukemia were evaluated clinically, morphologically, biochemically, and therapeutically. Forty‐five patients had a preceding stable phase (38 Ph +, 7 Ph ‐); five patients presented with de novo Ph+ blast crisis. The most frequent clinical signs of impending blast crisis were weakness, fatigue, increasing splenomegaly, anemia, thrombocytopenia, marrow fibrosis, and a rising neutrophil alkaline phosphatase. Fever (unrelated to infection), skin infiltration, lymphadenopathy, hepatomegaly, thrombocytosis, and basophilia were much less common. The development of aneuploidy occurred in less than one‐half of the total group. Myeloblastic morphology at blastic transformation was most frequent with occasional lymphoblastic, promyelocytic, and undifferentiated cases seen. Terminal deoxynucleotidyl transferase was present in one‐third of the patients, but had no clear‐cut relationship to the morphology. Response to treatment was generally disappointing (two complete and 15 partial remissions in 45 treated patients).
Improvement in complete response rate, duration of response and survival with adriamycin combination chemotherapy for non‐Hodgkin lymphoma: A prognostic factor comparison of two regimens
Authors: Cabanillas Fernando , Rodriguez Victorio , Freireich Emil J.
Published: February 2007

The results of a chemotherapy regimen utilizing adriamycin in combination with vincristine, prednisone plus or minus cyclophosphamide (CHOP‐HOP) for the treatment of non‐Hodgkin lymphoma are compared to those of a non‐adriamycin containing combination (COP). The complete remission (CR) rate of 67% for CHOP‐HOP in malignant lymphoma, diffuse histiocytic type (MLDH) is superior to 33% obtained with COP. In malignant lymphoma, nodular poorly differentiated lymphocytic (MLNPD), the CR rate was: CHOP‐HOP 83%, COP 44%. The prognostic factors for both treatment groups were compared and found to be similar. Thus, adriamycin appears to be responsible for this improvement in CR rate. When analyzed as a group, the patients treated with CHOP‐HOP had a longer survival than those treated with COP. This difference was also evident in the subgroup of patients with MLDH. The smaller subgroup of patients with MLNPD treated with CHOP‐HOP did not show a significant improvement in survival. A trend for longer duration of CR in both diffuse and nodular lymphomas was also observed, but this difference did not reach statistical significance possibly due to the smaller numbers of patients. Combination chemotherapy with adriamycin has resulted in a higher CR rate and survival for patients with non‐Hodgkin lymphoma particularly for the subgroup of patients with MLDH.
Alpha‐hemolytic streptococci: Clinical significance in the cancer patient
Authors: Pizzo P. A. , Ladisch S. , Witebsky F. G.
Published: February 2007

Alpha‐hemolytic Streptococci were associated with 29 episodes of sepsis (12 polymicrobial) in 27 patients with cancer during a nine year period. Only two patients had dental manipulation prior to the onset of sepsis, but each had received chemotherapy and 75% were granulocytopenic (PMN < 500/mm3) at the time of the infection. None of the patients developed bacterial endocarditis. Unlike the normal host in whom a transient bacteria with alpha‐hemolytic Streptococci may occur following dental extraction or periodontal procedures, the cancer patient is at risk for more clinically significant sepsis. This risk is probably related to the presence of chemotherapy‐induced oral mucusitis and granulocytopenia, and our results suggests that isolation of alpha‐hemolytic Streptococci in febrile cancer patients should not be dismissed as a contaminent.
Effects of BCG on peripheral blood counts and drug tolerance of patients with non‐Hodgkin lymphoma receiving combination chemotherapy
Authors: Brooks Robert J. , Jones Stephen E. , Gaines John A.
Published: February 2007

Peripheral blood counts and drug dosages were studied in 68 patients with advanced non‐Hodgkin lymphoma, who were assigned at random to receive either chemoimmunotherapy or chemotherapy, in order to determine if Bacillus Calmette Guerin (BCG) immunotherapy lessened myelosuppression or improved drug tolerance. Thirty‐seven patients received CHOP (cyclophosphamide, adriamycin, vincristine, and prednisone) plus BCG, and 31 patients received CHOP plus low‐dose bleomycin. These two treatment groups, similar for important clinical and prognostic factors, were evaluated at courses one, four, and eight of remission induction, by comparison of the following parameters: hemoglobins, hematocrits, platelet counts, white blood‐cell counts (including absolute neutrophil, lymphocyte, and monocyte counts), and dosages of cyclophosphamide and adriamycin. With successive treatment both groups experienced statistically significant progressive declines in the mean values of hemoglobin, hematocrit, total white blood‐cell count, absolute granulocyte and lymphocyte counts, and dosages of adriamycin and cyclophosphamide. These effects of treatment were comparable except for a slightly greater degree of mild anemia in the CHOP‐BCG group (mean hemoglobin ± SEM = 11.7 ± 0.3 gm/dl at course eight compared to 12.7 ± 0.3 gm/dl for the CHOP‐bleomycin group, p = 0.04). Thus, BCG appears to play no beneficial role in lessening myelosuppression resulting from chemotherapy or improving drug tolerance.
In vitro antitumor reactivity of mononuclear leukocytes from cancer patients receiving immunotherapy with BCG
Authors: Mavligit Giora M. , Hersh Evan M.
Published: February 2007

Mononuclear cell‐mediated cytotoxicity (MCMC) against cultured tumor target cells was studied sequentially in melanoma and breast cancer patients before and during BCG administration. MCMC showed temporary fluctuations. In patients with locally advanced melanoma and carcinoma of the breast after tumor load reduction, the administration of BCG may increase the MCMC. This did not always correlate with a favorable clinical course. Potentiating serum factors appeared in 50% of these patients during BCG therapy, while blocking factors were rare. Neither correlated with prognosis. In patients with disseminated melanoma receiving chemoimmunotherapy, increases in MCMC may be related to clinical course. Blocking serum factors frequently developed in this group of patients and potentiating factors were rare. Neither correlated with the clinical course. Significant MCMC among normal donors and the apparent lack of specificity suggest a common non‐specific (? natural) cellular reactivity against cultured tumor target cells.