bluuebunny/crossref_metadata_2025 huggingface dataset:
Thin needle biopsy of solid tumors in children
Authors: Jereb B. , Us‐Krasovec M. , Jereb M.
Published: February 2007

Thin needle biopsy of a suspected tumor will usually yield material amenable to cytologic examination and sufficient for diagnosis. Sixty children with suspected solid malignant tumors were subjected to this procedure. The masses biopsied were in bone, abdomen, mediastinum, tongue, pharynx, soft tissue, and peripheral lymph nodes.

The diagnostic yield was 66% on first biopsy and rose to 93% on repeated biopsies. The diagnostic accuracy was 97% in malignant tumors with histologic confirmation. There were no proved false‐negative diagnoses, and two (3%) false‐positive (for malignancy) diagnoses. All patients were followed up. There were no complications of note.
Degradation and clearance of methotrexate in children with osteosarcoma receiving high‐dose infusion
Authors: Wang Yeu‐Ming , Kim Pyong‐Young , Lantin Erlinda , van Eys D. Catherine , Romsdahl Marvin M. , Sutow Wataru W.
Published: February 2007

Plasma methotrexate (MTX) concentrations were quantitated in 34 patients after 127 high‐dose (35–350 mg/kg) infusions with citrovorum factor rescue. Significant linear correlations have been obtained between methotrexate dosage and concentrations in plasma at 6 and 24 hours after the initiation of the therapy. However, similar trends have not been observed when 48‐ and 72‐hour samples were analyzed. Clinical toxicity was not serious when the methotrexate level in plasma was < 4.5 × 10−6 M at 48 hours after the start of a six‐hour infusion in children. A minimal four‐hour steady‐state methotrexate plasma level can be maintained during a six‐hour infusion. Children excrete methotrexate at a faster rate than adults; the half‐life of MTX during the first phase of plasma clearance curve is one hour shorter in children. Urinary analyses have indicated that substantial methotrexate is metabolized. The chemical nature of these components has not been identified. Further, the urinary metabolic profiles varied among patients.
A phase II study of phenesterin (NSC‐104469)
Authors: Bennett J. M. , Frank J. , Sears M. , Lagakos S. W. , Horton J. , Colsky J. , Hall T. C.
Published: February 2007

Phenesterin was evaluated in 222 patients with two different dosage regimens, one by daily treatment and the other with an intermittent schedule. Toxicity was moderate with both programs. The largest group of patients treated had breast cancer; they experienced a 10% response rate. Of interest was a higher percentage of responses in ovarian cancer (36%). An expanded study of patients with ovarian cancer would be of interest.
Combination chemotherapy with MOPP in children with recurrent brain tumors
Authors: Cangir Ayten , van Eys Jan , Berry D. H. , Hvizdala Eva , Morgan Samuel K.
Published: February 2007

Twenty‐three children with CNS tumors were treated with combination chemotherapy including nitrogen mustard, vincristine sulfate, procarbazine, and prednisone (MOPP). All but one had progressive or recurrent tumors following surgery and irradiation. In addition, nine of these patients had prior chemotherapy. Seventeen out of 23 patients (73.4%) responded to MOPP chemotherapy including seven patients who had prior chemotherapy with single or multiple agents such as VCR, nitrosoureas, intrathecal methotrexate, and VM‐26. Three comatose patients who were being kept on Decadron® without benefit recovered from coma. At the time of this report 8 of the 17 responders are surviving without evidence of recurrence 7–30 months from the start of MOPP chemotherapy. In two of these children chemotherapy has been completely stopped.
Acute promyelocytic leukemia presenting as a pelvic mass
Authors: Belasco Jean Bello , Bryan J. Hugh , McMillan Campbell W.
Published: February 2007

The case history of a child with acute promyelocytic leukemia (APL) is reported to illustrate both an unusual presentation of APL as a pelvic mass and to review the pathophysiology and treatment of the disease. Therapy of APL consists of chemotherapy, namely adriamycin/daunomycin for remission induction, and of control of disseminated intravascular coagulation. A chloroma, if present, may require local irradiation in addition to chemotherapy. With aggressive management, the number of prolonged remissions may be greater for APL than for any other form of acute myelogenous leukemia (AML), with significant numbers of patients achieving five‐year survival.
Primary chemotherapeutic management of unresectable and metastatic hepatoblastoma in children: Report of four cases
Authors: Siegel Michael M. , Siegel Stuart E. , Isaacs Hart , Weitzman Jordan J. , Hanson Bruce A. , Higgins Gussie R. , Shore Nomie A.
Published: February 2007

Four children presenting with unresectable hepatoblastomas and one with metastatic disease are reported. Following initial biopsy all were treated with chemotherapy which included Adriamycin. Three of the four children showed a significant reduction in tumor size, and in two, delayed resection of the primary lesion was possible. Chemotherapy including Adriamycin represents effective initial cytoreductive therapy for childhood hepatoblastoma, thereby reducing the morbidity and mortality associated with the extensive hepatic resection usually required for an untreated lesion.
Remission induction in acute myelogenous leukemia using cytosine arabinoside synchronization: A southwest oncology group study
Authors: Steuber C. Philip , Humphrey G. Bennett , McMillan Campbell W. , Vietti Teresa J.
Published: February 2007

The use of cytosine arabinoside (Ara‐C) infused at kinetically suggested intervals is reported in 40 pediatric patients with acute myelogenous leukemia (AML) and its subtypes. Response was observed in 17 of the 34 evaluable patients. However, the severe, often fatal effects of the regimen prevent its recommendation as a standard induction regimen in AML in children.
Combination chemotherapy of non‐Hodgkin lymphoma
Authors: Forcier R. Jackson , McLntyre O. Ross , Nissen Nis I. , Pajak Thomas F. , Glidewell Oliver , Holland James F.
Published: February 2007

A randomized therapeutic trial of three induction regimens for patients with lymphosarcoma and reticulum‐cell sarcoma was conducted by the Cancer and Leukemia Group B (CALGB) (formerly Acute Leukemia Group B). Addition of streptonigrin, but not cyclophosphamide, to the combination of vincristine and prednisone improved the complete remission rate achieved after a 42‐day induction program. The duration of the subsequent remission and survival was not influenced by the induction combination assigned. Remission maintenance with cyclophosphamide was superior to maintenance with methotrexate. The results of this study are compared with others in which advantages for three or four drug treatment regimens have been reported.
Treatment of oat‐cell carcinoma of the lung in the community
Authors: Citronbaum Ronald
Published: February 2007

Nine patients with “limited” (thoracic) small‐cell lung carcinoma were treated with combined chemotherapy and radiotherapy (involved field and prophylactic whole brain). Induction drugs were Vincristine, Adriamycin, and Cyclophosphamide; and Cyclophosphamide, Vincristine, and CCNU for maintenance. Eight out of nine patients (89%) continue NED at a median follow‐up time of 12 months. This group is compared to 21 patients with more extensive disease and 6 patients with limited disease using various other regimens. Median survival in the extensive group was 5 months and 8 months for the limited‐diseased group treated with single agents. Intensive combination chemo‐irradiation therapy is safe and highly effective in patients with limited oat‐cell carcinoma of the lung, and leads to prolonged disease‐free survival.
Safe, rapid administration schedule for cis‐platinum—mannitol
Authors: Rainey John M. , Alberts David S.
Published: February 2007

Cis‐diamminedichloroplatinum (II) cis‐platinum, 25–75 mg/m2, with 40 gm mannitol and fluid were given over 1–2 hours to 40 patients with no evidence of elevated serum creatinine levels. Cis‐platinum was administered every 28 days at a dose of 50mg/m2 to 22 patients, and 75mg/m2 to 6 patients. Patients received from one to eight courses of therapy with no change in their serum creatinine level. A safe, simple method of cis‐platinum administration has been achieved.
Use of L‐asparaginase and cytosine arabinoside for refractory acute lymphocytic leukemia with particular reference to T‐cell leukemia
Authors: Steuber C. Philip , Levy Gary J. , Nix William L. , Shepherd Dell A. , Starling Kenneth A. , Fernbach Donald J.
Published: February 2007

Ten patients with late‐stage acute lymphocytic leukemia were treated with L‐asparaginase and cytosine arabinoside. Complete remission was achieved in 8 patients including 5 of 5 patients with T‐cell leukemia. Major toxicity included anaphylactic reactions in 3 of the 10 patients.
CCNU, vinblastine, and delalutin therapy in renal cell carcinoma
Authors: Vosika Gerald J. , Ryan Michael J. , Fortuny Ignacio A. , Meyer Cynthia , Kiang David T. , Theologides Athanasios , Kennedy Byrl J.
Published: February 2007

Advanced renal cell carcinoma is relatively resistant to most adequately evaluated chemotherapeutic agents. The combination of CCNU and vinblastine, which has antitumor activity in a frog renal carcinoma model system, has demonstrated activity in initial studies in man. The current study investigated this combination of drugs together with a progestational agent, Delalutin. Seventeen patients with metastatic renal cell carcinoma were treated with CCNU, vinblastine and Delalutin. There were no objective responses. Four patients with stable disease had a mean survival of 18 months compared to 13 patients with progressive disease who had a mean survival of 5 months. The survival of the four patients with stable disease was in large part due to the slowly progressive natural history of their disease.
Comparison of two radioimmunoassays and a microbiologic assay for bleomycin
Authors: Elson Michael K. , Oken Martin M. , Shafer Rex B. , Broughton Alan , Strong James , Braun C. T. , Crooke Stanley T.
Published: February 2007

Recently two radioimmunoassays have been independently developed for determination of bleomycin levels. In this study these assays are compared with each other and with a standard microbiologic assay for bleomycin. Bleomycin levels were determined in serum and urine samples obtained at varying intervals following intramuscular bleomycin injection. There were systematic differences between the assays. One radioimmunoassay indicated bleomycin levels lower than the levels indicated by the microbiologic assay with serum samples. With urine samples, both radioimmunoassays indicated bleomycin levels greater than the microbiologic assay.
Bleomycin in combination chemotherapy of metastatic wilms tumor: A late recurrent case, refractory to conventional therapy
Authors: Kisielius Tomas , Bianco Adrian , Merrill John M. , Taylor S. G. , Dewys William
Published: February 2007

A patient with a late recurrence (13 years) of Wilms tumor is presented. After relapse with conventional chemotherapy, an objective partial remission was obtained with bleomycin, vinblastine, cyclophosphamide, and cis‐platinum. Stable disease was noted when bleomycin was withheld. Bleomycin in this combination appeared to effect a good response, and further studies of chemotherapy of Wilms tumor should include bleomycin in combination with other active agents.
Serial studies of serum dopamine‐B‐hydroxylase and urinary vanillylmandelic and homovanillic acids in neuroblastoma
Authors: Brewster M. A. , Berry D. H.
Published: February 2007

Recent reports have suggested that elevations of serum dopamine‐B‐hydroxylase (DBH) activity may correlate with diagnosis in neuroblastoma patients excreting vanillylmandelic acid (VMA). We have serially studied serum DBH and urinary homovanillic acid (HVA) and VMA excretion during the disease course of five patients with neuroblastoma. DBH activities did not indicate clinical course, therapies, or prognosis. Dilution studies revealed an age‐related alteration in DBH effectors and they suggest that these may be different in neuroblastoma.
An evaluation of corynebacterium parvum during remission maintenance therapy in pediatric patients with acute lymphoblastic leukemia
Authors: Lankford J. , Nitschke R. , Wells J. , Cox C. , Humphrey G. B.
Published: February 2007

The biologic impact and clinical toxicity of Corynebacterium parvum administered at a dose of 5 mg/M2 by intravenous or subcutaneous routes were evaluated in 18 children receiving combination chemotherapy for maintenance of acute lymphoblastic leukemia (ALL) in remission. Several nonspecific immunologic and hematologic parameters were evaluated. Patients were also monitored for changes in cutaneous sensitivity to histamine. No changes in any parameter were observed in patients after only one course of C parvum injection. However, after 6‐10 courses, glass‐adherent peripheral blood leukocytes of C parvum‐treated patients augmented the response of PHA‐stimulated autologous lymphocytes. In all nine patients studied who received C parvum injection subcutaneously for at least six months, there were significant increases in the mean bone marrow myelocyte‐erythrocyte (ME) volumes compared to pretreatment values. These results suggest that periodic evaluations are desirable in patients receiving repeated administration of C parvum, since changes in immunologic and hematologic responses may be demonstrable only after several injections. In contrast to the reported experience in adults, subcutaneous C parvum administration in children was not well tolerated, whereas intravenous infusion was generally well tolerated.
Ectopic production of human chorionic gonadotropin: A case report
Authors: Erlichman Charles , Pringle J. F. , Quirt I. C.
Published: February 2007

The ectopic production of the β‐subunit of human chorionic gonadotropin (hCG) is described in a patient with an anaplastic carcinoma. After chemotherapy the marker decreased in a logarithmic fashion to undetectable levels but the neoplasm progressed and the patient died. The specificity of the β‐subunit of hCG is discussed. Discordance of the marker and clinical disease is pointed out, and several possible explanations are outlined. The lack of specificity of the β‐subunit of hCG and the discordance that it may exhibit means that its use in diagnosing and following disease progression may be limited.
Immunodiagnosis of childhood all: Problems associated with the use of peripheral blood alone
Authors: Lauer Stephen J. , Casper James T. , Borella Luis D.
Published: February 2007

The immunologic classification of acute lymphoblastic leukemia (ALL) based solely on peripheral blood (PB) cell phenotypes may lead to conflicting results. This was demonstrated by the simultaneous assay of five immunologic markers on PB and bone marrow (BM) cells from 13 children with untreated ALL. We assayed erythrocyte (E) rosettes at 4°C and 37°C, presence of membrane Ig(mIg), and binding of antisera raised against thymus (T), and E− ALL blasts, respectively. At diagnosis, the PB of these children contained > 90% lymphoid cells with 0–48% E rosettes and 1‐84% cells with T antigen(s). Of 7 children with WBC < 10,000/cu mm there were 4 who had 20% or more E rosettes and T‐antigen‐positive cells. Of 6 children with WBC > 10,000/cu mm there were only 2 who had more than 20% E rosettes and T‐antigen‐positive cells. Based on examination of PB alone, six children may have been classified as having T‐like ALL. However, these results were due to the presence of circulating normal T lymphocytes, and assay of BM cells established that only one of the 13 children had T‐like ALL and none had B‐cell ALL. Bone marrow blasts from 12 patients did not form rosettes at 37°C, did not have mIg, and did not react with anti‐T serum. A high proportion of BM blasts from these 12 patients (39‐96%) did react with antiserum against E− ALL blasts. Of these 12 patients 11 had a higher proportion of E− ALL antiserum‐positive blasts in the BM than PB. Thus, immunologic classification of ALL should be based on the study of BM blasts, or both PB and BM cells.
L‐asparaginase used with cytosine arabinoside in treatment of childhood acute lymphocytic leukemia refractory to vincristine and prednisone
Authors: Smithson William A. , Gilchrist Gerald S. , Burgert E. Omer
Published: February 2007

Eleven patients with acute lymphocytic leukemia in relapse were treated with L‐asparaginase and cytosine arabinoside (1‐β‐D‐arabinofuranosylcytosine) in induction therapy and the same drugs plus cyclophosphamide in maintenance therapy. Three patients had complete remissions lasting 6, 16, and 78+ weeks. One patient experienced partial remission and four had decreased bone marrow or peripheral blasts but were not clinically improved. The responses, which were brief, lasted 1‐16 weeks with one exception of 78+ weeks. Four patients had allergic reactions to L‐asparaginase that were unpredictable with assays of antibodies against L‐asparaginase.
An autopsy study of eye involvement in acute leukemia of childhood
Authors: Robb Richard M. , Ervin Lauri D. , Sallan Stephen E.
Published: February 2007

The eyes of 60 children who had died of acute leukemia between 1968 and 1977 at the Children's Hospital Medical Center have been examined pathologically. An attempt has been made to relate eye findings to the state of the systemic disease at the time of death. Eight of the 60 patients had leukemic retinal infiltrates and all eight had fulminant disease with terminal leukocyte counts over 100,000 per cubic millimeter and a high percentage of „blast”︁ cells. Twenty‐six patients (43%) had leukemic infiltration of the choroid that was inapparent clinically. Choroidal involvement was not correlated with high terminal leukocyte counts but was invariably associated with widespread infiltration of other organs. Four patients had optic nerve involvement; all four had coexistent meningeal leukemia. Isolated retinal hemorrhages could not be correlated with other parameters of the leukemic process.
Cisplatin, bleomycin, and vinblastine combination therapy of testicular tumors: An analysis
Authors: D'aoust Joan C. , Prestayko Archie W. , Einhorn Lawrence H. , Comis Robert L. , Ginsberg Sandra J. , Archambault W. A. T. , Crooke Stanley T.
Published: February 2007

A combination regimen consisting of cisplatin, bleomycin, and vinblastine was evaluated in 86 patients with metastatic testicular tumors. Prior therapy included surgical resection of primary tumor (84 patients), radiotherapy (21 patients), chemotherapy (33 patients). Thirteen patients received prior bleomycin and vincristine or vinblastine. Of 80 evaluable patients 51 achieved complete response (CR) and 26 achieved partial response (PR), for an overall response rate 96.5%. There was no significant difference in response rates or survival with respect to prior therapy, sites of metastatic lesions, and tumor histology. The median survival time was not reached in an observation period of 44+ months. Sixty patients were alive 11+–44+ months, and 57 of these were free of disease. Thirty‐two of the 60 patients (53%) had a survival time greater than 20 months. Toxicities included nephrotoxicity (18 patients) leukopenia, (69 patients), thrombocytopenia (nine patients), and anemia (56 patients). Bleomycin‐induced pulmonary toxicity was fatal in one patient. Other toxicities included nausea and vomiting, stomatitis, fever, alopecia, and neurological effects.
Teratomas in children and young adults
Authors: Ganick Dorothy J. , Gilbert Enid F. , Opitz John M.
Published: February 2007

A review of all teratomas seen at the University of Wisconsin Hospital between 1965 and 1977 revealed that sacrococcygeal and presacral teratomas were most common. In these cases survival was best in infants less than one year old, with the exception of two cases of malignant medulloepithelioma. Testicular teratomas were predominant in the young adult male, and survival was poor. Pathology and treatment of teratomas are discussed, with an accompanying discussion of congenital anomalies associated with teratomas.
A comparative trial of daunorubicin, cytosine arabinoside, and thioguanine, and a combination of the three agents for the treatment of acute myelocytic leukemia
Authors: Wiernik Peter H. , Glidewell Oliver J. , Hoagland H. Clark , Brunner Kurt W. , Spurr Charles L. , Cuttner Janet , Silver Richard T. , Carey Robert W. , Delduca Vincent , Kung Faith H. , Holland James F.
Published: February 2007

In this study 523 previously untreated patients with acute myelocytic leukemia were randomly allocated to induction therapy with daunorubicin 60 mg/M2 daily × 3, cytosine arabinoside and thioguanine 100 mg/M2 each every 12 hours until marrow hypoplasia was achieved, or a 5‐day course of the three drugs with daunorubicin 100 mg/M2 given on dav 1 and cvtosine arabinoside plus thioguanine each given at a dose of 100 mg/M2 every 12 hours for five days. All patients received cyclophosphamide 600 mg/M2 followed in 24 hours by hydroxyurea 500 mg/M2 every six hours for four doses monthly for maintenance therapy. Patients were randomized to receive one of three antimetabolite treatments beginning 24 hours after the last dose of hydroxyurea each month for seven days. One such treatment consisted of 6‐mercaptopurine 100 mg/M2 daily, another group received 6‐thioguanine at the same dose daily, and the third group received 50 mg/M2 of both antimetabolites daily.

There were no significant differences in complete response rate, remission duration, or survival among the various treatment groups.
Slipped capital femoral epiphysis following radiotherapy and chemotherapy
Authors: Ryan Beverly R. , Walters Thomas R.
Published: February 2007

There may be an increased frequency of slipped femoral epiphysis in pediatric patients who have received radiation to the pelvic area and combination chemotherapy. Previous reports include bilateral slipping of the epiphysis, eight years after radiation, in a patient with a pelvic neuroblastoma and the occurrence in a patient who had received radiation for Hodgkin disease, with a primary site in the pelvic region. No direct correlation was established in either case.

This is a report of two patients who received pelvic radiation and combination chemotherapy who subsequently developed slipped femoral epiphysis. Our purpose is to heighten the suspicion in patients who have received radiation and chemotherapy for pelvic tumors. It is recommended that the femoral heads and acetabula be shielded when their inclusion in the treatment fields is not crucial to the treatment of the underlying disease.
Action of cytosine arabinoside on human tumor cells isolated from malignant effusions: In vitro phosphorylation and inhibition of dna synthesis
Authors: Stahel Rolf A. , Peter Hans‐Jakob , Sauter Christian
Published: February 2007

Tumor cells were isolated from malignant effusions of three patients with disseminated solid tumors of different origin. Intracellular accumulation of nondiffusible cytosine arabinoside (ara‐C) nucleotides was used to measure phosphorylation. Mouse leukemia L 1210 and L 1210/CA, and ara‐C‐resistant subline, were used as reference cells. Phosphorylation activity was similar in the cells from all three solid tumors and showed a linear increase with drug concentrations of 0.1–100 μg/ml. In contrast to activity in L 1210 cells, the in vitro activity was not saturable at drug levels up to 100 μg/ml. Ara‐C inhibited the incorporation of thymidine into DNA 84%–90% in the solid tumor cells at a concentration of 10 μg/ml. Higher drug concentrations did not result in further inhibition. In one patient, DNA synthesis of tumor cells isolated before and after intraperitoneal instillation of 1,000 mg ara‐C was measured. The in vivo inhibition was found to correspond to the in vitro data.

Solid tumor cells isolated from malignant effusion have no greatly reduced capacity for cellular formation of ara‐C/nucleotides, but higher drug levels than achieved with conventional therapy are necessary for sufficient ara‐C nucleotide synthesis.
Ovarian involvement in neuroblastoma
Authors: Meyer William H. , Yu George W. , Milvenan Eileen S. , Jeffs Robert D. , Kaizer Herbert , Leventhal Brigid G.
Published: February 2007

A case of neuroblastoma involving the ovaries bilaterally at diagnosis is reported. A review of previous cases of neuroblastoma at Johns Hopkins Hospital revealed no previous occurrence of ovarian metastatic disease at diagnosis, but involvement in about one‐third of cases at autopsy. This appears to be a more common site of metastatic disease than has been previously recognized. The significance of this site of metastases in neuroblastoma is unknown.
Bilateral wilms tumor presenting with acute renal failure and clinical findings mimicking cardiac failure
Authors: Holbrook C. Tate , Crist William M. , Kohaut Edward C. , Buntain William L.
Published: February 2007

A six‐year‐old girl presented with clinical signs and symptoms of right‐sided heart failure. Cardiac catheterization demonstrated filling defects in both pulmonary arteries felt to represent metastatic lesions or thromboemboli. Intravenous pyelogram revealed bilateral renal masses and intrarenal obstruction. Acute renal failure was unresponsive to standard therapy. An open renal biopsy revealed Wilms tumor with favorable histology. Aggressive chemotherapy and irradiation were undertaken and renal function returned. This case adds to the heterogeneity of presentations described for Wilms tumor, and review of the literature reveals no other cases with similar presenting signs.
Improved remission induction rate with D‐ZAPO but unimproved remission duration with addition of immunotherapy to chemotherapy in previously untreated children with ANLL
Authors: Baehner Robert L. , Bernstein Irwin D. , Sather Harland , Higgins Gussie , McCreadie Samuel , Chard Ronald L. , Hammond Denman ,   Children's Cancer Study Group
Published: February 2007

In 163 children with acute nonlymphocytic leukemia (ANLL), a D‐ZAPO induction program consisting of daunomycin, 5‐azacytidine, cytosine arabinoside, prednisone, and vincristine resulted in a remission rate of 71.8%. Immunologic therapy was employed during maintenance with the aim of prolonging remission and improving survival. The administration of immunotherapy consisting of a mixture of bacillus Calmette‐Guérin (BCG) and allogeneic acute myelomonocytic leukemic cells injected intradermally on day 14 of each of the first three monthly cycles of 6‐thioguanine for ten days, 5‐azacytidine and cytosine arabinoside for four days, and vincristine for one day did not improve remission duration or survival compared to that due to chemotherapy alone. Important prognostic factors identified in this study included a remission induction rate significantly better for females than males (P = 0.04), for children between the ages of 5 and 10 years compared to those greater than this age group (P = 0.01), and a prolonged remission duration (P = 0.04), and survival (P < 0.01) for patients with initial white blood counts of <20 × 109/liter.
Histiocytosis X: Clinical trial of chlorambucil: A report from childrens cancer study group
Authors: Lahey M. E. , Heyn R. M. , Newton W. A. , Shore N. , Smith W. B. , Leikin S. , Hammond D.
Published: February 2007

A prospective study for histiocytosis X was designed to determine whether “good risk” patients, ie, those without evidence of dysfunction of liver, lung, or hemopoietic system, would respond to single agent therapy; in this case chlorambucil (CMB) used in a dose of 5 mgm/m2 /day. If there was no response after an adequate trial period, treatment was initiated with four drugs using a combination of prednisone, vinblastine, cyclophosphamide and methotrexate. There were 26 evaluable patients, 57% of whom were less than two years of age at onset of therapy. There were three complete and four partial responses to CMB for a response rate of 26.9%. Sixteen patients received an adequate trial of four‐drug therapy with three complete and two partial responses for a response rate of 33%. These responses were inferior to those previously reported for either single agents or combined therapy in histiocytosis X.
Antiemetic effect of intravenous diazepam in patients receiving cis‐diamminedichloroplatinum II: A pilot study
Authors: Robins H. Ian , Ershler William B. , de Jongh Leon , Chang Yuang‐Chi , Drozdowicz Paulette M. , Carr Brian I. , Meyer Deborah K.
Published: February 2007

A pilot study suggesting the usefulness of intravenous diazepam as an antiemetic for adult patients receiving cis‐diamminedichloroplatinum is presented. Observations included 24 patients and 34 courses of therapy. Patients received diazepam and prochlorperazine, and the incidence of vomiting and subjective evaluation of nausea were compared to previous courses of therapy with prochlorperazine alone. A positive response was observed in 87% of the patients. Use of other antiemetics is briefly reviewed.
L‐asparaginase effect on antithrombin‐III levels
Authors: Anderson Norwood , Lokich Jacob J. , Tullis James L.
Published: February 2007

The effect of L‐asparaginase (L‐asp) therapy on circulating antithrombin‐III (AT‐III) was monitored in three patients with acute lymphoblastic leukemia. Serial determination for AT‐III by both a functional assay and an immunologic assay demonstrated a rapid decrease in serum AT‐III levels, followed by a protracted recovery beyond the period of L‐asp exposure. One of the three patients developed a reversible venous thrombosis of the arm. The mechanism of the L‐asparaginase effect may be related to peripheral degradation of AT‐III or to inhibition of production.
Ewing sarcoma: Phalangeal primary with fatal cardiac metastases
Authors: Wilson Kenneth S. , Nyssen John , Alexander Skaria
Published: February 2007

A 39‐year‐old man had pain and swelling of the terminal phalanx of a finger. Radiograph was interpreted as osteomyelitis, and amputation through the midphalanx was performed. Histology revealed Ewing sarcoma. Lung metastases rapidly developed. Right lung irradiation and systemic chemotherapy, including doxorubicin, were instituted. He developed progressive severe right ventricular failure which was attributed to effects of large pulmonary metastases. Autopsy showed massive right ventricular metastases, the primary pathological cause of the heart failure, without evidence of doxorubicin cardiomyopathy.
A new therapy schedule for pediatric non‐Hodgkin lymphoma toxicity and preliminary results
Authors: Meadows A. T. , Jenkin R. D. T. , Anderson J. , Chilcote R. , Coccia P. , Exelby P. , Kushner J. , Leikin S. , Siegel S. , Wilson J. F. , Hammond D.
Published: February 2007

A pilot study of the toxicity and efficacy of a new treatment schedule for childhood non‐Hodgkin's lymphoma was conducted by members of the Children's Cancer Study Group (CCSG) prior to its use in a randomized phase III trial. Chemotherapeutic agents used were cyclophosphamide (CPM), vincristine (VCR), and prednisone, together with intravenous (IV) and intrathecal methotrexate (IT MTX). Radiation therapy was also employed.

From September 1976 to April 1977, 27 eligible, newly diagnosed patients with non‐Hodgkin's lymphoma were entered onto this pilot study. Toxicity was acceptable with minor adjustments in dosage and timing of the myelosuppressive agents. Fourteen of the 22 patients entered onto maintenance remain entirely disease‐free, and all have completed the prescribed course of chemotherapy. None of the 12 patients characterized as having a “favorable” prognosis has relapsed, with a median follow‐up of 27 months from on study.
Prophylactic Co‐trimoxazole and lactobacilli preparation in neutropenic patients
Authors: Ekert H. , Jurk I. H. , Waters K. D. , Tiedemann K.
Published: February 2007

A randomized study of intestinal decontamination was undertaken in 68 children with leukemia and solid tumours. Framycetin, colymycin, nystatin, and metronidazole were given in 35 neutropenic episodes in 33 children, while co‐trimoxazole and lactobacilli preparation were administered in 35 episodes in 35 children. The diseases, severity of neutropenia, and incidence of infection at entry into study were comparable in the two groups. There was no significant difference in the incidence of infections developing during the phase of neutropenia. The median and range of time required to recover from neutropenia were also not different. Co‐trimoxazole and lactobacilli were significantly better tolerated, there being no nausea and vomiting, no refusal to take medication, no dose reduction or change to an alternative regimen. We conclude that co‐trimoxazole and lactobacilli preparation improve quality of life during a neutropenic episode and have the additional advantage of being relatively inexpensive.
Retinoids for the prevention of epithelial cancers: Current status and future potential
Authors: Clamon Gerald H.
Published: February 2007

Prevention of epithelial cancers is needed, as the treatment of such cancers in the advanced state has failed. Vitamin A and its structural analogs called retinoids will prevent cancers of the lung, breast, bladder, stomach, and cervix in animals exposed to carcinogens. Synthetic retinoids offer less toxicity than natural retinoids and may be acceptable to human trials. Identification of a suitable group at risk for an epithelial cancer which might be reasonably expected to benefit from retinoids should precede planning of a clinical trial.
Long‐term survivors of high‐grade malignant astrocytomas
Authors: Dara P. , Slater L. M. , Talreja D. , Armentrout S. A.
Published: February 2007

This report describes our experience with 40 evaluable patients with high‐grade malignant astrocytomas. Eleven patients were treated with surgery and radiotherapy; 29 patients were treatedwith surgery, radiotherapy, and BCNU chemotherapy. Ten of these 29 patients are two‐year survivors. Their mean survival is over 57.3 months, and they have been off chemotherapy for one to 27 months, mean 13.7 months. Seven of these patients received 800 to 1,100 mg/m2 of BCNU; three other long survivors received greater amounts of BCNU. Our current recommendation is that patients with high‐grade malignant astrocytomas be treated with surgery, radiotherapy, and at least 800 mg/m2 of BCNU.
Cis‐platinum therapy of previously treated head and neck cancer: The Southwest Oncology Group's two‐dose‐per‐month outpatient regimen
Authors: Panettiere Frank J. , Lehane Daniel , Fletcher William S. , Stephens Ronald , McCracken J. Dean , Rivkin Saul
Published: February 2007

The Southwest Oncology Group tested an outpatient Cis‐platinum regimen in patients with carcinoma of the head and neck. Courses which consisted to two doses, a week apart, were scheduled to be given at 4‐week intervals. Eighty‐nine poor risk head and neck cancer patients, who had received extensive prior therapy with surgery, radiation, and/or multiple drugs were studied. Sixteen (18% of all entered and 25% of the 65 fully evaluable) had objective tumor regression. The median duration of response was 136 days. Toxicity was moderate. Myelosuppression was minimal with only 3% of patients exhibiting leukocyte nadirs below 2,000 and less than 2% experiencing platelet counts below 50,000. Significant, but reversible, impairment of renal function occurred in 8% of patients. Individual susceptibility to such renal toxicity appears to have been predictable. This simple outpatient program with its effectiveness and minimal toxicity in poor risk patients deserves further utilization.
Trisomy 21 in bone marrow cells of a patient with a prolonged preleukemic phase
Authors: Sikand G. S. , Taysi K. , Strandjord S. E. , Griffith R. , Vietti T. J.
Published: February 2007

The clinical, hematologic, and cytogenetic findings are described in a patient who developed clinical and hematologic features of acute myelogenous leukemia (AML) after a three‐year period of observation with unexplained thrombocytopenia. Five months before the diagnosis of AML she developed hepatosplenomegaly and a lupus‐like syndrome. At this time she was also found to have trisomy 21 in all bone marrow cells studied, in addition to trisomy 8 in a few cells. The finding of trisomy 21 in all of the bone marrow cells examined could reflect a nonrandom alteration in the leukemic stem line or it might indicate that mosaic patients with trisomy 21 cells in their bone marrow share the increased risk of AML that has been documented for trisomy 21 patients.
Malignant histiocytosis in adults: Report of 7 patients from north east Italy
Authors: Carbone Antonino , Tirelli Umberto , Volpe Rachele , Veronesi Andrea , Galligioni Enzo , Trovò Mauro G. , Tumolo Salvatore , Grigoletto Eligio
Published: February 2007

The clinical records and histologic material of seven adult male patients with malignant histiocytosis (MH), observed consecutively at our center during a four‐year period, have been reviewed; four of these cases were seen in a year. All patients were born and lived within a radius of 30 miles from Pordenone, a town in northeast Italy. The diagnosis of MH was made in all cases on lymph node biopsy on the basis of the established histologic criteria [1]. At presentation, abnormal histiomonocytic cells were found in the bone marrow and peripheral blood of four patients, two of whom also showed cerebrospinal fluid involvement with atypical histiocytes at a relatively early stage of the disease. Staging procedures documented extensive disease in lymphatic, as well as in extralymphatic, sites in four patients; in three patients, the disease was confined to the lymphatic system. Combination chemotherapy was the first treatment employed in all cases. Four patients, three of whom had limited disease, achieved complete remission with quadruple combination chemotherapy (ABVD, CHOP, or MOPP); three patients with extensive disease achieved only partial remission of short duration with HOP. These results further support the view that adult MH is not obligatorily and rapidly fatal. Good responses to treatment with combination chemotherapy are possible, particularly in patients with disease limited to only lymphatic sites.
Intensive chemotherapy for metastatic neuroblastoma: A southwest oncology group study
Authors: Nitschke R. , Cangir A. , Crist W. , Berry D. H.
Published: February 2007

Thirty‐three children with Evans stage IV neuroblastoma were treated with an intensive chemotherapy regimen reported by Helson to be highly effective. The purpose of the study was to determine whether the toxic regimen was manageable by different investigators and to increase the sample of patients. Remission induction therapy consisted of courses repeated every four weeks: Cyclophos‐phamide (CTX) 80 mg/kg IV, with IV fluids and furosemide on days 1 and 2; vincristine (VCR) 0.03 mg/kg IV 12 hours after cyclophosphamide; trifluoro‐methyl‐2‐deoxyridine (F3TdR) 45 mg/kg IV push, and papaverine (PAP) 45 mg/kg (12‐hour infusion) under cardiac monitoring on days 3 and 4. Initially during maintenance, courses of therapy were reduced to two days. Because this was found to be ineffective therapy, the courses were extended to four days. Some of the patients who achieved response were removed from the protocol and placed on different maintenance therapy. Seventeen of 21 children newly diagnosed and 6/12 children previously treated for metastatic neuroblastoma achieved partial or complete remissions. Eight of 16 newly diagnosed patients achieving response are still alive, six without evidence of disease for periods of time ranging from 20 to 41 months. The median of the administered drug dosages was 100% of the recommended dosages. Seventy percent of the 229 courses given were initiated at correct interval. Therapy had to be delayed on the others because of toxicity. The value of the four‐drug combination is limited because of side effects related to myelosuppression which resulted in severe complications and frequent hospitalizations.
Myelopoiesis in immunologically classified subgroups of childhood acute lymphocytic leukemia
Authors: Crist William M. , Ragab Abdelsalem H. , Vogler Larry , Lui Victor K. S. , Castleberry Robert P. , Findley Harry W. , Merijanian Greg
Published: February 2007

Soft agar culture studies of 43 immunologically characterized patients with childhood acute lymphocytic leukemia (ALL) are presented. The immunologic subsets studied include “null”‐cell, pre‐B‐cell, and T‐cell leukemias. Abnormal myelopoiesis, including high peripheral blood and low marrow, colony‐forming cell numbers, low colony‐stimulating activity, and normal maturation of colony‐forming cells in vitro was noted in each group as previously described for immunologically uncharacterized ALL. We conclude that immunologic subsets of childhood lymphoblastic leukemia cause similar abnormalities of myelopoiesis. Lack of differences in growth characteristics among immunologic subsets of ALL make it impossible to use this tissue culture technique in sub‐classification of these leukemic disorders.
A randomized study of intermittent chemotherapy with or without BCG inoculation in maintenance therapy of childhood ALL
Authors: Ekert H. , Waters K. D. , Matthews R. N. , Tauro G. P. , Rice M. S. , Seshadri R. , Mauger D. C. , Tiernan J. R. , McWhirter W. R. , O'Regan P. , Olsen T. E. , Mathews J. D.
Published: February 2007

One hundred ninety‐six children with acute lymphocytic leukemia were entered into a randomized study of maintenance chemotherapy with either intermittent chemotherapy and immunotherapy with bacillus Calmette‐Guerin (BCG) or only intermittent chemotherapy. On admission to the study, patients were stratified into three prognostic categories on the basis of clinical and laboratory features at presentation. Patients considered to have a favorable prognosis (PF) were induced with vincristine and prednisone; those with an unfavorable prognosis (PU) received combination chemotherapy consisting of either Ara‐C, cyclophosphamide and asparaginase, or vincristine, prednisolone, and daunomycin followed by Ara‐C and asparaginase; those with an average prognosis (PA) received vincristine and prednisolone followed by a single course of Ara‐C and asparaginase. All patients received central nervous system prophylaxis with 2,400 rad cranial irradiation and four injections of intrathecal methotrexate. One hundred seventy‐seven patients (90%) achieved complete remission, and 165 were randomized. Those randomized to Group A (83) received maintenance chemotherapy with six‐week courses of 6‐mercaptopurine, weekly oral methotrexate, and monthly vincristine. Each six‐week course was followed by a two‐week interval of no chemotherapy, and treatment was con tinued for 36 months. Patients randomized to Group B (82) received the same maintenance chemotherapy, but during the two‐week interval without chemotherapy, they were given BCG inoculation. With a median follow‐up of 110 weeks, no significant difference in duration of remission, survival, or CNS relapse was found between Groups A and B in the total patient population or within each prognostic category. In patients classified as PU, a significantly lower proportion (P < 0.02) remained in complete remission. Within this group, patients with a white cell count > 100 × 109/L had a significantly shorter duration of remission (P < 0.05). Patients classified as PF showed a This research was done by the Australasian Cancer Society Childhood Leukemia Group.
Acute lymphocytic leukemia developing in a male with germ cell carcinoma: A case report
Authors: Johnson Douglas C. , Luedke Dan W. , Sapiente Ronald A. , Naidu R. G.
Published: February 2007

A case of germ cell carcinoma (of presumed testicular origin) is described in which acute lymphocytic leukemia developed within nine months of the diagnosis. Possible relationships between the two neoplasms are discussed, as well as the need for continued observation of patients with germ cell tumors as they are living longer and may be at higher risk for developing a second cancer.
The relevance of platelet and fibrinogen kinetics and coagulation studies to extent of disease and performance status in patients with adenocarcinoma
Authors: Williams C. K. O. , Pineo G. F. , Gallus A. S. , McCulloch P. B.
Published: February 2007

In this study of 18 cancer patients, results of laboratory evaluation of a “hyper‐coagulable state” have been correlated with the extent of the disease and the functional activity of the patients. Most coagulation tests were normal. Higher levels of serum fibrinogen degradation products were associated with wider dissemination of disease. Fibrinogen survival time (t 1/2) was shorter in patients with extensive disease than in those with less extensive disease (P < 0.05); platelet t1/2 was also shorter in the former group, though not significantly. Coexistence of severest physical disability and extensive disease was associated with the most marked reduction of platelet and fibrinogen t1/2. There was little correlation between platelet and fibrinogen t1/2, thus suggesting independent mechanisms of destruction of the two blood components. We suggest that future studies of hemostatic changes in cancer patients should include assessment of impairment of physical performance of the patients, as well as the extent of the tumor.
Reactivation of hand‐schüller‐christian disease six and thirteen years after discontinuation of systemic therapy
Authors: Grimm Ruby A. , Muss Hyman B. , Patterson Richard B. , Weathers Dwight R. , White Janis P. , Medford Houck M.
Published: February 2007

We present two cases of reactivation of Hand‐Schüller‐Christian disease or multifocal eosinophilic granuloma 6 and 13 years after discontinuation of systemic therapy. Both patients received oral therapy with methotrexate and prednisone continuing for 2—3 years after the disease was thought to be in remission. Relapses were detected because of disease symptoms and treated with surgery with or without radiation. Neither patient has required reinstitution of systemic therapy. These cases are cited as evidence of the chronicity of the disorder and as a reminder that reactivation is possible after years of disease inactivity. Therefore, long‐term clinical follow‐up of patients in remission is indicated.
Leptomeningeal carcinomatosis in small cell carcinoma of the lung
Authors: Aisner Joseph , Ostrow Stanley , Govindan Srinivasan , Wiernik Peter H.
Published: February 2007

Among 137 patients with small cell carcinoma of the lung (SCCL) treated on two consecutive protocols, leptomeningeal metastases were documented in 12 patients (9%), 10 antemortem by cerebrospinal fluid (CSF) cytology, one by myelogram, and one only at necropsy. Signs and symptoms included confusion in seven, limb weakness in six, paresthesias in three, headache in two, urinary incontinence in two, and nausea and vomiting, diplopia and neck pain in one patient each. Nine of the 12 patients had evidence of other metastases while three patients relapsed first in the CSF and one had disease only in the leptomeninges. Treatment for this complication including irradiation, intrathecal chemotherapy, or systemic chemotherapy was generally ineffective with a median duration of survival of 50 days (range 5 to 130) after diagnosis of leptomeningeal. Necropsies showed thick tumor deposits along cord, distal nerve roots, cauda equina, and in Virchow—Robbins spaces with deep invasion into adjacent neural substance in six of the seven. Leptomeningeal involvement appears to have become manifest as median survival has increased. CSF cytology should therefore be examined in patients who develop unusual neurological findings during the course of this disease and methods of prevention may need to be considered in future studies.