bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment of stage III neuroblastoma with emphasis on intensive induction chemotherapy: A report from the neuroblastoma group of the spanish society of pediatric oncology
Authors: Castel V. , Badal M. D. , Bezanilla J. L. , Llombart A. , Ruiz‐Jiménez J. I. , De Toledo J. Sánchez , Melero C. , Mulet J.
Published: February 2007

From October 87 to April 92, 172 children were admitted in the N‐I‐87 protocol of the Spanish Society of Pediatric Oncology for the diagnosis and treatment of neuroblastoma. Forty‐eight were considered Evans stage III, 33 of them being older than 1 year. All children were treated with induction chemotherapy (IC) and surgery. IC consisted of three courses of high‐dose cisplatin‐VM‐26 alternating with three further courses of cyclophosphamide‐doxorubicin (CAD). Infants less than 1 year received the same drugs at lower doses.

After surgery, maintenance chemotherapy was administered to all children during 14 months. It consisted of four pairs of drugs rotated every 4 weeks. Radiotherapy was administered exclusively to patients older than 1 year with residual tumor after IC and surgery.

Response was evaluated after IC and surgery. In children older than 1 year, response was obtained in 28/33 (88%). Fifteen of them (47%) achieved complete remission (CR), seven (22%) good partial response (GPR), six (19%) partial response (PR); and in three patients (9%) there was progressive disease (PD). Actuarial survival at 48 months was 0.60 ± 0.10 and EFS was 0.61 ± 0.12. Audiologic impairment was considered the worst toxicity. In children less than 1 year the response rate to IC and surgery was 93% (14/15); nine infants obtained complete response and four had GPR. Only one patient experienced PD in the first 6 months of therapy and died. The other 14 are alive and well at a mean follow‐up time of 48 months. Chemotherapy toxicity was mild and reversible. © 1995 Wiley‐Liss, Inc.
Streptococcus sanguis bacteremia and colorectal cancer: A case report
Authors: Kampe Carsten E. , Vovan Thomas , Alim Awoni , Berenson James
Published: February 2007

Streptococcus sanguis, usually considered a nonpathogen of the oral cavity, was isolated from blood cultures from a patient who was subsequently found to have a cecal adenocarcinoma. Further studies are needed to determine if Streptococcus sanguis infections have diagnostic implications similar to those of Streptococcus bovis. © 1995 Wiley‐Liss, Inc.
Relapse after first cessation of therapy in childhood acute lymphoblastic leukemia: A 10‐year follow‐up study
Authors: Miniero R. , Saracco P. , Pastore G. , Zurlo M. G. , Terracini B. , Rosso P. , Masera G.
Published: February 2007

The outcome of 171 children with ALL who relapsed for the first time after elective cessation of therapy (1–86 mo) and followed over 10 years (median 60 mo; range 1–232 mo) has been evaluated. One hundred and three patients relapsed in the bone marrow (BM), 29 in the testis (T), 21 in the central nervous system (CNS), 14 in the BM plus another site and 4 in other sites. Second remission was achieved in 97% of patients (97% BM, 100% T, 90% CNS, respectively) with reinduction schedules including three or more drugs. All but 4 out of 100 patients who relapsed in the BM received cranial reprophylaxis with intrathecal CT alone or CT plus radiotherapy. Seven patients in second CR underwent allogeneic bone marrow transplantation from an HLA matched sibling. The overall survival was 34% and disease‐free survival (DFS) probability at 100 years was 22%. A second relapse was observed in 73% of patients. Forty children are alive in second continuous remission and 24 are alive after a second or subsequent relapse. Patients with isolated T relapse showed a significant better outcome than those with BM or CNS involvement. Most patients (62%) with isolated BM relapse showed a further disease recurrence in BM, and DFS was shorter when relapse occurred within 12 months from off‐therapy. Eighty‐two patients in second CR stopped the treatment a second time and showed a survival and DFS probabilities, respectively, of 69% and 43%.

Thus, children with ALL who relapse after cessation of therapy still have a high risk of further late relapses and should be treated with intensive chemotherapy and CNS reprophylaxis. BMT must be considered for all patients relapsing in the BM within 12 months from off‐therapy. © 1995 Wiley‐Liss, Inc.
Increased renal parenchymal echogenicity in ifosfamide‐induced renal fanconi syndrome
Authors: Hanquinet Sylviane , Wouters Michael , Devalck Christine , Perlmutter Noemie , Sariban Eric
Published: February 2007

Three children who presented with a Fanconi syndrome induced by the chemotherapeutic drug ifosfamide were found to have renal abnormalities on sonogram examinations. Renal echographic changes consisted in hyperechogenicity of the parenchyma with good corticomedullar differentiation. After discontinuation of the chemotherapy, the serum and urine metabolic abnormalities due to proximal tubulopathy were completely or greatly improved. Imaging studies at that time showed a complete resolution of the renal hyperechogenicity. We suggest that in patients exposed to ifosfamide, renal sonogram may be of value to monitor the tubular toxicity of this drug. In these patients, urine and serum monitoring as well as prospective echographic follow‐up kidney abnormalities may lead to earlier detection of ifosfamide‐induced Fanconi syndrome as well as earlier detection of disease reversibility. © 1995 Wiley‐Liss, Inc.
Results of a randomized study of early stage Hodgkin's disease using ABVD, EBVD, or MBVD
Authors: Avilés Agustin , Soto Bibiana , Guzmán Renaldo , García Edna L. , Nambo M. Jesús , Díaz‐Maqueo José C.
Published: February 2007

From January 1986 to December 1989, 157 previously untreated patients, with Hodgkin's disease stage I or II without bulky disease, were enrolled in a clinical comparative study. The objectives of the study were to compare the efficacy and safety of using epirubicine or mitoxantrone instead of adriamycin in the combination chemotherapy regimen ABVD (adriamycin, bleomycin, vinblastine, and dacarbazine). The complete response rate was better in the patients treated with the ABVD or EBVD regimens compared to the MBVD arm. Also, differences in overall survival and relapse‐free survival were better in the patients who received ABVD or EBVD compared to the MBVD regimen.

Hematological, gastrointestinal and cardiac toxicity were similar in the three groups. Dose intensity, delays and complications were also similar in the three groups. The mitoxantrone‐containing regimen was found to have less efficacy in comparison to the other regimens tested in the present study in patients with favorable stage I or II Hodgkin's disease. © 1995 Wi1ey‐Liss Inc.
Cyclophosphamide/doxorubicin vs. Cisplatin/teniposide in the treatment of children older than 12 months of age with disseminated neuroblastoma: A pediatric oncology group randomized phase II study
Authors: McWilliams Nancy B. , Hayes F. Ann , Green A. A. , Smith E. Ide , Nitschke Ruprecht , Altshuler Geoffrey A. , Shuster Jonathan J. , Castleberry Robert P. , Vietti Teresa J.
Published: February 2007

This prospective study was designed to estimate the response rates and to compare two drug pairs, cyclophosphamide/doxorubicin (Cy/A) and cisplatin/teniposide (P1/VM) in previously untreated patients with disseminated neuroblastoma >12 months of age at diagnosis. Estimated complete clinical response rates after five courses of therapy were 13% (70 patients) and 22% (64 patients) for Cy/A and P1/VM, respectively (P = 0.17). After surgical removal of residual tumors in patients with partial response, the complete response rates were 27% and 34% (P = 0.50), respectively. The overall CR/PR rates after induction and surgery were 59% and 73% (P = 0.077). There was no significant difference in event free survival (P = 0.48) or survival (P = 0.40). Five year survival on the two arms were 14% (SE = 5%) and 12% (SE = 4%), respectively. Toxicity was significant but manageable. The Cy/A arm had significantly higher hematopoietic toxicity but significantly lower GI toxicity. Significant allergic reactions were seen with the P1/VM arm, none in the Cy/A arm. Given the activity of these two regimens, further therapy with a combination of these regimens is suggested. © 1995 Wiley‐Liss, Inc.
Treatment combined with bone marrow transplantation for advanced neuroblastoma: An analysis of patients who were pretreated intensively with the protocol of the study group of Japan
Authors: Ohnuma Naomi , Takahashi Hideyo , Kaneko Michio , Uchino Jun‐Ichi , Takeda Takeo , Iwafuchi Makoto , Ohhira Mutsuro , Nishihira Hirokazu , Mugishima Hideo , Yokoyama Jotaro , Okada Akira , Nagahara Noboru , Taguchi Nobuyuki , Tsuchida Yoshiaki
Published: February 2007

One hundred and ten patients with advanced neuroblastoma were treated with the protocol of the Study Group of Japan between January 1985 and March 1991. Patients received six cyclic courses of regimen A1, consisting of cyclophosphamide (1,200 mg/m2), vincristine (1.5 mg/m2), tetrahydropyranyl adriamycin (40 mg/m2), and cisplatin (90 mg/m2). Primary tumors and regional lymph node metastases were removed some time during the first six cycles of regimen A1. After six cycles of A1, the patients were divided into three groups. Patients in group 1 received alternating treatment with regimen B (cyclophosphamide and ACNU) and intensified A1, and those in group 2 were treated with alternating administration of regimen C (cyclophosphamide and DTIC) and intensified A1. Patients in group 3 were treated with supralethal therapy and bone marrow transplantation (BMT). Event‐free survival rates at five years were 38.8% in the chemotherapy group (groups 1 and 2) and 50.0% in the transplant group (group 3).

Because of the study design that was not in truly randomized fashion and because of the small number of patients in each risk group, it is indicated, though not concluded, that the transplant group had a better prognosis than the chemotherapy group in the cases with stage III disease or with amplified N‐myc oncogene, based on the statistical calculations. Differences in survival rates for patients who underwent BMT when complete remission (CR) was achieved and for those who achieved CR but who did not undergo marrow transplant were statistically insignificant.

BMT‐related death occurred in 3 of 31 cases (9.7%) undergoing marrow transplant, and the causes of the death included hemorrhagic pneumonia, myocardial disturbance and hemorrhagic uremia. © 1995 Wi1ey‐Liss Inc.
Unusual secondary tumors after childhood lymphoid malignancy
Authors: Aricò Maurizio , Bossi Grazia , Cecchetto Giovanni , Dall'Igna Patrizia , Viganò Claudia
Published: February 2007

Second malignant neoplasms (SMN) in individuals who survived childhood cancer have been reported with increasing frequency during the last decades. The overall probability of developing second malignancy for children treated for cancer was estimated at about 2–5% at 25 years. In children, the tumors most often associated with the development of SMN are retinoblastoma and Hodgkin's disease.

We report two cases of unusual second tumors in two patients cured of lymphoid malignancy: one boy cured of acute lymphoblastic leukemia developed mediastinal ganglioneuroma nine years later and one girl had gastric carcinoma seven years after Hodgkin's disease. Both developed a tumor in nonirradiated areas.

Gastric carcinoma and ganglioneuroma are not reported as recurrent SMN in survivors after childhood cancer, with one single case of gastric carcinoma and one of ganglioneuroblastoma having been reported as second tumor in survivors after childhood cancer. © 1995 Wi1ey‐Liss Inc.
Cytomegalovirus‐associated stage 4S neuroblastoma relapsed stage 4
Authors: Nigro Giovanni , Schiavetti Amalia , Booth James C. , Clerico Anna , Dominici Carlo , Krzysztofiak Andrzej , Castello Manuel
Published: February 2007

Neuroblastoma is one of the most frequent solid tumors in childhood, rarely recurrent after five years from diagnosis. Cytomegalovirus (CMV), a major pathogen causing congenital birth defects and severe opportunistic diseases, has been shown to have teratogenic, immunodepressive and oncogenic properties.

The case of a girl with stage 45 neuroblastoma diagnosed at three months and relapsed as stage 4 five years later is reported. In both circumstances, active CMV infection was revealed by positive CMV‐specific IgM and IgA antibodies, CMV‐DNAemia and CMV culture.

At three months, the patient presented with subcutaneous nodules, hepatosplenomegaly and increased aminotransferase levels, and the opsoclonus‐myoclonus syndrome. Mental retardation developed later on. At 5 years, relapsed neuroblastoma was preceded by a mononucleosis‐like syndrome concomitant with active CMV infection and decreased levels of immune cells and natural killer activity.

Clinical, virologic, and immunologic findings suggest an immune‐mediated pathogenic role for CMV in this tumor. © 1995 Wi1ey‐Liss Inc.
Primary Hodgkin's disease of the bone
Authors: Fried Geta , Ben Arieh Yehudith , Haim Nissim , Dale Janet , Stein Moshe
Published: February 2007

A primary extranodal presentation occurs in less than 0.25% of patients with Hodgkin's disease (HD) and we describe the primary clinicopathologic findings in a rare case of a 21‐year‐old female with primary bony involvement of Hodgkin's disease.

The patient presented with microcytic, hypochromic anemia and shoulder pain. The diagnosis of HD (lymphocyte depleted type) was made by biopsy taken from a lytic lesion in the lateral third of the clavicle. Staging work‐up revealed an additional lesion in the ilium, but there was no evidence of lymph node involvement. MOPP/ABV (nitrogen mustard, Oncovin, procarbazine, prednisone/adriamycin, bleomycin, and vinblastine) chemotherapy resulted in complete response lasting, to date, 36 months.

To the best of our knowledge, this is only the second reported case of disseminated primary Hodgkin's disease of the bone and all have had a favourable response to combination chemotherapy. A review of the literature is also presented. © 1995 Wi1ey‐Liss Inc.
Reversible thrombocytopenia with levamisole
Authors: Winquist Eric W. , Lassam Norman J.
Published: February 2007

Levamisole is an immunomodulatory agent which is used in the adjuvant therapy of certain malignancies. Agranulocytosis is the most commonly reported hematologic side effect associated with this drug. We report here a patient who developed thrombocytopenia nearly 2 years after starting adjuvant levamisole therapy for malignant melanoma. In this case, thrombocytopenia was shown to be levamisole‐related by re‐challenge with the drug. Levamisole‐induced thrombocytopenia (LIT) has been rarely diagnosed, but may be seen more frequently as increasing numbers of patients receive adjuvant therapy for colon cancer and melanoma. © 1995 Wi1ey‐Liss Inc.
Genetic predisposition and cyclophosphamide treatment in a girl with bladder carcinoma?
Authors: Kenet G. , Mandel M. , Mor Y. , Toren A. , Jonas P. , Kende G. , Rechavi G. , Neumann Y.
Published: February 2007

Transitional cell carcinoma of the bladder rarely occurs in young female patients. We present a case of bladder carcinoma which appeared after treatment with cyclophosphamide, in a 14‐year‐old girl genetically predisposed to bladder cancer. © 1995 Wi1ey‐Liss Inc.
Wilms' tumor: Cure of malignant pleural effusion exclusively with chemotherapy
Authors: Canpolat Cengiz , Jaffe Norman
Published: February 2007

A malignant pleural effusion was diagnosed by thoracentesis in a 12‐year‐old patient with an established diagnosis of Wilms' tumor. He was treated with chemotherapy and achieved a reduction in the size of the primary tumor and resolution of the effusion. The primary tumor was then resected and chemotherapy continued for a total of 18 months. At the request of the parents, radiation therapy to the thorax was withheld. The patient has remained free of disease for the past 8 years. © 1995 Wi1ey‐Liss Inc.
Childhood NHL in Switzerland: Incidence and Survival of 120 Study and 42 Non‐Study Patients
Authors: Wagner H. P. , Dingeldein‐Bettler I. , Berchthold W. , Lüthy A. Ridolfi , Hirt A. , Plüss H. J. , Beck D. , Wyss M. , Signer E. , Imbach P. , Feldges A. , Bleher E. A. , Plaschkes J. , Briner J. , Leibundgut K. , Von Der Weid N.
Published: February 2007

Based on the Swiss Pediatric Oncology Group (SPOG) cancer registry data during 1981–1991, a high average incidence of 8 new NHL per million children younger than 15 years per year was found. Of 162 children with NHL registered in 1976–1991, 120 were study patients, i.e., officially registered and treated according to SPOG or Pediatric Oncology Group (POG) protocols, while 42 were non‐study patients, i.e., patients not officially enrolled on protocols.

Overall, 91 of 120 (76%) study patients remained alive. Seventy‐nine study patients were treated according to older SPOG protocols, and 53 (67%) of these survived, while 38 of 41 (93%) study patients treated according to newer POG protocols remained alive (P = 0.0068). Only 22 (52%) of the 42 non‐study patients survived (P = 0.0001). There was no improvement if the survival of non‐study patients before and since 1986 was compared. Population‐based treatment results in Switzerland were similar to those in the United Kingdom. They provided an important base for the development of future treatment strategies. © 1995 Wiley‐Liss, Inc.
Non‐11p Constitutional Chromosome Abnormalities in Wilms' Tumor Patients
Authors: Olson Jane M. , Hamilton Anne , Breslow Norman E.
Published: February 2007

The incidence in Wilms' tumor patients of constitutional chromosome defects other than those involving the short arm of chromosome 11 was examined using data on 5,854 patients registered in the National Wilms Tumor Study. Trisomy 18 and Turner syndromes were found to occur at higher rates than expected based on chromosome surveys of newborns. Four patients were reported to have trisomy 18; all of these patients were over 5 years of age at the time of diagnosis of Wilms' tumor and none survived longer than six months. Four patients were reported to have Turner syndrome; these patients are currently doing well and have all survived at least 3 years following diagnosis. Two of the Turner patients and one of the trisomy 18 patients had horseshoe kidneys; we speculate that this renal anomaly may contribute to the higher rates of tumor in these patients. No clear pattern was found among patients with other chromosome defects, although two patients had defects involving 2q37. © 1995 Wi1ey‐Liss, Inc.
Malignant Melanocytic Lesions of Unknown Primary Site in Children and Adolescents
Authors: Pappo Alberto S. , Kuttesch John F. , Kaste Sue C. , Parham David M. , Rao Bhaskar N. , Pratt Charles B.
Published: February 2007

Background. Metastatic melanoma with an unidentified primary site represents 4% of all newly diagnosed cases of malignant melanoma in adults. Little is known of the incidence and clinicopathologic features of this clinical entity in the pediatric population.

Methods. We reviewed all previously diagnosed cases of malignant melanoma in children and adolescents (<21 years) who were treated at our institution and identified three patients who presented with metastatic melanocytic lesions with an unidentified primary site.

Results. This clinical presentation accounted for 9% of all malignant melanocytic lesions treated at our center over a 20‐year period. The clinicopathologic features were similar to those seen in adults. Two patients died of progressive disease within two years of presentation; the third is alive and disease‐free 18 years post‐diagnosis.

Conclusions. Although uncommon in the pediatric population, malignant melanoma should be considered in the differential diagnosis of poorly differentiated disseminated malignancy that involves lymph nodes or viscera with no identifiable primary tumor. © 1995 Wi1ey‐Liss, Inc.
Long‐Term Follow‐Up of Stage III Testicular Carcinoma Treated With Mithramycin (Plicamycin)
Authors: Kennedy B. J. , Torkelson Jane L.
Published: February 2007

In 1965 we reported mithramycin (plicamycin) to produce objective regression in 7 of 12 patients with advanced testicular carcinoma. Between 1963 and 1975 mithramycin was administered to 62 patients with advanced testicular carcinoma as the initial chemotherapy and to 30 patients who failed to respond to prior chemotherapies. There were 13 complete regressions (23%) in 56 patients who as initial chemotherapy received more than one course of mithramycin. The median follow‐up is 23 years with 10 patients still alive. A partial regression occurred in 11 (18%), all of whom are dead. Of 30 patients receiving mithramycin after prior chemotherapies, none had a complete regression, 5 had a partial regression, and all are dead. Of 13 patients undergoing complete regression, 85% never had a recurrence of testicular carcinoma. The median follow‐up of 23 years implies that these patients are cured. © 1995 Wi1ey‐Liss, Inc.
Unusual Cutaneous Toxicity Following Treatment With Dactinomycin: A Report of Two Cases
Authors: Kanwar Vikramjit S. , Gajjar Amar , Ribeiro Raul C. , Bowman Laura , Parham David M. , Jenkins Jesse J.
Published: February 2007

Dactinomycin‐induced cutaneous toxicity is rare in pediatric patients not receiving radiation therapy. We describe dactinomycin‐related lesions in the axilla, groin, and central line exit site of two children treated for rhabdomyosarcoma, neither of whom had received radiation treatment. One patient was initially treated with systemic antifungal therapy, and developed recurrent lesions on reexposure to the drug. The other was noted to have mild, diffuse hyperpigmentation. Skin biopsies revealed interface dermatitis with syringometaplasia in both cases. Both children recovered uneventfully within 4 weeks. Recognition of unusual rashes with a characteristic distribution in patients receiving dactinomycin should aid in diagnosis, and help avoid unnecessary therapeutic procedures. © 1995 Wi1ey‐Liss, Inc.
Secretion of a Large Molecular‐Weight Form of Insulin‐Like Growth Factor by a Primary Renal Tumor
Authors: Korn Elizabeth , van Hoff Jack , Buckley Patrick , Daughaday William H. , Carpenter Thomas O.
Published: February 2007

A 5‐year‐old boy with an abdominal mass was found to have a primary renal tumor of poorly identifiable histology. Prior to resection of the tumor, the patient exhibited several episodes of biochemical hypoglycemia. The hypoglycemia did not recur after operation. Analysis of tumor tissue and of pre‐ and post‐operative sera by column chromatography showed elevated insulin‐like growth factor II (IGF‐II) levels in the tumor; an abnormal large‐molecular weight precursor form of IGF‐II (pro‐IGF‐II) comprised 53% of total IGF‐II in the tumor and 42% in preoperative serum. No pro‐IGF‐II was found in the serum 6 weeks post‐operatively. Abnormal IGF‐II secreted by the tumor may have mediated the hypoglycemia seen prior to tumor resection. This pediatric renal tumor is the first to our knowledge for which an association of non‐islet cell tumor‐related hypoglycemia and elevated tumor IGF‐II content has been described. © 1995 Wi1ey‐Liss, Inc.
Recombinant erythropoietin in acute chemotherapy‐induced anemia of children with cancer
Authors: Beck Maja Nenadov , Beck Daniel
Published: February 2007

Chemotherapy‐induced anemia in children with cancer is usually of acute onset. To investigate an alternate treatment to transfusion (Tx), we undertook a phase I‐II clinical trial of daily administrations of recombinant erythropoietin (rHuEPO). Patients with a hemoglobin (Hgb) value <75 g/l were treated for 14 days in cohorts of 3 at escalating daily doses of 25, 50, 70, 80, 90, and 100 U/kg respectively. The maximum‐tolerated dose was not encountered. Of 18 courses given to 15 children aged 0.5–18 years, 7 (39%) were associated with increased or stable Hgb levels (courses without Tx), while 11 (61%) were terminated by a Tx, without evidence of a dose‐response relationship. Changes in mean Hgb levels and absolute reticulocyte counts were paralleled by those of mean white blood cell, platelet, and absolute neutrophil counts during the first 7 days and when the end‐points of the study were reached. Numbers of circulating burst‐forming units‐erythroid remained low throughout courses without Tx. No cumulative increase of serially determined serum EPO levels was observed and serum ferritin levels were elevated in both groups of courses.

We conclude that daily administrations of rHuEPO were safe but ineffective in our trial. Recovery of chemotherapy‐induced myelosuppression appeared to be the rate‐limiting factor for the outcome, without evidence of an enhanced stimulation of erythropoiesis. The lack of a proliferative response of specific progenitor cells suggested a mechanism of transient primary resistance to rHuEPO. © 1995 Wiley‐Liss, Inc.
Lack of efficacy of postoperative chemotherapy and delayed radiation in very young children with pineoblastoma
Authors: Duffner Patricia K. , Cohen Michael E. , Sanford Robert A. , Horowitz Marc E. , Krischer Jeffrey P. , Burger Peter C. , Friedman Henry S. , Kun Larry E.
Published: February 2007

Eleven infants with pineoblastomas were treated with prolonged postoperative chemotherapy in an attempt to delay radiation and reduce neurotoxicity. These infants were part of the Pediatric Oncology Group infant brain tumor study but the outcome of infants with pineoblastomas was not previously reported. Ages ranged from 1 month to 35 months, with eight of 11 ≦ 12 months at diagnosis. Four had + cytology and three had + myelograms at diagnosis. The majority had partial surgical resection (25–75% reduction in tumor) and 10 had shunts. Chemotherapy consisted of two 28‐day cycles of cyclophosphamide plus vincristine, followed by one 28‐day cycle of cisplatin plus etoposide. Craniospinal radiation was planned following completion of either 2 years of chemotherapy (children less than 24 months at diagnosis) or following one year (children 24–36 months at diagnosis). Neuroimaging results following two cycles of cyclophosphamide and vincristine were one partial response, five stable disease, and five progressive disease. There were no responders in the leptomeninges. All children ultimately failed chemotherapy (2 months–11 months). Nine failed in the primary site. Of those eight children in whom a metastatic workup was performed at time of progression, all had evidence of leptomeningeal disease. Six received radiation following failure on chemotherapy. All failed either in the primary site, leptomeninges or extraneurally (peritoneal cavity). All children died. Survival following diagnosis ranged from 4 months to 13 months. This chemotherapy regimen was neither effective in controlling tumor in the primary site nor in treating or preventing leptomeningeal spread. © 1995 Wiley‐Liss, Inc.
Incidence of childhood acute lymphoblastic leukemia (ALL) and population‐based treatment results in Switzerland: Experiences with 507 study and 149 nonstudy patients
Authors: Stupnicki A. , von der Weid N. , Imbach P. , Arnet B. , Berchtold W. , Delaleu B. , Hirt A. , Pluess H. J. , Beck D. , Wyss M. , Luethy A. Ridolfi , Feldges A. , Signer E. , Morin A. M. , Caflisch U. , Leibundgut K. , Frey E. , Kuechler H. , Baumgartner C. , Bleher E. A. , Angst R. , Blauenstein U. , Nobile L. , Vischer D. , Wagner H. P.
Published: February 2007

Of 656 patients with ALL (all types) diagnosed in Switzerland during 4 consecutive 4‐year periods (1976–1979, 1980–1983, 1984–1987, 1988–1991), 507 were officially registered on protocols (“study” patients) while 149 were not (“nonstudy” patients). The mean incidence of 3.8/100,000 children <15 years/year is higher than reported for other Western countries. Evidence is presented suggesting that the 656 patients represent only approximately 90% of all children with ALL residing in Switzerland, indicating that the true incidence of ALL might even be higher. The fraction of “nonstudy” patients fell from 40% (1976–1979) to 15% (1984–1987). The rate of survival at 4 years of all patients with ALL (“study” and “nonstudy”) increased by 17% during the three consecutive periods 1976–1979, 1980–1983, and 1984–1987. As expected, a higher increase (20%) was observed in “study” patients and a statistically nonsignificant lower one (10%) in “nonstudy” patients. © 1995 Wiley‐Liss, Inc.
Vincristine neuropathy in type I and type II charcot‐marie‐tooth disease (hereditary motor sensory neuropathy)
Authors: Igarashi Masanori , Thompson Elizabeth I. , Rivera Gaston K.
Published: February 2007

A patient with Ewing's sarcoma and demyelinating type Charcot‐Marie‐Tooth disease (CMT) developed severe neuropathy after receiving a total vincristine dose of 6 mg. Recovery was slow and incomplete. A second patient with axonal type CMT developed moderate neuropathy but tolerated extended vincristine administration and recovered quickly. Possible underlying neuropathy should be excluded before vincristine treatment is begun by careful examination including inspection of the feet, followed by electrophysiologic studies as indicated. In demyelinating CMT, vincristine should be avoided; in axonal form cautious use may be considered. © 1995 Wiley‐Liss, Inc.
Successful treatment of invasive aspergillosis complicating prolonged treatment‐related neutropenia in acute myelogenous leukemia with amphotericin B lipid complex
Authors: Hospenthal Duane R. , Byrd John C. , Weiss Raymond B.
Published: February 2007

Herein we report the successful treatment of invasive aspergillosis with the liposomal amphotericin B (AMB) formulation, Amphotericin B Lipid Complex (ABLC™). This investigational compound was employed in a 50‐year‐old patient with acute myelomonocytic leukemia complicated by prolonged, treatment‐induced granulocytopenia and documented Aspergillus flavus sinusitis with signs of disseminated aspergillosis. The patient demonstrated radiographic signs of pulmonary aspergillosis and biochemical signs of hepatic involvement that were resistant to a 23 day course of conventional AMB (Fungizone®) therapy. Following therapy with ABLC™ her fever abated, her chest X‐ray findings improved, and her hepatic function tests improved with eventual resolution. © 1995 Wiley‐Liss, Inc.
Prospective randomised trial of chemotherapy given before radiotherapy in childhood medulloblastoma. International society of paediatric oncology (SIOP) and the (German) society of paediatric oncology (GPO): SIOP II
Authors: Bailey C. C. , Gnekow A. , Wellek S. , Jones M. , Round C. , Brown J. , Phillips A. , Neidhardt M. K.
Published: February 2007

In a multicentre randomised clinical trial 364 children with biopsy proven medulloblastoma were randomly assigned to receive or not pre‐radiotherapy chemotherapy. Children with total or subtotal removal of the tumour, no evidence of invasive brain stem involvement, and no evidence of metastatic disease either within or without the cranium were designated “low risk”, those with gross residual tumour, evidence of invasive brain stem involvement or metastases in the central nervous system were designated “high risk”. All children were prescribed 55 Gy to the tumour bearing area. “Low risk” children could be randomised to “standard” radiotherapy 35 Gy to the craniospinal axis or “reduced” dose 25 Gy to the craniospinal axis. Chemotherapy consisted of vincristine, procarbazine, and methotrexate given in a 6‐week module before radiotherapy, and for “high risk” children, vincristine and CCNU given after radiotherapy. No benefit for the receipt of pre‐radiotherapy chemotherapy could be demonstrated for any group. In addition, a negative interaction was observed between the receipt of the chemotherapy and reduced dose radiotherapy with a particularly poor outcome being observed in this group of children. © 1995 Wiley‐Liss, Inc.
Urticarial vasculitis: An autoimmune disorder following therapy for Hodgkin's disease
Authors: Strickland Donald K. , Ware Russell E.
Published: February 2007

Immunological abnormalities have been described in patients with Hodgkin's disease, both associated with the malignancy itself and occurring secondary to therapy. These abnormalities often manifest as an immunodeficiency state, but can also present as immune dysregulation and autoimmune disease. We report two young patients with Hodgkin's disease who, following successful therapy, developed urticarial vasculitis (UV), a form of cutaneous autoimmune vasculitis. Both patients also had systemic symptoms including fever, an elevated erythrocyte sedimentation rate and serum copper, and abnormal in vitro studies of lymphocyte enumeration and proliferation. Distinguishing UV from recurrent Hodgkin's disease was especially difficult in one patient, and was possible only by lymph node biopsy. One patient has responded well to immunosuppressive therapy, while the other, who has more profound immune dysfunction, has developed a chronic autoimmune disorder. UV may thus occur in patients after therapy for Hodgkin's disease; we hypothesize that immune dysregulation, either associated with the malignancy or resulting from therapy, is important in the pathogenesis of this autoimmune process. © 1995 Wiley‐Liss, Inc.
Recombinant human granulocyte‐macrophage colony‐stimulating factor in septic neutropenic pediatric cancer patients: Detection of circulating hematopoietic precursor cells correlates with rapid granulocyte recovery
Authors: Fink Franz‐Martin , Maurer‐Dengg Kathrin , Fritsch Gerhard , Mann Georg , Zoubek Andreas , Falk Markus , Gadner Helmut
Published: February 2007

Cycling intensive chemotherapy currently used to treat pediatric solid tumors induces severe neutropenia. Prolonged neutropenia is a major risk factor for septic death which occurs in up to 5% of febrile or septic neutropenic episodes. We treated 18 neutropenic pediatric cancer patients (eight females, 10 males) during 30 febrile and/or septic episodes with single daily doses of E. coli‐derived non‐glycosylated recombinant human granulocyte‐macrophage colony‐stimulating factor (rh‐GM‐CSF, 5 μg per kg of body weight). The cytokine was administered for a median period of 6.5 days (2–12 days). Analysis of circulating hematopoietic progenitor cells was performed at day 1 (baseline) and day 5 of rh‐GM‐CSF treatment and included flow cytometric CD34 analysis as well as the methylcellulose‐based clonogenic assay.

Prompt hematopoietic recovery and resolution of septic problems was observed in all children. The counts of leukocytes (WBC), absolute neutrophils (ANC), and platelets (PLT) rose above 1,000/μL, 1,000/μL, and 50,000/μL within 4 days (0–9), 5.5 days (2–13), and 6 days (0–14), respectively. Faster granulocyte recovery and improved recruitment of circulating hemopoietic precursors was observed in children with detectable amounts (>0.1%) of CD34‐positive mononuclear cells prior to rh‐GM‐CSF treatment.

We conclude that, to some extent, the efficacy of rh‐GM‐CSF treatment in neutropenic cancer patients is influenced by the hematopoietic recovery status on the progenitor cell level. Although they respond more slowly to the treatment, patients without circulating CD34‐positive progenitor cells may gain most from growth factor therapy. Rh‐GM‐CSF can be safely administered to febrile and/or septic neutropenic children treated for cancer. © 1995 Wiley‐Liss, Inc.
Plain radiography for diagnosis of gastrointestinal perforation in immune‐compromised children—is it enough?
Authors: Gilad E. , Paret G. , Katz M. , Vardi A. , Kennet G. , Barzilay Z.
Published: February 2007

Gastrointestinal perforation is a surgical emergency in the pediatric patient and any delay in diagnosis might be hazardous. In immunocompromised children, the clinical signs of perforation may be blunted. We describe a child with acute lymphoblastic leukemia (ALL) and a perforated appendix and ileum in whom computerized tomography (CT) revealed extraluminal air that was not initially identified on plain abdominal film. Our case demonstrates the importance of early abdominal CT and ultrasound examination in detecting these potentially lethal complications. © 1995 Wiley‐Liss, Inc.
Acute renal failure in high dose carboplatin chemotherapy
Authors: Frenkel Joost , Kool Gea , De Kraker Jan
Published: February 2007

Carboplatin has been reported to cause acute renal failure when administered in high doses to adult patients. We report a 4 1/2‐year‐old girl who was treated with high‐dose carboplatin for metastatic parameningeal embryonal rhabdomyosarcoma. Acute renal failure developed followed by a slow partial recovery of renal function. Possible contributing factors are discussed. © 1995 Wiley‐Liss, Inc.
Cardiovascular risk profile of early and later onset type 2 diabetes
Authors: Song SH , Hardisty CA
Published: February 2007

The aim of this study was to determine the cardiovascular disease (CVD) risk profile between early (<40 years of age) and later (>40 years of age) onset type 2 diabetes (T2DM) patients without prior history of CVD.

A cross‐sectional study was undertaken on hospital‐based patients identified from the diabetes register. T2DM patients without prior history of CVD were included for analysis. The CVD risk profile as defined by obesity, dyslipidaemia and hypertension was compared between early and later onset T2DM patients. The proportion of lipid and blood pressure lowering treatment in each group was also determined.

In all, 1057 T2DM patients were identified of whom 67 (6.3%) and 990 (93.7%) were aged below and above 40 years, respectively. Sixty‐seven and 667 patients did not have CVD complications in the early and later onset cohorts, respectively. Despite being ∼three decades younger with a shorter duration of diabetes, early onset patients had poorer glycaemic control compared to the later onset cohort. A significant proportion of these young diabetic patients had hypertension (∼80%) and adverse dyslipidaemic profile (∼80%) with higher triglyceride and lower HDL. Morbid obesity (body mass index >40) was more common among the early onset cohort (∼25%). Significantly less early onset patients were treated with statin and anti‐hypertensive medications particularly among female subjects.

It was concluded that, despite having an adverse CVD risk profile, early onset patients with T2DM were less likely to receive cardio‐protective treatment. Copyright © 2007 John Wiley & Sons.
Anatomy of the prostate: An historical survey of divergent views
Authors: McNeal John E.
Published: February 2007

Historically, the study of the prostate anatomy has been characterized by a proliferation of contradictory findings. The major divergent views of prostate anatomy are here reviewed and compared in order to facilitate further study and the ultimate selection of the best anatomical model. The details of Lowsley's original concept of the prostate lobes and the subsequent evolution of this concept into several contradictory hypotheses are traced. Discrepancies between the findings of Lowsley, Franks, and McNeal are explained. Conclusions are drawn which may facilitate the further study of anatomy and disease in both the human animal prostate.
Endocrine control and physiology of the prostate
Authors: Sandberg Avery A.
Published: February 2007

The endocrine control of prostatic physiology and anatomy is reviewed with emphasis on those factors in the hypothalamus and anterior adenohypophysis which affect the gland either directly or through the testes. The role of circulating estrogens and androgens and their binding to plasma proteins is presented, and the intracellular metabolism of testosterone, particularly in relation to specific receptors, is summarized. The possible significance of intracellular events in prostate cancer development is considered with particular emphasis on those parameters which may reside outside the endocrine effects on the prostatic cells.
An assessment of bone scans for monitoring osseous metastases in patients being treated for prostate carcinoma
Authors: Slack N. H. , Karr J. P. , Chu T. M. , Murphy G. P.
Published: February 2007

The National Prostatic Cancer Project held a workshop in March 1980 to examine procedures used to evaluate bone metastases. Variations in techniques used by each of 9 treatment centers, as well as the National Cancer Institute, were compared. One center in particular had developed procedures for quantitating bone scans in addition to the customary qualitative evaluation. Changes in bone scan assessments were also related to changing levels of isoenzymes of acid and alkaline phosphatase. Most consistently correlated with disease changes were prostatic acid phosphatase, as determined by counter‐immuno‐electrophoresis, and the isoenzyme of bone alkaline phosphatase. Gamma cameras were recommended over rectilnear scanners as were multiple spot films to concentrate on problem areas. Bone scans must be performed prior to therapy and for best assessment no sooner than 3 months to avoid the flair phenomenon. Consistency of both machine settings and patient position are paramount, as are quality of equipment and review of past scans and X‐ray films where appropriate to obtain the best assessment of disease status.
Evaluation of prostatic carcinoma: Noninvasive and preoperative techniques
Authors: Resnick Martin I.
Published: February 2007

Transrectal ultrasonography was performed in 345 patients with clinical benign prostatic hyperplasia who underwent simple prostatectomy. Four patients with negative ultrasonic scans were found to have stage A2 prostatic tumors. Of the 57 patients with positive scans, ten were found to have clinically unsuspected carcinoma; however, changes secondary to carcinoma could not reliably be differentiated from those resulting from chronic inflammation and calculi. Transrectal portable ultrasonography is useful for the staging of patients with prostatic cancer, and four of the ten patients with seemingly stage B disease were found to have seminal vesicle involvement. Tumor response to endocrine therapy can be objectively monitored, but tumor reactivation often goes undetected. Because the technique does not reliably differentiate carcinoma, chronic inflammation, and calculi, the use of transrectal ultrasonography in the screening of asymptomatic patients in an effort to detect early carcinoma appears to be of limited value.
Levels of carbenicillin in serum and prostatic tissue after intravenous administration in patients with benign prostatic hyperplasia
Authors: Mishina Teruo , Miyakoda Keiichi , Araki Hirotaka , Watanabe Hiroki , Kaiho Hiroo
Published: February 2007

Carbenicillin (CB‐PC) was administered intravenously (5 gm over one‐half hour) to 25 patients suffering from benign prostatic hyperplasia. Prostatic biopsies and sera were obtained one, two, three, four, and five hours later for histology and biochemical analyses of the serum and prostatic tissue levels of CB‐PC. The serum and prostatic tissue levels of carbenicillin attained were sufficient to eradicate gram‐negative bacteria within the five time intervals studied. The ratio of prostatic tissue level of CB‐PC to the serum level of this agent increased in proportion to the grading of round cell infiltration of the prostatic tissue. The results of this study point to the clinical usefulness of CB‐PC in the treatment of chronic and acute prostatitis.
Immunology and biochemistry of the regan isoenzyme
Authors: Fishman William H.
Published: February 2007

The Regan isoenzyme is a placental‐type alkaline phosphatase that is expressed in a number of human tumors, particularly in gonadal and urologic cancers. Attention is given to the unique gene that codes for placental alkaline phosphatase and the similarities and differences in the tumor and placental gene products. The separation and identification of individual organ‐specific isoenzymes is accomplished by a variety of biochemical, immunologic, and electrophoretic techniques and the correlation of the Regan isoenzyme, non‐Regan isoenzyme, and Nagao isoenzyme, and the Kasahara isoenzyme is made with their developmental counterparts. The L‐leucine‐sensitive phenotypes of placental and tumor alkaline phosphatases and the non‐Regan early placental type alkaline phosphatases appear to be developmental phase‐specific. Oncotrophoblast gene expression has been investigated with monophenotypic cell culture lines as a consequence of modulation by prednisolone and hyperosmolarity. Finally, general discussion of oncodevelopmental proteins as tumor markers precedes a current opinion of Regan isoenzyme as a tumor marker. Evidence now points to seminoma as a consistent producer of Regan isoenzyme although much more work will be required to establish its clinical utility.
Radioimmunoassay of bone marrow prostatic acid phosphatase
Authors: Bruce Andrew W. , Mahan Donald E. , Beleville William D.
Published: February 2007

The clinical value of prostatic acid phosphatase (PAP) measurements in the bone marrow aspirate of patients with prostatic adenocarinoma has been unclear. Using a radioimmunoassay (RIA) to measure PAP, we have evaluated this potential indicator of occult metastases in 127 controls and in 300 patients with prostatic adenocarinoma. Elevations of the tumor marker were found in 9%, 10%, 19%, and 82% of patients with stages B, C, D1, and D2 adenocarcinoma respectively. Clinical follow‐up ranging from 7 to 43 months (average 23 months) was available for 97 patients without any initial indication of metastasis by bone scan. In this group 11 patients had elevated levels of bone marrow acid phosphatase (BMAP) by RIA and four developed radiological evidence of bone metastais 21 – 25 months following initial staging. However, only three of the 86 patients with normal BMAP levels have developed bone metastasis. Our results indicate that measurement of bone marrow PAP by immunological methods has prognostic significance. Dilution of the bone marrow aspirate by peripheral blood, however, may limit the application of this technique.
The prostate of the nonhuman primate: Normal anatomy and pathology
Authors: Lewis R. W. , Kim J. C. S. , Irani D. , Roberts J. A.
Published: February 2007

The caudal and cranial prostate of different species of nonhuman primates were examined for histologic characteristics and pathological abnormalities. One hundred specimens from 12 species were represented. Among the pathologies found were: 1) cystic hyperplasia; 2) fibromuscular hyperplasia; 3) squamous metaplasia; 4) chronic and acute bacterial prostatitis; 5) prostate adenocarcinoma; and 6) other miscellaneous pathologic changes. A historical review of histological characteristics and pathological abnormalities of the nonhuman primate prostate is given. Based upon findings in this study, anatomical similarity of the caudal lobe of the prostate to the peripheral zone of the prostate in humans as described by McNeal is found. In the patas monkey the relationship of the cranial and caudal lobe suggests strongly the relationship seen between the central and peripheral zones in man. The case of prostatic adenocarcinoma described has only been reported in one other nonhuman primate.
Androgen steroid‐receptor binding in the canine epididymis
Authors: Younes M. A. , Pierrepoint C. G.
Published: February 2007

The epididymis of the dog has been studied with regard to its ability to bind androgens with a high affinity and low capacity. A proteinaceous molecule was demonstrated in the high‐speed supernatant fraction of disrupted cells that bound DHT and sedimented in a sucrose density gradient with a sedimentation coefficient of 8S with respect to bovine serum albumin. This binding protein was able to transport DHT to the nucleus at elevated temperatures where it sedimented as a 4S in a 5–20% sucrose density gradient. Even though this protein appears to be similar to other androgen receptors in other accessory sex organs in a variety of mammalian tissue, it is different from androgen‐binding protein (ABP). The apparent specificity of the receptor protein for androgens was demonstrated using competition studies. The molecular configuration of the steroids was found to be instrumented in this selectivity. A reduced affinity of the androgen receptor was found when the steroid did not possess a hydroxyl group at the 17,β‐position and a 3‐oxo‐group irrespective of the degree of saturation of the A‐ring. Studies concerning the physical properties of the androgen binder revealed a protein with a molecular weight of 220,000, a Stokes' radius of 54Å, and a frictional ratio of 1.35.