bluuebunny/crossref_metadata_2025 huggingface dataset:
Endometrial carcinoma after Hodgkin disease in childhood
Authors: Brown Gail , Li Frederick P. , Cohen Harvey , Cassady J. Robert , Goldstein Donald
Published: February 2007

A 34‐year‐old patient developed metastatic endometrial carcinoma after Hodgkin disease in childhood. She had ovarian failure after abdominal irradiation and chemotherapy for Hodgkin disease, and received exogenous estrogens, a treatment implicated in the development of endometrial cancer in menopausal women. Young women on replacement estrogens for ovarian failure after cancer therapy may also have increased risk of endometrial carcinoma and should be examined periodically.
Malignant lymphoma with a high content of epithelioid histiocytes: Report of a T‐cell variant of so‐called lennert lymphoma and review of the literature
Authors: Han T. , Barcos M. , Yoon J. M. , Rakowski I. , Minowada J.
Published: February 2007

The present report describes the first case of well‐differentiated nodular lyraph‐ocytic lymphoma evolving into Lennert lymphoma of T‐cell origin. A 58‐year‐old white female developed malignant lymphoma, well‐differentiated, lympho‐cytic type, nodular, with focal bone marrow involvement (stage IV) in May 1975. She received 16 cycles of cyclophosphamide and prednisone combination chemotherapy which was completed in October 1976. A complete remission was achieved. In December 1976, she relapsed and was treated with cyclophosphamide, vincristine, bleomycin, and prednisone until May 1977. Lympha‐denopathy decreased until August 1978, but then increased again. Biopsy of an axillary lymph node was interpreted as Lennert lymphoma. She received methotrexate, cyclophosphanide, vincristine, adriamycin, and prednisone beginning in September 1978. When last seen in November 1979, she was in partial remission. Lymphoid cells obtained from lymph node which was involved with Lennert lymphoma consisted of 93% standard E‐rosettes and 83% gravity E‐rosettes. Cytoplasmic immunoglobulin on frozen sections was negative, but acid phosphatase (ACP) and alpha‐naphthyl acetate esterase reactions were strongly positive. These findings support a T‐cell proliferation in Lennert lymphoma. A review of the literature reveals only four cases of Lennert lymphoma of T‐cell origin.
Phase I evaluation of vindesine in children: A southwest oncology group pilot study
Authors: Komp Diane , Vats Tribhawan , Shepherd Dell A. , Vietti Teresa , Hoogstraten Barth , Haas Charles D.
Published: February 2007

Twenty‐one children (19 with leukemia) were given 34 courses of vindesine on a weekly or twice‐weekly schedule in escalating doses. Thirty‐three courses were fully or partially evaluable for response and/or toxicity. Granulocyto‐penia was the dose‐limiting toxicity. Transient jaw, neck, or bone pain was common after each dose. Motor weakness, paresthesias, and constipation were neither frequent nor severe. In this Phase I study, vindesine had some antileu‐kemia activity in children previously treated with vincristine and other drugs. Phase II studies are warranted and a starting dose of 1.85 mg/m2 twice weekly appears tolerable.
Feminization in hepatocellular carcinoma corrected by chemotherapy: A case report
Authors: Aabo Kristian , Dimitrov Nikolay V.
Published: February 2007

A 17‐year‐old boy with metastatic hepatocellular carcinoma and feminization became asymptomatic after administration of antineoplastic agents. Serum estradiol level, urine estrogens, and tumor estrogen receptors were changed after the treatment. Achievement of partial remission resulted in normalization of the serum sex hormone profile and disappearance of the feminization in spite of the presence of residual tumor. Thus, serum hormone levels alone can‐not be used as tumor markers for control of therapy. This suggests that chemotherapy may have altered the biological behavior of the tumor, which resulted in loss of its ability to synthesize estrogen and estrogen receptors.
Metastasis to the central nervous system from colorectal cancer
Authors: Chyun Y. , Hayward E. , Lokich J.
Published: February 2007

Eighteen of 78 patients (23%) with metastatic colorectal cancer developed clinically significant metastases to the central nervous system (CNS). The patients developing CNS metastases had a decreased likelihood of associated liver metastases compared to the patients without CNS metastases (22% versus 80%). Pulmonary metastases were present in 55% of patients with CNS lesions and in 25% of those without CNS lesions. Overall survival from diagnosis of the primary tumor was comparable (median, 28 months) for patients with or without CNS lesions. The incidence of CNS metastases was comparable irrespective of Duke stage at presentation. For early lesions (Duke B or C), CNS metastases were associated with a shorter survival (31 versus 42 months). For advanced disease (Duke D lesions) at presentation, the overall survival of the group with CNS metastases was longer (24 versus nine months). Therefore, the longer survivorship of patients with advanced disease may contribute to a greater likelihood of CNS metastases.
DOPA Metabolism in Neuroblastoma
Authors: Helson L. , Johnson G. A. , Smith R.
Published: February 2007

Blood plasma samples from 60 neuroblastoma patients prior to, during, and following treatment were studied for their content of circulating DOPA using a radioenzymatic assay. Normal values were established from children who were tumor‐free or had other nonneurogenic tumors. The highest plasma DOPA concentration in tumor‐free or nonneuroblastoma controls was 5.3 ng/ml with a mean of 2.15 ng/ml. Most neuroblastoma patients (28/31) with active disease had DOPA values above this level. Only one out of 30 “successfully” treated patients without evidence of disease was encountered with an abnormally high level. In treated patients, elevated values forewarned of impending clinical recurrence or persistent tumor. Cerebrospinal fluid DOPA levels in one patient with cerebral neuroblastoma were extraordinarily high and suggests that this assay may prove useful to distinguish neuroblastoma from other central neuroectodermal or metastatic tumors.

Plasma DOPA appears to be a reliable predictive and diagnostic test for neuroblastoma.
Beta‐2‐microglobulin review: Its relevance in clinical oncology
Authors: Cooper E. H. , Plesner T.
Published: February 2007

Beta‐2‐microglobulin (β2‐m) is an intrinsic part of the HLA system and is most probably involved in cell recognition. The levels of free β2‐m in the blood and urine are influenced by β2‐m production and its clearance and destruction in the kidney. Many tumors can be associated with an elevated serumβ2‐m, the reason is unknown. The most promising application of β2‐m as a tumor marker would appear to be lymphoid malignancies, especially multiple myeloma and chronic lymphocytic leukemia.
Hypoglycemia in a child with hepatoblastoma
Authors: Ha K. , Ikeda T. , Okada S. , Inui K. , Tagawa T. , Takada K. , Uchimura N. , Kakudo K. , Okada A. , Yabuuchi H.
Published: February 2007

A five‐year‐old boy with hepatoblastoma, who showed a severe hypoglycemia as an initial symptom, was studied. After resection of tumors, hypoglycemia disappeared and did not recur despite recurrence of tumor. A high concentration of insulin‐like activity (ILA) was found in preoperative serum and in the tumor extract. Hypoglycemia in this patient seemed to depend mainly on ILA and in part on liver enzyme activities related to carbohydrate metabolism.
Osteogenic sarcoma following treatment with megavoltage radiation and chemotherapy for bone tumors in children
Authors: Freeman Carolyn R. , Gledhill Robert , Chevalier Louise M. , Whitehead V. Michael , Esseltine D. L.
Published: February 2007

While osteogenic sarcoma has been well‐recognized as a late complication of exposure to high doses of ionizing radiation in the orthovoltage energy range, it has been less frequently reported in patients treated with megavoltage radiation. This potential complication should, however, not be dismissed as an occurrence to be seen only after high‐dose orthovoltage radiation. We have recently seen two children who developed osteogenic sarcoma following treatment with megavoltage radiation and combination chemotherapy for primary bone tumors. The implications in regard to aggressive multimodality treatment for pediatric malignancies are discussed.
The nude mouse model for human retinoblastoma: A system for evaluation of retinoblastoma therapy
Authors: Benedict William F. , Dawson Jo Ann , Banerjee Ashutosh , Murphree A. Linn
Published: February 2007

We have critically examined the nude mouse model for human retinoblastoma to determine whether or not characteristics found in the parent tumor are retained in the mouse. We have demonstrated that most tumors grown in the anterior chamber of the nude mouse maintain a similar karyotype, show the same degree of differentiation and develop an adequate tumor blood supply when compared to the primary tumor from which they were obtained. Because of these findings, we suggest that this model may be particularly useful for evaluating new methods or combinations of treatment for human retinobastoma.
Doxorubicin, vincristine, and cis‐diamminedichloroplatinum (II) therapy in patients with advanced breast cancer
Authors: Trump Donald L. , Ettinger David S. , Abeloff Martin D.
Published: February 2007

Preliminary data suggesting synergistic activity of cisplatinum and doxorubicin and the expected poor prognosis of women with breast cancer who progress on treatment with cyclophosphamide, methotrexate and 5‐fluorouracil (CMF), led to a trial of monthly doxorubicin (50 mg/M2), vincristine (1.4 mg/M2) and cisplatinum (50 mg/M2) in such patients. Overall partial response rate to this regimen was 42%; 37% progressed and 21% could not complete two cycles of therapy because of gastrointestinal (three or renal (one) toxicity. This study does not support the use of cisplatinum, 50 mg/M2, in combination with doxorubicin and vincristine in patients with breast cancer which has proven refractory to CMF therapy.
Protected environments in cancer chemotherapy: Design and function of a large unit
Authors: Bodey Gerald P. , Rosenbaum Beverly
Published: February 2007

The construction of a new hospital building permitted the design of a new protected environment unit. The design and operating procedures of this unit are described. Microbiological monitoring has been conducted using air sampling, floor sampling, and settling plates. Microbial contamination is substantially lower in the protected environment unit than in comparable locations elsewhere in the hospital.
Interstitial pneumonitis associated with mitomycin C and DTIC: A case report
Authors: Yoon J. M. , Rao U. , Vassilopoulos P. P. , Ledesma E. , Mittelman A.
Published: February 2007

A case of interstitial pneumonitis secondary to mitomycin C and DTIC combination therapy in a 58‐year‐old male with metastatic adenocarcinoma of the rectum is reported. Dry cough and dyspnea, especially on exertion, were presenting symptoms. Arterial blood gas analysis was compatible with severe impairment in pulmonary diffusion capacity. Chest x‐ray showed a diffuse increase in interstitial markings in both lung fields consistent with interstitial pneumonia. Histologically, prominence of type I pneumocytes, focal proliferation of type II pneumocytes, and varying degree of fibroblastic proliferation and collagenization within the alveolar septae were observed. The obliteration of alveolar septal vessels due to endothelial edema and/or proliferation of fibroblast‐like mesenchymal cells were also noted. Withdrawal of drugs and institution of high dose corticosteroid therapy were followed in rapid improvement in dyspnea and arterial blood gas findings. If diagnosed early, this potentially life threatening complication may respond to such therapy.
Acute myeloblastic leukemia following non‐hodgkin lymphoma in an adolescent. A report of a case with preleukemic syndrome, and review of the literature
Authors: Kaur Prakash , Miller Denis R. , Andreeff Michael , Chaganti Raju , Meyers Paul A.
Published: February 2007

Reports of acute nonlymphoblastic leukemia occurring after successful treatment of Hodgkin and non‐Hodgkin lymphoma (NHL) are appearing with increasing frequency. Two years after completion of LSA2‐L2 therapy for stage III, poorly differentiated lymphocytic lymphoma, a 16‐year‐old boy developed a preleukemic state characterized by a refractory macrocytic anemia with excess blasts, dyshematopoiesis, abnormal cluster:colony ratio on in vitro bone marrow culture, and acquired deficiencies of erythrocyte pyruvate kinase, triose phosphate isomerase, and adenylate kinase. Four months later acute myeloblastic leukemia was evident. The RNA index determined by flow cytofluorometry was increased. Four marker chromosomes were found and involved complex translocation of chromosomes 11 and 17 (t11;17) in 100% of the cells, and chromosome 4 (t4q;4) in 10% of the cells.

A thorough literature search uncovered four other reports of acute nonlymphoblastic leukemia occurring in children treated for NHL and a total of 58 cases in the adult and pediatric age groups. Over 50% of the patients had AML, were men over 50 years of age, and were treated with radiotherapy and chemotherapy. It is anticipated that additional cases of second malignancies will be reported in this population of patients whose outlook for the curability of the primary malignancy is 75%.
CT scans of long‐term survivors of various childhood malignancies
Authors: Allen Jeffrey C. , Deck Michael D. F. , Howieson John , Brown Mark
Published: February 2007

Forty‐two children with various systemic malignancies in continuous remission for 1 to 3 years after the completion of chemotherapy had CT scans with normal ventricular dimensions, similar to a noncancer “control” population. Seventeen of these patients had acute lymphocytic leukemia (ALL) treated either with prophylactic cranial irradiation and intrathecal methotrexate [7] or intrathecal methotrexate alone [10] and the remaining 25 patients had soft tissue sarcomas. Sixteen other patients with sarcomatous meningitis had enlarged ventricles while on chemotherapy. Nine had ALL. Seven had soft tissue sarcomas, none of whom received any prior CNS irradiation or intrathecal chemotherapy. In this retrospective study no evidence of hydrocephalus or significant white matter hypodensity was detected in long‐term survivors of childhood cancer, regardless of whether prophylactic intrathecal chemotherapy and/or cranial irradiation was given. Direct involvement of the CNS with meningeal cancer was the most important association with ventriculomegaly.
The role of local radiation in the treatment of non‐hodgkin lymphoma in children
Authors: Jereb Berta , Wollner Norma , Kosloff Cynthia , Exelby Philip
Published: February 2007

Eighty‐one patients between 1 and 15 years of age with non‐Hodgkin lymphoma were seen at Memorial Sloan‐Kettering Cancer Center (MSKCC) in an 8‐year period ending December 1973. There was no statistically significant difference among the survival distributions for site or histologic type. The patients also were divided into three groups according to the chemotherapeutic regimen employed in their care, and further subdivided as to whether they received “curative” radiotherapeutic attempts. Children treated with multiple agent chemotherapeutic regimen (LSA‐2) did significantly better than children of the LSA‐1 or nonprotocol (NP) group. Children with Stage I and Stage II disease did significantly better than children with Stage III and Stage IV disease. Radiation therapy as employed in this study prevented recurrence of local disease. All patients in whom the disease recurred died within a year from the appearance of recurrence. However, no statistically significant association between radiation and survival could be shown in this series.
Methyl‐CCNU, 6‐Thioguanine, and 5‐fluorouracil in advanced colorectal cancer
Authors: Aroney R. S. , Dalley D. N. , Chan W. K. , Bell D. R. , Levi J. A.
Published: February 2007

Consecutive studies were undertaken in advanced colorectal adenocarcinoma, comparing two different schedules of the combination methyl‐CCNU, 6‐thioguanine, and 5‐fluorouracil in 89 patients. The two schedules exhibited similar efficacies, with a combined complete and partial remission rate of 17%, a median response duration of 36+ weeks, and a median survival of 53+ weeks. Significant symptomatic benefit was seen in 52% of patients. Toxicity was predominantly hemopoietic and gastrointestinal, being acceptable overall, with only minor qualitative differences between the two protocols. These tripledrug regimens exhibit response rates and survival patterns comparable with those reported for other multidrug combinations and some single agents. It would appear that major improvements in the management of advanced‐stage disease must await the availability of more efficacious agents used alone or in combination.
A prospective study of histocompatible leukocyte and platelet transfusions during induction chemotherapy of adult acute nonlymphocytic leukemia
Authors: Cooper M. Robert , Heise Eugene R. , Ii Frederick Richards , Muss Hyman B. , White Douglas R. , Rhyne Leonard , Howard Virginia , Spurr Charles L.
Published: February 2007

A prospective clinical trial was conducted to test the effectiveness of granulocyte transfusions during induction chemotherapy of patients with adult acute nonlymphocyte leukemia. Thirty‐eight patients who received prophylactic granulocyte transfusions from related donors when their phagocyte counts decreased to < 1000 μl were compared to twenty‐five controls who did not have qualified donors from which to obtain granulocyte transfusions. The frequency of complete remissions (CR) (28/38 versus 7/25) was significantly greater for the granulocyte transfusion group than for controls. Patients older than 45 responded more often in the transfused group (P < 0.025) when compared to the similar age group in controls. Both duration of complete remission and survival were greater in the granulocyte transfused group. However, these differences were not statistically significant. Survival for all responders (complete plus partial remission) was longer for the granulocyte transfusion group (P = 0.01). No significant difference in frequency or severity of either infection or hemorrhage was noted in the two groups. The advantage noted in this study largely occurred in patients older than 45 and this suggests that this age group is more likely to respond if they have histocompatible donors from which to obtain granulocyte and platelet transfusions. Immune mechanisms may be involved in the beneficial effects observed with HLA compatible granulocyte transfusions.
VP 16–213 and cyclophosphamide in the treatment of refractory acute nonlymphocytic leukemia with monocytic features
Authors: Hurd David D. , Peterson Bruce A. , McKenna Robert W. , Bloomfield Clara D.
Published: February 2007

The treatment of refractory acute nonlymphocytic leukemia remains a major clinical problem in leukemia therapy. VP 16–213 is an investigational agent that may have specificity for monocytic blasts, and the combination of VP 16–213 and cyclophosphamide is synergistic in experimental leukemia. Seven patients with highly refractory acute nonlymphocytic leukemia, which demonstrated monocytic features, were treated with a combination of VP 16–213 and cyclophosphamide after they had failed to respond to multiple courses of intensive induction regimens. Three complete remissions and one partial remission were achieved. The times to complete remission were 21, 23, and 34 days. The durations of complete remission were 5, 9, and 12+ months. Myelo‐suppression was the most common side effect; one patient experienced nausea and stomatitis. There were no documented infections or hemorrhage, and no one died as a result of therapy. This combination is both well tolerated and effective in the treatment of refractory leukemia with monocytic features.
Sick sinus syndrome with seroconstrictive pericarditis in malignant lymphoma involving the heart: A case report
Authors: Donnelly M. Sheila , Weinberg David S. , Skarin Arthur T. , Levine Harold D.
Published: February 2007

A case of the sick sinus syndrome and constrictive pericarditis with effusion (seroconstrictive pericarditis) as manifestations of lymphomatous involvement of the heart is presented. Autopsy findings documented infiltration of the sinus node by undifferentiated malignant lymphoma cells. The clinical course is described and problems with diagnosis and management of such a complication are discussed. This is one of the few cases in the literature in which an uncommon cause of conduction system disease and pericardial constriction was substantiated by electrocardiogram, angiography, and autopsy.
Lung abscesses following corticosteroid therapy for central nervous system metastases
Authors: Joss Rudolf A. , Goldberg Ronald S. , Yates Jerome W. , Krakoff Irwin H.
Published: February 2007

Although the occurrence of lung abscesses has decreased among the general population since the advent of antibiotics, a specific subgroup of cancer patients has demonstrated a propensity for this complication. Four patients with lung cancer, receiving corticosteroid therapy for brain metastases, developed large lung abscesses. These patients represent 12% of the 33 patients with central nervous system metastases seen in this institution over the period of one year. Physicians should be alert to this possible complication of corticosteroid therapy in patients with lung cancer.
Progress in the treatment of childhood acute leukemia: A review
Authors: Steinhorn Sandra C. , Myers Max H.
Published: February 2007

The dramatic improvements in the survival experience for children diagnosed with acute leukemia are analyzed using data collected through hospitals participating in the National Cancer Institute's End Results Group Program between 1950 and 1973. Children under 15 years of age who were diagnosed with both acute lymphocytic leukemia (ALL) and acute nonlymphocytic leukemia (ANLL) showed moderate improvements in the 1950s, but beginning in the 1960s those with ALL did far better. Statistically significant differences at the 0.05 level were noted between their three‐year survival rates for all cohorts analyzed between 1960 and 1973. For the 1970‐1973 cohort, three‐year survival rates were 49% and 20% for ALL and ANLL, respectively, and five‐year survival rates were 34% and 12%. Between 1950 and 1976 the age‐adjusted incidence rate for all childhood leukemias remained relatively stable in a sample of five geographic areas, changing from 4.6 per 100,000 children under 15 years of age to 4.3 per 100,000. In contrast, the corresponding age‐adjusted mortality rate fell approximately 45% over the same period, from 4.4 per 100,000 to 2.4 per 100,000.
Treatment of a primary intracranial germ cell tumor with systemic chemotherapy
Authors: Kirshner Jeffrey J. , Ginsberg Sandra J. , Fitzpatrick Alicia V. , Comis Robert L.
Published: February 2007

Primary germ cell neoplasms of the central nervous system (CNS) are rare tumors which generally respond to radiotherapy. Experience is limited in managing the refractory patient. We report a patient whose suprasellar dysgerminoma responded completely to 5,000 rad. Seven years later, disease recurrence was refractory to an additional 4,000 rad. Theorizing that the “blood‐brain barrier” was no longer intact after extensive radiotherapy and tumor involvement of the ventricular system, the patient was treated with systemic bleomycin, cisplatin, and vinblastine. Pharmacokinetic studies revealed that the bleomycin and cisplatin entered the cerebrospinal fluid. Serial CT scans and CSF levels of β‐HCG confirmed the clinical impression of a partial remission. Subsequent tumor progression was refractory to therapy with intraventricular bleomycin. It is concluded that systemic chemotherapy may be beneficial in certain cases of CNS germ cell neoplasms.
Malignant mesothelioma in children: Report of seven cases and review of the literature
Authors: Brenner Joseph , Sordillo Peter P. , Magill Gordon B.
Published: February 2007

Seven children with malignant mesothelioma have been seen at Memorial Hospital since 1953. In six, the origin was at the pleura and in one at the peritoneum. None of the patients related a history of exposure to asbestos. Two patients lived more than five years. The other five patients died within two years of the diagnosis. Distant metastases were seen in four of the patients, including three who had metastases to brain. Surgery or radiotherapy were not effective in controlling the disease in most of the patients. One patient had a complete response to a combination of Adriamycin, cyclophosphamide, and vincristine and has remained free of disease for 51/2 years. The seven cases are reviewed, as are the other 42 cases of malignant mesothelioma in children reported in the literature.
Characteristics of children with acute nonlymphocytic leukemia in long‐term continuous remission: A report for childrens cancer study group
Authors: Baehner Robert L. , Kennedy Anne , Sather Harland , Chard Ronald L. , Hammond Denman
Published: February 2007

Children and young adults less than 18 years of age with acute nonlymphocytic leukemia who remained in long term bone marrow and extramedullary remission for two years or longer since starting maintenance were compared to the remaining responders for the following characteristics: cell type, sex, age at diagnosis, race, pretreatment, white blood count, length of time from start of induction therapy to achievement of an M1 marrow, marrow rating at day 56 of therapy, marrow rating at the start of maintenance therapy, and specific study. Forty‐eight patients of a group of 333 qualified as having long term remission (14.4%). Multivariant analysis indicated that patients between the ages of 3 and 10 years (p = 0.003) as well as the length of time to achieve an M1 marrow from the start of treatment (p = 0.03) were the only characteristics associated with achievement of a long term remission. Maintenance therapy was discontinued in 15 patients from 2.5 to 4.8 years after start of maintenance and all patients remained in bone marrow remission for periods from 0+ to 3.0+ years after stopping treatment. Of the 33 who have remained on a continuous maintenance therapy 12 have had bone marrow relapses. These data confirm the prognostic value of age and length of time to achieve remission during induction in acute nonlymphocytic leukemia and suggest that there may be no significant benefit from maintenance therapy continued beyond 2 years for patients in their initial remission.
Computed tomography brain scans in long term survivors of childhood acute lymphoblastic leukemia
Authors: Esseltine D. W. , Freeman C. R. , Chevalier L. M. , Smith R. , O'Gorman A. M. , Dubé J. , Whitehead V. M. , Nogrady M. B.
Published: February 2007

There have been varying frequencies cited for the occurrence of abnormal brain CT scans in Jeukemic patients and confiding evidence about the significance of these abnormalities and their relationship to sanctuary therapy. Our study of CT brain scans in 26 long survivors of acute lymphoblastic leukemia showed an overall prevalence of 35% abnormal scans. There was no statistically significant difference between the number of abnormal scans seen in patients given radiotherapy as part of their CNS prophylaxis and those receiving only intrathecal methotrexate. Because the children in each treatment group were evenly matched with respect to other treatment variables possibly relevant to the causation of abnormal brain scans, a strong case is made for more rigorous design of such studies, preferably in a prospective fashion, looking simultaneously at other parameters of brain structure and function.
Cystosarcoma phylloides: A case presentation
Authors: Orsini James M. , Perloff Marjorie , Rybak Benito
Published: February 2007

A case of cystosarcoma phylloides is presented here showing the natural history of this disease both clinically and pathologically from 1962 through 1979, and demonstrating the management of this disease by surgery and by chemotherapy with the use of adriamycin at 25 mg/m2 daily, times three days, every 28 days, which to our knowledge has not been used in this particular setting.
Coexistence of myeloid and lymphoid neoplastic subpopulations in chronic myelogenous leukemia
Authors: Hutchinson Raymond J. , Rosenstock Jeffrey G. , Nowell Peter C. , Finan Janet
Published: February 2007

Serial cytogenetic studies have been performed on a child with Philadelphia chromosome (Ph1)‐positive chronic myelogenous leukemia (CML) and correlated with clinical, morphologic, and cytochemical data in an attempt to elucidate further the natural history of leukemic progression observed in this disease. Once the initial blast crisis had occurred, two genetically different leukemic clones of cells, one presumably having arisen from the other, coexisted throughout the remainder of the patient's course. The initial clone comprised diferentiating myeloid cells, while the second clone appeared on morphologic and cytochemical grounds to be lymphoid and blastic. A dynamic equilibrium existed between these two populations of cells, with the balance altered by chemotherapy and/or other selective pressures. The leukemic progression demonstrated in this case is consistent with the concept of clonal evolution of malignant cell populations. In planning therapy, it may be necessary to consider each of these coexistent clones and their different therapeutic requirements.
Non‐hodgkin's lymphoma in children: Results of treatment with the modified LSA2‐L2 protocol
Authors: Vecchi Vico , Pession Andrea , Serra Laura , Rosito Pasquale , Mancini Antonia Francesca , Paolucci Guido
Published: February 2007

From June 1976 to May 1980, 25 previously untreated children with non‐Hodgkin's lymphoma (NHL) were studied and treated with a protocol modified from the one (LSA2L2) proposed by Wollner [8]. Stage III and IV had, in addition, prophylactic treatment of the central nervous system (CNS) with cranial irradiation (2,400 rad plus intrathecal metho‐trexate). The complete remission rate is 96%. Of these patients, 76% are disease free surviving after a median observation time of nearly two years. The disease‐free actuarial survival is 100% for 6 children with Stage I‐II disease and 68% for 19 Stage III‐IV children after median observation times respectively of 25 + and 19 + months. None of the 19 high‐risk patients developed CNS disease after prophylactic treatment.

Mediastinal involvement and leukemic conversion at diagnosis were not unfavorable prognostic factors, but primary skeletal or subcutaneous disease and Burkitt‐type histology were ominous features in patients treated by this regimen.

It is concluded that good results are obtained when an aggressive multimodal and multiple drug regimen like the LSA2‐L2 is coupled with CNS prophylaxis and is used assiduously to maintain complete remission during the first 12 months of treatment.
Efficacy of amikacin and ticarcillin as empiric therapy in febrile neutropenic children with cancer
Authors: Faden Howard S. , Deshpande Ganesh N. , Grossi Mauro , Surgalla Michael , Ettinger Lawrence J. , Freeman Arnold I.
Published: February 2007

Amikacin (600 mg/m2/day IV) and ticarcillin (12 gm/m2/day IV) were administered to 38 children with cancer, neutropenia (< 1,000 PMN/mm3), and fever (≥ 38°C) during 46 febrile episodes. Sixty‐one percent of the children were severely neutropenic (<200 PMN/mm3). Febrile episodes consisted of 15 documented (E coli 5, K pneumoniae and P aeruginosa 1, P. aeruginosa 1, S marcescens 1, S aureus 4, S epidermidis 1, S viridans 1, adenovirus 1), 13 clinically apparent, nine possible, and nine doubtful infections. Efficacy of amikacin and ticarcillin was not determined in persons with gram‐positive, viral, and doubtful infections. Amikacin and ticarcillin were administered from 3 to 13 days (mean 7.3 days). Peak serum concentrations of amikacin on days two and five of treatment ranged between 13 and 35 μg/ml; trough levels remained below 2 μg/ml in 92% of the samples. Eighty‐six percent of evaluable febrile episodes improved and 14% were unchanged. Among eight infections due to gram‐negative enteric bacilli, six were cured (75%), and two (25%) improved temporaily. The excellent results observed in this study may be attributed, in part, to the predictably high serum concentrations of amikacin which exceeded the MICs of seven of eight gram‐negative pathogens. Renal toxicity was not observed. Two children (9.5%) developed mild, transient, unilateral hearing losses. These data suggest that the combination of amikacin and ticarcillin is an effective and safe empiric antibiotic regimen in febrile children with cancer.
The development of hyponatremia following combination chemotherapy for metastatic germ cell tumors
Authors: Ginsberg Sandra J. , Comis Robert L. , Miller Myron
Published: February 2007

The combination of high dose vinblastine, cisplatin, and bleomycin is an extremely effective, but potentially quite toxic, program for the treatment of metastatic germ cell tumors. In addition to the well‐described toxicities, we have noted moderate to severe hyponatremia associated with these drugs. Twelve patients who were receiving this combination chemotherapy program had serum electrolyte levels, plasma osmolality, and creatinine clearance performed prior to and again 5 to 9 days after chemotherapy. Nine of the patients had standard water load tests prior to and again 6 to 15 days after chemotherapy. All 12 patients developed a fall in serum sodium concentrations following chemotherapy, and four patients had severe symptoms attributable to the hyponatremia. Eight patients also developed hypoosmolality suggesting that the hyponatremia was secondary to impaired water handling. In five patients further evidence of impaired water handling was documented by the development of an abnormal standard water load test following chemotherapy. The hyponatremia and impaired water handling may be due primarily to the high doses of vinblastine in the chemotherapeutic program. Patients who are receiving this combination chemotherapy program should be observed for the development of hyponatremia. The presence of severe, symptomatic hyponatremia and impaired water handling may require appropriate treatment including water restriction and hypertonic saline administration.
Chemotherapy of pulmonary blastoma: A case report and review of the literature
Authors: Kummet Thomas D. , Doll Donald C.
Published: February 2007

Pulmonary blastoma is a rare lung tumor of uncertain histogenesis. Although surgery may be curative therapy for localized lesions, recurrent tumor has been resistant to various treatment modalities. We report a case of metastatic pulmonary blastoma that had a partial remission with combination chemotherapy. Suggestions are made for the treatment of localized and metastatic pulmonary blastoma.
Chronic idiopathic thrombocytopenic purpura (ITP:) development of acute non‐lymphocytic leukemia subsequent to treatment with cyclophosphamide
Authors: Krause John R.
Published: February 2007

Chronic idiopathic thrombocytopenic purpura (ITP) is most often treated successfully with steroids and/or splenectomy. In those who fail to respond with the foregoing treatment, immunosuppressive drugs are sometimes added to the regimen. Cyclophosphamide has been reported heretofore to be effective with a minimum of side effects and complications. However, the use of alkylating agents and the induction of a second malignancy is now well recognized. This report describes three cases of refractory ITP treated with cyclophosphamide who subsequently developed an acute non‐lymphocytic leukemia. Cyclophosphamide should be used with discretion in the treatment of chronic idiopathic thrombocytopenic purpura which is a non‐neoplastic disorder.
The comparative clinical pharmacology and pharmacokinetics of vindesine, vincristine, and vinblastine in human patients with cancer
Authors: Nelson Robert L.
Published: February 2007

The pharmacokinetics of vindesine, vincristine, and vinblastine were investigated in patients with cancer. All drugs were administered rapidly via intravenous injection, and drug levels were determined in serum obtained at intervals after injection by radioimmunoassay. All three drugs exhibited a triphasic serum decay pattern, with no major differences in alpha or beta phase half‐lives noted among them. However, vincristine had a longer and more variable terminal phase half‐life (85 ± 69 hr) than vindesine (24 ± 10 hr) or vinblastine (25 ± 7 hr). Central compartment volumes were also different. The most important finding was the observation of differences in the serum or body clearances of these drugs (vincristine 0.106 liter/ kg/hr, vindesine 0.252 liter/kg/hr, and vinblastine 0.740 liter/kg/hr). These differences correlate well with the results of similar studies done in animals, with acute LD50 data in mice, and with the usually employed weekly clinical doses for these drugs. These findings support the hypothesis that differences in the toxicities of these alkaloids may be related in part to differences in their pharmacokinetics.
Sequential chemotherapy of advanced colorectal cancer with standard or high‐dose methotrexate followed by 5‐fluorouracil
Authors: Solan Andrew , Vogl Steven E. , Kaplan Barry H. , Berenzweig Marc , Richard Joseph , Lanham Richard
Published: February 2007

Thirty patients with advanced measurable colorectal cancer were randomized to receive either methotrexate (MTX) 200 mg/m2 or 40 mg/m2, followed in four hours by 5‐fluorouracil (5‐FU) 600 mg/m2. Patients receiving the higher dose MTX were given leucovorin rescue 24 hours later. Eight of 13 patients treated with 200 mg/m2 MTX + 5‐FU developed severe hematologic toxicity, leading to two toxic deaths. In addition, 9/13 developed mild azotemia, and three patients had severe gastrointestinal toxicity. No patients with prior chemotherapy responded to either regimen. Among those without prior chemotherapy, there were two of six and three of eight partial responses, respectively, in the 200 mg/m2 and 40 mg/m2 MTX regimens. Sequential 200 mg/m2 MTX followed by 5‐FU after four hours has unacceptable toxicity. Sequential treatment with standard dose MTX + 5‐FU is tolerable and merits further study.
Treatment of advanced malignant melanoma with high dose methotrexate and folinic acid rescue
Authors: Leahy Michael F. , Silver Hulbert K. B. , Klimo Paul , Hall Thomas C.
Published: February 2007

Twenty‐eight patients with advanced malignant melanoma were treated with high dose methotrexate (HDMTX) and folinic acid (FA) rescue. Nineteen patients were treated with 6‐hour infusions and 10 patients with 24‐hour infusions. One patient in the 6‐hour infusion group showed a partial response. In the 24‐hour infusion group there were no responses but there was a significant increase in renal toxicity. It is concluded that HDMTX and FA rescue are not useful agents in the treatment of advanced malignant melanoma.
Normal infant after combination chemotherapy including teniposide for Burkitt's lymphoma in pregnancy
Authors: Lowenthal R. M. , Funnell C. F. , Hope D. M. , Stewart I. G. , Humphrey D. C.
Published: February 2007

A 32‐year‐old woman was treated for Burkitt's lymphoma diagnosed during the 22nd week of pregnancy. Chemotherapy consisting of doxorubicin (Adriamycin), vincristine, teniposide (VM‐26), cyclophosphamide, and prednisolone (AVTEP) was given each 2.5 to 3 weeks from the time of the diagnosis until delivery in the 37th week. Bleomycin and intrathecal methotrexate were also given from the 35th week. The infant was born after an assisted vaginal delivery and was fully developed and normal in all respects.

This paper confirms prior reports that cytotoxic chemotherapy may safely be given during the second and third trimesters of pregnancy without adverse effects on the fetus. To our knowledge it is the first report of the use of teniposide, a new podophyllin derivative, during pregnancy.
The measurement of leukocyte subsets in the peripheral blood of cancer patients with solid tumors using monoclonal antibody reagents
Authors: Harris Jules E. , Deboer Kathie P. , Vahey Anne L. , Braun Donald P.
Published: February 2007

Monocyte and lymphocyte subsets were quantitated in the peripheral blood of normal subjects and patients with solid tumors using the monoclonal antibody reagents OKM1, BRL63D3, OKT3, OKT4, and OKT8. Percentages and numbers of cells reacting with monoclonal reagents were analyzed by indirect immunofluorescence. Correlations between leukocyte subset values and stage of disease or immunocompetence were sought. No differences from normal were seen in the percentage of OKT3, OKT4, and OKT8 cells or in the ratios of OKT4/OKT8 cells in peripheral blood mononuclear cells (PBMC) from all cancer patients, patients with localized disease, or patients with advanced disease. A significant decrease in absolute numbers of lymphocytes, OKT3 cells, OKT4 cells, and OKT8 cells was seen in the peripheral blood of patients with advanced disease reflecting the absolute lymphopenia of these patients. A significant increase was seen in the percentages of PBMC reacting with OKM1 and BRL63D3 from patients with advanced disease compared with normal donors or localized disease patients. A positive correlation was found between PHA responsiveness and absolute numbers of OKT3 and OKT4 cells. A negative correlation was found between PHA responsiveness and percentages of OKM1 cells. These data indicate that malignant disease does not alter T cell subset percentages in patient peripheral blood but may decrease their absolute numbers in association with absolute lymphopenia. On the other hand, percentages of OKM1 and BRL63D3 cells are increased in patients with advanced solid tumors in association with impaired PHA responsiveness.
Fatal pneumothorax in “BCNU lung”
Authors: Wilson Kenneth S. , Brigden Malcolm L. , Alexander Skaria , Worth Anne
Published: February 2007

A patient with recurrent glioma treated with BCNU developed pneumothorax and interstitial pulmonary fibrosis. She died from “BCNU lung” and its complications, although she was free of her initial disease.
Infant leukemia in hungary
Authors: Kardos Gabriella , Révész T. , Koós Rozália , Petróczky Ágnes , Schuler D.
Published: February 2007

The treatment of childhood leukemia in Hungary is carried out in the framework of a national multicenter study. During the past ten years 633 newly diagnosed patients were treated in one of the ten centers. Of these, 39 were less than a year old at the time of diagnosis; 24 presented with ALL, 12 with AML, and three were found to have juvenile CML. Initial WBC count, which is the most important prognostic factor in childhood leukemia, was significantly higher in infants than in older children. Accordingly, the treatment results in these patients were inferior to those in children. Therapy of leukemia in infants remains a serious problem and warrants further studies to establish the best approach.
Nasopharyngeal carcinoma in childhood
Authors: Lombardi Fabrizio , Gasparini Marco , Gianni Cristina , de Marie Maria , Molinari Roberto , Pilotti Silvana
Published: February 2007

We have retrospectively evaluated a series of 27 consecutive children observed from 1965 to 1980 with nasopharyngeal carcinoma (NPC). Histological diagnosis in each patient was undifferentiated carcinoma of nasopharyngeal type (UCNT) with prominent lymphocytic infiltration. Regional node involvement was present in 26 of 27 patients and two children presented with distant metastases. Twenty evaluable children with primary nasopharyngeal tumor with or without positive cervical nodes underwent radiotherapy (RT) with uniform criteria in technique. Adjuvant cyclophosphamide (CPM) was administered to a total of 11 children. The actuarial relapse‐free survival and overall survival are 40% and 55% at four years, respectively.

In this series, the most important prognostic factor was represented by the extent of the tumor in the nasopharynx. Permanent control of the primary tumor was obtained in 85% of patients. CPM given after RT did not reduce the incidence of relapse. However, the fact that 45% of patients developed distant metastases as first treatment failure suggests that combined chemotherapy should be tested in the management of NPC in children, especially when primary tumor is locally advanced.
Acute renal failure following intravenous pyelography (IVP) in a patient with diffuse hypergammaglobulinemia: A case report
Authors: Antman Karen Hamm , Parker Leroy M. , Goldstein Jeffrey D. , Skarin Arthur T. , D'Orsi Carl J.
Published: February 2007

A 65‐year‐old woman with polyclonal hypergammaglobulinemia developed acute renal failure requiring hemodialysis after an intravenous pyelogram (IVP). An increased risk of renal injury after IVP for patients with polyclonal hypergammaglobulinemia has not been previously recognized, although a parallel risk to patients with myeloma has been well established. At autopsy, immunoperoxidase staining of the bone marrow demonstrated plasma cell subpopulations with intracellular staining for IgG, IgA, and IgM and χ and λ light chains, proving that this patient did not have occult myeloma. Immunoperoxidase staining of casts in renal tubules also demonstrated polyclonal immunoglobulins.
Lung cancer as a complication of prolonged survival in patients with lymphoma
Authors: Konits Philip H. , Aisner Joseph , Whitacre Margaret , Wiernik Peter H.
Published: February 2007

As a result of successful therapy with radiation, chemotherapy, or both, patients with lymphoma are living longer. The improved survival has led to an increased awareness of long term complications including second or subsequent malignancies. We have recently seen six cases of lung cancer‐three adenocarcinomas, one squamous cell carcinoma, and two small cell carcinomas‐among 655 patients with Hodgkin and non‐Hodgkin lymphoma suggesting a possible association, although other carcinogenic or cocarcinogenic factors cannot be eliminated.
Childhood T‐cell acute lymphoblastic leukaemia expressing “Ia‐like” antigen: A case report
Authors: Kupa Ann , Beckman Ian G. R. , Bradley John , Moore Helen , Thomas Miriam , Zola Heddy , Cheney Kevin , Rice Michael , Toogood Ian
Published: February 2007

A 4‐year‐old girl presenting with vomiting, abdominal pain, and renal failure was found to have gross hepatosplenomegaly, a renal mass, and bilateral pleural effusions. A diagnosis of acute lymphoblastic leukaemia (ALL) was suggested by a peripheral white cell count (WCC) of 119,000 × 106/mm3, 57% blasts, 22% lymphocytes, and confirmed by bone marrow examination. Lymphocyte surface marker studies at diagnosis enabled classification as a T‐ALL, with a significant proportion of the T cells also bearing receptors for the third component of complement (C3). Seventy‐two percent of the peripheral blood mononuclear cells reacted with anti‐Ia monoclonal antibody (FMC 4), and a smaller proportion (25%) carried receptors for the Fc portion of IgG.

The T‐classification of this ALL was verified at central nervous system (CNS) relapse and at a subsequent nodal relapse. Double‐marker studies on cells from the infiltrated lymph node prepared in suspension confirmed the presence of Ia‐positive T cells. The Ia marker is usually a useful discriminant between T and non‐T cells in normal and ALL cell populations. The case described here highlights the need for a panel of markers to be used in classification of childhood ALL and supports the suggestion that there is a distinct subtype of Ia‐positive T‐ALL.