bluuebunny/crossref_metadata_2025_split huggingface dataset:
Day 7 marrow response and outcome for children with acute lymphoblastic leukemia and unfavorable presenting features
Authors: Gaynon Paul S. , Bleyer W. Archie , Steinherz Peter G. , Finklestein Jerry Z. , Littman Phillip , Miller Denis R. , Reaman Gregory , Sather Harland , Hammond G. Denman 
Published: February 2007

AbstractThe percent of marrow blasts on day 7 of therapy was determined for 128 children with previously untreated acute lymphoblastic leukemia and white blood count (WBC) ± 50,000/μl and/or lymphomatous features enrolled in the Childrens Cancer Study Group trial of the Berlin Frankfurt Munster 76/79 regimen (CCG‐193P). Patients received four‐drug induction therapy including vincristine, prednisone, l‐asparaginase, and daunomycin. Ninety‐seven patients had fewer than 25% marrow blasts on day 7. Of these, 94 survived and maintained remission through day 28 and were designated early responders. Thirty‐one patients had greater than 25% marrow blasts on day 7. Of these, 28 survived and achieved remission on day 28 and were designated late responders. The outcome of patients who underwent a day 7 marrow aspiration was similar to those who did not. Early responders had a 77.4% ± 4.5% (standard deviation) 3‐year estimated disease free survival, while late responders had 47.3% ± 9.8% (P<0.001). Early responders had a superior outcome both in the subset with an initial WBC<50,000/μl (P = 0.025) and in the subset with a WBC ± 50,000/μl (P = 0.01). The day 7 marrow response had prognostic value in this population of children with unfavorable presenting features who received four‐drug remission induction therapy.
Epidural spinal cord compression as the presenting manifestation of tumor of unknown origin
Authors: Doll Donald C. , Ringenberg Q. Scott , Bickel John T. , Yarbro John W. 
Published: February 2007

AbstractEpidural spinal cord compression is a common complication of malignancy. In the majority of cases, the primary site is known at diagnosis or is evident following limited investigation. During the period January 1975 to December 1987 we encountered seven cases of tumor of unknown origin presenting as cord compression. Myelography detected the site of cord involvement in six cases, and computed tomography of the spine was utilized in one case. All seven patients underwent laminectomy. Histologic diagnosis was adenocarcinoma in four cases, squamous in one case, and large cell undifferentiated carcinoma in two cases. Evaluation for a primary site was unrewarding. Prognosis was poor, with a median survival of 10 weeks. Only one patient had a satisfactory response to treatment.
A successfully treated case of multicentric angiofollicular hyperplasia with oral chemotherapy (Castleman's disease)
Authors: Pavlidis Nicholas A. , Skopouli Fotini N. , Bai Mary C. , Bourantas Constantinos L. 
Published: February 2007

AbstractA case of angiofollicular lymph node hyperplasia of plasma cell type in a 60‐year‐old woman is reported. The patient presented with lymphadenopathy, splenomegaly, and fever. She responded dramatically to chlorambucil and corticosteroids and has remained free of disease for the last 30 months. The authors review and discuss the systemic cytotoxic treatment of this clinicopathologic entity.
Prognostic significance of regional lymph node involvement in childhood extremity rhabdomyosarcoma
Authors: Mandell Lynda , Ghavimi Fereshteh , Laquaglia Michael , Exelby Philip 
Published: February 2007

AbstractThirty‐four patients with extremity rhabdomyosarcoma were treated at Memorial Sloan‐Kettering Cancer Center during the years 1970 to 1987. The regional lymph node status at diagnosis was histologically confirmed in 27 patients. Of these 27 patients, there were 20 males and 7 females, ranging in age from 6 months to 22 years (median 10 years). The primary tumor was located in the upper and lower extremity in 11 and 16 patients, respectively. The histologic subtypes included embryonal in 13 patients and alveolar in 14 patients. Fourteen patients had no evidence of regional lymph node involvement (N0) and 13 patients had lymphatic metastases (N1). All patients were further staged according to the extent of surgical resection, the local invasiveness and size of the primary tumor, and the presence (M1) or absence (M0) of distant metastases.With a median follow‐up time from diagnosis of 9.2 years (minimum 5.3 years), the overall survival was 48% (13/27): N0, 12/14 and N1, 1/13 (P=.0002). Excluding those patients with M1 disease, the survival rate was: N0, 11/12; N1, 1/10 (P=.0001). The first site of relapse in the M0 patients was distant metastases in 8/10 cases.Our results suggest that regional lymph node involvement at diagnosis is an important prognostic factor in extremity RMS. Its presence appears to be associated with a high incidence of relapse in metastatic sites and poor survival outcome.
Superior vena cava syndrome associated with childhood malignancy: Analysis of 24 cases
Authors: Ingram Lewis , Rivera Gaston K. , Shapiro David N. 
Published: February 2007

AbstractTwenty‐four children with superior vena cava obstruction at initial presentation or associated with disease recurrence were treated at St. Jude Children's Research Hospital from 1973 to 1988. Of the 16 patients with superior vena cava syndrome at presentation, eight had non‐Hodgkin's lymphoma, four had acute lymphoblastic leukemia, two had Hodgkin's disease, one had neuroblastoma, and one had a yolk sac tumor. Their clinical condition at presentation was often critical and required rapid treatment. In all cases, histopathologic diagnosis was obtained without complication by either bone marrow aspiration, lymph node biopsy, thoracentesis, or thoracotomy prior to the initiation of definitive therapy.Eight children had superior vena cava syndrome as a late complication during the course of their therapy. None had an antecedent history of superior vena cava obstruction. In contrast to the patients with superior vena cava obstruction at presentation, this group was composed predominantly of patients with recurrent solid tumors. Other causes included disseminated candidiasis and superior vena cava thrombosis, thus underscoring the importance of recognizing the etiology of superior vena cava syndrome to facilitate proper treatment.
Non‐randomised study comparing toxicity of escherichia coli and erwinia asparaginase in children with leukaemia
Authors: Eden O. B. , Shaw M. P. , Lilleyman J. S. , Richards S. 
Published: February 2007

AbstractSeven hundred fifty‐eight unselected children entered into the United Kingdom Medical Research Council acute lymphoblastic leukaemia UKALL VIII Study and Trial were studied for differences in early treatment‐related toxicity according to the type of intramuscular L‐asparaginase received.Two hundred seventy‐five received a product obtained from Escherichia coli and 483 the enzyme from Erwinia chrysanthemi. The E. coli patients had a significantly higher incidence of neurotoxicity, pancreatitis, and life‐threatening sepsis (4%, 2%, and 20%, respectively) when compared with the Erwinia group (2%, 0%, and 18%). Severe hypersensitivity was seen in one patient from both groups and the incidence of glucose intolerance was not significantly different. These findings indicate that E. coli asparaginase may be more toxic. With a minimum follow up of 41/2 years there is no evidence that either product has made a significantly different contribution to disease‐free survival.
Treatment patterns in low‐grade non‐Hodgkin's lymphomas: A single institution study
Authors: Liesveld Jane L. , Raubertas Richard F. , Bennett John M. 
Published: February 2007

AbstractNinety‐two cases of low‐grade non‐Hodgkin's lymphoma were examined retrospectively to assess to what extent treatment deferral is practiced at a single university hospital with a local referral base. Clinical characteristics of this patient group were also analyzed; 70% of these cases were of nodular lymphocytic, poorly differentiated (NLPD) histology, and 74% were stage III or IV. Twenty‐two cases were not treated initially. Nine eventually required treatment at a median of 16 months. Survival did not differ based on whether treatment was initially deferred. Nodal progression was the most common reason for beginning treatment after initial deferral, and most cases of advanced stage disease required treatment because of nodal involvement or B‐type symptoms at diagnosis. Presence of intra‐abdominal adenopathy often prompted initial treatment even in asymptomatic cases. In this series, as compared to previously reported series of treatment‐deferred cases, more patients were judged to require treatment at disease outset, and the median time to treatment in those in whom treatment was initially deferred but then instituted was shorter. Despite this, for the entire population, 69% of total follow‐up time was spent off therapy.
A child with esthesioneuroblastoma with metastases to the spinal cord and the bone marrow
Authors: Perkkiö Mikko , Majuri Salme , Hänninen Auli , Paljärvi Leo 
Published: February 2007

AbstractEsthesioneuroblastoma is a rare tumor in children, and the correct diagnosis may be difficult, as is demonstrated in this case report. A 5‐year‐old girl was diagnosed with this tumor, which was incurable and behaved like a neuroblastoma, sending metastases to the bone marrow and invading the cranium and the spinal canal.
An exploratory study of environmental and medical factors potentially related to childhood cancer
Authors: Schwartzbaum Judith A. , George Stephen L. , Pratt Charles B. , Davis Bertha 
Published: February 2007

AbstractTo determine whether a general‐purpose epidemiologic questionnaire can be used in childhood cancer hospitals to identify associations between environmental factors and the major types of childhood cancer, we report the results of the analysis of the data obtained from such a questionnaire. On admission to St. Jude Children's Research Hospital in Memphis, Tennessee, between 1979 and 1986 a questionnaire was administered to 1,270 mothers of patients diagnosed with childhood cancer. Approximately onehalf of the children had acute leukemias (n = 629); the remainder had lymphomas (n = 237) or solid tumors (n = 404). Responses to questions regarding the patients' and parents' environmental and medical histories were compared across nine diagnostic categories. Only 5 of 232 variables remained nominally statistically significant (P < 0.05) after adjusting for confounding by patient or maternal age, year of birth or diagnosis, patient's race, and social class. The variables identified were length of time the patient was breast‐fed (χ2 = 16.1, P = 0.04); having a garden with fertilizers, herbicides, and pesticides (χ2 = 17.2, P = 0.03); maternal use of sex hormones during the year before the patient's birth (χ2 = 18.2, P = 0.02); maternal cigarette consumption (χ2 = 18.0, P = 0.02); and patient contact with persons with cancer (χ2 = 20.7, P = 0.01). Despite the large number of patients studied, we identified fewer significant variables than would be expected, on the average, under the null hypothesis. We conclude that the data obtained from a general‐purpose epidemiologic questionnaire do not provide a useful overview of the association between exposure to environmental factors and several types of childhood cancer.
Hepatocellular carcinoma with central nervous system metastasis: A case report and literature review
Authors: Friedman Henry Dan 
Published: February 2007

AbstractIn the United States and western Europe, hepatocellular carcinoma is not generally regarded as a distantly metastasizing tumor. The ability of hepatocellular carcinoma to metastasize to the brain is illustrated by the example of a 65‐year‐old white American man with no identifiable risk factors for primary liver cancer. Though hepatocellular carcinoma rarely metastasizes to the central nervous sytem, such metastases are reported to have led to tumor diagnosis or signaled tumor relapse.
Concept of maximum tolerated systemic exposure and its application to phase I‐II studies of anticancer drugs
Authors: Evans William E. , Rodman John H. , Relling Mary V. , Crom William R. , Rivera Gaston K. , Pratt Charles B. , Crist William M. 
Published: February 2007

AbstractThe traditional approach to conducting Phase I studies of anticancer drugs is to select a starting dosage for humans based on preclinical data (e.g., mg equivalent of 1/10 LD10 in mice), then empirically escalate dosages in cohorts of patients until the maximum tolerated dosage (MTD) is established. More recently, NCI and EORTC investigators have advocated the use of pharmacokinetic data from preclinical studies to facilitate more rapid dose escalation (e.g., double the dose until the area under the concentration‐time curve [AUC] in humans equals the AUC in mice at the LD10). The present paper describes a strategy which builds on the above approach, by extending the application of pharmacokinetic principles to systematically escalate systemic exposure (AUC) instead of dosage in Phase I trials. Human trials are initiated at whatever patient‐specific dosage is required to achieve an AUC equal to 1/10 the AUC in mice at the LD10, such that three patients at the first treatment level might receive three different dosages. If no dose‐limiting toxicity is observed, the next cohort of patients receives whatever dosage is required to achieve 2x AUC of the first dosage level, with AUC escalation continuing until the maximum tolerate systemic exposure (MTSE) is reached. By escalating systemic exposure instead of dosage, one adjusts for interpatient pharmacokinetic variability. This strategy will permit more rapid and precise dosage escalations and, more importantly, it should more precisely establish the maximum level of treatment intensity for future Phase II trials.
Natural killer cell function in children with malignant solid neoplasias
Authors: Gallego‐Melcón Soledad , Boren Teresa Español , de Toledo Jose Sanchez , Viñas Jorge Prats 
Published: February 2007

AbstractNatural killer (NK) cell numbers and lytic activity were determined in 40 children with various types of solid malignant neoplasias and in 25 control children by NKH‐1 monoclonal antibody and cytotoxicity against K562 target cells, respectively. Patients were analyzed at the time of diagnosis before initiation of therapy and followed over a median time of 15.8 months. Mean NK cell numbers and lytic activity were similar among different types of tumor analyzed. Patients with localized disease (stages I, II; n = 25) also showed values not statistically different from those of patients in advanced disease (stages III, IV; n = 15). According to their response to therapy, patients were divided into three groups: group 1 (complete remission; n = 28), group 2 (partial remission; n = 5), and group 3 (progression of disease; n = 6). Patients in group 3 showed at the time of diagnosis a mean NK activity significantly lower than that of patients in groups 1 and 2 and control children (P = 0.007). The defect in NK cell lytic capacity in vitro observed in patients with progressive disease suggests that NK cells play a role in the control of neoplasic growth in vivo and may imply that some children with refractory progressive disease can benefit from immu‐nomodulation destined to improve the lytic potential of NK cells.
The conduct of phase I‐II clinical trials in children with cancer
Authors: Pratt Charles B. 
Published: February 2007

AbstractPhase 1 Clinical Trials in children with cancer are carried out with therapeutic intent, so as to define antileukemic/antitumor activity, dose‐limiting toxicity, maximum tolerated dosage, and pharmacokinetics. These studies define a dosage of an agent or combination that may be used in a larger study of pediatric patients with leukemias or malignant solid tumors. The content of phase I and II protocols is outlined, with a brief discussion of the ethics of performance of phase 1 trials in children.
Reproduction following treatment for childhood leukemia: A population‐based prospective cohort study of fertility and offspring
Authors: Nygaard Randi , Clausen Niels , Siimes Martti A. , Márky Ildikó , Skjeldestad Finn Egil , Kristinsson Jon R. , Vuoristo Aira , Wegelius Ruth , Moe Peter Johan 
Published: February 2007

AbstractOf all children diagnosed with leukemia in Denmark, Finland, Iceland, Norway, and Sweden, 981 had discontinued therapy before 1985 and had been followed up annually after cessation of therapy. Progeny was registered and fertility evaluated among survivors who passed age 18 years without a relapse (n = 299).By April 1989, 48 offspring were registered, one of whom had congenital anomalies. This was no more than expected from the incidence of birth defects in the general population. No childhood malignancies or genetic diseases have so far been diagnosed in the progeny, in the study group, none of the 19 female and 8 male survivors of myeloid leukemias had become parents, and only 4 fathers were reported among the 131 male survivors of acute lymphoblastic leukemia (ALL). However, 23 of the 149 females treated for ALL had delivered 41 children. Fertility was measured as cumulative rates of first birth by maternal age. In a Cox regression analysis, cases who had received prophylactic radiation of the central nervous system (CNS) had a lower first birth rate than those without radiation (rate ratio 0.39, 95% CI 0.15–1.00), indicating that doses of 18–24 Gy to the brain may possibly be a risk factor. By using the Norwegian birth cohort of 1966 as a control group, matching the median year of birth for the study subjects, the group of female ALL survivors as a whole was as likely as the general female population to have given birth up to the age of 23.The first generation of females successfully treated for childhood ALL seems to have a nearly normal reproductive pattern during young adulthood, without increased risk of congenital anomalies in the offspring. However, cranial radiation as CNS prophy laxis may possibly impair subsequent reproduction.
Intraoperative radiotherapy in the multidisciplinary treatment of bone sarcomas in children and adolescents
Authors: Calvo Felipe A. , de Urbina David Ortiz , Sierrasesúmaga Luis , Abuchaibe Oscar , Azinovic Ignacio , Antillon Federico , Santos Manuel , Canadell José 
Published: February 2007

AbstractFrom September 1984 to December 1989, 38 patients of pediatric age with localized bone sarcomas received intraoperative radiotherapy (IORT) as part of a multidisci plinary treatment program. The age ranged from 6 to 21 years. The tumor histologies were 22 osteosarcomas and 16 Ewing's sarcomas.Thirty‐four had initial primary disease (90%) and 4 were treated for local recurrence (10%). IORT was used on 32 untreated patients and in 6 previously treated with external beam radiotherapy (EBR). The IORT field included the surgically exposed tumor bed area. Single radiation doses ranging from 10 to 20 Gy were delivered, using 6–20 MeV electron beams. The median follow‐up time for the entire group is 25 months (2–65+ months). The projected 5‐year disease‐free and overall survival rates are 65% and 69%, respectively. One patient developed a local recurrence in each histological group: one chondroblastic osteosarcoma and one cervical Ewing's sarcoma. Six patients died from metastatic progression: 3 initially recurrent tumors and three primary disease cases. Severe neuropathy and soft tissue necrosis were seen in some patients as IORT related complications.IORT is a feasible technique to be integrated in multidisciplinary programs that may promote local control in pediatric and adolescent patients with bone sarcomas. Peripheral nerves are dose‐limiting tissue structures for IORT.
Late effects of therapy in adult survivors of osteosarcoma and Ewing's sarcoma
Authors: Nicholson H. Stacy , Mulvihill John J. , Byrne Julianne 
Published: February 2007

AbstractTo study the late consequences of primary bone cancer, we interviewed 82 osteosarcoma and 29 Ewing's sarcoma survivors regarding their health, fertility and offspring, employment, annual income, and activities of daily living. All subjects had been diagnosed before age 20 (mean age, 14.6 years), had survived at least 5 years from diagnosis, and were at least 21 years of age. On average, they were 32.5 years of age at interview. As controls, 151 siblings were interviewed.During the follow‐up period, eight survivors had died, and eight survivors had been diagnosed with a second malignancy (7.2%;P= .002). No other health condition distinguished survivors from controls. Although the survivors were more likely than controls to have some difficulty climbing stairs and to have had employment disability, employment status and annual income at follow‐up were similar. Deficits in marriage and fertility were not significant.Adult survivors of primary bone tumors diagnosed during childhood or adolescence are at high risk for second malignancies and premature death, making continued medical follow‐up of utmost importance. Despite the physical impairment following limb amputation for many, the majority of outcomes we measured did not differ from controls, suggesting few adverse psychosocial outcomes in this group of cancer survivors.
Surgical complications in acute leukemia in childhood: A 20 year experience
Authors: Rice Michael S. , Cord‐Udy Catherine , Little Kenneth E. T. , Toogood Ian R. G. 
Published: February 2007

AbstractA retrospective study of all patients presenting with acute leukemia to a single institution during the period 1968–1988 was undertaken to determine the type and incidence of surgical complications. One hundred twenty‐eight of 296 patients were identified as requiring a surgical consultation for complications occurring during the course of the disease and many surgical disciplines were involved. Operative intervention was often required for these complications. Pediatric surgical specialists need to be aware of the range of surgical complications that can occur in children with acute leukemia and they must work in close co‐operation with pediatric medical oncologists to ensure optimal treatment for all patients.
Humoral hypercalcemia in seminomas
Authors: da Silva Marco A. P. , Edmondson James W. , Eby Charles , Loehrer Patrick J. 
Published: February 2007

AbstractSeminomas are germ cell tumors that are rarely associated with hypercalcemia. In this report, four cases of seminoma with concomitant hypercalcemia are presented and another three from the literature are reviewed. All seven patients exhibited hypercalcemia with a normal serum concentration of inorganic phosphorus and no evidence of skeletal metastases. The peripheral venous level of parathyroid hormone (PTH) was normal in four of the five patients in whom it was measured. The serum concentration of calcitriol was elevated in the two patients in whom it was measured. After systemic chemotherapy, the serum “corrected” total calcium concentration returned to normal and remained normal; the decrease in the levels temporally paralleled the decrease in tumor volume. Both patients with elevated calcitriol levels remained eucalcemic after treatment of the malignancy, suggesting that the increased serum calcitriol level was linked to the development of hypercalcemia as this humoral agent was inappropriately elevated by patients with this syndrome. In contrast to many forms of malignancy, the development of hypercalcemia did not adversely affect the prognosis of the patients with seminoma, since all seven patients entered complete remission. Hypercalcemia appears to be a heretofore unrecognized paraneoplastic syndrome associated with seminoma.