bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical trials in cancer therapy: Efforts to improve patient enrollment by community oncologists
Authors: Fisher William B. , Cohen Stuart J. , Hammond Monica K. , Turner Sandra , Loehrer Patrick J. 
Published: February 2007

AbstractA prerequisite for the completion of a clinical trial is the accrual of adequate numbers of patients. It is estimated that over 90–95% of all cancer patients are now treated in their local communities by practicing oncologists and are not seen by primary investigators at teaching hospitals. One risk of this trend is decreased patient enrollment into clinical trials. The private practitioner often lacks the academic oncologist's incentives to participate in clinical research. The Hoosier Oncology Group (HOG) is composed of community medical and radiation oncologists (85%) and Indiana University faculty members (15%). In an effort to improve patient enrollment onto clinical cancer research trials, HOG has attempted to identify 1) the major obstacles to patient enrollment by community oncologists and 2) potential aids to overcome such obstacles. One hundred fourteen members were surveyed and 75 responded (66%). The major obstacles were, in descending order: time demands on both the oncologist and his staff; explaining clinical trials to patients; completing flow sheets; perceived increased cost to the patient; remembering protocols; adhering to a rigid protocol. Aids identified as potentially most helpful were, in descending order: pocket‐sized synopses of protocols; computer generated, individualized prompts; the availability of a clinical trials specialist to explain the clinical trial to patients and assist in obtaining informed consent; the availability of a video tape which could be used to explain clinical trials to patients. These aids are being implemented with the attempt to systemically study their impact on patient accrual.
Acute fatal myeloencephalopathy after combined intrathecal chemotherapy in a child with acute lymphoblastic leukemia
Authors: von der Weid Nicholas X. , de Crousaz Henriette , Beck Daniel , Deonna Thierry , Miklossy J. , Janzer R. C. 
Published: February 2007

AbstractWe report a case of a fatal toxic encephalomyelopathy in a 12‐year‐old girl due to prophylactic intrathecal injection of methotrexate and cytosine arabinoside, with a characteristic progressive symptomatology leading to death after 28 days. The location and type of neuropathological changes support the hypothesis of a direct toxic effect of methotrexate and/or cytosine arabinoside on structures directly exposed to the cerebrospinal fluid.
Primary subconjunctival lymphoma: An unusual presentation of childhood non‐Hodgkin's lymphoma
Authors: Karadeniz Ceyda , Bilgiç Sevgül , Ruacan Sevket , Sarialioǧlu Faik , Büyükpamukçu Münevver , Akyüz Canan , Doǧan Ahmet 
Published: February 2007

AbstractOf 806 non‐Hodgkin's lymphoma cases, only one primary subconjunctival lymphoma case was observed in Hacettepe Children's Hospital over a period of 16 years. The patient was a 12 year‐old‐boy with a subconjunctival mass on the upper part of his right eye. Biopsy revealed malignant lymphoma. Extensive investigations disclosed no other site of tumor. He was given the modified LSA2‐L2 protocol. He has been in remission for 22 months. This may be the first report of a primary subconjunctival lymphoma in the childhood period.
Association of delivered drug dose and outcome for children with acute lymphoblastic leukemia and unfavorable presenting features
Authors: Gaynon Paul S. , Steinherz Peter G. , Bleyer W. Archie , Finklestein Jerry Z. , Miller Denis R. , Reaman Gregory H. , Sather Harland N. , Hammond G. Denman 
Published: February 2007

AbstractDose and dose intensity are believed critical for attaining a maximal therapeutic effect in drug‐responsive tumor systems. Childhood acute lymphoblastic leukemia may be an example of such a drug‐responsive system as it is cured with current chemotherapy in a majority of cases. Between August 1981 and May 1983, the Childrens Cancer Study Group enrolled 209 children with ALL and unfavorable presenting features on CCG‐193P, a trial based on the Berlin Frankfurt Munster 76/79 regimen. The cumulative delivered dose of each medication was recorded prospectively. Patients who completed the intensive portion of therapy in continuous complete remission were ranked by the percentage of protocol required drug delivered from the initiation of therapy to that date. No association was found between delivery of any single drug and subsequent disease‐free survival. However, when patients were ranked by the sum of the percentages of protocol vincristine, l‐asparaginase, and anthracycline delivered, children in the approximate middle and lower tertiles were 3 and 5 times more likely to have had a subsequent relapse than were those in the upper tertile (P =0.025, test for trend). Delivery of the full protocol prescribed dose of these agents may have been critical, but corroboration is certainly needed. Only prospective trials can determine if children with acute lymphoblastic leukemia and unfavorable presenting features might benefit from greater use of vincristine, l‐asparaginase, and/or anthracycline.
Analysis of N‐ras gene mutations in medulloblastomas by polymerase chain reaction and oligonucleotide probes in formalin‐fixed, paraffin‐embedded tissues
Authors: Iolascon Achille , Lania Arturo , Badiali Manuela , Pession Annalisa , Saglio Giuseppe , Giangaspero Felice , del Giudice Emanuele Miraglia , Perrotta Silverio , Cutillo Stefano 
Published: February 2007

AbstractPrecise data on the incidence of transforming ras oncogenes in pediatric tumors and the correlations with the histopathological properties of the tumors are very limited. Additionally the presence of ras activation in medulloblastomas has not been investigated so far. Using a combination of techniques including in vitro gene amplification by polymerase chain reaction (PCR) and detection of single base mutations by sequence‐specific oligonucleotides we studied N‐ras activation (mutations at codon 12, 13, and 61) in 32 medulloblastomas. DNA was isolated from 20 μm sections of formalin‐fixed paraffin‐embedded tissue. Mutations were found in 3 out of 32 examined medulloblastomas. In all cases only mutations of codon 61 were found: two of three mutations were C to A mutations at position 1 of the codon 61 (leading to a substitution of a glutamine residue for a lysine) and one was A to T mutation at position 3 in the same codon (glutamine‐histidine). Our results indicate 10% incidence N‐ras mutation in medulloblastoma, higher than in other CNS tumors studied so far. The main advantages of the procedure described are its greatly improved sensitivity, the increased speed with which tumor samples can be analyzed, and the possibility of using paraffin‐embedded sections to analyze various rare tumors in retrospect.
EBV genome and immunoglobulin gene rearrangement in the differential diagnosis of nasopharyngeal carcinoma and lymphoma
Authors: Vonsover Ami , Rechavi Gideon , Kesler Alexander , Rapaport Yoram , Brok‐Simoni Frida , Mileguir Fernando , Ramot Bracha , Gotlieb‐Stematsky Tamar 
Published: February 2007

AbstractHead and neck tumors include nasopharyngeal carcinoma (NPC) and lymphoma. The differential diagnosis of these tumors is based on histology, immunocytochemical staining, and EBV serology. In rare cases it might be difficult to distinguish between NPC and lymphoma in HE section or biopsies. DNA hybridization with cloned EBV and human Immunoglobulin gene fragments allows the detection of EBV‐related sequences and immunoglobulin gene rearrangements. The presence of EBV genome supports the diagnosis of NPC or EBV related BL, while rearrangement of immunoglobulin genes points to B‐cell lymphoma.The diagnosis in 11 patients suspected of head and neck tumors was carried out by hybridization of DNA extracted from the tumors and assayed with cloned EBV and IgHCJ DNA probes.One patient proved to have EBV‐associated BL based on positive hybridization with EBV probes and immunoglobulin rearrangement, presenting a unique hybridization with cloned EBV DNA BamHI W fragment, with bands of 3.2 and 3.9 kb. BL was confirmed in this patient by demonstration of c‐myc rearrangement. A second patient was negative in hybridization with EBV, and positive for immunoglobulin rearrangement, and therefore was diagnosed as having B‐cell lymphoma. In seven patients NPC was confirmed by hybridization with EBV‐DNA probes. In two patients, both NPC and B‐cell lymphomas were excluded.
A longitudinal study of growth and growth hormone secretion in children during treatment for acute lymphoblastic leukemia
Authors: Màrky Idikó , Mellander Lotta , Lannering Birgitta , Albertsson‐Wikland Kerstin 
Published: February 2007

AbstractDiminished growth rate during treatment for acute lymphoblastic leukemia (ALL) is of the multifactorial etiology. Effects on GH secretion have been shown after discontinuation of treatment including prophylactic CNS irradiation. Seventeen children treated for ALL with three different CNS preventive schedules were followed longitudinally with repeated estimations of the spontaneous GH secretion during a 24‐month period. No difference was found in GH secretion during this time between patients who had received no radiotherapy and those who had received 18 or 24 Gy as CNS prophylaxis. During dexamethasone treatment the GH secretion was completely suppressed, which can be a mediator for the diminished growth rate during the first 2 years of ALL treatment. We conclude that there is no clinical reason to perform GH analysis within the first 24 months of treatment for ALL.
A phase I trial of α‐interferon in combination with pentostatin in hematologic malignancies
Authors: Bernard Stephen , Gill Parkash , Rosen Peter , Gavigan Molly , Steagall Ann , Ellingham Elizabeth , Morgan Tim , Janic Gracie , Ozer Howard 
Published: February 2007

AbstractPentostatin, a novel inhibitor of adenosine deaminase, has shown activity in various lymphoid malignancies of both the T and B cell lineage. This agent has unique side effects and in general myelosuppression has been mild. Interferon has both antiviral and antineoplastic properties. This agent has shown activity in hairy cell leukemia, chronic granulocytic leukemia, low grade lymphoma, and myeloma. Side effects from interferon are in general dissimilar to those that have been seen with pentostatin and in particular myelosuppression has not been a major toxicity with low doses of interferon. This current trial explored the combination of pentostatin and interferon in hematologic malignancies. Fifteen patients were enrolled in this phase I trial at a fixed dose of pentostatin of 4 mg/m2 biweekly and interferon at doses of 0.5, 1, 2, or 4 million units/m2 of interferon. At the first three dose levels of interferon nausea and vomiting were the predominant toxicity and appeared to worsen with time on study. Fatigue also was seen at the lowest level of interferon and was severe enough to cause two individuals to discontinue the study medications. At higher dose levels of interferon, myelosuppression, nausea and vomiting, and fatigue were the predominant toxicities. One patient with hairy cell leukemia had a complete response and a second patient with T cell cutaneous lymphoma had a partial response which lasted for 6 to 7 weeks. The maximum tolerated dose of interferon with pentostatin in this patient population was four million units/m2.
Etoposide in the treatment of six children with langerhans cell histiocytosis (histiocytosis X)
Authors: Viana Marcos Borato , Oliveira Benigna Maria , Silva Celia Maria , Leite Virginia Hora Rios 
Published: February 2007

AbstractSix children received etoposide as the single agent for treatment of Langerhans cell histiocytosis (LCH; histiocytosis X). Five were less than 2 years old at diagnosis. All had multiorgan involvement; one had liver and pulmonary dysfunction. Two infants also had clinical signs of immune deficiency. Complete response was observed in five. There was no major toxicity. Although three of four evaluable patients relapsed, the drug was considered useful in moving the children from a symptomatic to an asymptomatic clinical status. Etoposide may become a “first‐line” drug in the treatment of systemic LCH, especially when the side effects of steroid therapy are considered unacceptable.
Neuroblastoma stage IV‐S: A heterogeneous disease
Authors: Wilson Peter C. G. , Coppes Max J. , Solh Hassan , Chan Helen S. L. , Jenkin Derek , Greenberg Mark L. , Weitzman Sheila 
Published: February 2007

AbstractEighteen patients were diagnosed and treated for Stage IV‐S neuroblastoma at The Hospital for Sick Children, Toronto between January 1971 and December 1988. All patients were 6 months of age or younger at diagnosis. Nine patients (50%) have remained disease free with a mean follow‐up of 9.3 years. Of the seven patients under 6 weeks of age at presentation, four presented in the early neonatal period and died, three due to mechanical complications related to progressive disease, and one due to late recurrence. The remaining three patients under 6 weeks of age, two of whom had skin involvement at diagnosis, are alive and disease free. Six of the 11 patients over 6 weeks of age at presentation survived, combined modality therapy (CMT) being more effective than single modality treatment. N‐myc was studied from tumor tissue at diagnosis in four patients and was amplified in three (25x, 25x, 100x), all of whom had late disease progression and died. The patient with a single gene copy has no evidence of disease 24 months following diagnosis. Our study confirms the heterogeneity described in this clinically defined group of patients. Because of it, management of Stage IV‐S neuroblastoma cannot be uniform and until further development of a subclassification, or a reclassification based on molecular biologic markers is developed, pediatric oncologists will regularly be confronted with a decision whether or not to treat a newly presenting patient that fits into the clinical classification IV‐S.
Intellectual function in long‐term survivors of childhood acute lymphoblastic leukemia: Protective effect of pre‐irradiation methotrexate a childrens cancer study group study
Authors: Balsom William R. , Bleyer W. Archie , Robison Leslie L. , Heyn Ruth M. , Meadows Anna T. , Sitarz Anneliese , Blatt Julie , Sather Harland N. , Hammond G. Denman 
Published: February 2007

AbstractHaving demonstrated in a laboratory model that the neurotoxicity of CNS irradiation can be ameliorated with pre‐irradiation methotrexate, we retrospectively compared two methods of CNS prophylaxis in childhood acute lymphoblastic leukemia which differed only in the timing of intrathecal methotrexate and radiotherapy. The results of standard IQ tests conducted 2–11 years after 24 Gy of cranial radiotherapy were obtained in 72 patients, of whom 27 had pre‐irradiation methotrexate and 45 did not (control group). The two groups were otherwise comparable. In girls, the full‐, performance‐, and verbal‐scale IQ scores were consistently higher in the pre‐irradiation methotrexate group than in the corresponding control group (P<0.025). Among girls <5 years of age when irradiated, the mean IQ scores were 25–29 points higher after pre‐irradiation methotrexate than after the control treatment (P<0.0007). These results suggest that pre‐irradiation methotrexate may help prevent CNS radiotoxicity in children, and that the benefit is dependent on patient age and gender.
Malignant thymoma associated with peripheral T‐cell lymphocytosis
Authors: Doll Donald C. , Landreneau Rodney J. , List Alan F. 
Published: February 2007

AbstractThree cases of peripheral T‐cell lympho‐cytosis associated with thymoma are described. Each patient had a malignant, predominantly lymphocytic thymoma with resolution of lymphocytosis upon treatment of the epithelial neoplasm. These findings suggest that lymphocytosis complicating thymoma is a paraneoplastic phenomenon and is not part of the neoplastic process.
Complications associated with indwelling catheters
Authors: Simmons Jeané R. , Buzdar Aman U. , Ota David M. , Marts Kathy , Hortobagyi Gabriel N. 
Published: February 2007

AbstractBetween 1983 and 1985, 170 consecutive patients received doxorubicin‐containing adjuvant chemotherapy through central venous catheters, and four via a long indwelling catheter in the antecubital fossa. The objective of this retrospective study is to determine the acute and chronic complications associated with indwelling catheters. Ninety‐four (56%) patients did not experience any complications. The incidence of acute complications was 2%, which included three pneumothorax. Twenty‐nine (17%) patients experienced chronic complications. Of those, 20 (12%) developed infectious complications, and 9 (19%) developed thrombus. In addition, 12 (7%) developed multiple complications, and 32 (19%) patients had other local complications at the catheter site, which included allergic reactions and catheter breakage. Each of these complications was resolved with appropriate treatment. None of the patients died from complications of the indwelling catheter.
Bone marrow necrosis and thrombotic complications in childhood acute lymphoblastic leukemia
Authors: Eguiguren José M. , Pui Ching‐Hon 
Published: February 2007

AbstractTwo children with bone marrow necrosis at diagnosis or at relapse of acute lymphoblastic leukemia (ALL) had thrombotic complications 15 and 17 days after starting remission induction therapy including prednisone, vincristine, and L‐asparaginase. The close temporal relationship of these two relatively rare events suggests that bone marrow necrosis is a predisposing factor to the development of thrombosis.
Isolated central nervous system relapse of testicular cancer
Authors: Perry James J. , Jelinek James S. 
Published: February 2007

AbstractCentral nervous system involvement with testicular cancer usually occurs with advanced systemic disease. Isolated CNS disease at relapse is rare. We report a patient who developed a solitary brain metastasis with no other systemic disease after having achieved a complete response to frontline therapy. After combined modality therapy for the CNS disease, the patient has remained disease‐free for more than 3 years. The literature regarding brain metastases in relapsed testicular cancer is reviewed, including nine cases of isolated brain metastases. The CNS can be a “sanctuary” site for testicular cancer, and in the unusual subset of patients with isolated brain relapse, long‐term remission is possible with aggressive therapy.
Secondary acute non‐lymphoblastic leukemia in two children following treatment with a cis‐diamminedichloroplatinum‐II‐based regimen for osteosarcoma
Authors: Jeha Sima , Jaffe Norman , Robertson Resa 
Published: February 2007

AbstractAcute nonlymphocytic leukemia (ANLL) developed in 2 of 142 pediatric patients with osteosarcoma treated with a cis‐diamminedichloroplatinum‐II (CDP)‐based regimen: acute monomyelogenous leukemia (M4) with a normal female karyotype in one and acute myelogenous leukemia (M2) with t (8,21) in the other. The ANLLs occurred, respectively, in each patient 3 and 4 years after the initial diagnosis of osteosarcoma. In contrast to most of the adult experience and consistent with the majority of reported ANLL in children, the disease was characterized by an absence of the smoldering phase and cytogenetic findings similar to those seen in de novo ANLL.
Determination of the maximum tolerated dose of idarubicin when used in a combination chemotherapy program of reinduction of childhood ALL at first marrow relapse and a preliminary assessment of toxicity compared to that of daunorubicin: A report from the childrens cancer study group
Authors: Feig Stephen A. , Krailo Mark D. , Harris Richard E. , Baum Edward , Holcenberg John S. , Kaizer Herbert , Steinherz Laurel , Pendergrass Thomas W. , Saunders E. Frederick , Warkentin Phyllis L. , Bleyer W. Archie , Hammond G. Denman 
Published: February 2007

AbstractAn escalating‐dose trial of idarubicin, used weekly for 3 doses in combination with vincristine, prednisone, and L‐asparaginase (VPLI), to reinduce remission of childhood ALL at first bone marrow relapse was conducted by the Childrens Cancer Study Group (CCSG). The maximum tolerated dose (MTD) of idarubicin, used in the manner, was determined to be 12.5 mg/m2/dose. Twelve of 16 (75%) evaluable patients in first marrow relapse of ALL treated at a dose of 10 or 12.5 mg/m2 entered a second complete remission, compared to 41 of 69 evaluable patients (59%) treated in a comparable way with daunorubicin (30 mg/m2) (VPLD). Prolonged myelosuppression was observed in both groups, but the frequency of documented bacterial sepsis and the duration of required hospitalization were greater among patients treated with idarubicin. No additional toxicity, specifically attributable to idarubicin, was observed at these doses.
Children with cancer: Special considerations in the discontinuation of life‐sustaining treatment
Authors: Freyer David R. 
Published: February 2007

AbstractEvery year in the United States, over 2,100 children die of progressive cancer, or of complications related to the disease or its treatment. Physicians, other clinicians, and parents caring for these children are often faced with decisions about the continuation or termination of life‐sustaining treatment (LST). In adults, a consensus has emerged which holds that LST may be ethically discontinued if the burdens of continued treatment outweigh its benefits for the patient. While this standard is also applicable to LST decisions in pediatric oncology, its appropriate use must address several medical and ethical issues characteristic of children with cancer. These special considerations, which are the subject of this discussion, include the extensive medical experience of children with cancer, the nature of modern oncology treatment, the unpredictable patterns of response to treatment, the parent and/or physician biases which may threaten the child's well‐being, the distinction between being incurably ill and imminently dying, the need for effective palliative care, and the variable levels of cognitive and emotional development which determine a child's capacity for participating in an LST decision. Consideration of these factors facilitates a consistent approach to these difficult decisions which is both compatible with current ethical guidelines and responsive to the particular needs of these patients.
Benign cystic mesothelioma of the peritoneum: The occurrence of an adult entity in a child
Authors: Hanukoglu Aaron , Gewurtz Gabriella , Zaidel Liliana , Krispin Mayer , Fried Daniel 
Published: February 2007

AbstractBenign cystic mesothelioma of the peritoneum is considered a disease of adulthood occurring predominantly in women. We report a case of benign cystic mesothelioma of the peritoneum in an 11‐year‐old boy. The innumerable cystic lesions that varied in size occupied the entire peritoneal cavity. He underwent two laparotomies in a period of 15 months during which a partial removal of the tumor was performed. Four years after the second operation the child is well and active, despite significant tumor tissue left behind after the first two operations. The management of this disease is discussed, and the importance of a conservative approach minimizing the number of laparotomies and avoiding radical surgical intervention especially in childhood is emphasized.