Asunto(s)
Antineoplásicos/toxicidad , Neoplasias Encefálicas/tratamiento farmacológico , Sesquiterpenos/toxicidad , Tricotecenos/toxicidad , Adulto , Astrocitoma/tratamiento farmacológico , Neoplasias Cerebelosas/tratamiento farmacológico , Evaluación de Medicamentos , Femenino , Humanos , Masculino , Meduloblastoma/tratamiento farmacológico , Persona de Mediana Edad , Oligodendroglioma/tratamiento farmacológico , Tricotecenos/uso terapéuticoRESUMEN
One-hundred-two patients with Stage III and IV malignant melanoma were analyzed to determine whether immunologic status in terms of skin testing along with sex and age played a role in recurrence and survival. Before treatment, patients had skin tests with five recall antigens (monilia, mumps, PPD, SK-SD, trichophyton) along with phytohemagglutinin (PHA). Univariate statistical analysis revealed sex as the major significant variable with respect to survival for Stage IVB patients, with female patients surviving longer than males. Patients with resected disease and greater SK-SD skin test reactivity tended to survive longer than those with impaired reactivity. Similarly, reactivity to trichophyton was associated with improved survival among patients with metastases. A multivariate analysis of the patients shows improved remission duration with mumps positivity in Stage III and Stage IVA patients. It appears that certain skin tets analyzed in this fashion have prognostic importance in these patients and should be analyzed with other variables of disease status.
Asunto(s)
Melanoma/inmunología , Neoplasias Cutáneas/inmunología , Antígenos/análisis , Femenino , Estudios de Seguimiento , Humanos , Masculino , Melanoma/patología , Persona de Mediana Edad , Recurrencia Local de Neoplasia , Estadificación de Neoplasias , Pronóstico , Neoplasias Cutáneas/patología , Pruebas CutáneasRESUMEN
A new marker chromosome, deletion 11q23, was observed with the Giemsa banding technique in the bone marrow of a patient with idiopathic sideroblastic anemia. The abnormality was not detectable in the peripheral blood or with nonbanded chromosome studies. Nineteen of 40 cases of this disorder studied and reported to date had chromosomal aberrations, although the majority had only nonbanded karyotypes performed. This apparently high incidence of chromosomal defects and the finding in the present case indicate that more banded-karyotype analyses are needed to assess the presence of possible nonrandom cytogenetic changes in idiopathic sideroblastic anemia.
Asunto(s)
Anemia Sideroblástica/complicaciones , Aberraciones Cromosómicas/etiología , Cromosomas Humanos 6-12 y X , Trastornos de los Cromosomas , Humanos , Cariotipificación , Activación de Linfocitos , Masculino , Persona de Mediana Edad , Fitohemaglutininas/farmacologíaRESUMEN
A 29-year-old white male with an extraosseous osteogenic sarcoma is reported. He first noted a nodule at the site of eventual tumor development some eight years previously, following an intramuscular penicillin injection. Treatment consisted of wide surgical excision and radiation therapy, and he remains healthy some 8 months later. To our knowledge this represents the first case of extraosseous osteogenic sarcoma occurring at the site of a previous intramuscular injection.
Asunto(s)
Inyecciones Intramusculares/efectos adversos , Osteosarcoma/etiología , Penicilinas/efectos adversos , Neoplasias de los Tejidos Blandos/etiología , Adulto , Nalgas , Humanos , Masculino , Osteosarcoma/terapia , Penicilinas/administración & dosificación , Neoplasias de los Tejidos Blandos/terapia , MusloRESUMEN
Cytogenetic abnormalities have been found in approximately 50% of all patients with acute leukemia. Although no chromosomal abnormalities have been found which are characteristic of a specific cell type, patients with AML and DiGuglielmo's syndrome more frequently have hypodiploid chromosome numbers, while patients with ALL seldom have hypodiploid numbers of chromosomes and may actually exhibit an extreme degree of hyperdiploidy in the leukemic cells. Chromosome analysis may be helpful in characterizing patients with preleukemia and DiGuglielmo's syndrome, and aneuploidy may correlate with shortened survival in these conditions. Although data so far available are conflicting concerning the relationship of aneuploidy to response to therapy in patients with acute leukemia, it is possible that as improved therapeutic regimens become available for the treatment of acute leukemia, more sophisticated cytogenetic analysis may be helpful in predicting survival and response to therapy.
Asunto(s)
Aberraciones Cromosómicas , Leucemia/genética , Aneuploidia , Diploidia , Femenino , Humanos , Cariotipificación , Leucemia Eritroblástica Aguda/genética , Leucemia Linfoide/genética , Leucemia Mieloide/genética , Leucemia Mieloide Aguda/genética , Masculino , Preleucemia/genética , PronósticoRESUMEN
A prospective study employing adrenalectomy and oophorectomy followed by limited-term combination chemotherapy was used in the treatment of 39 patients with advanced breast cancer. Chemotherapy was abruptly stopped at 8 weeks in order to take advantage of rebound immunocompetence. Delayed hypersensitivity was tested by dinitrochlorobenzene skin tests and responses to phytohemagglutinin. There were 22 CRs among 33 patients who entered remission. Eleven patients had a PR with greater than 50% reduction of tumor. Thirteen of 20 patients with visceral disease had a CR. There was a close association between response and competence of the cell-mediated immune system. The median duration of unmaintained remission in those patients with a CR was greater than 16 months. Four of the six failures had had recent radiation therapy to the chest wall which may have influenced immunocompetence. Responses to chemotherapy appear to be additive to endocrine ablation. Rebound of immunocompetence after chemotherapeutic immunosuppression may be related to remission induction and maintenance.
Asunto(s)
Neoplasias de la Mama/terapia , Adrenalectomía , Adulto , Anciano , Antineoplásicos/uso terapéutico , Neoplasias de la Mama/inmunología , Castración , Dinitroclorobenceno , Femenino , Humanos , Hipersensibilidad Tardía , Inmunidad Celular , Persona de Mediana Edad , Metástasis de la Neoplasia , Pronóstico , Estudios Prospectivos , Remisión EspontáneaRESUMEN
A retrospective study of the methods of treatment in 98 patients with advanced breast cancer over the past five years showed striking differences in remission rates, duration of remissions, and overall survival according to the method of treatment. Adrenalectomy and oophorectomy produced remissions in 58% of patients, with a median duration of 22 months. Survival curves were impressive and favored the surgically ablated group, who had a median survival of 32 months. Sixty-seven percent of responders continue to survive at four years. Chemotherapy with single agents produced remissions in 30% of patients, having a median duration of nine months. Additive endocrine therapy produced 33% to 36% remission rates, with median durations of 12 to 16 months. Responses were more frequent and longer lasting in older patients. Radiotherapy, when used without supplemental therapy, resulted in good local control, but a short median survival of 7.5 months.
Asunto(s)
Neoplasias de la Mama/terapia , Adrenalectomía , Andrógenos/uso terapéutico , Antineoplásicos/uso terapéutico , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/radioterapia , Neoplasias de la Mama/cirugía , Fenómenos Químicos , Química , Estrógenos/uso terapéutico , Femenino , Humanos , Inmunoterapia , Metástasis de la Neoplasia , Ovario/cirugía , Remisión Espontánea , Estudios Retrospectivos , Factores de TiempoRESUMEN
Possible predictive criteria of the refractoriness to therapy of the blastic phase of Ph-1-positive chronic granulocytic leukemia (CGL) have been sought. Eight cases in the blastic phase were studied. The blasts were noted to be of two types: some displayed a high nuclear:cytoplasmic ratio with deep blue cytoplasm, while others had a comparatively low nuclear:cytoplasmic ratio and bluish gray cytoplasm containing a few small granules. Electron microscopic studies showed a variety of features, including defective organelles and giant mitochondria. Cytochemical staining revealed the majority of blast cells to be peroxidase- and Sudan black-negative; granular PAS positivity was the rule. Serial cytogenetic studies demonstrated increasing aneuploidy. Bone marrow biopsy showed myelofibrotic changes in two cases. Two patients entered complete remission with prednisone and vincristine and with Ara-C and thioguanine, respectively. It is concluded that the blastic phase of CGL may manifest heterogeneity.