Leverger, Guy; Bernheim, Alain; Daniel, Marie‐Thérèse; Flandrin, Georges; Schaison, Gérard; Berger, Roland
doi: 10.1002/mpo.2950160402pmid: 3419390
Cytogenetic studies performed on 130 consecutive childhood acute nonlymphocytic leukemias (ANLL) investigated in the same center between 1977 and 1986 are reported. The incidence of clonal chromosomal abnormalities was 68.5% with uneven distribution among the groups of the FAB nomenclature. The high incidence of t(8;21) translocation cases which was 58.6% of M2 ANLL cases was remarkable. Complete remission rate was lower (P<0.05) in ANLL with all karyotypically abnormal metaphases (AA) than in the other ANLL (NN with only normal metaphases and AN with a mixture of normal and abnormal metaphases). Median survival was also shorter in AA ANLL than in AN and NN cases (P<0.01). Median survival was different according to karyotype abnormalities: 11q anomalies and t(15;17) were not associated with a good prognosis and the t(8;21) is not associated with a particularly long median survival (16 months) when compared with other ANLL as opposed to the results of others. The longest survival (26 months) was observed in patients with acute myelomonocytic leukemia with bone marrow eosinophilia. It may be concluded that chromosome studies have a prognostic value in childhood ANLL.
Byrne, Julianne; Mulvihill, John J.; Connelly, Roger R.; Austin, Donald A.; Holmes, Grace E.; Holmes, Frederick F.; Latourette, Howard B.; Meigs, J. Wister; Strong, Louise C.; Myers, Max H.
doi: 10.1002/mpo.2950160403pmid: 2843733
Jaffe, Norman; Sullivan, Margaret P.; Ried, Hubert; Boren, Hallie; Marshall, Robert; Meistrich, Marvin; Maor, Moshe; Cunha, Miguel Da
doi: 10.1002/mpo.2950160404pmid: 3138517
We evaluated reproductive function in 27 male long‐term survivors of childhood cancer treated during the prepubertal and pubertal period. Sperm samples were obtained from 23 patients; four who refused to provide specimens indicated that they had fathered normal healthy children. Thirteen patients were 12 years old or younger at the time of diagnosis and initiation of therapy. Chemotherapy was calculated according to the cumulative amount of drug administered and correlated with the surface area. Sterility was associated with large doses of single alkylating agents or reduced doses administered with other agents in combination regimens. It was noted in boys treated in both the prepubertal and pubertal period. Sterility was also observed in patients who received testicular radiation alone or in combination with chemotherapy. However, it was not an inevitable consequence in all patients, despite treatment with similar or identical regimens. Fertility potential could not be predicted by clinical examination (testicular size) or gonadotrophin and testosterone values. The results were compared to published reports of treatmentinduced sterility in adult males. Additional investigations are required to establish more accurate correlations of dosage with reproductive potential.
Odom, Lorrie F.; Morse, Helvise; Tubergen, David G.; Blake, Marilyn
doi: 10.1002/mpo.2950160405pmid: 3419391
Results of a pilot protocol employing chemoimmunotherapy for treatment of 23 children with acute non‐lymphoblastic leukemia consecutively diagnosed between 1975 and 1979 are reported. Twenty‐two children achieved remission, ten of whom are surviving 6.5–9.5 years after completion of primary systemic therapy (median 7.8 years). Treatment consisted of intermittent courses of Daunomycin, Cytosine Arabinoside, 6‐Thioguanine, VP‐16, with or without Decadron.
Perrone, Laura; Sinisi, Antonio A.; Sicuranza, Romolo; Di Tullio, Maria T.; Indolfi, Paolo; Giuliano, Maria G.; Bellastella, Antonio; Faggiano, Michelangelo
doi: 10.1002/mpo.2950160406pmid: 2843734
Twenty‐three prepubertal subjects treated for Wilms' tumor (10 males and 13 females) were endocrinologically evaluated off therapy from 0.5 to 4.08 years. They were divided into two groups: 11 subjects (6M, 5F) who had received chemotherapy only (group 1) and 12 (4M, 8F) who had in addition received abdominal radiation (1,500–3,000 rads) (group 2). Follicle‐stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), thyroid‐stimulating hormone (TSH), free thyroxine (FT4), free tri‐iodo thyronine (FT3), testosterone (T), estradiol‐17β (E2), and cortisol (F) were measured by radioimmunoassay (RIA). Plasma levels of TSH, PRL, FT4, FT3, and F were normal in both groups, as were FSH, LH, T, and E2 in group 1. In group 2, female subjects showed FSH levels significantly higher than controls, while LH and E2 were normal; male subjects showed significantly higher LH levels, while FSH and T levels were normal. These results indicate that in the treatment protocol used by us for Wilms' tumor (WT), chemotherapy does not affect endocrine function, whereas abdominal radiation seems to damage gonadal function directly. The present findings indicate that gonadal damage may be revealed in WT before puberty not only in females, as has been previously reported, but also in male subjects.
Gramatovici, Razvan; D'Angio, Giulio J.
doi: 10.1002/mpo.2950160407pmid: 3262194
Langerhans' cell histiocytosis (LCH) (previously histiocytosis X) is an infrequent disease with protean clinical manifestations and an unpredictable course.
Lebaron, Samuel; Zeltzer, Lonnie K.; Lebaron, Christine; Scott, Shannon E.; Zeltzer, Paul M.
doi: 10.1002/mpo.2950160408pmid: 3419392
Nausea, vomiting, and the extent to which chemotherapy‐bothered children were assessed by patient and parent ratings for 31 children (65 courses) receiving combination chemotherapy with either highdose cyclophosphamide or doxorubicin /daunorubicin. Patients and parents both reported more severe vomiting with cyclophosphamide than with the anthracyclines. The use of antiemetics did not affect emesis for the former drug; for the anthracyclines, there was more severe emesis for courses with antiemetics than for those with none. Adolescents reported more severe nausea than children, and females reported both more nausea and bother than males. There were no significant age or sex findings for parent reports. The findings suggest that chemotherapy‐related nausea and vomiting in children is a complex phenomenon not accounted for by drugs alone.
Marschke, Robert F.; Kvols, Larry K.; Cullinan, Stephen A.; Laurie, John A.; Mailliard, James A.; Tschetter, Loren K.; O'Connell, Michael J.
doi: 10.1002/mpo.2950160409pmid: 3419393
Eighteen ambulatory patients who had proven metastatic adenocarcinoma of the pancreas and measurable disease but no previous chemotherapy were treated with bisantrene given by constant central intravenous infusion over 72 hours at a total dose of 300 mg/m2 repeated every 3 to 4 weeks. No objective regression was seen. The median interval to progression was 6 weeks; the median survival was 14 weeks. Primary toxic reactions were nausea, vomiting, and leukopenia. In no instance were these life‐threatening. When administered by the method we used, bisantrene cannot be recommended for treatment of advanced pancreatic adenocarcinoma.
Showing 1 to 10 of 17 Articles
In a retrospective cohort study of 47 Wilms' tumor survivors and their 77 sibling controls, female survivors had a fourfold excess risk (risk ratio, 4.1; 95% confidence interval, 1.7‐10.1) for any adverse livebirth outcome, including birth defects, compared with their sibling controls. Wives of male survivors had no apparent excess risk for problem pregnancies. The families had a number of severe reproductive problems and major birth defects, such as primary amenorrhea in two survivors, bicornuate uterus in two survivors and one control, and mental retardation in one male survivor and a male control. The son of a female survivor died after bilateral Wilms' tumors. Birth defects in the offspring of female survivors are compatible either with intrauterine constraint, possibly due to radiation‐induced fibrosis or with the complex of malformations associated with Wilms' tumor. Female survivors of Wilms' tumor appear to be at increased risk for a variety of reproductive problems, from sterility to fetal loss, early delivery, and birth defects in offspring. Furthermore, relatives of survivors of Wilms' tumor may be at risk of having associated birth defects, with clinically significant consequences.