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Biomedical subjects

A A Audebert

Publications and source records attributed to A A Audebert.

At least 19 recordsLinked to original sources

Combination of ABVD and radiotherapy in early stages of Hodgkin's disease: analysis of a series of 94 patients. Pierre and Marie Curie Group (GPMC).

In order to reduce, if not completely suppress, late complications of combined chemotherapy and radiotherapy in Hodgkin's disease (HD), MOPP regimen (mechlorethamine, vincristine, procarbazine and prednisone) was replaced by ABVD (doxorubicin, bleomycin, vinblastine and dacarbazine). Ninety-four patients with HD clinical stages I to IIIA with no staging laparotomy were treated by three courses of ABVD followed by radiotherapy. Irradiation was performed on extended fields in 41 cases and on involved fields in 53 others. Consolidation chemotherapy was planned in 67 cases with at least one unfavorable prognostic factor, but achieved only in 33 cases. Seventeen patients relapsed within 1 to 46 months after the beginning of treatment. Ten patients died, 7 of HD and 3 of intercurrent diseases or accident. Disease-free survival rate with a median follow-up of 60 months is 80%. This study showed, on the one hand, many digestive and general side-effects after ABVD and, on the other, a satisfactory hematological tolerance. Furthermore, mediastinitis or cardiovascular complications were not more frequent than with MOPP. These results point out the development and use of better tolerated regimens for initial chemotherapy in HD, without jeopardizing the good results of the treatment.

Adult↗

Refractory anemia with excess of blasts in transformation. Clinical, hematologic, and cytogenetic findings in nine patients.

Clinical, hematologic, and cytogenetic data of nine patients with refractory anemia with excess of blasts in transformation (RAEB-t), classified according to the French-American-British Cooperative Group for myelodysplastic syndrome (MDS), are reported. At diagnosis, eight out of nine cases, had chromosomal abnormalities and three out of nine developed acute leukemia. Karyotype studies allowed individualization of two groups of patients: five with nonrandom major karyotype abnormalities (MAKA) including hypodiploidy, chromosomes 5 and 7 involvement, at least four other abnormalities, and a poor prognosis (survival always under 3.5 months); and four patients with either normal karyotypes or minor karyotype abnormalities (MIKA) (no more than three abnormalities) and a better prognosis (survival from 14 to 38 months). Karyotype appears to be a major prognostic factor among RAEB-t.

Acute Disease↗

Relationship of histological subtypes to prognosis in early stage Hodgkin's disease: a review of 312 cases in a controlled clinical trial. The Groupe Pierre et Marie Curie.

To assess the prognostic significance of a newer histologic classification of Hodgkin's disease (HD), microscope slides from the time of diagnosis of 312 clinical stage IA or B, IIA or B and IIIA patients were reviewed in 1987, 6-10 years after their participation in a radiochemotherapeutic trial (1976-1982). Overall, the diagnostic reproducibility of the Rye classification by the same pathologist was confirmed. However, a new analysis showed an improvement in the differential diagnosis between HD and non-Hodgkin's lymphomas (NHL) by the identification of 24 NHL (8%) amongst the patients originally diagnosed as HD. Most of the NHL identified on review had been classified originally as mixed cellularity. On review, none of the new histological subtypes of HD was significant for prognosis of relapse-free survival or overall survival. Only identification of NHL was shown to have an independent prognostic value on relapse rate (P = 0.012) and on overall survival (P = 0.10). It is concluded that diagnosis of HD by itself remains, in 1988, the sole histologic factor influencing the prognosis of these patients.

Adolescent↗

Sequential karyotype study on Ph-positive chronic myelocytic leukemia. Significance of additional chromosomal abnormalities during disease evolution.

Twenty-eight patients with Ph-positive chronic myelocytic leukemia (CML), who all died of the disease, had cytogenetic studies throughout the progression of the disease: at diagnosis, during chronic phase (CP), accelerated phase (AP), and blastic transformation (BT). The aim of this sequential study was to appreciate the frequency and the significance of additional chromosomal abnormalities (ACA) during CML evolution, especially in the CP. In our series ACA were rare (five of 28 patients) and simple (four of five) in CP. They were much more frequent and complex in AP (11 of 16) and in BT (22 of 24) with complex abnormalities (13 of 24). In CP, ACA predictive value for metamorphosis was poor: only three of 13 patients had ACA within 1 year before BT, and only two of 11 within 1 year before AP. ACA were mainly observed during the last period before BT: ten of 17 patients studied within 6 months prior BT had ACA, but by then two of three were in AP. ACA, especially when complex, appear to be a hallmark of CML metamorphosis.

Adult↗

Cytogenetic studies in twelve patients with primary myelofibrosis and myeloid metaplasia.

Chromosome studies on bone marrow and/or peripheral blood cells without phytohemagglutinin were performed on 12 patients with primary myelofibrosis with myeloid meta-plasia (PMMM) between 1980 and 1984. Abnormal clones were found in six patients (50%). In five cases the abnormal clone involved the long arm of chromosome #7, two of which also had partial trisomy of chromosome #1 and trisomy of 9. Additional abnormalities involving chromosomes #3, #5, #11, #13, #15, and #21 were each found once. Review of the literature showed few studies on the cytogenetics of PMMM. No specific chromosomal pattern can be established; however, abnormalities described are nonrandom.

Aged↗

Spontaneous regression of cytogenetic and haematologic anomalies in Ph1-positive chronic myelogenous leukaemia.

We report a case of a 27-year-old man with Ph1-positive chronic myelogenous leukaemia (CML). At the time of diagnosis 100% Ph1-positive cells were found with a trisomy 8 in 50% of them. In absence of therapy, his haematological status remained stable for 3 years. Subsequently a progressive regression of haematologic and cytogenetic data was observed. Eight years after diagnosis the karyotype showed only 37% Ph1-positive cells and the trisomy 8 had disappeared.

Adult↗

Translocation 1;7 in preleukemic states.

A translocation t(1;7) interpreted as t(1;7)(p11;p11) was first reported by Scheres et al. in eight patients with various hematologic disorders. The karyotype of the abnormal cells was trisomic for 1q and monosomic for 7q. Those investigators reported having found four other cases in the literature. We report herein studies of two patients with the same t(1;7).

Adult↗

[Abnormality of chromosome number 1 in 3 cases of acute transformation of chronic myeloid leukemia].

The authors report three cases of Ph1-positive chronic myelogenous leukemia (CML) with chromosome no 1 abnormalities. Such abnormalities have seldom been reported: three cases out of 42 in blast crisis and none of the 70 patients in the chronic phase in our series. In case no 1 a translocation: (t(1q;14q) was noted. In case no 2 the rearrangement was more complex: partial duplication of the long arm of chromosome no 1 and presence of a 21q+ corresponding to chromosome no 21 on which a part of the long arm of chromosome no 1 was transferred. In case no 3 a double translocation was noted between chromosomes no 1 and no 11, involving either the p or q arm. A review of the literature shows that abnormalities of chromosome no 1 are more frequent during the blast crisis that in the chronic phase of CML. Chromosome no 1 abnormalities are found in a number of myeloproliferative syndromes but even more frequently in solid tumors. The rearrangement sites are reviewed by the authors. Such rearrangements of chromosome no 1 may indicate an increased potential of malignancy.

Adult↗

Two cases of acute leukemia following treatment of malignant glioma.

Two female patients, 42 and 30 years old, respectively, died of acute nonlymphocytic leukemia 43 and 38 months, respectively, after a subsequent treatment: chemotherapy for one and irradiation and chemotherapy for the other, following excision of a malignant glioma. At the time of death, both seemed to be in complete remission of their brain tumor. Both had been treated with procarbazine and nitrosoureas. The latter were responsible for severe myelosuppressive episodes and seem to have played an essential role in the induction of the leukemia. In one case, a myelodysplasia was observed before the onset of the AL and the diagnosis of refractory anemia with excess of blasts seemed warranted. Secondary acute leukemias are rare in the evolution of malignant gliomas and the usefulness of subsequent radiochemotherapy cannot be questioned at the present time. The risks involved in this therapy are minor when compared to the short-term fatal prognosis of this type of tumor.

Acute Disease↗

[Hematologic and cytogenetic study of 7 cases of preleukemic state or acute leukemia following the treatment of a first malignancy].

The authors present 7 cases of preleukemic state and/or acute leukemia following the treatment of a first malignancy (3 malignant lymphomas, 3 epithelial cancers and one polycythemia vera). A preleukemic state was found in all patients. In 6 cases it was followed by an acute non-lymphoblastic leukemia which was rapidly fatal; in one case, death occurred during the preleukemic phase. A karyotype was prepared during the preleukemic phase in 6 out of 7 patients and in 4 out of 6 during the leukemia. Karyotypes prepared during the preleukemic state presented at least one of the abnormalities which are characteristic of secondary hematopoietic disorders: -5/5q; -7/7q; involvement of 17. The same major clone was found in 3 of the 6 patients who were karyotyped during the acute leukemic phase. These karyotype abnormalities are not only characteristic of secondary acute leukemias but also of secondary dysmyelopoietic syndromes.

Adult↗

Hematologic and cytogenetic study of two cases of acute leukemia associated with breast cancer.

The authors present two cases of patients with breast cancer with lymph node extension and who both had surgery. As a pancytopenia with hypercellular bone marrow was discovered at the same time in the first patient, she received no complementary treatment; 4 months later, she presented with an acute lymphocytic leukemia (ALL) for which a remission was easily induced, but she died of a pulmonary infection. The second patient received local radiotherapy (50 grays) and adjuvant chemotherapy (Alkeran for 26 months). Forty-seven months after the diagnosis of breast cancer and 16 months after the end of the treatment, an acute nonlymphoblastic leukemia (ANLL; M6) was diagnosed after 8 months of a preleukemic state. Treatment did not produce any results and death occurred on the 17th day. Cytogenetic studies on the bone marrow cells of both patients were performed. In the first patient in the ALL phase normal cells coexisted with a 47 chromosome clone, the extra chromosome being a D (+ 13?). In the second patient, several karyotype abnormalities were already present in the preleukemic state and also during the acute leukemic phase. No normal mitoses were found; hypodiploidy was present as well as major abnormalities such as markers, rings, and, among others, the systematic loss of a #5 and a #7. The first patient seems to have presented with a de novo ALL, associated with the malignant tumor; whereas, the second patient showed all the characteristics of an induced ANLL. The clinical, hematologic, and cytogenetic characteristics of these two patients are analyzed and compared to those of other cases in the literature.

Adenocarcinoma↗

[Acute leukemia associated with breast cancer (author's transl)].

Two cases of acute leukemia in patients with breast cancer are reported. In the first patient, erythroleukemia occurred three years after breast cancer was treated by mastectomy, followed by local radiotherapy ; complementary chemotherapy (melphalan) has been given for twenty-six months. The second patient had onset of acute lymphoblastic leukemia four months after breast cancer was treated by surgery only. This patient subsequently has complete remission. Both patients died shortly after onset of leukemia. In the first patient, bone marrow cytogenetic studies evidenced major abnormalities at an early stage of the disease, with abnormal mitoses in all the cells, whereas, in the second patient, only minor abnormalities were found. A review of previously published cases of breast cancer with acute leukemia was done. Our findings suggest that the association of leukemia with breast cancer may result from therapy is some cases (secondary induced acute leukemias) while in others it may occur spontaneously.

Aged↗

[Psoriatic arthritis with renal amyloïdosis. A case-report. Review of the literature (author's transl)].

A case of severe psoriatic arthritis with both spinal and peripheral joint involvement is reported. The patient, an HLA B27-positive man, was thirty-one years old at onset. Both antiinflammatory drugs and immunosuppressive agents (chlorambucil followed by azathioprine) were ineffective and the patient became bed-ridden. Thirty-three months after onset a severe nephrotic syndrome developed. Renal biopsy let to diagnosis of secondary renal amyloïdosis. The patient died five months later in spite of chemotherapy with melphalan and prednisone. Autopsy could not be performed. A review of the literature showed twelve other cases of psoriatic arthritis with secondary amyloïdosis. Men are affected more often than women. Twelve years was the average interval between onset of joint involvement and diagnosis of amyloïdosis. In three instances, however, this interval was less than thirtyeight months. Arthritis often included both spinal and peripheral joint involvement. Amyloïdosis was evidenced by a nephrotic syndrome in eight out of twelve cases. Prognosis is poor with a fourteen months average interval between onset of clinical amyloidosis and death.

Adult↗

[Hypertrophic pulmonary osteoarthropathy with paraneoplastic secretion of four hormones. Considerations on pathogenesis (author's transl)].

The case of a patient with small-cell carcinoma of the lung, bone marrow metastases, and hypertrophic pulmonary osteoarthropathy is reported. Normal growth hormone serum concentrations contrasted with significant increases in ACTH, beta-MSH, calcitonin, and gastrin. A hormonal etiology has previously been suggested for hypertrophic pulmonary osteoarthropathy. Our findings indicate that the hormone responsible for hypertrophic pulmonary osteoarthropathy may be an APUD polypeptidic substance, that differs from immunoreactive GH but is related to somatomammotropins.

Adrenocorticotropic Hormone↗