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Biomedical subjects

A Canevari

Publications and source records attributed to A Canevari.

At least 37 records · Page 2Linked to original sources
PubMed1984

VP 16-213 and cytosine-arabinoside combination chemotherapy for refractory acute lymphoblastic leukemia in adults.

Fifteen adult patients with refractory or relapsing acute lymphoblastic leukemia (ALL) received a 5-day remission induction regimen consisting of VP 16-213 (60 mg/m2 every 12 hr) and cytosine-arabinoside (100 mg/m2 every 12 hr) up to a maximum of three courses. The overall response rate was 60% (9/15), four patients (27%) achieving CR and five (33%) attaining PR. Responders were maintained with monthly courses of the same combination until progressive disease developed. The median duration of response was 4.5 months (2-12+ months). The regimen was relatively well tolerated. The major toxicity was hematologic. Non-hematologic toxicities included mild nausea and vomiting (11/15) and total alopecia (15/15). The results obtained with this combination are encouraging, in view of the poor prognosis associated with refractory or relapsing ALL in adults.

Adolescent↗
PubMed1984

Efficacy trial of pipobroman in polycythemia vera and incidence of acute leukemia.

A trial was conducted between 1970 and 1981 with pipobroman (PB) in 100 consecutive patients with polycythemia vera (PV), followed for a median time of 60 months, to evaluate the efficacy of this drug and assess the risk of acute leukemia. Phlebotomy was not done before PB was given. Hematologic remission was achieved in 92% of previously untreated patients in a median time of 12 weeks (range, 6-48 weeks) and maintained for a median of 48 months. Acute hematologic toxicity was absent. The median overall survival was 140 months with 65% five-year complication-free survival; the overall death rate at 12 years was 23% (6% of patients died of thrombotic complications). The actuarial risk of acute leukemia was 6% and 9% at five and seven years, and the time from the diagnosis of PV to leukemia ranged from 14 to 81 months. Myelofibrosis occurred in three patients and lung carcinoma in one. All leukemias were nonlymphoid with prominent monocytic component and dyserythropoiesis. One patient had erythroleukemia, two cases were heralded by preleukemia with chromosomal abnormalities, one involving the chromosomes 5 and 7. PB is effective in PV; however, despite an easy induction of remission, continuous low-dose maintenance is necessary and the risk of subsequent acute leukemia is still significant.

Clinical Trials as Topic↗
PubMed1984

Efficacy trial of pipobroman in essential thrombocythemia: a study of 24 patients.

Pipobroman (PB) was tested in a prospective efficacy trial in 24 previously untreated patients with essential thrombocythemia and followed up for a median of 47 months (range, 12-120). Plateletpheresis was not done. Hematologic complete response (platelet count less than 450 X 10(9)/L for 3 consecutive months) was achieved in 92% of the cases, in a median time of 12 weeks (range, 2-22). However, continuous low-dose maintenance therapy with PB was necessary to avoid recurrences of the disease. Major thrombocythemia-related complications were observed in 20% of the cases; the 5-year overall and complication-free survival rates were 92% and 75%, respectively. No acute or chronic toxicity was observed; no drug-induced amenorrhea and subsequent acute leukemia occurred. PB does appear to be efficacious in essential thrombocythemia; however, the evaluation of its leukemogenic risk will await further experience.

Adult↗
PubMed1983

Low-grade malignancy non-Hodgkin's lymphomas: prognostic relevance of their clinicopathologic heterogeneity.

We reviewed 182 consecutive adult patients with low-grade malignancy, non-Hodgkin's lymphomas classified according to the Kiel classification, followed at the Division of Hematology, Policlinico S. Matteo, Pavia, from January 1975 to December 1981, to recognize, in each histopathologic type, important subgroups from the prognostic standpoint. Median follow-up was 36 months. No significant differences were observed in the response rate to conventional therapy (radiotherapy for localized disease, CVP for advanced stages) between the 4 cytologic types. The centrocytic-centroblastic lymphoma with diffuse nodal architecture showed an intermediate-grade malignancy (median survival, 50 months) and underwent cytologic progression to the high-grade malignancy centroblastic type in 10% of the cases. Large-cell centrocytic and polymorphic lymphoplasmacytoid lymphomas had a poor prognosis (median survival less than 30 months) when treated with conventional therapy for favorable histologies, and 6% of the cases transformed into the high-malignancy immunoblastic type. Patients with lymphocytic lymphoma with bulky mediastinum had a median survival of 20 months. The identification of these subgroups with a worse prognosis may have therapeutic implications.

Adult↗
PubMed1983

Immunological imbalance in uncomplicated chronic alcoholism.

The lymphocyte response to unspecific mitogenic lectins and the frequency of the lymphocytary populations and two subpopulations (DR- and Fc gamma-positive T-cells) as well as the serum immunoglobulin levels were tested. Blood samples were drawn from 15 volunteers with chronic alcoholism, an no clinical detectable correlated diseases and from 8 healthy subjects as controls. An activation of the immune system was found, characterized by an increase of T lymphocytes, DR-positive T-cells, IgA and IgG. Aspects of this activation are discussed.

Adult↗
PubMed1982

Risk of leukemia in patients treated for Hodgkin's disease.

We reviewed 251 consecutive adult patients with Hodgkin's disease treated at the Division of Hematology, Policlinico S. Matteo, Pavia, from January 1970 to December 1979, to assess the risk of development of acute leukemia. The median time of follow-up was 48 months (range 6-135). No leukemia occurred in 88 patients treated with radiotherapy or chemotherapy alone. Six acute non-lymphoid leukemias occurred in the group of 163 patients treated with MOPP and radiotherapy (crude rate of leukemia of 7.5 per 1000 person-years at risk). All cases were in clinical remission and off therapy; the latent period from initiation of therapy to onset of leukemia ranged between 30 and 90 months. The actuarial probability of leukemia at five and seven years was 2.9 and 4.7% for the entire group of patients, and 3.8 and 5.8% for the combination therapy group. All leukemias , except one, had a preleukemic phase lasting 1-12 months, with cytopenia and dysplastic marrow. The median survival after leukemia was 4.7 months.

Adult↗
PubMed1982

Adult acute lymphoblastic leukemia. Response to therapy according to presenting features in 62 patients.

Sixty-two adult patients with acute lymphoblastic leukemia (ALL) were treated with an induction regimen including vincristine, daunorubicin and prednisone (VDP) followed by CNS prophylaxis. Forty-five patients (72.5%) achieved complete remission (CR). The CR were maintained with daily 6-MP and weekly MTX. Monthly reinduction cycles with vincristine and prednisone (plus daunorubicin every three courses) were also given. Median duration of CR was 10.4 months. Overall survival was 17.4 months. The remission rate and length of CR were studied in relation to the clinical and hematological features present at diagnosis. CR rate was adversely influenced by age only over 40 and by tumoral presentation. The length of remission was negatively influenced by tumoral presentation, CNS involvement, high circulating blast count, L2 and L3 cytology, and T or B immunological phenotype. Multiple regression analysis confirmed the weight of FAB morphology in determining the length of remission. Among L2 adult patients, tumoral presentation appears to be the major unfavourable prognostic factor.

Adolescent↗
PubMedDate not supplied

Antithrombin III biological activity and emotional stress in patients with coronary artery disease.

We studied the effect of emotional stress (mental arithmetic for 10 minutes) in ten postinfarction patients and in ten age-matched, apparently healthy subjects as controls. Blood samples for the determination of epinephrine and AT III levels were taken in basal conditions, at the end of mental stress and after 30 minutes of recovery. Mental stress induced a significant increase in epinephrine levels and a significant decrease in AT III levels in control subjects. Both parameters returned to baseline values after 30 minutes of recovery. On the contrary, in postinfarction patients AT III levels of recovery were still significantly lower than those of baseline, suggesting a reduced ability to restore the original concentration of this physiologic inhibitor. Our data can contribute to a better understanding of the complex relationships among phychosocial factors, the haemostatic system and vascular disease.

Adult↗
PubMedDate not supplied

Extramedullary disease in Ph'-positive chronic myelogenous leukemia: frequency, clinical features and prognostic significance.

Of 349 consecutive patients with Philadelphia-positive chronic myelogenous leukemia (Ph' + CML), 14 (4%) developed extramedullary disease (EMD) during their illness. The sites of EMD were: bone (57%), lymph nodes (29%), skin and soft tissues (21%), central nervous system (14%). The median time from diagnosis of CML to the occurrence of EMD was 48 months. At the time of diagnosis of EMD, 7 patients were hematologically in chronic phase, while 7 showed features of accelerated or blastic CML. For patients lacking medullary blastic transformation criteria, the median time from diagnosis of EMD to blast crisis was 4 months. The overall median survival from development of EMD was 5 months. In conclusion, EMD may occur during the course of CML either in the context of a frank blastic transformation, or as an isolated tumoral infiltrate which heralds an impending blast crisis. Its recognition requires a prompt change to acute-phase chemotherapy.

Adult↗
PubMedDate not supplied

Combination chemotherapy with alternating MOPP-ABVD in advanced Hodgkin's disease.

Fifty untreated adult patients with advanced Hodgkin's disease (HD) were given alternating MOPP-ABVD chemotherapy in a prospective eight-cycle program. This series included 33 patients with stage II-III disease and bulky lymphoma and/or B symptoms, and 17 patients with stage IV disease. Nodular sclerosis amounted to 52%, and systemic symptoms were present in 70% of patients. The median follow-up was 50 months from the initiation of therapy (range: 36-78 months). The complete remission rate was 80%, with no differences according to the main patient characteristics before therapy, except for bulky (65%) versus non bulky (88%) disease (p = 0.05). The actuarial 4-year overall (OS) and relapse-free survival were 78% and 71%, respectively. No clear-cut pretreatment characteristics showed an influence on survival, although there was a trend favoring non bulky versus bulky disease (p = 0.08). The actuarial 4-year OS of complete responders was 92%; all 13 patients who died had evidence of HD; the cause of death was disease progression and organ failure in 11 cases, acute myelomonocytic and opportunistic infections with AIDS in the other two cases, respectively. No severe pancytopenia episodes or life-threatening complications occurred during therapy; gastrointestinal and neurological toxicity were mild and no patient refused to complete the treatment. Menstruating women were given estrogen-progesterone combinations, and all continued to have regular menses throughout chemotherapy and afterwards; a young woman had a normal pregnancy resulting in a normal live birth. Only one case of stable amenorrhea was observed. Oligospermia after chemotherapy was seen in seven of 10 tested males, and azoospermia in one case.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

Hemorrhagic and thrombotic complications in polycythemia vera. A clinical study.

This study reviewed the clinical and hematologic characteristics of 161 patients with polycythemia vera treated with myelosuppressive agents, with or without antiaggregating platelet therapy, in order to determine the features associated with a risk of hemorrhagic or thrombotic complications. At presentation, 7 patients (4.3%) showed hemorrhages and 36 (22%) complained of thrombotic events. None of the evaluated clinical and hematologic parameters was significantly related to hemorrhagic or thrombotic presentation. During the clinical course, four of 107 patients (3.7%) experienced hemorrhagic complications and 34/107 patients (28%) complained of occlusive events, which accounted for 30% of total deaths. Among the clinical and hematologic presenting features, only age over 60 yrs could be identified as an unfavorable prognostic factor for the occurrence of thromboembolic episodes. Marked thrombocytosis, a high packed cell volume (PCV) and the thrombotic onset were not significantly related to the thrombotic risk. Platelet count and PCV at the time of the occlusive episode did not correlate with the clinical event; however, inadequate control of the proliferative disease seemed to increase the thrombotic tendency. Antiaggregating drugs, although unable to avoid thrombosis in our experience, might be safely associated with the myelosuppressive therapy, particularly in selected patients.

Adult↗