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Biomedical subjects

A M Hussein

Publications and source records attributed to A M Hussein.

At least 37 records · Page 2Linked to original sources
PubMed1991

Interleukin 1 protects against 1-beta-D-arabinofuranosylcytosine-induced alopecia in the newborn rat animal model.

Alopecia is one of the most psychologically distressing side effects of cancer chemotherapy. Previously, we made the following observations: (a) treatment of 8-day-old rats with 1-beta-D-arabinofuranosylcytosine (ara-C), doxorubicin, and cyclophosphamide (CYC) consistently produced either total body alopecia (ara-C and CYC) or alopecia confined to the head and proximal part of the neck (doxorubicin); (b) Imuvert, a biological response modifier derived from the bacterium Serratia marcescens, uniformly produced complete protection against alopecia induced by ara-C and doxorubicin but not that induced by CYC; and (c) the protective effect of Imuvert against chemotherapy-induced alopecia is mediated by a monocyte-mediated cytokine. In the experiments reported here, interleukin 1 was examined as the potential cytokine. Interleukin 1 offered excellent protection against alopecia induced by ara-C but not that produced by CYC in the newborn rat animal model.

Alopecia↗
PubMed1991

Phase II trial of mitoxantrone in head and neck carcinoma.

Nineteen patients with measurable and incurable head and neck carcinoma (17 squamous cell and two adenoid cystic) received intravenous bolus doses of 14 mg/m2 mitoxantrone in the first course. The doses were escalated or de-escalated by 2 mg/m2 in subsequent courses, based on leukocyte nadir, to achieve mild (3,000-3,999/mm3) or moderate (2,000-2,999/mm3) toxicity and response. The courses were repeated every 3 weeks. All 60 courses were evaluated for toxicity. Leukopenia was mild, moderate, severe (1,000-1,999/mm3), and life-threatening (less than 1,000/mm3) in 17%, 23%, 42%, and 2% of courses, respectively. Mild thrombocytopenia (100,000-129,999/mm3) occurred in two courses. The median interval to nadir leukopenia was 14 days (range 7-36) with a median of 13 days (range 3-50) to recover to normal. After the first course, leukopenia was mild in 16%, moderate in 32%, severe in 26%, and life-threatening in 5%. One patient died of pulmonary embolism 8 days after the first course and had concomitant leukocyte count of 700/mm3. Eighteen patients had at least one course resulting in leukopenia. Three of six patients receiving greater than or equal to 4 courses (cumulative dose 56-102 mg/m2) had an asymptomatic decrement of 14%, 17%, and 29%, respectively, in radionuclide left ventricular ejection fraction. The other toxicities were mild. In the 16 patients with squamous cell carcinoma that could be evaluated for response, one had a partial response lasting 8 months, and six had stable disease. One of the two patients with parotid adenoid cystic carcinoma had a minor response lasting 16 months. Mitoxantrone on a bolus schedule has minimal activity and is not indicated in head and neck squamous cell carcinoma.

Adult↗
PubMed1991

Synergism of ara-C-imuvert combination in aborting the development of transplanted chloroleukemia in the rat.

The development of chloroleukemia in the rat after transplantation of C51 chloroma cells can be aborted by treatment with an exogenous source of differentiating activity (DA) or by stimulation of endogenous DA production by the administration of Imuvert, a biologic response modifier. Success or failure of treatment was determined by the ratio of DA to leukemic cell load. Accordingly, in the present study we examined the hypothesis that treatment with cytosine arabinoside (ARA-C) to reduce the leukemic cell load coupled with Imuvert would be more effective than either given alone. Treatment with ARA-C-Imuvert aborted the development of chloroleukemia in 79% of the animals in contrast to 0%, 9% and 45% in animals treated with buffer, ARA-C, or Imuvert respectively. These results suggest that stimulation of endogenous DA in combination with cytoreductive agents offers a potentially curative treatment for myelogenous leukemia.

Animals↗
PubMed1990

Protection from chemotherapy-induced alopecia in a rat model.

Alopecia (hair loss) is among the most distressing side effects of cancer chemotherapy. Little progress has been made, however, in its prevention or treatment, partly because of the lack of suitable experimental model. In recent work on the treatment of myelogenous leukemia in the rat, the following observations were made: (i) treatment of 8-day-old rats with cytosine arabinoside consistently produced alopecia, and (ii) ImuVert, a biologic response modifier derived from the bacterium Serratia marcescens, uniformly produced complete protection against the alopecia. In subsequent experiments, both cyclophosphamide and doxorubicin also produced alopecia in this model, and the doxorubicin-induced alopecia was prevented by treatment with ImuVert. The potential relevance of these observations to chemotherapy-induced alopecia in the clinical setting should be examined.

Alopecia↗
PubMed1990

Chemotherapy with cisplatin and 5-fluorouracil for penile and urethral squamous cell carcinomas.

Six men with either recurrent (n = 4) or unresectable (n = 2) squamous cell carcinoma of the penis (n = 5) and urethra (n = 1) received chemotherapy with cisplatin intravenously at a dose of 100 mg/m2. This was followed 24 hours later by a continuous intravenous infusion of 5-fluorouracil (5-FU) at a dose of 960 mg/m2/d for five days every 3 to 4 weeks. There was universal alopecia. The other toxicities were mild and consisted of mucositis, nausea, vomiting, reversible creatininemia, and transient azotemia. After chemotherapy, five patients had a clinical partial response and one had a complete response. Of the five patients with no metastases, three had residual unresectable tumors. These three patients received radiation and survived for 6, 8, and 20 months after the start of chemotherapy. The other two patients were rendered disease-free by surgery. The first patient, who was a partial responder to chemotherapy, survived for 26 months. The second patient, who was a clinical complete responder, had excision of microscopic disease and is disease-free at 32+ months after the start of chemotherapy. This is the first article to report that the combination of cisplatin and 5-FU is active in penile and urethral carcinomas. After chemotherapy, surgery may be useful in selected patients to accurately assess response and excise localized residual tumors. Patients rendered tumor-free may achieve long-term survival.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1990

Small cell carcinoma of the large intestine presenting as central nervous systems signs and symptoms. Two case reports with literature review.

Extrapulmonary small cell carcinoma is rare. Small cell carcinoma of the colorectum has been reported in 73 patients. Patients with colorectal small cell carcinoma present with signs and symptoms related to the primary site. Usually patients present with advanced stage. Rarely do patients with colorectal small cell carcinoma present with signs and symptoms related to the central nervous system (CNS). We report two patients who presented with CNS signs. The two patients underwent craniotomy for definitive diagnosis and resection in one patient. In both cases, pathology was consistent with pure small cell carcinoma. Post-operatively, a search for a primary revealed the rectum and the hepatic flexure of the colon to be the sites. Patients were started on combination chemotherapy. One patient achieved a complete remission and the second is currently receiving chemotherapy with a partial response. This is the first report of colorectal small cell carcinoma presenting as CNS lesion(s).

Adult↗
PubMed1990

Small cell carcinoma of the stomach. Case report and review of the literature.

Small cell carcinoma of the stomach is an unusual and rare neoplasm with only eight reported cases in the world literature. Like small cell carcinomas elsewhere, they possess rapid growth ability and high propensity to metastasize with short survival. Clinically, small cell carcinoma is indistinguishable from adenocarcinoma. Because of the rarity of gastric small cell carcinoma, there is minimal information available on the optimal treatment. Herein, we report on a patient with metastatic pure small cell carcinoma of the stomach. He underwent palliative surgery and postoperative combination chemotherapy with transient partial response. He died 10 months after diagnosis with progressive widespread disease.

Adult↗
PubMed1990

Tumor lysis syndrome after induction chemotherapy in small-cell lung carcinoma.

Small-cell lung cancer (SCLC) is responsive to combination chemotherapy. Response rates of 50-80% can be achieved depending on whether the cancer is limited or extensive. Rarely, patients with SCLC respond so rapidly to induction chemotherapy that they develop a tumor lysis syndrome. This syndrome may lead to azotemia and renal failure if not recognized early and treated appropriately. This complication of therapy is important to recognize as the treatment of SCLC is sometimes administered on an outpatient basis. In addition, certain chemotherapeutic agents used in SCLC, such as cis-platin, are nephrotoxic and could potentially aggravate the azotemia secondary to the tumor lysis syndrome.

Acute Kidney Injury↗
PubMed1990

Carcinoid tumor presenting as central nervous system symptoms. Case report and review of the literature.

Carcinoid tumors are relatively uncommon. They are known for their slow growing behavior and unique symptoms. Patients with carcinoid tumors usually present with signs and symptoms due either to local disease or to the carcinoid syndrome. During the course of these tumors, they tend to metastasize to different sites, including regional lymph nodes, lungs, liver, and bone. They rarely metastasize to the central nervous system (CNS) and very rarely present with signs and symptoms related to CNS metastasis. We report a patient who presented with CNS symptoms and was found to have a pulmonary carcinoid tumor involving the liver and the dura mater. In this article, CNS involvement in carcinoid tumors is discussed, and the literature is reviewed.

Brain Diseases↗
PubMed1990

Combination chemotherapy and radiotherapy for small-cell carcinoma of the esophagus. A case report of long-term survival and review of the literature.

Small-cell carcinoma of the esophagus is a rare tumor and has received little attention until recent years. It should be differentiated from the far more common poorly differentiated squamous-cell carcinoma of the esophagus, because treatment by surgical resection alone or by radiation therapy results in limited survival of a few months. It is now recognized that esophageal small-cell carcinoma presents with early widespread dissemination and is chemosensitive, similar to primary small-cell carcinoma of the lung. We report on a patient with small-cell carcinoma of the esophagus treated with combination chemotherapy consisting of cyclophosphamide, vincristine, and VP-16 followed by local radiation therapy. Pathologic complete remission was achieved. The patient is currently in remission 22 months after diagnosis, the longest survival reported thus far.

Aged↗
PubMed1990

Hypercalcemia in head and neck squamous-cell carcinoma.

Hypercalcemia was previously considered a terminal phenomenon in advanced head and neck squamous-cell carcinoma. We report on six patients with head and neck carcinoma and hypercalcemia refractory to conventional measures. Three patients had stage IV tumor not amenable to surgery or radiation therapy and three others had carcinoma recurrent after surgery and/or radiation therapy. Five of the six patients had paraneoplastic hypercalcemia and one had extensive bone metastases. One refused chemotherapy and died in 2 months. Five treated with cisplatin 100 mg/m2 i.v. and 5-fluorouracil (5-FU) 960 mg/m2/day x 5, on days 2-7 as a continuous infusion, had prolonged control of hypercalcemia and required no other therapy to maintain eucalcemia. All three patients with no prior therapy, and one of the two patients with recurrent cancer, had a partial response after chemotherapy. The survivals of the patients with recurrent cancer were 1 and 3 months. The survivals in the patients with no prior antitumor therapy were 10, 11+, and 23 months, respectively. In conclusion, hypercalcemia in head and neck carcinoma can be well controlled by cisplatin and 5-FU chemotherapy for a prolonged period. The impact of chemotherapy on survival was minimal in patients with recurrent cancer. In contrast, patients with hypercalcemia at initial presentation of an advanced head and neck cancer have a high likelihood of tumor control and prolongation of survival by chemotherapy.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1990

Spontaneous pneumomediastinum in esophageal carcinoma.

Although fistulae and hypercalcemia are rare at the time of diagnosis of esophageal carcinoma, they are not uncommon terminal events. Most fistulae communicate with the respiratory tract. Uncommon sites of fistulae due to esophageal carcinoma include extension to the aorta, pleura, pericardium, and mediastinum. We report a patient with a spontaneous pneumomediastinum discovered during radiologic staging of esophageal carcinoma. The symptoms were dysphagia, weight loss, and pneumonia. The patient had hypercalcemia refractory to conventional measures, another adverse prognostic factor. Cisplatin 100 mg/m2 was tolerated without acute toxicity and lowered the serum calcium to normal. However, the patient died due to respiratory failure 2 days after cisplatin therapy. To our knowledge, this is the first report of a spontaneous pneumomediastinum at presentation of an esophageal carcinoma. The course of our patient and a review of the literature suggest that fistulae and/or hypercalcemia are medical emergencies and are often fatal in esophageal carcinoma.

Carcinoma, Squamous Cell↗
PubMed1989

Activity of pirarubicin (4'-0-tetrahydropyranyladriamycin) in malignant mesothelioma.

Eight patients with diffuse malignant mesothelioma of the pleura or peritoneum, previously untreated with chemotherapy, were treated with a new anthracycline 4'-0-tetrahydropyranyladriamycin (pirarubicin). Pirarubicin was given intravenously at the rate of 5 mg per minute, at doses ranging from 35 to 70 mg/m2 once every 21 days. On clinical evaluation, one patient had complete response lasting 4 months. On second-look laparotomy residual tumor was found and she was labelled a partial responder and changed to alternate chemotherapy. Another patient had a partial response of recurrent chest wall tumors lasting 11 months. A third patient had a partial response lasting 4+ months of a pleural-based tumor and resolution of pleural effusion. After the fifth course of chemotherapy, he developed severe granulocytopenia, pseudomonas sepsis, shock, and renal failure. Despite recovery of blood counts to normal within 3 days, renal failure proved fatal. Autopsy revealed only fibrosis and no gross or microscopic evidence of malignant mesothelioma. A fourth patient had improvement in evaluable disease lasting about 4 months; and the remaining four had stable disease for at least 2 months each. The authors conclude that, whenever feasible, noninvasive clinical assessment of tumor response should be supplemented by surgical-pathologic evaluation. Pirarubicin is active in malignant mesothelioma. This is the first report documenting complete tumor eradication after chemotherapy in an adult with malignant mesothelioma.

Aged↗
PubMed1989

Evolving role of surgical treatment in limited-disease small cell lung carcinoma.

The diagnostic role of surgical procedures in small cell lung carcinoma (SCLC) is well established. The therapeutic role of surgery has changed over the years. At present, curative resection is the treatment of choice in peripheral T1-2 N0M0 SCLC, and adjuvant chemotherapy may be beneficial. Surgery is also indicated in SCLC patients diagnosed by a limited pathologic sample in whom the clinical course suggests nonsmall cell lung carcinoma (NSCLC). The resection may reveal either a mixed tumor or an alternate diagnosis and may be potentially curative. Surgery, at the time of maximal response to chemotherapy in T3N0M0 SCLC, may be curative and reveal the presence of NSCLC elements. The best survival is in patients found to be tumor-free at surgery, and the worst survival is in N2 patients.

Carcinoma, Non-Small-Cell Lung↗
PubMed1989

Carcinomatous meningitis from transitional cell carcinoma of the bladder: case report.

In the past decade, there has been an increasing awareness of central nervous system metastases as a frequent complication of some malignancies, particularly in lung, breast and hematologic cancers. However, the central nervous system remains an uncommon location for metastases from certain primary tumors including those from the genitourinary system. We report on a patient with transitional cell carcinoma of the bladder who was treated with combination chemotherapy, and during the course of his disease developed carcinomatous meningitis. We anticipate this unusual complication of bladder transitional cell carcinoma will be seen more frequently, especially in the light of available data from effective chemotherapeutic regimens. We report this patient to alert physicians to this complication and to consider using prophylactic measures in responding patients as is the case in other malignancies.

Antineoplastic Agents↗
PubMed1989

Brain metastases in malignant pleural mesothelioma. Case report and review of the literature.

Recent advances in pleural malignant mesothelioma include the sequential use of palliative surgery, perioperative radiation therapy, and systemic chemotherapy. Radical treatments may not only palliate but also improve survival in some patients. The latter may be associated with the appearance of metastases in unusual sites including the central nervous system. In malignant mesothelioma, brain metastases were previously reported in 19 patients at autopsy and in only 1 patient antemortem. We detail the clinical presentation in the second patient with pleural malignant mesothelioma thus far reported to develop brain metastases. The difficulties in diagnosis, the role of immunoperoxidase stains in malignant mesothelioma, excellent tolerance of different modalities of treatment, and a review of the literature of brain metastases in mesothelioma are discussed. Based on our report, the possibility of brain metastases should be investigated by careful clinical examination prior to a radical treatment in patients with progressive refractory mesothelioma.

Aged↗
PubMed1987

Schistosomiasis in a cystic teratoma of the ovary.

The authors report the case of an ovarian teratoma infected by the eggs of the trematode Schistosoma haematobium. In consideration of the rare observation, bearing a paradigmatic value, they briefly discuss the particular tropism that the parasite demonstrated towards some tumoral structures and they also outline the immunological mechanisms activated by the Schistosoma.

Adult↗