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Biomedical subjects

B M Cogan

Publications and source records attributed to B M Cogan.

3 recordsLinked to original sources

Subacute pulmonary failure complicating therapy with high-dose Ara-C in acute leukemia.

Seventy-four adult patients with acute leukemia in relapse were studied. They received high-dose intravenous boluses of cytosine arabinoside (Ara-C) according to the following schedules: 3 g/m2 over 2 hours, every 12 hours for 4 to 12 consecutive doses, or a continuous infusion over 5 days at 200, 400, or 800 mg/m2/day. The patients' ages ranged from 16 to 68 years (median, 35). Subacute pulmonary failure attributable to Ara-C was observed in 16 of 72 evaluable patients (22%) and appeared 2 to 21 days (median, 6) after the first dose. None of the 28 patients who received up to six doses experienced any toxicity. With repeated courses or more than six doses in the first course there was a sharp increase in the incidence of toxicity. Thus, subacute pulmonary failure developed in 6 of 24 patients who received 9 doses and 6 of 19 patients who received 12 doses. The increase in toxicity with increasing number of doses is significant (P = 0.03). This suggests that the high-dose Ara-C regimen should be used with awareness of possible drug-induced pulmonary toxicity.

Acute Disease↗

Arterial perfusion with Tc-99m macroaggregated albumin (MAAAP) in monitoring intra-arterial chemotherapy of sarcomas.

Thirty infusion studies with Tc-99m-labeled macroaggregated albumin were carried out in 21 patients who had histologically proven peripheral tumors. Three patterns of tumor perfusion were noted: increased central radioactivity in 13 patients, decreased central radioactivity with or without increased peripheral radioactivity in four, and absence of radioactivity in four. In the last category, all four patients had no evidence of tumor neovascularity by contrast angiography. In all 21 patients the intraneoplastic patterns showed very good correlation between contrast angiography and radionuclide angiography. Pulmonary tracer uptake was documented in all 14 patients who had counts performed over the lungs; one had no evidence of tumor neovascularity by either angiographic study, and only 8 of the 13 remaining (61%) showed evidence of appreciable tumor arteriovenous shunting by contrast angiography. Decreased tumor perfusion, presumably due to vessel spasm, was found in one patient.

Adolescent↗