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Biomedical subjects

C A Presant

Publications and source records attributed to C A Presant.

At least 19 recordsLinked to original sources
PubMed1979

Human chorionic gonadotropin and malignant mesothelioma.

A 56-year-old male presented with ascites and gynecomastia. Laparoscopy demonstrated peritoneal tumors which were biopsied. Conventional histology and electron microscopy revealed the tumor to be a malignant mesothelioma. The ascitic fluid and tumor cell lysate, but not serum, contained hCG by specific assay, and the immunoreactive hCG had characteristics similar to purified hCG in filtration on Sephadex G-100. Malignant mesothelioma is a tumor which may be associated with elevated hCG concentrations. Demonstration of hCG in ascitic fluid should suggest the presence of neoplasm.

Ascitic Fluid↗
PubMed1979

Cyclophosphamide plus 5-(3,3-dimethyl-1-triazeno)-imidazole-4-carboxamide (DTIC) with or without Corynebacterium parvum in metastatic malignant melanoma.

One hundred twenty patients with metastatic malignant melanoma were randomized to receive either cyclophosphamide, 600 mg/m2 IV, on day 1 plus DTIC 200 mg/m2 IV days 1 through 5, or the same chemotherapy plus C. parvum 5 mg/m2 IV on day 8 and day 15. Therapy was repeated every 21 days. Although responses were observed in 13.8% of patients on cyclophosphamide plus DTIC versus 25.5% of patients on cyclophosphamide plus DTIC plus C. parvum, the median duration of remission was 15.6 weeks on chemotherapy and 13.0 weeks on chemotherapy plus C. parvum. Furthermore, survival was similar on both regimens (6.1 months versus 5.7 months, respectively). Favorable prognostic factors included metastatic disease confined to skin or lymph nodes (33% responses), performance status greater than 70% (24% response rate), and administration of three or more courses of chemotherapy (31% response rate). The dose limiting toxicity was myelosuppression, which was equal on both regimens. Chills and fever were common in response to C. parvum, and, rarely hypotension, cyanosis, or immune nephritis was observed. The addition of C. parvum to chemotherapy with cyclophosphamide plus DTIC is not recommended.

Bone Marrow↗
PubMed1979

Adriamycin, BCNU plus cyclophosphamide (ABC) in advanced carcinoma of the head and neck.

Forty-four patients with advanced carcinoma of the head and neck were treated with cyclophosphamide, 400 mg/m2 plus BCNU, 100 mg/m2 day 1 followed by adriamycin 40 mg/m2 day 2, with therapy repeated every 4 weeks. Of 31 evaluable patients, there were 1 complete response, and 10 partial responses (35%). Four of 8 patients without prior chemotherapy had complete or partial responses, as did 7 of 23 patients who had received prior chemotherapy. The mean survival for patients with partial responses was 8.8 months, and for patients with stable disease was 7.8 months. The mean time to progression for patients with partial responses was 5.4 months, and for patients with stable disease was 3.2 months. Granulocytopenia was the dose limiting toxicity, and patients with increasing degrees of myelosuppression appeared to have higher quality responses and longer survival. The ABC treatment program is useful in the palliative management of patients with advanced carcinoma of the head and neck.

Antineoplastic Agents↗
PubMed1979

Imidoester inhibition of lymphocyte DNA synthesis.

Imidoesters amidinate free amino groups and produce inter- and intramolecular covalent bonds. To determine whether imidoesters influenced lymphocyte transformation, human peripheral blood or calf lymph node lymphocytes were cultured with dimethyladipimate (DMA), a bifunctional (cross-linking) imidoester, or methyl acetimidate (MAC), a monofunctional (noncross-linking) imidoester. Both DMA and MAC decreased the rate of endogenous DNA synthesis in a dose-dependent fashion. In further work, lymphocytes were treated with Phaseolus vulgaris phytohemagglutinin, concanavalin A, or periodate. DMA (1 mM) decreased DNA synthesis in P. vulgaris phytohemagglutinin-stimulated human cells by 65%, Concanavalin A-stimulated cells by 98.2%, and periodate-stimulated cells by 85%. Similar results were obtained with 1 mM MAC. Inhibition by DMA was slightly greater than was the inhibition by MAC. Decreased DNA synthesis resulted if DMA was added to P. vulgaris phytohemagglutinin-stimulated human lymphocytes at initiation of culture (72%) or after 16 hr (75%); inhibition was less when DMA was added after 24 hr (43%) and was not apparent if added after 48 hr. Therefore, both monofunctional and bifunctional imidoesters inhibit endogenous and stimulated DNA synthesis in human and calf lymphocytes.

Cells, Cultured↗
PubMed1979

Phase I study of thymidine plus 5-fluorouracil infusions in advanced colorectal carcinoma.

In order to determine the minimal toxic dose of a 5-day infusion of 5-fluorouracil (5--FU) in combination with an infusion of thymidine (TdR), 12 patients, received TdR at a dose of 8 g/m2/day for 5 1/2 days, beginning at the same time as a 5-day infusion of 5-FU at doses of 5--20 mg/kg/day. Myelosuppression was the dose-limiting toxicity, and the minimal toxic dose of 5--FU was found to be 7.5 mg/kg/day. Gastrointestinal toxicity was minimal to absent. In eight patients with carcinoma of the colon who had received no prior chemotherapy, there were two patients with partial responses (at doses of 5.0 and 7.5 mg/kg/day of 5--FU), two patients with stable disease, one patient with progressive disease, and three patients with early death (two drug-related deaths and one disease-related death). In four patients who had received prior 5--FU, one had stable disease, one had progressive disease, and two had early death (one drug-related death). We conclude that the addition of TdR to 5--FU infusions changes the dose-limiting toxicity from gastrointestinal toxicity to myelosuppression. The minimal toxic dose is decreased to approximately one third of that when 5--FU is administered alone.

Clinical Trials as Topic↗
PubMed1979

Phase II trial of piperazinedione in malignant melanoma: a report by the Southeastern Cancer Study Group.

Forty-one evaluable patients with malignant melanoma resistant to other chemotherapeutic agents received 9 mg/m2 of piperazinedione every 3 weeks. Two patients had partial responses and one additional patient had stable disease. One of the partial responses occurred in a patient with subcutaneous metastases and the other occurred in a patient with pulmonary and osseous metastases. Both antitumor responses occurred in the 17 patients with a performance status of greater than or equal to 80%. The dose-limiting toxicity was myelosuppression; thrombocytopenia was more frequently observed than granulocytopenia.

Antibiotics, Antineoplastic↗
PubMed1978

Adriamycin, 1,3-bis (2-chloroethyl) 1 nitrosourea (BCNU, NSC No. 409962), cyclophosphamide plus prednisone (ABC-P) in melphalanresistant multiple myeloma.

Fourteen patients with multiple myeloma resistant to melphalan plus prednisone were treated with BCNU 50 mg/m2 plus cyclophosphamide 200 mg/m2 on day 1, adriamycin 20 mg/m2 on day 2 and prednisone 60 mg orally, daily for days 1 through 5. Therapy was repeated every four weeks. Depending upon criteria used, objective antitumor responses were achieved in five to nine of the 14 patients. Mean survival was 9.5 months and actuarial median survival was 7.0 months. Six patients are alive, four to 35 months after initiation of therapy. This preliminary report indicates that this combination may be a useful treatment program in the management of patients with advanced multiple myeloma. A review of studies employing adriamycin plus BCNU suggests that these regimens currently offer the most effective treatment of melphalan-resistant patients.

Aged↗
PubMed1977

Adriamycin, 1,3-bis (2-chloroethyl)-1-nitrosourea (BCNU, NSC 409962) and cyclophosphamide therapy of drug-resistant metastatic breast carcinoma.

Thirty-two evaluable patients with metastatic carcinoma of the breast received chemotherapy consisting of BCNU plus cyclophosphamide followed in 18 hours by Adriamycin. Treatments were repeated every 4 weeks. Complete or partial responses were observed in 14 patients (43.7%) and in 12 of 27 drug-resistant patients (44.4%). An additional 26% of patients had objective improvement, for an overall objective response rate of 70.4% in drug-resistant patients. Skin, lymph node, and soft tissue metastases more frequently responded to therapy, while hepatic, peritoneal, and osseous metastases responded with an intermediate frequency. Pulmonary, pleural, and central nervous system metastases did not respond to therapy. The median duration of complete and partial responses was 6.8 months, and the median survival of these patients was 9.6 months. Overall, the median survival of all patients in this study was 6.5 months. The dose-limiting toxicity was myelosuppression, particularly granulocytopenia. Congestive heart failure and stomatitis were rare. This combination of drugs is a reasonably well-tolerated regimen for treating advanced breast carcinoma in an ambulatory setting, and produces a high rate of objective antitumor response of moderate duration.

Adenocarcinoma↗
PubMed1977

Severe myelosuppression from piperazinedione, (NSC No. 135758), cyclophosphamide plus dimethyl-triazeno-imidazole carboxamide (DTIC).

In order to determine whether piperazinedione used in low doses in combination with cyclophosphamide plus dimethyl-triazeno-imidazole carboxamide (DTIC) produced variable or severe myelosuppression, a Phase I Study was performed in 10 patients who received 16 courses of the three-drug combination. Although mild myelosuppression was consistently observed at doses of 4 mg piperazinedione, 400 mg cyclophosphamide, plus 400 mg DTIC, variable, severe, and prolonged myelosuppression was seen in three of six patients who received a dose of each of the drugs only 25% higher. The only other abnormality observed was nausea and vomiting. This study indicates that low doses of piperazinedione can produce variable and severe myelosuppression when used in combination with other myelosuppressive agents, and that only small increments in dosage may produce marked increases in the degree of myelosuppression. Future combination chemotherapy regimens employing piperazinedione should undergo cautious Phase I toxicity testing to avoid severe depression of blood counts.

Bone Marrow↗
PubMed1977

Amphotericin B induction of sensitivity to adriamycin, 1,3-bis (2-chloroethyl)-1-nitrosourea (BCNU) plus cyclophosphamide in human neoplasia.

Seven patients with metastatic tumors resistant to therapy with adriamycin, BCNU, plus cyclophosphamide received the same chemotherapy combined with amphotericin B. One complete response (acute myelomonocytic leukemia), two partial responses (carcinoma of the breast and multiple myeloma), and one case with objective improvement (carcinoma of the breast) were observed in seven evaluable trials. Myelosuppression was not consistently changed by addition of amphotericin B. Fever and chills were common after amphotericin B. Bronchospasm and hypotension occurred twice. Amphotericin B reverses resistance to adriamycin-containing chemotherapy regimens in some patients.

Adult↗
PubMed1977

Influenza immunization of adult patients with malignant diseases.

To characterize the immunogenicity of influenza vaccine in patients with malignant disease, 21 patients with lymphoreticular neoplasms and 21 patients with solid tumors were immunized with inactivated influenza A/New Jersey/76 whole virus vaccine. The patients were randomized with respect to time of vaccine administration in relation to administration of chemotherapy. Fourfold or greater antibody titer increases occurred in 94% of controls and 71% of cancer patients (P less than 0.05), and the magnitude of antibody response was also significantly lower in cancer patients (P less than 0.01). There was no correlation of antibody responsiveness with sex, age, tumor type, absolute lymphocyte count, disease status, or type of chemotherapeutic agent used. Fifty percent of patients immunized at the time of chemotherapy administration showed seroconversion, which is significantly less than the 93% response rate observed in patients immunized between chemotherapy courses. It is thus recommended that individuals with malignant disease should receive influenza immunization between chemotherapy courses.

Antibodies, Viral↗
PubMed1977

Enhanced DNA synthesis in isolated calf lymph node lymphocyte cultures.

Calf sub-mandibular lymph node lymphocytes and human peripheral blood lymphocytes were oxidized by NaIO4. In liquid cell cultures, both types of cells were transformed with enhanced DNA synthesis. In mixed lymphocyte cultures, untreated human lymphocytes were transformed by irradiated-oxidized human cells. However, untreated calf lymphocytes were not transformed by irradiated-oxidized calf cells. Either human or calf lymphocytes were isolated from cell-cell interaction in agarose on slides. After 2-3 days of culture, cells were pulsed with tritiated thymidine. Autoradiography indicated greater numbers of cells with active DNA synthesis in NaIO4-oxidized calf cells and in calf cells incubated with Phaseolus vulgaris E-PHA compared to untreated lymphocytes. Similarly treated human cells did not show any increase in the numbers of cells with active DNA synthesis. No enhancement of DNA synthesis was seen in oxidized calf cells which were reduced with NaBH4 or cultured with hydroxyurea. In these restricted in vitro systems, calf cells are 'transformed' independent of cell-cell interaction, while human cells are not.

Animals↗
PubMed1977

Biological characterization of a prolonged antileukemic effect of 5-azacytidine.

A prolonged cytotoxic effect of 5-azacytidine (aza-CR) on leukemic colony-forming units (LCFU) was observed in mice with transplanted L1210 leukemia. LCFU showed rapid reaccumulation in the marrow 12 hr after injection of 0.1 mg of aza-CR per mouse. However, after 0.5 mg of aza-CR, repopulation was delayed for at least 6 days. Experiments were performed to determine the mechanism of this prolonged antileukemic effect. Suspensions of leukemic marrow prepared from mice treated 4 days previously with 0.5 mg of aza-CR were exposed to [3H]thymidine in vitro in order to kill cells in S phase. Suspensions exhibited a 40% reduction in LCFU, indicating the prolonged effect was not due to cell cycle progression delay. Mice given whole-body irradiation prior to receiving L1210 demonstrated the same delayed repopulation following the high dose of aza-CR as nonirradiated mice, suggesting that the effect was likely not due to an immune reaction. aza-CR, when given to normal mice as long as 2 days prior to leukemic transplantation, was able to prolong the survival of leukemic mice, but not when given at longer intervals. Administration of aza-CR to mice 1 day or 1 hr prior to leukemic transplantation resulted in decreased LCFU survival as well as delayed repopulation of LCFU; the rate of repopulation was not changed. This indicated a prolonged residual activity of the drug, but not sufficient to explain the total in vivo suppression. In contrast, administration of aza-CR to leukemic mice suppressed repopulation of a subsequent leukemic transplant for 4 days, even when the cells were given 2 days after the aza-CR. Cytidine was partially able to reverse the delayed repopulation of LCFU when given 1 day after aza-CR, but it was unable to reverse the phenomenon 2 days after aza-CR. Therefore, a high dose of aza-CR produces a prolonged antileukemic effect which is probably mediated by continued availability of an aza-CR metabolite. Since this effect is more pronounced in leukemic mice than in nonleukemic mice, the pharmacokinetics of high doses of aza-CR probably differ in normal and leukemic mice.

Animals↗