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Biomedical subjects

C Behar

Publications and source records attributed to C Behar.

At least 19 recordsLinked to original sources
PubMed1990

CSF drug levels for children with acute lymphoblastic leukemia treated by 5 g/m2 methotrexate. A study from the EORTC Children's Leukemia Cooperative Group.

A multicenter EORTC study was conducted in children with acute lymphocytic leukemia to determine whether 5 g/m2 of methotrexate (MTX) (24 h i.v. infusion, four cycles) is an appropriate dosage for obtaining CSF drug concentrations approaching the critical cytotoxic level of 10(-6) M. A total of 193 cycles were analyzed for 58 patients. At the end of the 24 h infusion, the mean MTX serum level was 65.27 +/- 33.11 microM; the mean CSF MTX level was 1.47 +/- 1.1 microM; no significant difference in CSF MTX levels was observed between patients with (n = 20) and those without i.v. Ara-C (n = 38). The mean CSF MTX/serum MTX ratio was 0.029 +/- 0.027. CSF drug concentrations greater than or equal to 10(-6) M were achieved in 81% of the courses. The highest level was 8.4 X 10(-6) M. Only 5% of patients failed to achieve this drug concentration in at least one cycle. No significant correlation was observed between blood and CSF MTX levels. Mean CSF MTX levels were comparable from one cycle to another.

Adolescent↗
PubMed1989

Initial chemotherapy including ifosfamide in the management of Ewing's sarcoma: preliminary results. A protocol of the French Pediatric Oncology Society (SFOP).

Phase II studies using ifosfamide both alone and combined with vindesine and cisplatin have shown the effectiveness of this drug in patients with Ewing's sarcoma (ES) who had relapsed during VAC (vincristine, actinomycin, cyclosphosphamide)/VAd (vincristine, Adriamycin) therapy. In November 1984, these results led the SFOP to adopt a protocol consisting of (1) initial chemotherapy with three cycles of IVA (ifosfamide, 3 g/m2 on days 1 and 2; actinomycin D, 750 mg/m2 on days 1-3; vincristine, 1.5 mg/m2 on day 1) alternating every 3 weeks with IVAd (vincristine on day 22; ifosfamide on days 21-23; Adriamycin, 60 mg/m2 on day 22); (2) radical surgery if possible; (3) local radiotherapy (RT); and (4) maintenance chemotherapy with alternating IVA and VAd (vincristine, Adriamycin) for up to 9 months. In May 1987, 87 patients with previously untreated ES entered the study; 61 had localized ES. To date, 54 patients with localized disease and 22 with metastatic disease have finished initial chemotherapy; 40 patients with localized disease have been evaluated. In all, 28 patients (70%) were in complete remission (17 patients) or had a tumor regression of greater than 50% 11 patients) and were considered to be good responders; 12 patients were considered to be poor responders. After local radiotherapy in all but 7 patients and surgical resection in 29, 52 of 54 were considered to be in clinical remission. A total of 13 patients with metastatic disease were good responders at the completion of the initial chemotherapy. These results confirm the efficacy of primary chemotherapy using ifosfamide for the treatment of ES.

Adolescent↗
PubMed1989

[Liposarcoma in children. Apropos of 3 cases and a review of the literature].

Liposarcoma is an uncommon tumour in childhood. Three cases are reported. Two patients remain alive and well without local recurrence or metastasis following the initial treatment, however one patient died as a result of direct tumour extension despite chemotherapy. A review of the literature revealed the following features: the extremity are the most common location, the predominance of myxoid histology and its best prognosis. The treatment is the complete surgical excision, the efficiency of radiotherapy or chemotherapy has not been formally proved.

Buttocks↗
PubMed1988

[Acquired anticoagulants in children. Apropos of a series of 35 cases].

The authors report the clinical and biological data in 35 children presenting with circulating anticoagulant. The discovery of this abnormality was fortuitous in 28 cases, on the occasion of preoperative tests. In all cases they consisted of anticoagulants of the antiprothrombinase type, directed against the phospholipidic part of the complex. In 34 cases, no thrombosis or hemorrhage complication occurred. Among the 18 children who were followed, anticoagulant disappeared spontaneously in 17 cases. Some aspects of the circulating antibodies are quite particular in children: the frequent lack of clinical expression, the frequent postviral or drug-related etiology, the most often spontaneously favourable outcome.

Blood Coagulation↗
PubMed1987

Chromosomal subclonal evolution in paroxysmal nocturnal hemoglobinuria evolving into acute megakaryoblastic leukemia.

Four cytogenetic studies were performed in the course of a paroxysmal nocturnal hemoglobinuria evolving into acute megakaryoblastic leukemia. The clonal evolution was characterized by a unique structural change (9p) at the time of diagnosis, heralding an accelerated and complex karyotypic alteration including 5q-, 12p-, +21, -5, -7. At the terminal phase, the initial population was replaced within 1 week by a new overgrowing clone with -5, +8, +17. This suggests that the paroxysmal nocturnal hemoglobinuria-associated preleukemia and leukemic states share with acute nonlymphocytic leukemia the same nonrandom chromosomal changes.

Adult↗
PubMed1987

Treatment of acute lymphoblastic leukemia in children with the BFM protocol. A cooperative pilot study.

From January 1981 through July 1983, 141 children with newly diagnosed acute lymphoblastic leukemia were registered in a cooperative clinical study whose objective was to evaluate the toxicity and the feasibility of the German Berlin-Frankfort-Münster (BFM) protocol. The results were comparable with those reported by the BFM group. For the 133 patients (94%) who achieved complete remission, the actuarial disease-free survival was 67% at 4 years. These results were obtained in spite of a high rate of deaths in complete remission during the initial year of the study. Subsequently, probably as a result of improved expertise in the handling of the protocol, the proportion of toxic deaths declined sharply. Although the current BFM protocol adjusts for aggressiveness of therapy according to the volume of the liver and spleen, splenomegaly (but not hepatomegaly) remained of prognostic significance. Moreover, for patients with bad risk features, an initial high hemoglobin level was found to represent an additional factor of negative significance.

Adolescent↗
PubMed1986

Chromosomal changes in a documented case of malignant histiocytosis: significance of polyploidy.

A case of malignant histiocytosis was studied by cytology, cytochemistry, electron microscopy, and cytogenetics. It was shown that the malignant cells expressed a fully differentiated histiocytic pattern with high macrophagic activity. This correlated with the presence of polyploid metaphases. The significance of polyploid cells in the definition of malignant histiocytosis is discussed.

Aged↗
PubMed1986

Telangiectatic osteosarcoma.

Two cases of telangiectatic osteosarcoma are described. The difficulty in differentiating this tumour from aneurysmal bone cyst is emphasized both from the pathological and radiological aspects.

Adolescent↗
PubMed1986

Autologous bone marrow transplantation (ABMT) for acute leukaemia in complete remission: a pilot study of 33 cases.

Thirty-three leukaemic patients in CR were treated by high-dose therapy followed by ABMT: 18 of them had acute non-lymphoblastic leukaemia (ANLL) in first remission (CR1) with a mean age of 23.7 years (3-44). All but one of them were conditioned with a polychemotherapy regimen including 6-thioguanine, Ara-C, CCNU, and cyclophosphamide. The marrow cells were purged by chemical means in 16 cases. Five transplant-related deaths were observed: three cardiac failures, one interstitial pneumonitis and one aspergillus pneumonia. At the time of analysis (October 1984), four patients had relapsed and eight were still in unmaintained CR1 (44+, 46+, 30+, and five between 2.5+ and 8+ months post transplant). Fifteen patients had acute lymphoblastic leukaemia: four were autografted in CR1 and 11 children were grafted in CR2; the conditioning regimen was fractionated total body irradiation followed by cyclophosphamide for all but one patient who was conditioned with BACT (Burkitt leukaemia); the marrow was purged by a chemical agent in 11 patients and by monoclonal antibodies and C' in four: four out of 15 patients relapsed (two grafted in CR1 and two grafted in CR2); 10 patients are still in unmaintained CR: two adults grafted in CR1 (26+; 12+ months) and eight children with a mean follow-up of 13.4 months post graft (2 + -45+ months). The clinical study leads to the following conclusions: in adult patients the marrow should be harvested during CR1 and at the time of minimal residual disease. The quality of previous chemotherapy and conditioning regimen prior to ABMT play a prominent role in the in vivo eradication of the leukaemic cells. The real impact of marrow purging is still unknown and a larger series of homogeneous patients, conditioned with the same protocols and the same transplant timing, is required before any conclusions can be drawn.

Acute Disease↗
PubMed1981

[Autologous haematopoietic stem cell transplantation. Preliminary results of a regional multicentric study (author's transl)].

Autologous bone marrow transplantation represents a new approach to the treatment of malignant diseases when conventional therapy has failed. For this reason, the authors have collected bone marrow from 46 patients, including 24 with acute leukaemia, 7 with chronic myeloid leukaemia, 10 with lymphosarcoma and 5 with solid tumours. The mean of total cryopreserved CFU-c was 8.5 X 10(6) (range: 0.2-25). Ten cases of autologous bone marrow transplantation are reported. Seven patients had been prepared with high dosage chemotherapy alone (TACC) and three with chemotherapy combined with total body irradiation. Haematopoiesis restarted within 9 to 15 days in 5 patients and within 22 to 34 days in the other 5. Complete remission was obtained in all 5 patients with acute myeloid leukaemia grafted during their first relapse, the longest remission up to now being 390 days. One patient with chronic granulocytic leukaemia is still in second chronic phase after 360 days. Stem cells were transplanted early in the course of a T-lymphosarcoma, during complete remission; maintenance chemotherapy was withdrawn, and the chances of success of this treatment alone are being evaluated. The kinetics of blood and bone marrow CFU-c populations after transplantation were studied in 4 cases and were found to correlate closely with haematopoietic recovery following ablative bone marrow therapy. Stem cell transplantation can only be justified in acute leukaemia if it is carried out immediately after complete remission to consolidate the results and, hopefully, to prolong the remission.

Acute Disease↗
PubMed1979

Lymphoblastic leukaemia and Kaposi's sarcoma.

The authors report the case of a young white girl in whom the diagnosis of lymphoblastic leukaemia was made at the age of 5 years. Chemotherapy induced remission and long term surveillance began. Seven years after the onset of the first disease this girl died of an undiagnosed illness characterised by multiple nodules in both lungs. The autopsy gave the diagnosis of Kaposi's sarcoma.

Adolescent↗
PubMed1975

[The state of prothrombin, plasminogen and fibrinogen in the newborn infant].

The esterase activity of thrombin and plasmin on artificial substrates was used to study the kinetics of these enzymes by Lineweaver and Burk's method. In the plasma of new-born infants, plasmin obtained from streptokinase has an avidity comparable with that in adults. Thrombin is obtained by the action of staphylocoagulase and taipan venom. Its avidity has important individual variations and is different from that in adults. An inhibitor is present both in the plasma and in the serum of the new-born. Fibrinogen was studied by variations in absorption of light during coagulation by thrombin. The abnormalities observed depend on the physical and clinical conditions of the medium (ph, osmolality). These characteristics depend on the age of the infant, but also seem to depend on the conditions of the sample and, in particular, on fibrinolytic reactions. The existence of foetal fibrinogen is discussed.

Age Factors↗
PubMedDate not supplied

[Autograft of bone marrow following intensive treatment in acute lymphoid leukemia in children].

Ten children were autografted for ALL in second complete remission (CR). The conditioning regimen consisted of cyclophosphamide (60 mg/kg/day X 2) and total body irradiation (10 to 13.2 grays). It was well tolerated, no deaths occurred during the first 3 months post-graft. Nine children remained in second CR, without any maintenance therapy, from 2 to 40 months after ABMT and the median survival time was 11 months. One child died 112 days post-graft, following a cerebral hemorrhage (thrombocytopenia less than 10 X 10(9) platelets/liter). One girl, affected by B ALL, was autografted while in first CR after intensive chemotherapy (modified BACT) 5 months after diagnosis. She relapsed 8 months later. Seven bone marrows have been purged ex vivo by chemotherapy (ASTA-Z) and 3 by anti-CALLA monoclonal antibodies and complement.

Adolescent↗