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Biomedical subjects

C Cauchie

Publications and source records attributed to C Cauchie.

At least 19 recordsLinked to original sources

On the value of intensive remission-induction chemotherapy in elderly patients of 65+ years with acute myeloid leukemia: a randomized phase III study of the European Organization for Research and Treatment of Cancer Leukemia Group.

We report the results of a prospective study in patients more than 65 years of age in whom two different therapeutic strategies were compared: immediate intensive-induction chemotherapy (arm A) versus "wait and see" and supportive care and mild cytoreductive chemotherapy only for relief of progressive acute myeloid leukemia (AML)-related symptoms (arm B). The major objective of the study was to compare survival outcome of both regimens. Thirty-one patients on arm A received one or two courses of daunorubicin, vincristine, and cytarabine for remission induction followed by one additional cycle for consolidation in case of complete remission (CR). Among 29 patients on arm B, cytoreductive chemotherapy (hydroxyurea, cytarabine) had to be initiated for palliation of leukemia-associated complications in 21 patients at a median of 9 days after diagnosis. Overall survival duration for patients treated on arm A was significantly (P = .015) longer than the survival in arm B (median survival, 21 weeks v 11 weeks; projected survival at 2.5 years, 13% v 0%). Eighteen (58%) of arm A patients and none (0%) of arm B patients entered CR. Of the first group, projected disease-free survival at 2 years is 17%. The median percentages of days spent in the hospital by arm A and B patients were 55% and 50%, respectively. This study shows that a strategy based on modern supportive care and a wait and see approach yields extremely poor results. It is not superior in regard to the frequency of hospital admission and is inferior regarding survival outcome.

Aged↗

Enzymes of purine metabolism in B-chronic lymphocytic leukemia.

In order to study if enzymes of purine metabolism could be used as cell markers in B-chronic lymphocytic leukemia (B-CLL), the activities of adenosine deaminase (ADA), purine nucleoside phosphorylase (PNP), and 5'-nucleotidase (5'N) were repeatedly measured in blood mononuclear cells from B-CLL patients and were compared to those obtained in normal controls. Enzyme activities in patients were also compared to other biological parameters indicative of B-CLL to activities of ADA and PNP in erythrocytes. Results show that B-leukemic cells display abnormal enzyme patterns: subnormal ADA activity is characteristic; 5'N activity is depressed in 60% of the cases but increased in 15%. An inverse relationship between PNP activity and corresponding lymphocytosis is observed in leukemic but not in normal cells. The enzymatic anomalies seem to be linked to the presence of an unusual peripheral lymphocytic population, induced by the leukemic process. Indeed, ADA and PNP are not abnormal in erythrocytes. In untreated nonevolutive patients, the enzyme profile tends to remain stable throughout the course of the illness; normalization of enzyme patterns in treated patients occurs only when therapy induces improvement in T and B cell distribution.

5'-Nucleotidase↗

Thymidine kinase and thymidine phosphorylase activities in various types of leukaemia and lymphoma.

Thymidine kinase (TK) isoenzymes and thymidine phosphorylase (TP) activities have been measured in peripheral mononuclear cells of patients with acute lymphoblastic and monoblastic leukaemia or B-chronic lymphocytic leukaemia, as well as in normal subjects, and also in lymph node cells from patients with non-Hodgkin's lymphoma, with Hodgkin's disease and with benign adenopathies. TK1 isoenzyme activity was highest in acute lymphoblastic leukaemia and in centroblastic lymphoma. Then in progressively decreasing order appeared the Hodgkin's disease values, the centroblastic centrocytic lymphoma values and the benign reactive lymph node cell values. When compared to normal blood mononuclear cells, TP was greatly decreased in acute lymphoblastic leukaemia and slightly but significantly decreased in chronic leukaemia. Monoblastic cells exhibited a unique enzyme pattern; moderately increased TK1 activity and high TP activity. Our results suggest that both enzymes are indicative of the maturation status of leukaemic cells from B lineage. They demonstrate that in lymph node cells, TK1 reflects the proliferative status of both malignant and non-malignant cells and that in monoblastic cells the synthesis of dTMP through de novo synthesis is favoured.

Humans↗

[Myeloma and hypereosinophilic leukemoid reaction (author's transl)].

In a 56-year-old man with a myeloma marked eosinophilia was discovered. The diagnosis of myeloma was made on the discovery of plasmocyte infiltration in the mandible. Despite surgery and chemotherapy, general bone infiltration by plasma cells occurred over 15 months. The leukocyte count rose to 226,000/mm3 with 162,720 mature eosinophils. Pathogenic problems suggested by such an unusual association (myeloma-eosinophilic leukemoid reaction) are considered.

Eosinophilia↗

Cellular aspects of selective IgA deficiency.

Five patients with no detectable serum IgA (less than 20 mug/ml) and one patient with low serum IgA were compared to normal subjects. The number of circulating E-RFC was normal as was the lymphocyte DNA synthesis induced by PHA, Con A, and streptokinase-streptodornase. The patients had normal numbers of IgA-bearing lymphocytes and normal or increased numbers of B cells. Purified anti-immunoglobulin antibodies specific for IgG, IgA and IgM induced a normal lymphocyte DNA synthesis as did PWM. The patients' lymphocytes were able in vitro to transform into actively secreting IgA plasmocytes. This transformation was determined by counting the IgA and immunoglobulin-containing cells and then measuring the IgA and IgG secretion in the cultures. In some patients PWM was selectively suppressive in IgA B-cell transformation into IgA secreting cells; in the other patients PWM had no effect on the IgA B-cell differentiation. PWM enhanced the IgG secretion in the patients' cultures as well as IgA and IgG secretion in the normal controls.

Adult↗