Biomedical subjects

D Bremond

Publications and source records attributed to D Bremond.

6 recordsLinked to original sources

PubMed1996

Cyclophosphamide/mitoxantrone/melphalan (CMA) regimen prior to autologous bone marrow transplantation (ABMT) in metastatic breast cancer.

Dose-intensive treatment followed by ABMT is currently used in different approaches to treat breast cancer patients. An active non cross-resistant regimen combining cyclophosphamide (C), mitoxantrone (M) and melphalan (A) (CMA), was developed as the conditioning regimen before ABMT. The purpose of this phase II study was to evaluate this protocol and the duration of its effect in metastatic patients, who responded to chemotherapy. Criteria for inclusion included histologically documented breast cancer, age < 55 years and the first detection of measurable metastatic lesions. Following first-line chemotherapy in responding patients, histologically negative bone marrow was collected and cryopreserved. Then, intensification with cyclophosphamide (120 mg/kg), mitoxantrone (60 mg/m2), and melphalan (140 mg/m2) was followed by ABMT. Sixty-one metastatic breast cancer patients with a mean age of 40 years were included. Sites of measurable metastases included: liver 24, lung 14, central nervous system four, pleura three, skin six, and chest wall six, nodes eight and bone marrow one. Nineteen patients had lesions in two or more sites, and 22 had bone involvement. The response of 60 patients could be evaluated: before ABMT 31 were in clinical complete response (CR), 22 in partial response > 50% (PR), and seven had new progression. After ABMT, 36 patients were in CR, 16 in PR, one progressed and one was stable. Seven (11.5%) toxic deaths occurred. Mean time for hematological recovery was 32.5 days, without hematopoietic growth factors. Median survival was 33 +/- 9.4 months from the start of therapy, and 25.7 +/- 4.6 months from the date of ABMT. Median event-free survival was 20 months from the start of therapy, and 13 +/- 2 months from ABMT. With a median follow-up of 51 months, probability of actuarial survival, measured from the beginning of initial chemotherapy, was 36%, and event-free survival was 18%. In metastatic breast cancer responding to chemotherapy, high-dose consolidation with CMA and ABMT resulted in a median survival of 33 months. These results lay the ground work for evaluation in a randomized trial in metastatic breast cancer.

Adult↗

PubMed1994

Nasal dermoid sinus cyst.

Nasal dermoid sinus cyst is one of the diagnoses of midline nasal masses in children. This retrospective study analyzes the various theories regarding the origin of this congenital abnormality, the differential diagnosis, and the value of magnetic resonance imaging, as well as the various surgical options available.

Child, Preschool↗

PubMed1994

[Acute post-rhinoplasty dacryocystitis. Apropos of a case].

Lacrimal ducts are exposed to surgical wounds during cosmetic surgery of the nose because of the anatomic situation. Beside minor and transitory injuries exist major injuries needing a surgical solution. The authors report a case of an acute dacryocystitis after an aesthetic rhinoplasty. After reviewing the literature and studying the possible traumatic mechanisms, the authors propose to treat the lacrymal injury by a bicanaliculonasal intubation before than performing a dacryocystorhinostomy.

Acute Disease↗

PubMed1985

[Sequelae of condylar fractures in the experience of the department and that of medical expertise].

Statistical analysis was conducted on findings in 104 cases of fractures in the condylar region and 25 patients examined to determine degree of incapacity as a result of these types of fracture. Data obtained illustrated the adverse effects of ascending ramus shortening, and the improvement obtained after surgical restoration of its height whenever this was indicated. Long-term follow up surveillance is also necessary after high subcondylar fractures with impaction of the ascending ramus because of the risk of external temporomandibular ankylosis.

Adolescent↗

PubMedDate not supplied

[An uncommon clinical form of phakolytic glaucoma].

A 85 year old man was admitted with an acute endolphtalmitis, a high intraocular pressure (60 mm Hg) and a visual acuity with only light perception. The diagnosis was a phacolytic glaucoma by diffusion of lens proteins through the small preexisting perforation of the lens capsule. The lens was removed by an intracapsular extraction without intraocular lens. The intraocular pressure was normal on the first postoperative day and the visual acuity was improved to 6/10 P2.

Acute Disease↗

PubMedDate not supplied

[The role of autografts in severe or metastatic breast cancers].

Intensive treatment of poor prognosis breast cancer has included bone marrow autografts. A multicentric study was conducted from 1988 to 1992, including 105 patients with a minimal follow-up of 2 years after the autograft. Inclusion criteria were: age < 55 years, measurable metastasis, inflammatory breast cancer, breast cancer with major lymph node invasion (> 8 N+). Chemotherapy (6 to 8 cycles) was used initially. In responders, bone marrow was harvested and frozen. Medullary invasion had to be absent for bone marrow harvesting. Management then included cyclophosphamide: 60 mg/kg, D-7, D-6; mitoxantrone: 12 mg/m2, D-9 to D-5; alkeran: 140 mg/m2, D-2 followed D0 for bone marrow autograft. For the 105 patients, mean age was 40 years; inflammatory breast cancer: 33 patients; > or = 8 N+: 11 patients; metastasis: 61 patients. For the cases with metastasis, the main sites were: liver: 24 patients, lung: 14 patients, bone: 22 patients, central nervous system: 4 patients. Nineteen patients had at least two metastasis localizations. Responders alone were included although 7 patients had been stabilized before the autograft. For the metastatic forms, median survival was 41 +/- 9 months from the onset to diagnosis of metastasis, with 8 patients surviving over 5 years. Median survival without progression was 12 months with a 4-year probability of 17%. For inflammatory breast cancers, the probability of survival was 50% and survival without progression was 42%. For patients with lymph node invasion > or = 8 N+, it was 72%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗