PubMed Health⌕ Search

Biomedical subjects

D D Hurd

Publications and source records attributed to D D Hurd.

60 records · Page 4Linked to original sources
PubMed1981

VP 16-213 and cyclophosphamide in the treatment of refractory acute nonlymphocytic leukemia with monocytic features.

The treatment of refractory acute nonlymphocytic leukemia remains a major clinical problem in leukemia therapy. VP 16-213 is an investigational agent that may have specificity for monocytic blasts, and the combination of VP 16-213 and cyclophosphamide is synergistic in experimental leukemia. Seven patients with highly refractory acute nonlymphocytic leukemia, which demonstrated monocytic features, were treated with a combination of VP 16-213 and cyclophosphamide after they had failed to respond to multiple courses of intensive induction regimens. Three complete remissions and one partial remission were achieved. The times to complete remission were 21, 23, and 34 days. The durations of complete remission were 5, 9, and 12+ months. Myelosuppression was the most common side effect; one patient experienced nausea and stomatitis. There were no documented infections or hemorrhage, and no one died as a result of therapy. This combination is both well tolerated and effective in the treatment of refractory leukemia with monocytic features.

Adult↗
PubMed1981

Cytogenetic conversion following allogeneic bone marrow transplantation for advanced chronic myelogenous leukemia.

We performed a pilot study to test the effectiveness of allogeneic bone marrow transplantation in the treatment of chronic myelogenous leukemia. Five patients in the advanced stages of chronic myelogenous leukemia (four in blast crisis, one in accelerated phase) with abnormal chromosomes underwent matched-sibling allogeneic bone marrow transplantation after preparation with busulfan, vincristine, cyclophosphamide, and fractionated total body irradiation. Engraftment and conversion to normal chromosome patterns after transplantation occurred in all five patients. None of the patients reverted to an abnormal chromosome pattern of demonstrated clinical or hematologic evidence of recurrent disease during the course of this study; however, longest survival from transplant was 248 days. Allogeneic bone marrow transplantation can eradicate the abnormal clone even in far advanced chronic myelogenous leukemia and can provide normal hematopoiesis. We suggest that clinical complications of chemotherapeutic toxicity and infection were responsible for the short survival in this group of patients, and that these complications could be decreased by performing transplantation in the chronic phase or early accelerated phase of the disease.

Adult↗
PubMedDate not supplied

Adverse reactions in patients transfused with cryopreserved marrow.

Marrow is cryopreserved for use in autologous bone marrow transplants, but little is known of the incidence of reactions in patients transfused with these cryopreserved marrows. Reactions in patients transfused during a 4-year period with 134 autologous marrows cryopreserved in dimethyl sulfoxide (DMSO) were compared with those in patients transfused with marrow that had been collected from HLA-compatible donors and that had not been cryopreserved. Patients transfused with cryopreserved marrow had significantly more nausea (44.8 vs. 14.1%; p less than 0.0005), vomiting (23.9 vs. 8.5%; p less than 0.01), chills (31.3 vs. 1.4%; p less than 0.0005), and fever (17.9 vs. 0%; p less than 0.005) than patients transfused with fresh allogeneic marrow. The incidence of emesis correlated with the dose of DMSO received, but that of nausea did not. All cryopreserved marrows were cultured for bacteria at the time of transfusion and 17 (12.7%) were found to be positive. Only 1 of the 17 patients transfused with culture-positive marrow developed sepsis during the transplant course with the same organism that was present in the transfused marrow. Although the reactions in donors transfused with cryopreserved marrow were readily treated, this study suggests that the incidence of some reactions might be decreased by reducing the dose of DMSO transfused. Bacterial contamination of transfused marrow was a worrisome complication, and efforts should be made to improve marrow collection and processing techniques to minimize that risk.

Bacteria↗
PubMedDate not supplied

Profound muscle weakness as the presenting feature of disseminated cryptococcal infection.

A patient with chronic lymphocytic leukemia who was treated with immunosuppressive therapy for a prolonged period presented with profound muscle weakness secondary to disseminated cryptococcosis. The infection developed despite 3 months of continuous ketoconazole therapy and was not responsive to amphotericin B or flucytosine. At autopsy, Cryptococcus neoformans was present in all sampled skeletal muscles, myocardium, and muscularis propria of the gastrointestinal tract but was not identified in either the central nervous system or the lungs. A review of the English-language literature failed to identify a similar case with such profound myotropism due to Cryptococcus. This case demonstrates that cryptococcosis should be considered in the differential diagnosis of an immunocompromised host presenting with muscle weakness.

Cryptococcosis↗