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Biomedical subjects

D Fière

Publications and source records attributed to D Fière.

At least 55 records · Page 3Linked to original sources
PubMed1983

[Highly malignant non-Hodgkin's lymphoma. Treatment by intensive sequential chemotherapy].

Sixty-two patients with aggressive non-Hodgkin's lymphoma (diffuse mixed, diffuse large cells, non-cleaved small cells (Burkitt-like), immunoblastic, lymphoblastic and other non-epidermotropic T lymphomas) were treated by intensive sequential chemotherapy combining heavy induction treatment (modified CHOP-Bleo), sequential consolidation treatment (cytosine arabinoside and thioguanine, then high-dose methotrexate and L-asparaginase) and final reinforcement (CVAP-Bleo). Complete remission was achieved in 59 patients (95%); 11 patients (18%) relapsed. Two patients died during the induction phase and one failed to respond. Two patients died of an unrelated disease while in complete remission. Blood toxicity was tolerable and treatment could be conducted without problems in most cases. The median survival cannot be reached with a 14-months follow-up, but the survival rate seems to plateau at 70%. The only two prognostic factors identified were poor general condition and high serum lactate dehydrogenase levels.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1983

Dysmyelopoietic syndromes. A search for prognostic factors in 193 patients.

Dysmyelopoietic syndromes cover sideroblastic or nonsideroblastic refractory anemia with or without excess of blasts, subacute or chronic myelomonocytic leukemia. The evolution of 193 patients was studied with regard to the initial hematologic picture. A certain number of variables of prognostic value have then been isolated: excess of marrow blasts (more than 5%); presence of circulating blasts or karyotypic anomalies; reduction in the number of polymorphonuclear leukocytes (less than 1.043 10(9)/l, of monocytes (less than 0.136 10(9)/l), of platelets (less than 140 10(9)/l), of in vitro granulopoietic progenitors (less than 5 per 10(5) nucleated cells plated), of erythrocytic incorporation of 59Fe at day 14 (less than 12%), of hemoglobin level (less than 92 g/l); previous exposure to radiation or chemotherapy; early hemolysis in 51Cr-labeled erythrocytes study; marrow heterogeneity in histology; less than 20% of ringed sideroblasts. The correlation between these variables and adjustments related to the length of survival and the order of magnitude of the critical level of the log-rank test show that the most significant variables in descending order are: excess of marrow blasts, neutropenia, thrombopenia, presence of circulating blasts, the type of erythropoietic insufficiency, and decrease of in vitro growth.

Anemia, Sideroblastic↗
PubMed1983

Comparison of chemotherapy with immunotherapy for maintenance of acute lymphoblastic leukemia in children and adults.

Two hundred and seventeen patients, 1-50 yr old, with acute lymphoblastic leukemia in complete remission were randomized to receive a 1-yr consolidation chemotherapy of either type P, comprising 7 different drugs, or type M, consisting of methotrexate interspersed with prednisone and vincristine. Thereafter, they were randomized a second time to receive a 4-yr maintenance of either chemotherapy or immunotherapy, comprised of allogeneic blasts and bacillus Calmette-Guérin (BCG). Consolidation P caused more toxicity than consolidation M. However, comparison between the consolidation therapies P and M showed no significant difference, neither for disease-free interval nor for duration of survival. Chemotherapy showed more lethal toxicity in adults than in children. Comparison between chemotherapy (C) and immunotherapy (I) as maintenance treatment showed a significant (p = 0.016) superiority of C for disease-free interval (DFI). The difference was even more pronounced (p = 0.009) in the group with less than 8 g/dl of hemoglobin (Hb) at diagnosis before therapy. On the other hand, for patients with more than 8 g/dl Hb at diagnosis, presumably those with T-ALL, no difference in DFI was seen. No difference has been seen so far between maintenance therapies I and C concerning the duration of survival. The patients who were receiving maintenance I when they relapsed and who were consequently retreated by chemotherapy, survived longer from relapse than those patients retreated for relapse while receiving maintenance C.

Adolescent↗
PubMed1982

[Prolonged survival in adults with acute myeloid leukemia treated with BCG immunotherapy].

Between november, 1974 and june, 1977, 64 adult patients with acute myeloid leukaemia in remission were divided at random into two treatment groups: chemotherapy alone (n = 32) or chemotherapy plus B.C.G. (n = 32). Fresh B.C.G. from the Pasteur Institute, Paris, was administered once a week, two or three times per month, in the intervals between chemotherapy cycles, using the Heaf-gun method. The duration of the first remission was significantly increased in the group receiving B.C.G. (median duration 685 days versus 390 days: p = 0.03 on log rank test) as was the overall survival (median duration of survival 1.471 days versus 554 days: p = 0.01). Second remissions were more frequent in the B.C.G. group (79% versus 42%; p = 0.014). In addition, prolonged survival was more frequent in the B.C.G. group, where 12/32 patients remained in first remission between 3 and 6 years, as against 5/32 in the chemotherapy group.

Adult↗
PubMed1982

Agar culture of bone marrow cells in acute myeloid leukemia and dysmyelopoietic syndromes. Reevaluation of its prognostic value.

The expression of results obtained in in vitro bone marrow cell culture as per ml of aspirated marrow instead of per 10(5) nucleated cells plated as studied in 41 patients with acute myeloid leukemia (AML) and 79 patients with a dysmyelopoietic syndrome. Four types of growth were found in AML patients: three with hypercellular marrow and either (a) microclusters, (b) isolated cells, or (c) macroclusters and a complete remission (CR) rate of 86%, 63%, and 14% respectively; (d) relative hypocellular marrow with a CR rate of 0%. This type of poorly responsive AML patient has recently been described [17]. Patients with dysmyelopoietic syndromes were subdivided into three groups according to th type of in vitro growth: subnormal, decreased, and leukemic. There was a good correlation between these in vitro groups and the outcome of patients: long survival, death from hemorrhagic and/or infectious complications, leukemic transformation (logrank test: chi 2 = 9.12, df = 2, p = 0.01).

Adult↗
PubMed1981

Androgen, estrogen and progestin binding sites in human leukemic cells.

Sex steroid binding capacity was investigated in malignant cells from 32 patients with acute non-lymphoblastic leukemia (25 patients with acute myeloid leukemia, 4 with subacute leukemia, 3 with chronic myeloid leukemia in blast crisis) and 30 patients with acute lymphoblastic leukemia. Specific binding of labelled steroids was characterized either by competition assay in cytosol fraction or by whole-cell incorporation. In some cases further characterization of the receptor complex was attempted by sucrose gradient centrifugation and gel filtration column. The results show the presence of specific binding sites for dexamethasone (22/32 in non ALL and 30/30 in ALL), for estrogens (11/15 in non-ALL and 5/12 in ALL), for progestins (8/25 in non-ALL and 5/13 in ALL) for androgens when R1881 was used as ligand (8/21 in non-ALL and 5/10 in ALL patients) but only 1/13 non-ALL patients and no ALL patients when labelled 5 alpha DHT was used. These results indicate that the blast cells from patients with acute leukemia contain specific proteins binding steroids with a high affinity. Our results for dexamethasone receptors are similar to those described in the literature in ALL and non-ALL.

Binding, Competitive↗
PubMed1978

[Prognostic value of delayed-hypersensitivity skin tests and rosette studies in acute non-lymphoid leukemias].

Delayed hypersensitivity skin reactions to Tuberculin and Candidin were studied in 28 patients with non lymphoid acute leukemias. The reactions were found negative in most patients during blastic crises, whereas delayed skin reactions to Candidin were positive during remissions. The possible prognostic significance of the depressed delayed hypersensitivity response in such patients deserves further studies. Alterations of circulating T lymphocytes were observed, including low percentages of E and active E rosette-forming cells during blastic crises, and persisting low E and E active rosettes in some patients in remission; such abnormalities were less frequent in patients with remission of long duration. The percentages of EA and EAC rosettes-forming cells were found normal during blastic crises and remissions. In some patients in remission, lymphocytes were found to bind sheep erythrocytes either uncoated or coated with IgM antibodies, this penomenon which is not observed with normal lymphocytes may reveal persisting abnormalities of a yet undefined nature.

Adolescent↗
PubMed1977

Possible high dosage gentamycin therapy in infected neutropenic patients.

Serum gentamycin levels have been studied in 23 neutropenic infected patients after high doses (62 mg/m2 and 72 mg/m2) of the drug, we observed: a higher gentamicin level than with an usual dosage, levels under the ototoxic 10/ml level, no renal failure, and, no patient ototoxicity.

Agranulocytosis↗
PubMed1975

[Encephalic pseudotumoral toxoplasmosis in the course of blood diseases].

The authors report two cases, the first pathological and the second clinical of pseudo-tumoural cerebral toxoplasmosis, occurring during the course of blood diseases. They refer to the conditions of appearance of this rare complication, with only twenty cases recorded in the literature, during malignant blood diseases. They stress the primordial role of immunological deficiency related either to the underlying disease (especially Hodgkin's disease) or to immuno-suppressive therapy. The clinical picture, with little in the way of typical features, is thus that of a diffuse méningo-encéphalitis. Pseudo-tumoural forms are rare. The authors also stress the minimum conditions required for the validity of the dye test and the value of the diagnosis of cerebral toxoplasmosis. An association of sulphadiazine-purimethamine, active and effective, cured the second patient.

Brain↗