PubMed Health⌕ Search

Biomedical subjects

G Auclerc

Publications and source records attributed to G Auclerc.

At least 55 records · Page 3Linked to original sources
PubMed1984

Prognostic value of lymphograms in chronic lymphatic leukemia.

Chronic lymphatic leukemia (CLL) is a disease with a prognosis that has previously been difficult to assess. In recent years, this problem has largely been overcome by various classifications based on clinical and hematologic findings. This article presents the results of a study designed to show the value of lymphograms in assessing the prognosis. These results show that prognosis is associated with lymph node structure, as assessed by lymphography. Lymphography, as an investigation is superior to scanning or echography, since these give information merely on nodal size. It is proposed that lymphograms should be used for assessing the gravity of the disease and help in the choice of therapy.

Chronic Disease↗
PubMed1984

Non-Hodgkin's lymphoma occurring after Hodgkin's disease. Four new cases and a review of the literature.

This article describes four cases of non-Hodgkin's lymphomas occurring after successful treatment of Hodgkin's disease (HD). The clinical symptoms consisted of digestive disorders, and the histology confirmed an intestinal involvement in these four patients. In all cases patients had diffuse large cell types (intermediate or high grade). The respective role of HD treatment (combination chemotherapy in 3 of 4 patients with irradiation in 3 of 4 patients) and of other pathogenic hypotheses, are discussed.

Adolescent↗
PubMed1984

[Breast cancer: chemotherapy preceding locoregional treatment with extension of the indications for conservative treatment].

About 80 per cent of patients with breast cancer ultimately die of metastatic disease in the following twenty years. Distant metastases are more important as cause of death than loco-regional relapses, it is why adjuvant chemotherapy is necessary, especially in young patients and in those with extensive disease. Initial chemotherapy preceding any locoregional treatment is justified on the basis that both surgery and anesthesia lead to immuno-depression. Further, the value of initial chemotherapy has been demonstrated in many experimental and clinical trials of Nissen-Meyer, Bonadonna and Cooper. We have treated 145 patients, including 67 with inflammatory breast cancer (IBC), with 4 to 6 weeks of Velbe, Thiotepa, Methotrexate Fluorouracil and Prednisone with Adriblastine added for those patients with IBC or T greater than 7 cm, or N2 N3. Because of tumor regression of more than 50 per cent observed in 80 per cent of the patients, the majority (123 patients) then received radiotherapy alone (cobalt + iridium) and are in a complete remission in all these cases after curietherapy. Maintenance treatment with the same drugs was prescribed for 6 to 18 months depending on the initial staging. Tumor regression appears to be an important prognostic factor. Median follow-up is only 17 months, the longest one being 42 months. The overall survival at 2 years for IBC, is 90 per cent with a disease-free survival of 80 per cent. Cosmetic results are excellent. While these results are encouraging, longer follow-up is needed to confirm this improvement.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1984

[Primary chemotherapy in breast cancer. Preliminary results].

Primary chemotherapy in carcinoma of the breast is justified by the high risk of distant metastases, immunodepression related to surgery and the experimental studies and clinical trials of Nissen-Meyer in 1967, and Fisher in 1968. Chemotherapy was associated with loco-regional Patey-type surgery (20 patients) or radiotherapy with cobalt and irridium (43 patients) in 63 cases of breast cancer, 33 of which were T4 or in exarcerbation. Initial chemotherapy comprised 3 to 6 infusions of Velbe, Thiotepa, Methotrexate, 5-Fluoro-uracil, prednisone plus adriamycine in the severe forms. Over 50 p. 100 tumour regression was observed in 80 p. 100 of patients without major toxicity reactions. In all cases of radiotherapy alone, the tumour disappeared completely in the two months after the end of radiotherapy. Only one of the 63 patients relapsed at the 8th month and she died. The follow-up period now ranges from 3 to 29 months (average 12 months). These results are encouraging but only a larger series will allow definite conclusions to be drawn.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1983

[Acute leukemias and solid tumors in the course of Hodgkin disease].

In a retrospective study of 1 094 patients treated for Hodgkin's disease between 1963 and 1976, we have observed 65 malignant complications including 28 granulosis acute leukemias and 37 solid tumors. The actuarial 10 year risk of developing acute leukemia is 4.7 per cent; and 5.4 per cent for solid tumors. These figures vary according to the medications received. They are more important in the case of polychemotherapy, particularly for acute leukemia, thus confirming the specific role of alkyl agents. While the course of solid tumors does not seem to differ from that of identical primitive tumors; on the other hand, induced leukemia seems to have a more perjorative prognosis than spontaneous leukemia and they are often announced by cytopenia. The overall risk of developing secondary cancer is multiplied by 2.4 compared to the normal population; that of developing acute leukemia is multiplied by 9.3. In order to reduce this risk, active non alkyl agents of limited duration must be advocated. Irradiation fields must also be reduced.

Actuarial Analysis↗
PubMed1982

[Clinical activity of m-Amsa and the combination of m-Amsa with cytosine arabinoside].

Of 91 acute leukaemia patients treated with m-Amsa, 19 received intermittent doses, 23 received daily doses and 49 underwent courses with combined m-Amsa and cytosine arabinoside (Ara-C). Intermittent doses had minimal therapeutic activity and toxicity. Among the 23 patients given daily doses, complete remission was observed in 5/12 relapses of ALL and in 2/11 relapses of AML. When Ara-C (200 mg/m2 x 5 days) was administered concomitantly with m-Amsa (200 mg/m2 x 5 days or 120 mg/m2 x 7 days), 17 out of 37 patients with advanced relapses of ALL (13/25 children and 4/12 adults) went into complete remission. While high doses of m-Amsa alone were well tolerated, the combined treatment with high doses of both drugs resulted in severe gastro-intestinal toxicity. Cardiac disorders were observed in patients who had previously received high doses of anthracyclins; there were 5 cases of dysrhythmia and 1 case each of sudden death, ECG alterations and heart failure. In view of its indisputable activity, m-Amsa should be used at an earlier stage in the treatment of acute leukaemias.

Adolescent↗
PubMed1982

Long-term cost of combined radiotherapy and chemotherapy.

Complications after treatment of Hodgkin's disease are a good model to evaluate the long-term cost of combined chemo- and radiotherapy. Secondary malignancies and mainly acute myelocytic leukemias are the main complications. The 35 of 1,889 cases reported represent increased risk by factor 129. Often preceded by a leukemic phase, they are of poor prognosis. Solid tumors are increased by factor 2.8. They may occur in patients treated by prolonged chemotherapy with alkylating agent without radiotherapy. In seven of 31 patients, solid tumors appeared in the irradiated area. Sterility in young males was present during the first year, though some recuperation was observed thereafter. Better adjustment of treatment to individual risk, to drug sensitivity, and active combinations devoid of alkylating agents are required to reduce the rate of these complications.

Antineoplastic Agents↗
PubMed1982

[Therapeutic strategy in nonseminomatous cancer of the testis].

The prognosis of non-seminomatous carcinoma of the testis has been revolutionized by the introduction of chemotherapy for both advanced and localised forms of the disease. In the last 15 years, 41 cancers of this type (13 Stage I, 16 Stage II and 12 Stage III) have been treated in our Department. All Stage I cancers received postoperative chemotherapy comprising Velbé, Thiotepa, Rufocromomycine and Methotrexate and all are in remission with an average follow-up period of 8 years. Five Stage II had this protocol, the II others had 3 cycles of PVB (a pulmonary recurrence in one case was treated with 3 further cycles of PVB +/- Adriamycin) and curative surgery. This survival is 100 p. 100 with a follow-up ranging from I to II years. Six patients had post-chemotherapy surgery which was always negative. The combination used in Stage I was also used in 8 Stage III patients; there were 7 failures despite falling back on PVB in 4 cases; the 8th case in still is remission after years' follow-up. The PVB protocol was used recently in 4 other cases with 2 complete remissions, one death in remission during thoracotomy (shocking) and one death from aplasia after the first cycle. This gives a 24 p. 100 5 year survival but only a third of Stage III patients had PVB from the outset. A review of the literature and our own experience suggest that curage and chemotherapy are no longer indicated in Stage I; curage is only proposed after 3 cycles of PVB in Stage II cases with a poor prognosis; 4 to 6 cycles of PVB are recommended in Stage III with secondary surgery if indicated. Maintenance therapy does not seem to be necessary.

Follow-Up Studies↗
PubMed1981

[Solid tumours after treatment for Hodgkin's disease (author's transl)].

In a retrospective study covering the years 1963-1976 and involving 1 094 patients, 33 solid tumours were found to have occurred in 31 patients previously treated for Hodgkin's disease. The mean actuarial risk at 10 years of developing a second solid tumour is estimated at 5.4%, but the incidence varies according to the treatment applied, being 10.9% in patients under combined chemotherapy and 1.8% in patients under single-agent chemotherapy (p less than 0,04). This would confirm the role of chemotherapy in the development of second solid tumours, the course of which does not seem to differ from that of indentical primary tumours. The overall risk of having secondary solid tumours after treatment for Hodgkin's disease is 2.4 times higher than in normal control population (p less than 0.01).

Female↗
PubMed1981

[Hodgkin's disease: characteristics and prognosis of forms with initial bone marrow involvement (author's transl)].

The distinctive features and prognosis of Hodgkin's disease with initial bone marrow involvement were studied in 53 patients. This form is characterized by clinical and biological signs of rapid evolution, diffuse lymphoid tissue involvement with enlarged liver and spleen, increased lymphocyte depletion and pancytopenia--the last named being rare in other forms. Sternberg cells were found in 80% of bone marrow biopsies, often associated which fibrosis, which always disappeared during remissions. Remission was obtained with multiple chemotherapy (chiefly MOPP) in 82% of the patients and was complet in 44%. Blood toxicity was severe in cases with myelofibrosis. Relapses occurred in 14 out of 39 patients and were either local and responsive to radiotherapy or diffuse and invariably lethal. They usually took place in those lymph nodes which were most affected initially. Additional radiotherapy and courses of MOPP reduce the risk of relapse. The long-term prognosis was similar to that of other visceral forms, with a survival rate leveling off at 83% after 6 years in patients in complete remission.

Adult↗