PubMed Health⌕ Search

Biomedical subjects

G Javier

Publications and source records attributed to G Javier.

51 records · Page 3Linked to original sources
PubMed1981

[Maintenance chemotherapy and inmunotherapy in acute lymphoblastic leukemia (author's transl)].

UNLABELLED: Sixty-one children with ALL were treated between 1970 an 1973 according to a scheme including: a) Remission induction with vincristine-prednisolone-daunorubicine. b) Cytoreduction therapy with 4 drugs (6-MP, MTX,Ara-C and CYCLO) combined two by two in 3 types of associations given at three months cycles. Every three months, two-week "reinductions" with vincristine and prednisolone plus one dose of i.t. MTX. c) Early therapy on CNS, according to two patterns: one group received one dose of i.t. MTX after induction, repeated every 3 months; the other group was given cranial irradiation [2,400 r] plus 5 doses of i.t. MTX. d) After three years of chemotherapy, patients were treated for two more years with BCG by scarification. RESULTS: Complete remission was achieved in 93%. After three years of chemotherapy, 37% of the first group (not irradiated) and 55% of the second (irradiated) persisted in C.R. Twenty-five patients initiated BCG-therapy; eighteen of these (72%) persisted, after 2 years, in C.R.; then all treatment was suppressed. Initial relapses in the 5 years period were hematological in 13, CNS in 13, both hematological and CNS in 2, and testicular in 3. Mortality of patients in C.R. was 4 (7.7%). Survival rates were 33% after 5 years for the non-irradiated group and 50% in the irradiated one. At present, 30% of all evaluable patients who attained remission continue in C.R. after an average time of 102 months-40% in the irradiated group and 20% in the not irradiated-. This difference, statistically significant, is due to the number of CNS relapses: 13 of 30 (43%) in the first group and 3 of 22 (13.1%) in the second. The 24% relapses occurring during immunotherapy do not permit to assess the efficacy of this form of therapy.

Antineoplastic Agents↗
PubMed1980

[Chronic granulomatous disease: clinical and functional studies in six cases (author's transl)].

Six cases of chronic granulomatous disese (CGD), three of which correspond to the X-linked genetic form and the three other to the autosomic recessive type are reported. The fact of half of the patients being females is relevant as only 24 are cited by Klebanoff and Clark in their revision in 1978. X-linked CGD: The three patients, two of them brothers, presented their first manifestations in the first year of life; in one of the BCG given at one week of life resulted in adenitis of protracted course with calcificaton. The clinical course has been very severe in two of them. At the present time the patients are 15, 11 and 9 years old. Functional studies have shown very low values in NBT tests, O2 consumption, iodination and bactericidal activity in all three. Intermediate values in the mothers and normal values in the fathers were found. Autosomal CGD: Of our three patients, two were sisters. The first manifestations appeared during the first thrimester of life. The eldest had hepatic and pulmonary granulomata at three years old. At five years, she presented an intestinal obstruction syndrome with gastric antral, duodenal and ileal stenosis caused by intramural granulomata and inflammation; she died of pneumonia shortly after. Her sister had dermatitis, hepatic abscess, pneumonia, adenitis and osteomyuelitis of the ribs; she died at six years old after a bronchopneumonia. Last patient had a sister who died at two years old affected probably gy CGD. At present our patient is 17 months old and so far had recurrent otitis, adenitis, a pneumonia and, recently, hepatic granulomata have been found. Fonctional studies in the two sisters showed similar alterations as those of the three boys. In this patient an alteration of chemotaxis of cellular origen was found as well.

Adolescent↗
PubMed1976

[Neonatal leukemia. Report of seven cases (author's transl)].

No more than 150 cases of neonatal leukemia had been reported in the literature. Seven additional cases are reported herein. The incidence of neonatal leukemia has been of one in 50,000. Its incidence among the group of neonates requiring hospitalization has been of 0.075%. The seven neonates with leukemia consist of five males and two females. Two of them had an associated Down's syndrome. Abdominal distension, hepatomegaly, splenomegaly, cutaneous manifestations and purpura were the most frequent clinical findings in our patients. Severe anemia was present in only three patients. Thrombocytopenia was recognized in six of them. A high white blood cell count was present in five patients. The number of blast cells in their peripheral blood smear ranged between 16 and 100%. A remarkable myeloid dominance was observed. One patient died two hours after birth and his diagnosis was made at autopsy. Three patients were diagnosed before the age of three weeks. The three patients with myeloid leukemia were treated with DNR and Ara-C. A complete hematological remission was achieved in two of them. One patient died of a Pn. carinii pneumonia one month after the remission was induced. The remainder patient of this group had a Down's syndrome and the leukemia had been confirmed by hepatic biopsy. After two years of maintenance with Ara-C and Thioguanine he is alive and both, peripheral blood and bone marrow, remains normal. A lymphocitic leukemia was seen in only two patients. One was treated with prednisolone and VCR, and the other with prednisolone, VR and L-Asp. In both cases a good response to the chemotherapy was observed. Autopsy was performed in all patients who died but one. The pathological findings are analyzed. The low survival among patients with neonatal leukemia may be influenced by the toxic side effects of the used chemotherapy. All aspects of the medical treatment including drugs of choice and the usefullness of isolation devices are further discussed.

Cytarabine↗
PubMed1976

[Factors influencing outcome in children with acute lymphoblastic leukemia (author's transl)].

Several factors such as age, sex, cytological type, visceromegaly, blast cell count in peripheral blood and recently some immunological traits, have been incriminated by some authors as having a variable prognostic value. Hypothetical influence of some of these factors on the rate and duration of the complete remission in an homogeneous group of 61 children with acute lymphoblastic leukemia have been studied. All of them were treated with same schedule (C protocol) in order to eliminate therapy influence. Some differences, without statistical significance, have been found related to: A) Sex: Mean duration of complete remission has been longer in females. B) Blast cell count in peripheral blood: Patients with initial blast-cell values under 25.000/mm3 have shown an increased number of complete remissions and a longer duration of the complete remission. No relationship has been found between initial age or visceromegaly and duration of complete remission. Neither, no relationship between cytomorphologic type and rate and duration of the complete remission could be established in our series.

Age Factors↗
PubMed1976

[Duration of chemotherapy in acute lymphoblastic leukemia of childhood (author's transl)].

Most of criteria on duration of chemotherapy in acute lymphoblastic leukemia of children are based upon the prolonged state of complete remission (CR). Twenty five cases of 30 months CR duration were studied for their follow-up. Maintenance therapy in these patients was made according to two modalities. The first one was a cyclic single therapy with no prophylactic CNS treatment and the other was a combination chemotherapy method including periodical reinductions and i.t. administration of methotrexate. Most of the 30 month remissions (twenty) were attained by the last method. Until now evolution of the 25 patients has been as follows. Two died, being in CR, by infectious diseases. Eleven more suffered relapses, most of them in the following year. The other twelve patients remain in the initial CR. Chemotherapy was supressed in 10 patients (in seven at 36 months and in three at 48 months) starting then BCG immunotherapy. Three of these children suffered relapses a few months after suppression. Seven others are in remission of 47 months median duration. In other five patients, chemotherapy was not interrupted. Two died by infectious diseases and other three have relapsed. Even though the experience is too short in order to establish any conclusion, results obtained until now appear to favor suppression of chemotherapy after 30 to 36 months in patients remaining in CR.

Child↗
PubMed1976

[Multiple agent cyclic chemotherapy in the treatment of acute lymphoblastic leukemia of children ("C"-protocol) (author's transl)].

UNLABELLED: 61 consecutive children having A.L.L., were treated, between 1970 and 1974, according to a chemotherapy protocol including: 1. Induction treatment with prednisolone, vincristine and daunorubicine. 2. Maintenance therapy using three types of two drugs combinations, administered by cycles of three months duration each one. The associations were: mercaptopurine-methotrexate, mercaptopurine-cytosine arabinoside and methotrexate-cyclophosphamide. Between cycles, "reinductions" with prednisolone and vincristine of two weeks duration were given. 3. "Prophylactic" treatment of CNS leukemia was administered according to two modalities: a) In group named C-1, 32 patients received one dose of i.t. methotrexate at the end of the induction treatment and every three months. b) The other 29 patients (C-2 group) were treated by cranial irradiation (2400 r.) and five doses of i.t. methotrexate, after the induction of remission (C.R.). RESULTS: 57 out of 61 patients (93%) attained C.R. Twelve months after induction of C.R., in C-1 group, one patient died by infectious disease and eight relapsed. Twenty (68%) remained in C.R. The number of CNS relapses in this period was six (20%). In C-2 group, from 21 evaluable cases, 18 children (85%) were in C.R. at the end of first year and relapses in CNS were only two (9%). The median duration of remission in the first group was about three years. Percentage of cases with CNS relapses in three years was 35%. At the end of 4 th. year 37% remained in the initial C.R.-80% of the evaluable patients receiving cranial irradiation persisted in remission at the end of the second year. Efficacity of the prophylactic treatment of CNS infiltration, by cranial irradiation and i.t. chemotherapy is confirmed. Cyclic use of several combinations of drugs don't appear to be superior to the use of one single association (MP-MTX), but other combinations used here may be taken in account in cases of severe intolerance to one of these drugs.

Antineoplastic Agents↗