PubMed Health⌕ Search

Biomedical subjects

H Høst

Publications and source records attributed to H Høst.

At least 55 records · Page 3Linked to original sources

Immunologic subsets in B cell lymphomas defined by surface immunoglobulin isotype and complement receptor--their relationship to survival.

Cell surface marker profiles were studied on cell suspensions from monoclonal B cell lymphomas. Surface immunoglobulin (sIg) was examined in 178 cases, whereas combined data with sIg and receptors for complement (C3) were available in 99/178 cases. The results showed that B cell lymphomas can be divided into distinct immunological subsets according to surface marker expression. Whereas some histologic subgroups (diffuse centroblastic/centrocytic, centrocytic, immunocytoma) (Kiel classification) consisted of few immunological subtypes, others were more heterogeneous (follicular centroblastic/centrocytic, centroblastic, lymphocytic). By combining immunological and histological subgroups, more than 40 phenotypes could be identified; this diversity most likely reflects, the heterogeneity of the B cell compartment. As part of the same study the prognostic significance of cell marker phenotypes was examined. Survival analysis undertaken on 149/178 patients did not uncover any significant relationship between type of heavy or light chain expression, C3 receptor expression and clinical outcome. Our data do not confirm recent findings that the type of immunological phenotype may be of prognostic significance.

Aged↗

Estrogen receptors and long-term prognosis in breast cancer.

The long-term prognosis in 233 primary breast cancer patients, most of whom had received ovarian irradiation, has been related to the estrogen-receptor status of the primary tumors. The median observation time was 9 years. The receptor status did influence disease-free interval and survival only in patients having metastases in axillary nodes. Thus, in the postmenopausal patients with axillary metastases, the disease-free interval and survival time were longer in receptor-positive than in receptor-negative patients during the first few years of observation. However, this difference disappeared in the course of the subsequent years. In the premenopausal women with axillary metastases the receptor status did not influence the short-term prognosis, and, unexpectedly, seemed to affect adversely the long-term prognosis. It is concluded that the long-term prognosis is no better in breast cancer patients having estrogen receptors in their primary tumors than in those with receptor-negative tumors.

Aged↗

Randomized phase II trial of carminomycin versus 4'-epidoxorubicin in advanced breast cancer.

Sixty-three evaluable patients with advanced breast cancer were randomly allocated to receive three-week intravenous courses of carminomycin (18 mg/m2) or 4'-epidoxorubicin (90 mg/m2). The former yielded one (3%) partial response for nine weeks among 29 patients whereas, in the other arm, nine (27%) of 34 patients achieved partial response for a median of 28 weeks (range, nine to 36 weeks; p less than 0.02). The major toxic effect of these anthracyclines was leukopenia with median white blood cell nadirs of 1,600/microL (range, 300-4,000/microL) versus 1,800/microL (range, 500-4,300/microL), respectively. Acute nonhematologic toxic effects were qualitatively similar but carminomycin produced significantly less gastrointestinal intolerance and alopecia. Patients whose disease failed to respond to first-line anthracycline received doxorubicin (60 mg/m2) every three weeks. Four partial responses were obtained among 19 patients previously treated with carminomycin. Following 4'-epidoxorubicin therapy, one of 12 evaluable patients also attained partial response. Survival curves were not affected by the initial treatment option. Carminomycin has marginal activity against breast cancer whereas 4'-epidoxorubicin deserves further evaluation of its therapeutic index relative to doxorubicin. The design used in this trial appears attractive for prompt phase II evaluation of anthracycline analogs.

Adult↗

Multi-modality treatment of advanced malignant germ cell tumours in males. I. Experience with cis-platinum-based combination chemotherapy.

Three-weekly cis-platinum-based combination chemotherapy with or without subsequent surgery and/or radiotherapy resulted in a 58% 3-year-survival in 79 patients with advanced malignant germ cell tumours. Poor risk factors were relapse after previous chemotherapy, retroperitoneal bulky disease, liver metastases and extremely high serum levels of AFP, beta-HCG, and LDH. Patients with pure seminoma had a high curation rate. The overall toxicity was acceptable. Cis-platinum-based chemotherapy is at present the most effective cytotoxic treatment for patients with advanced malignant germ cell tumours. The relatively low survival rate in poor-risk patients necessitates more aggressive primary chemotherapy in this subgroup of patients.

Antineoplastic Combined Chemotherapy Protocols↗

Multi-modality treatment in males with advanced malignant germ cell tumours. II. Experience with surgery and radiotherapy following cis-platinum-based chemotherapy.

After chemotherapy with cis-platinum, vinblastine and bleomycin, 33 surgical procedures were performed in 29 patients with advanced malignant germ-cell tumours. The tumour masses could be completely resected macroscopically in 26 patients. Histology of the operation specimens showed fibrosis/necrosis (9 specimens), mature teratome (13 specimens) and vital malignant tumour (11 specimens). Patients with fibrosis/necrosis or completely resected mature teratoma had an excellent prognosis, whereas only 5 of the 11 patients with vital malignant tumour survived in spite of second-line treatment with chemotherapy/radiotherapy. Preoperatively elevated serum levels of AFP, beta-HCG and/or LDH indicated the presence of residual vital malignant germ cell tumour. Eight of 14 patients were rendered tumour-free by radiotherapy given as second- or third-line treatment. In general, tumour masses, remaining after cis-platinum-based induction chemotherapy should be resected as completely as possible even in the case of mature teratoma or fibrosis/necrosis. Radiotherapy should be considered as second- and third-line treatment in selected patients.

Antineoplastic Combined Chemotherapy Protocols↗

Phase I study of the plant protein ricin.

A Phase I study was carried out with ricin, a plant toxin acting by inhibiting protein synthesis, on 54 cancer patients with advanced disease. Ricin was given as i.v. bolus injections every two weeks at dose levels ranging from 4.5 to 23 micrograms/sq m of estimated body surface area. Ricin was well tolerated at doses up to 18 to 20 micrograms/sq m. At these levels and at higher levels, flu-like symptoms with fatigue and muscular pain appeared and, in some patients, nausea and vomiting occurred also. No myelo-suppression was seen. Antibodies to ricin were detected in serum after two to three ricin injections. Ricin was eliminated from blood according to first order kinetics. At each dose level, the plasma concentrations, as well as the side effects, showed only minor differences between patients. The highest dose given, 23 micrograms/sq m, gave plasma concentrations twice those found previously to be therapeutically effective in tumor-bearing mice. Of 38 evaluable patients, one patient with lymphoma had a partial response. Stable disease was observed in four patients with renal cancers, in two with soft tissue sarcomas, and in one patient each with mesothelioma, thyroid, and rectal cancer. A dose of 23 micrograms/sq m is recommended for Phase II trials of ricin.

Abrin↗

A phase II trial of peplomycin in squamous cell carcinoma of the lung.

A phase II trial has been performed in squamous cell carcinoma of the lung using peplomycin. This compound is a bleomycin analogue with less pulmonary toxicity and a broader antitumor effect than bleomycin in experimental animal systems. Twenty-one evaluable patients were treated using a dose schedule of 5 mg/m2 twice weekly intravenously. None of the patients had previously received radiation or chemotherapy. The median dose of peplomycin received was 160 mg (range 45-254). One patient obtained a partial remission lasting 3 months. One out of 21 patients developed clinical symptoms and a decrease in the lung function test performed during treatment indicative of toxicity. Other manifestations of toxicity are comparable to those of bleomycin.

Aged↗

Phase II trial of diaziquone (AZQ) in advanced malignant melanoma.

Forty-two evaluable patients with malignant melanoma received AZQ 27 mg/m2 i.v. every 4 weeks. In 5 patients with poor marrow reserve this dose was reduced to 20 mg/m2. Doses were rapidly escalated when no significant myelosuppression was encountered in previous courses. Twenty-five patients had received no prior chemotherapy. A single partial response was obtained for 3 months. Inconsistent myelosuppression was the main toxic effect in this trial. The median WBC and platelet nadirs were 3200/mm3 (900-19,500) and 105,000/mm3 (33,000-530,000) respectively. In 2 patients leukopenia was complicated by a transient episode of infection. One-third of the patients did not experience significant myelosuppression. Non-hematologic adverse reactions were generally mild to moderate and consisted of nausea and vomiting in 26 patients and alopecia in 1. It is concluded that at this dose schedule AZQ is ineffective against malignant melanoma.

Adult↗

Myelopathy following radiotherapy of bronchial carcinoma with large single fractions: a retrospective study.

A series of 387 patients with bronchial carcinoma treated with a concentrated split course regimen was surveyed for radiation myelitis. The total dose was 38 Gy. Three fractions of 6 Gy were given the first week. After a three-week interval the patients had a second course of radiotherapy with fractions of 4 Gy on 5 consecutive days. A spinal shield was used in 230 patients for the last two fractions of radiotherapy. The median survival for all patients was 9.4 months. Seventeen cases of radiation myelopathy were found. The life table method was used to calculate the risk of myelopathy in surviving patients, showing risk levels of 30 +/- 15% in patients surviving three years or more. The average age of the patients with myelopathy was 57.6 years, compared to 62.9% years in the total population. Statistical analysis showed a borderline significant increased risk for myelopathy in females, and a significant increased risk in younger patients (P = 0.03). No difference in the incidence of myelopathy was found in patients treated with or without a spinal shield.

Actuarial Analysis↗

Role of radiation therapy in small cell anaplastic carcinoma of the lung.

The previously established roles of radiotherapy in the management of small cell anaplastic carcinoma of the lung have changed with the development of improved chemotherapy. A group of the International Association for the Study of Lung Cancer has concluded that while there is established evidence that the addition of chemotherapy improves the results of radiation therapy, the value of the addition of loco-regional radiation therapy to chemotherapy is uncertain and more difficult to assess. No advantage in short-term (median) survival has been shown in randomized studies, but current data suggest a possible advantage in long-term control of loco-regional disease. Further results of prospective trials are needed to resolve this question. Prophylactic cranial irradiation reduces the incidence of cerebral metastases but so far has not resulted in improved survival. Pending the results of further randomized studies, its routine use in all patients is not advocated. The palliative role of radiation therapy is valuable in symptomatic treatment. Various current modifications of technique to improve the results of conventional radiation treatments with an altered fractionation schedule and use of sensitizers and large fields are not believed to show major advantages. The clear documentation of treatment details and the definition of the criteria for the assessment of results are important if further comparisons of results are to be made possible. In particular, the need for reporting long-term survival at 2 years in contrast to the more usual median survival time is stressed.

Antineoplastic Agents↗

Leukocyte adherence inhibition assay in human pulmonary neoplasia.

The hemocytometer leukocyte adherence inhibition technique was used to study cell-mediated immuno-activity of patients with lung cancer. KCl extracts (3.5 M) from the lung cancer cell line Calu-1 and the breast cancer cell line MCF-7 were used as antigens. Of 138 patients with lung cancer, 85% showed a positive response against the Calu-1 antigen. The response was independent of the histological type of the tumor and was the same among untreated patients, patients undergoing different types of treatment and patients who died within 3 months after blood collection. Twenty-five percent of the untreated lung cancer patients also reacted against the breast cancer antigen. Among lung cancer patients undergoing different types of treatment, 36% reacted while 50% of the patients who died within 3 months after blood collection reacted against the breast cancer antigen.

Antigens, Neoplasm↗

Distribution of T-cell subsets identified by monoclonal antibodies in cell suspensions from lymph node biopsies of human B-cell lymphomas.

The distribution of T-cell subsets has been examined in cell suspensions from lymph node biopsies from 37 non-Hodgkin lymphomas (NHL) of B-cell origin and 8 cases of Hodgkin's disease (HD). T-inducer/helper cells (T4+ cells) and T-suppressor/cytotoxic cells (T8+ cells) were identified by the monoclonal antibodies OKT4 and OKT8, respectively. Compared with reactive lymph nodes the T-cell subset distribution was aberrant in 18/37 (48.6%) of the B-cell lymphomas. The T-suppressor subset was dominating cells in 14/37 (37.8%) and the T-helper subset in 4/37 (10.8%) of the cases examined. In patients with leukaemic disease, a concordant T-cell subset distribution in lymph nodes and PBL was observed in 5 out of 6 cases. HLA-DR antigen was examined in a selected number of cases with a heteroantiserum. In general, the T-cells from neoplastic tissues expressed an increased percentage of HLA-DR antigen. This was most pronounced in cases with a dominance of T8+ cells, in which the majority of T8+ cells expressed HLA-DR antigen. These findings suggest that an increased proportion of activated T-suppressor cells are present in a proportion of B-cell lymphomas. Possible clinical and biological implications are discussed.

Antibodies, Monoclonal↗