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Biomedical subjects

H Haaxma-Reiche

Publications and source records attributed to H Haaxma-Reiche.

33 records · Page 2Linked to original sources
PubMed1992

Treatment of brain metastases of small cell lung cancer with teniposide.

Over 50% of patients with small cell lung cancer (SCLC) will develop symptomatic brain metastases during the course of their disease. Results of whole brain radiotherapy, the standard treatment, are rather poor and relapses are frequent. Thus, new modes of therapy are urgently needed for these patients. In this study, the efficacy of teniposide was evaluated at a dose of 150 mg/m2 intravenously on days 1, 3, and 5 at 3-week intervals. In 11 of 26 evaluable patients an intracranial response was observed. Median response duration was 23 weeks (range, 9 to 50). Toxicity was acceptable, with grades 3/4 leukocytopenia and thrombocytopenia reported in 37% and 16%, respectively, of 123 courses. Therefore, teniposide is an effective agent against brain metastases of SCLC and is suitable for palliation of these patients.

Aged↗
PubMed1989

Normal cerebrospinal fluid dynamics. A study with intraventricular injection of 111In-DTPA in leukemia and lymphoma without meningeal involvement.

The cerebrospinal fluid flow pattern in seven patients with leukemia or lymphoma, but without prior meningeal or cerebral disease, was studied following introduction of indium-diethylenetriamine pentaacetic acid In-DTPA 111 in a lateral ventricle through an Ommaya reservoir. The time to egress from the ventricular system into the basal cisterns was variable but generally short. One hour after administration, the basal cisterns were clearly visible in all patients. Thereafter, kinetics throughout the cranial and spinal subarachnoid space were consistent. The flow patterns of three patients cured of meningeal dissemination and one patient with mild meningeal leukemia were similar to the normal pattern.

Adolescent↗
PubMed1989

High dose etoposide for brain metastases of small cell lung cancer. A phase II study. The EORTC Lung Cancer Cooperative Group.

Symptomatic brain metastases are found in about 40% of patients with small cell lung cancer. Cranial irradiation is the first line treatment for this form of metastatic disease. Frequently brain metastases recur after this treatment or develop after prophylactic cranial irradiation. For these patients no effective antitumour therapy is available. In this study the efficacy of high dose etoposide 1.5 g m-2 was evaluated. In 10 (43%) out of 23 evaluable patients a response was seen. Toxicity was severe with five aplasia-related deaths. For palliative purposes this regimen is too toxic in heavily pretreated patients.

Adult↗
PubMed1989

Initial bolus of conventional versus high-dose dexamethasone in metastatic spinal cord compression.

We randomly assigned dexamethasone in an initial bolus of 10 mg IV or 100 mg IV followed by 16 mg daily orally to 37 patients with metastatic spinal cord compression. The average pain score before the start of treatment was 5.2 (SD = 2.8) and decreased significantly (p less than 0.001) to 3.8 at 3 hrs, 2.8 at 24 hrs, and 1.4 after 1 week. There were no differences between the conventional and high-dose group on pain, ambulation, or bladder function.

Adult↗
PubMed1988

Podophyllotoxins for brain metastases of small cell lung cancer.

A patient with brain metastases of small cell lung cancer (SCLC) responded initially to cranial irradiation. Recurrences were subsequently successfully treated with high-dose intravenous etoposide (VP 16-213) and teniposide (VM 26). Epipodophyllotoxins are potentially useful for CNS metastases of SCLC.

Brain Neoplasms↗
PubMed1988

Experiences with the Ommaya reservoir for prophylaxis and treatment of the central nervous system in adult acute myelocytic leukemia.

Intraventricular chemotherapy was administered to adult AML patients via an Ommaya reservoir. Twenty-eight patients received central nervous system (CNS) prophylaxis and seven patients were treated for meningeal leukemia (ML). A treatment course lasted at least 6 months. Asymptomatic ML developed in two patients (7%) of the prophylaxis group concomitantly with bone marrow relapse. One of these patients had not completed the standard course. CNS remission could be obtained in all evaluable patients with ML. The easy entrance to the cerebrospinal fluid (CSF) offers the advantage of frequent investigations of the CSF, early diagnosis and treatment of CNS relapses without radiotherapy, and caused little patient discomfort. CNS prophylaxis in this small study seemed to prolong first remission duration slightly. In M4 and M5 subtypes CNS prophylaxis can be valuable.

Adolescent↗
PubMed1988

Acute lymphoblastic leukemia in adults: results of intraventricular maintenance chemotherapy for central nervous system prophylaxis and treatment.

The results of intraventricular (i.vt.) chemotherapy in 36 cases of adult acute lymphoblastic leukemia (ALL) were analyzed to define a useful and reliable form of central nervous system (CNS) prophylaxis. Patients received methotrexate (MTX) via an Ommaya reservoir six times every 4 weeks. This was repeated when bone marrow relapse occurred. Intraventricular maintenance CNS prophylaxis during half a year appeared adequate, since primary CNS relapses were seen in only two patients (5.6%). These patients had failed to follow the prophylaxis schedule. The procedure was implemented and repeated relatively easily and did not lead to neurotoxic problems. The i.vt. route was also satisfactory for the treatment of initial and recurrent episodes of meningeal leukemia (ML). The therapy reduced morbidity caused by ML to a minimum.

Adolescent↗
PubMed1988

Penicillin concentrations in cerebrospinal fluid (CSF) during repository treatment regimen for syphilis.

Penicillin concentrations in cerebrospinal fluid (CSF) were measured in 40 asymptomatic patients with syphilis, 10 of whom had neurosyphilis. The patients were treated with 2.4 MIU procaine penicillin a day intramuscularly in combination with 500 mg probenecid every six hours orally. This intramuscular treatment regimen did not consistently yield treponemicidal penicillin concentrations in the CSF (subtreponemicidal CSF concentrations were found in 17 patients, four of whom had neurosyphilis). These data provide additional evidence that the cure of asymptomatic neurosyphilis is not guaranteed by intramuscular penicillin treatment.

Drug Therapy, Combination↗
PubMed1987

High-dose etoposide for central nervous system metastases of small cell lung cancer. Preliminary results.

High-dose etoposide (1.0-1.5 g/m2) was given to 17 small cell lung cancer (SCLC) patients with metastases in the central nervous system. In 4 out of 9 evaluable patients with brain metastases and 4 out of 5 patients with meningeal carcinomatosis a response was seen. In all patients severe myelosuppression was observed. Three patients died of septicemia during the aplastic phase. Despite severe toxicity high-dose etoposide is potentially useful for CNS metastases of SCLC.

Adult↗
PubMed1984

Penetration of VP 16-213 into cerebrospinal fluid after high-dose intravenous administration.

VP 16-213 in standard doses is active against a number of solid tumors. Its penetration into the cerebrospinal fluid (CSF) is very limited at these dose levels. In 10 patients treated with high-dose VP 16-213 (0.9-2.5 g/m2), CSF levels of up to 0.54 microgram/mL were detected. In two patients with central nervous system (CNS) metastases of small cell lung cancer (SCLC) a response was seen after 1.0 and 1.5 g/m2 intravenously. High-dose VP 16-213 can possibly play a role in the treatment of CNS metastases of SCLC. Its application in late intensification regimens as a form of prophylaxis of CNS metastases should be investigated.

Adult↗
PubMed1982

Combination chemotherapy for acute lymphocytic leukaemia in 25 adults.

Twenty-five consecutive adult patients with acute lymphocytic leukaemia (ALL) all achieved complete remission, twenty-two with vincristine-prednisone, while thirteen patients also received daunorubicin (DNR). Three patients obtained remission only after treatment with cytosine arabinoside (Ara-C), 6 thioguanine (6-TG) and adriamycin (ADM). Despite central nervous system (CNS) prophylaxis by intraventricular infections via an Ommaya reservoir, 2/22 patients had a CNS relapse. The median remission duration of the whole group was 19 months. Four patients could stop therapy after 3 years. The median survival duration of all patients was 38 months. The quality of life of the patients during this chemotherapeutic regimen was good.

Adolescent↗