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H L Seewann

Publications and source records attributed to H L Seewann.

At least 19 recordsLinked to original sources
PubMed1995

Heavy-chain immunoglobulin gene rearrangement and cytoplasmic immunoglobulin expression in acute monocytic leukemia following primary germ cell tumor.

A case of acute monocytic leukemia with rearrangement of the immunoglobulin heavy-chain gene and strong cytoplasmic immunoglobulin expression in a young patient treated with multi-drug chemotherapy for primary seminomatous germ cell tumor 13 months earlier is reported. The short latency period from the beginning of therapy for primary germ cell tumor and the abrupt onset of leukemia with no identifiable prodrome bear similarities to podophyllotoxin-related leukemias.

Adult↗
PubMed1995

Interferon-alpha for induction and maintenance in multiple myeloma: results of two multicenter randomized trials and summary of other studies.

BACKGROUND: Interferon (IFN) treatment trials in multiple myeloma have yielded discordant results regarding response rates, maintenance duration, and survival times. Further randomized trials and global evaluations of available data are urgently needed for clarification. PATIENTS AND METHODS: 256 patients participated in a randomized trial, 125 on IFN + VMCP, and 131 on VMCP alone. 100 patients were randomized to IFN maintenance (n = 46) or were untreated controls (n = 54). Global evaluations are based on 1,518 patients in induction and 924 in maintenance trials. RESULTS: The induction trial demonstrated a significantly (p < 0.05) lower rate of progressive disease under IFN + VMCP (10.6%) than under VMCP (22.9%), but this benefit was limited to stage I or II patients. Median progression-free survival was longer in the IFN + VMCP arm (23.2 months vs. 15.8 months); median overall survival did not differ significantly (38.9 vs. 30.2 months). The IFN maintenance treatment trial showed significantly superior results in the IFN arm versus controls (median maintenance duration: 17.8 months and 8.2 months (p < 0.01), survival: 50.6 and 34.4 months (p < 0.05), respectively). Previous IFN treatment increased the benefits of IFN maintenance therapy. Adverse effects of IFN during induction were hematologic toxicity, fever, and infections, requiring dose reductions. Toxic effects of IFN maintenance treatment were mild. Global evaluations of randomized trials showed small but significant benefits of combined IFN induction therapy and significantly prolonged maintenance duration and survival under IFN maintenance. CONCLUSIONS: Presently available data support the use of IFN maintenance treatment because it significantly prolongs maintenance duration and survival. IFN added to induction chemotherapy resulted in minor improvements at the expense of increased toxicity, highlighting the need for better induction regimens.

Adult↗
PubMed1993

Chemohormonal and immunohormonal approaches in advanced prostatic carcinoma.

The standard palliative treatment for patients with advanced prostate cancer has for the past 50 years been androgen withdrawal. However, owing to the presence of hormone-insensitive cell clones, the benefits of this approach have now appeared to reach their optimum. It is now generally believed that further major therapeutic advances in the treatment of prostate cancer are unlikely, unless consideration is given to these hormonally independent cells. Two possible alternative strategies which address this problem are chemohormonal and immunohormonal approaches, both of which are discussed in detail in this article.

Androgen Antagonists↗
PubMed1991

Treatment of thrombocytosis in chronic myeloproliferative disorders with interferon alfa-2b.

Thirty-six patients with chronic myeloproliferative disorders (CMPD) with thrombocytosis (essential thrombocythaemia 19 patients, chronic megakaryocytic granulocytic myelosis five, polycythaemia vera six, chronic myelogenous leukaemia six) were treated with interferon alfa-2b to reduce the platelet count. The pre-treatment platelet count was in the range 450-700 x 10(9)/L in eight patients, 700-1000 x 10(9)/L in eight and above 1000 x 10(9)/L in 20. In the induction phase of treatment 22 patients were treated with interferon alfa-2b 3 million units (MU) daily subcutaneously for 2 months or until the platelet count returned to normal, if earlier. Fourteen patients received 5 MU interferon alfa-2b daily in the same way. In the maintenance phase the doses were reduced to 3 MU and 5 MU thrice weekly, respectively. Complete response (CR), defined as a reduction of platelet count to below 450 x 10(9)/L, was achieved in 78% of patients (within 2 months of induction in 64%). The platelet depleting effect was dose dependent: CR in 2 months in 52% on 3 MU interferon alfa-2b versus 75% on 5 MU. Reduction of interferon dose was followed by an increase in platelet count in 39% of patients. The white cell count fell by 50% in Philadelphia-negative CMPD. Side effects were common, though generally mild, but led to withdrawal of treatment in six patients. Three patients suffered cerebrovascular events during treatment and one shortly thereafter.

Adult↗
PubMed1991

Interferon alfa-2b with VMCP compared to VMCP alone for induction and interferon alfa-2b compared to controls for remission maintenance in multiple myeloma: interim results.

The present trial was designed to evaluate whether interferon (IFN) combined with standard induction chemotherapy and/or interferon remission maintenance treatment improve treatment results in patients with multiple myeloma. Up to now 89 patients have received IFN plus vincristine/melphalan/cyclophosphamide/prednisolone (VMCP) as induction therapy, and 86 conventional VMCP. The proportion of patients with progressive disease was significantly lower (P less than 0.005) under IFN + VMCP as compared to the VMCP treatment group. Survival times were significantly longer (P less than 0.02) after IFN + VMCP induction therapy than after VMCP alone. In the second phase of this investigation, 33 progression-free myeloma patients were assigned to receive IFN as maintenance therapy, and 41 patients served as untreated controls. Patients maintained with IFN showed a tendency towards increased progression-free survival. Haematological side effects were observed significantly more often in patients receiving IFN, with more severe haematological toxicity in patients on the combined IFN + VMCP regimen and an increased number of patients with mild haematological toxicity in the group maintained with IFN. Other side effects, such as fever and fatigue, remained within tolerable limits. In conclusion, the preliminary results of this current clinical trial indicate significant advantages of combined IFN + VMCP induction treatment in terms of reduced disease progression and prolonged survival and possible benefits of IFN maintenance therapy in patients with multiple myeloma.

Adult↗
PubMed1991

Non-systemic diffuse lymphangiomatosis of spleen and liver.

We present a 27-year-old woman with non-systemic diffuse lymphangiomatosis of spleen and liver. The tumour consisted of capillary and cavernous lymphatic vessels located in abundant fibrous tissue. The vascular endothelium showed immunoreactivity for factor VIII-related antigen. A basal lamina could be demonstrated immunohistochemically and by electronmicroscopy.

Adult↗
PubMed1988

Interferon-alpha-2 in the treatment of idiopathic myelofibrosis.

We investigated the effect of human recombinant DNA-derived IFN-alpha-2 given in a dose of 1-2 X 10(6) units daily by subcutaneous injection to five patients with advanced idiopathic myelofibrosis (IM). Transfusion dependent anemia and symptomatic splenomegaly were taken as inclusion criteria for this pilot study. Two patients succumbed, one and three months after starting interferon-treatment because of pneumonia and traumatic cranial injury, respectively. While on IFN-treatment no improvement of cytopenia or reduction of splenomegaly was seen in four of the patients. In one patient, however, the requirement for erythrocyte transfusions decreased from 5 to 1.7 monthly upon IFN-treatment. After two, four and six months respectively IFN-treatment had to be stopped in these cases because of progressive thrombocytopenia and/or neutropenia. These observations suggest, that IFN-alpha might be of only marginal value in the treatment of advanced idiopathic myelofibrosis.

Aged↗
PubMed1987

[Recombinant (IFN-alpha 2b) therapy in hairy cell leukemia].

Eighty-five patients with hairy-cell leukemia were treated in a multicentric "open label" study with IFN-alpha 2b and evaluated. Induction therapy was 2 X 10(6) U IFN-alpha 2b/m2, 3 times a week, s.c. The results show this regimen to be highly effective with only a few tolerable and transient side effects consisting mainly of flu-like symptoms. After 6 months of therapy 4% CR, 69% PR, and 16% MR, were noted. In a small group of four patients who had achieved CR or PR, we tested the effect of varying doses for maintenance therapy. Our preliminary results indicate that a relapse caused by interruption of IFN therapy or dose reduction to 3 X 10(6) U given once a week, o.c. could be successfully treated by readministration, or escalating the dosage of IFN. It seems that remission maintenance requires long-term treatment with IFN. In a short-term in vitro test we studied the effect of IFN-alpha 2 on the incorporation of 3H-thymidine and 3H-uridine into hairy cells of five patients. Fort both precursors no appreciable effect was detected. However, after prolonged incubation for 48 h, a significant enhancement of 3H-uridine incorporation was observed, while 3H-thymidine incorporation remained unaffected. Cell marker analysis performed with monoclonal antibodies before and after incubation of hairy cells with IFN-alpha 2 for up to 7 days did not reveal any change of the phenotype of hairy cells.

Clinical Trials as Topic↗
PubMed1986

[Jamshidi biopsy in clinical hematology. Method, indications and results of over 1,000 completed biopsies with special reference to chronic myeloproliferative diseases].

One thousand and five bone marrow biopsies were performed in patients with haematologic or oncologic disorders during a ten year period from 1976 to 1985 according to the method of Jamshidi and Swaim. Indications and method of biopsy are discussed in detail. Major side effects were not observed, however minor accidents (0.2%) as well as problems in yielding biopsy-material (1.6%) are reported. The rate of biopsy-failure, including biopsies with insufficient (crushed) material, was 5%. In our hands the predominant value of the Jamshidi-biopsy for diagnosis of hematologic disorders is given by the following reasons: Bone marrow histology gives a more detailed architectural picture than cytologic smears. Sampling of bone marrow for both methods (cytology and histology) through the same instrument is possible. The procedure is easily performed and gives the patient no more discomfort than a simple sternal puncture. Chronic myeloproliferative disorders (CMPD, 31%), malignant lymphomas (40%) and aplastic (hypoplastic) syndromes (4%) were the most frequent indications for bone marrow biopsy. Clinical and histological findings were compared in 235 patients with CMPD. The histological defined entity of chronic megacaryocytic-granulocytic myelosis could be differentiated easily from chronic granulocytic leukemia (CGL), however it was not always distinguishable from primary thrombocythemia by means of clinical and hematological criteria. Myelofibroses on the basis of CGL were separated from idiopathic or postpolycythemic fibroses by hematological findings. The diagnostic value of bone marrow biopsies was superior to cytology in all CMPD and proved to be an essential diagnostic method in cases with high platelet count. Marrow involvement was found in 59% of 218 previously untreated patients with non Hodgkin's lymphomas and in 9% of 123 patients with Hodgkin's disease. Jamshidi-biopsy proved to be a simple and indispensable procedure in staging of Hodgkin's and non-Hodgkin's lymphomas.

Anemia, Aplastic↗
PubMed1984

[Iron overload].

Explore the source record for details and available documents.

Blood Transfusion↗
PubMed1984

[Drug therapy in advanced squamous cell carcinoma of the ORL region].

This paper reviews the role of chemotherapy in advanced squamous cell carcinoma of the head and neck region (SSCHN). Two different areas of administration are discussed separately: (1) Palliative therapy in recurrent disease, and (2) chemotherapy as additional measure in first line treatment of advanced SSCHN aiming at an increase of the disease-free survival and the cure rate. Overall response rates of 80% and complete clinical remissions in about 40% of the cases can be achieved in locally untreated tumors. On the other hand, recurrent SSCHN respond not as well to chemotherapy; nevertheless, a good temporary palliative effect is reached in more than half of the patients. As example for the numerous combination programs studied in the last few years, we report some data of the two protocols evaluated at our clinic, cis-diamminedichloroplatinum/adriamycin and methotrexate/5-fluorouracil, respectively.

Antineoplastic Agents↗
PubMed1983

The value of bone marrow biopsy in chronic myeloid leukaemia.

Seventy-six patients with chronic myeloid leukaemia (CML) could be subdivided by core biopsy into chronic granulocytic leukaemia (CGL, n = 24) and chronic megakaryocytic granulocytic myelosis (CMGM, n = 52). By pure clinical definition 59 patients were grouped as classical CML and 17 showed a course which we termed atypical myelosis. The most reliable criteria for distinguishing between the classical and atypical forms were ALP-Index, peripheral leukocyte and platelet count and the estimated number of megakaryocytes in the bone marrow. The classical myeloses consisted of 40 per cent CGL and 60 per cent CMGM whereas the atypical consisted of CMGM only including all stages of fibrosis. Fibrosis was at the time of bone marrow biopsy found in 20 per cent of classical CML and in about 50 per cent of atypical myeloses. In classical CML Philadelphia chromosome could be detected in all the patients with CGL and in 50 per cent of those with myelofibrosis. Atypical myeloses did not exhibit Philadelphia chromosome. In 70 per cent of the cases it was possible to distinguish between CGL and CMGM by peripheral blood findings and bone marrow cytology.

Adult↗
PubMed1982

[IgD-paraproteinemia in lymphoplasmacytoid immunocytoma].

Laminectomy was performed in a 54-year-old patient who had a hemicauda syndrome. An epidural tumour, extending into the spongiosa of the third lumbar vertebra was found. Histologically it was a lymphoplasmacytoid lymphoma. Subsequent haematological investigation revealed a multilocular involvement (stage IV) and paraproteinaemia of the IgD-kappa-type. There was no Bence-Jones protein in the urine. After irradiation of the affected lumbar vertebra the patient was treated with a combination of chlorambucil and prednisone, later on with COP and VMCP regimens. A rapid downhill course set in 16 months after diagnosis and the patient died from intracerebral expansion of the immunocytoma. The clinical diagnosis was confirmed at autopsy. The generalized lymphoplasmacytoid immunocytoma contained evidence of terminal transformation into the polymorph subtype.

Chlorambucil↗
PubMed1982

[Comparative clinical and histological investigations in chronic myeloid leukaemias ].

76 cases of CML were divided according to clinical parameters (duration of illness prior to diagnosis, size of spleen, leucocyte and platelet counts, ALP index, bone marrow cytology and others) into groups showing a classical or an atypical course of the disease. All patients were submitted to bone marrow biopsy, using the method of Jamshidi and Swaim. The histological subtypes of CML, i.e. chronic granulocytic leukaemia and chronic megakaryocytic granulocytic myelosis were correlated with the two clinical types of disease. The classical form of CML was histologically inhomogeneous and was subdivided into 40% cases of chronic granulocytic leukaemia and 60% cases of chronic megakaryocytic granulocytic myelosis. At the time of bone marrow biopsy 20% of patients with classical leukaemia were already found to have myelofibrosis. The atypical myeloses consisted of chronic megakaryocytic granulocytic myelosis only and myelofibrosis was present initially in 50% of patients. In view of these findings agnogenic myeloid metaplasia is considered to be merely a variant of chronic myeloid leukaemia and the term "atypical myelosis" is preferred.

Bone Marrow Examination↗