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H Mahmoud

Publications and source records attributed to H Mahmoud.

48 records · Page 3Linked to original sources

The non-random dic(9;12) translocation in acute lymphoblastic leukemia is associated with B-progenitor phenotype and an excellent prognosis.

A dicentric translocation involving the short arms (p) of chromosomes 9 and 12 was identified in 15 of 2303 successfully banded cases of acute lymphoblastic leukemia (ALL) in children, consecutively entered on protocols of the Pediatric Oncology Group (1986-1990) or St Jude Children's Research Hospital (1984 and 1990). The dic(9;12)(p1?1;p1?2) was seen only in patients with a B progenitor cell immunophenotype: the frequency was 0.8% among pre-B cases (4/508) and 0.9% (11/1177) among early pre-B cases. Laboratory and clinical characteristics were similar to those of the general population of children with ALL, with the exception of a marked male preponderance (12/15 cases). Flow cytometric studies revealed a leukemic cell DNA index of 1.0 in all cases. All fifteen patients are in continuous complete remission at a median follow-up duration of 57+ months (range 9-93+ months). These findings suggest that the dic(9;12) is a recurrent chromosomal translocation in pediatric ALL, occurs exclusively in B-progenitor ALL, and unlike other non-random translocations, is associated with an excellent prognosis.

Adolescent↗

Cholelithiasis after treatment for childhood cancer.

The authors evaluated the risk of development of cholelithiasis in 6050 patients treated at a single hospital for various childhood cancers with different therapeutic modalities, including chemotherapy, surgery, radiation therapy, and bone marrow transplantation, from 1963 to 1989. Patients with underlying chronic hemolytic anemia or preexisting gallstones were excluded. Nine female and seven male patients with a median age of 12.4 years (range, 1.2 to 22.8 years) at diagnosis of primary cancer had gallstones develop 3 months to 17.3 years (median, 3.1 years) after therapy was initiated. Cumulative risks of 0.42% at 10 years and 1.03% at 18 years after diagnosis substantially exceed those reported for the general population of this age group. Treatment-related factors significantly associated with an increased risk of cholelithiasis were ileal conduit, parenteral nutrition, abdominal surgery, and abdominal radiation therapy (relative risks and 95% confidence intervals = 61.6 [27.9-135.9], 23.0 [9.8-54.1], 15.1 [7.1-32.2], and 7.4 [3.2-17.0], respectively). There was no correlation with the type of cancer, nor was the frequency of conventional predisposing features (e.g., family history, obesity, use of oral contraceptives, and pregnancy) any higher among the affected patients in this study than in the general population. Patients with cancer who have risk factors identified here should be monitored for the development of gallstones.

Adolescent↗

Percutaneous lumbar intrathecal catheter for the administration of chemotherapy.

We present a patient with Burkitt's lymphoma in whom the initial diagnostic lumbar puncture was difficult due to a recent lumbar laminectomy and residual spinal cord tumor. According to our current protocol, he was to receive intrathecal chemotherapy for three consecutive days. To avoid the need for repeated attempts at lumbar puncture and to ensure the proper instillation of therapy, a percutaneous IT catheter was placed for 48 hours and the three doses of IT chemotherapy were administered through this catheter. Due to the importance of IT chemotherapy, options must be available to deliver these medications when technical or anatomic abnormalities exist. One such option is the short term placement of a percutaneous IT catheter.

Adolescent↗

Acute lymphocytic leukemia of childhood: the problem of relapses.

Developing improved therapy for the one-third or more of patients who can be expected to relapse after initial treatment for acute lymphoblastic leukemia would be less difficult if one could identify potential failures unequivocally at diagnosis. Subgroups of patients who should be considered candidates for highly experimental therapy include infants (less than 1 year of age), patients with the Philadelphia chromosome and perhaps patients with B-cell leukemia. The most important factor that determines the success of therapy after relapse is the length of the patient's initial remission. We recommend bone marrow transplantation for children whose first remission did not exceed 18 months. For all others, it appears that intensive chemotherapy affords as great a potential for cure as one could expect from transplantation. We favor intensive chemotherapy over transplantation in cases of late bone marrow relapse (greater than 18 months), because of the currently high peritransplantation mortality rate. It is not clear whether either modality will be adequate for patients relapsing on contemporary treatment programs.

Antigens, Neoplasm↗

Biology and staging of childhood non-Hodgkin lymphoma.

Childhood non-Hodgkin lymphomas are relatively common childhood cancers composed of malignant B lymphocytes or thymocytes at various stages of maturation, usually intermediate or late. Most often, they have a diffuse pattern of infiltration and are high grade, lymphoblastic, small noncleaved-cell (undifferentiated, Burkitt or non-Burkitt types) or large cell types. Primary site correlates with immunophenotype and histopathology. For example, most abdominal tumors are B cell and non-lymphoblastic types, and most thoracic primary tumors are of thymocytic origin. Skin presentations are rare, usually lymphoblastic in histology and often of the pre-B cell phenotype. An appropriate work-up and adequate staging is mandatory, since the selection of therapy depends heavily on disease stage. Histopathologic findings are additionally important in determining appropriate therapy for advanced-stage disease. Finally, cytogenetic studies of B and T cell malignancies have defined nonrandom abnormalities in many of these neoplasms and, together with molecular analyses, hold exciting promise for an improved understanding of tumor pathogenesis.

Adolescent↗

Management of uremic pericarditis.

Five uremic patients with hemodynamically significant pericardial effusion, which did not respond to conservative treatment (intractable effusion) or tamponade, were treated with instillation into the pericardial sac of a nonabsorbable steroid, triamcinolone hexacetonide, and with intermittent drainage. This was done by insertion of a drainage catheter into the pericardial space under direct vision by subxiphoid pericardiotomy performed under local anesthesia. All patients responded well to the procedure, and immediate relief of the symptoms was achieved. No complications of the procedure were observed, and the drainage catheters were removed 48 to 72 h thereafter. Two patients died of unrelated causes--1 month and 3 years after the events. Two other patients are still alive and on a hemodialysis program, and one has a functioning kidney graft. During the 3 to 8 years of follow-up, no recurrent pericarditis was observed, and no constrictive pericarditis developed in any patient.

Administration, Topical↗