Megaloblastic anemia during pregnancy.
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Biomedical subjects
Publications and source records attributed to J D Bitran.
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Twenty-three patients with metastatic non-oat cell bronchogenic carcinoma (MNOBC) were treated with cyclophosphamide, adriamycin, methotrexate, and procarbazine (CAMP) after radiation therapy. Objective responses were seen in 11 of 23 patients (48%) with a projected median survival time of 12.5 months for responding patients and patients with stable disease. Lung, liver, and cutaneous sites of involvement proved to be highly responsive; bone involvement was less responsive. CAMP is an effective combination in the treatment of MNOBC and its use in patients with less advanced disease should be explored.
Acute leukemia is less common during the reproductive years than in children or in post-menopausal women. Effective chemotherapy exists for adult lymphocytic leukemia, and the median survival is 18 to 20 months. Acute myelogenous leukemia still has a less favorable prognosis, with a medial survival of 12 months despite effective chemotherapeutic agents. The occurrence of acute leukemia in pregnancy does not change the overall prognosis, which depends primarily on the cytopathologic types. If leukemia occurs during the first trimester, therapeutic abortion is advised since the rate of spontaneous abortion after chemotherapy is high in the first trimester and fetal malformations are common. Acute leukemia can be treated in the second and third trimesters with little effect on the pregnancy or fetus. In patients cured of acute leukemia, the potential for subsequent pregnancies exists with little likelihood of increases in fetal malformations.
Twenty-six patients with metastatic pancreatic or gastric adenocarcinoma were treated with 5-fluorouracil, Adriamycin, and mitomycin C. One complete and five partial responses were observed among 15 patients with pancreatic adenocarcinoma (40% response rate) and six partial responses were observed among 11 patients with gastric adenocarcinoma (55% response rate). Responders had a significantly longer survival than nonresponders in both groups.