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Biomedical subjects

J Herson

Publications and source records attributed to J Herson.

At least 19 recordsLinked to original sources
PubMed1979

Hexamethylmelamine: an evaluation of its role in the treatment of ovarian cancer.

Hexamethylmelamine (HMM), NSC 13875, a synthetic agent structurally related to triethylenemelamine, has clinical antitumor activity and a role in the treatment of ovarian cancers of epithelial origin. Fifty-four patients, with International Federation of Gynecology and Obstetrics Stage III or IV carcinomas, previously untreated with chemotherapy or irradiation therapy, were treated with HMM (8 mg/kg/day) as a single agent at the M. D. Anderson Hospital and Tumor Institute in Houston, Texas, between January, 1973, and May, 1976. The response end points analyzed were complete plus partial response rate, duration of remission, and survival time. The complete and partial responses were verified whenever possible by "second-look" operation. Seventeen patients (31.8%) responded to HMM and three had no evidence of cancer, determined by multiple biopsies at second-look operation. Gastrointestinal, hematologic, and nervous system toxic effects were severe in 10 patients, requiring discontinuation of HMM. This study shows that HMM can induce a complete response and provide an extended disease-free interval without maintenance chemotherapy.

Adult↗
PubMed1979

Evaluation of overall toxicity of high-dosage methotrexate regimens.

The occurrence of overall toxicity was analyzed for 43 patients with osteosarcoma who received 349 high-dosage courses of methotrexate (HD-MTX) with citrovorum factor (Leukovorin) "rescue" (CF). The dosages of HD-MTX ranged from 50 to 350 mg/kg. Overall toxicity was assessed on the basis of five manifestations of toxicity: stomatitis, dermatitis, myelosuppression, liver dysfunction, and kidney function abnormalities. The great majority (91.4%) of the infusions were well tolerated, but 8.6% were associated with moderate or severe toxicity. Stomatitis and serum glutamic-oxaloacetic transaminase (SGOT) changes were the most frequent postinfusion findings. Three patients died from causes related to MTX toxicity. Dose, age, sex, and number of prior infusions were investigated by logistic regression analysis for prognostic effect on frequency of moderate to severe overall toxicity. Age and number of prior infusions had significant (P less than 0.06) effects on overall toxicity. Patients older than 15 years with greater than 10 prior infusions constituted the "high risk" group with a risk of moderate to severe toxicity 6.3 times that of the younger patients with fewer than 10 infusions.

Adolescent↗
PubMed1979

Vincristine and prednisone vs vincristine, L-asparaginase, and prednisone for second remission induction of acute lymphocytic leukemia in children.

Second remission induction rates for vincristine and prednisone alone (VP) and vincristine, L-asparaginase, and prednisone (VLP) are compared for children with acute lymphocytic leukemia. No evidence of a significant difference between the second induction complete remission rate for VP (78.6%) and VLP (73.7%) was found. Duration of first remission and prognostic group at initial diagnosis (defined on the basis of age and white blood count at initial diagnosis) are shown to be significant prognostic factors for second remission induction; and three second remission induction risk groups are defined on the basis of these two factors. Periodic reinforcement with prednisone in first remission does not appear to lower second induction complete response (CR) rates for VP. There was no evidence of a significant difference in the frequency of occurrence of severe toxicity between the VP and VLP regimens.

Adolescent↗
PubMed1979

Long-term survival in childhood acute leukemia: "late" relapses.

The "late" relapse patterns of childhood acute leukemia were studied in 83 children in their first continuous complete remission for more than three years prior to randomization for stopping therapy (40 patients) or continuing therapy (43 patients) for a total of six years. Twenty of 83 (22.9%) have relapsed: Ten in the bone marrow, one in the central nervous system, and nine in the testes. The testes relapse rate of 41.1% (7/17) in males discontinuing therapy at three years was much higher than that of 8.7% (2/23) in males continuing therapy. This difference is significant at P = 0.01 (Wilcoxon test).

Bone Neoplasms↗
PubMed1979

Risk of radiation-related subsequent malignant tumors in survivors of Ewing's sarcoma.

Twenty-four long-term survivors of Ewing's sarcoma were identified as being at risk for a second primary tumor. Among this group of patients followed from 3 to 22 years, 4 new bone tumors were observed, whereas 1.2 x 10(-3) were expected. All new tumors arose in heavily irradiated areas. The risk associated with radiation after 3 years was 7.2 cases/million person-years per rad. The cumulative cancer risk over 10 years for irradiated patients was 35% (SE, 15.1%). Intensive chemotherapy (cyclophosphamide and vincristine administered in five or more courses) seemed to exert an enhancing effect, increasing the rate of development of new tumors.

Adolescent↗
PubMed1979

Predictive probability early termination plans for phase II clinical trials.

A phase II clinical trial is designed to gather data to help decide whether an experimental treatment has sufficient effectiveness to justify further study. In a one-arm trial with dichotomous outcome, we wish to test a simple null hypothesis on the Bernoulli parameter against a one-sided alternative in a sample of N patients. It is advisable to have a rule to terminate the trial early when evidence accumulates that the treatment is ineffective. Predictive probabilities based on the binomial distribution and beta and uniform prior distributions for the binomial parameter are found to be useful as the basis of group sequential designs. Size, power and average sample size for these designs are discussed. A process for the specification of an early termination plan, advice on the quantification of prior beliefs, and illustrative examples are included.

Antineoplastic Agents↗
PubMed1978

Prognosis after metastases in osteosarcoma.

Data from 106 patients with osteosarcoma who developed metastases during treatment were analyzed for prognostic factors for postmetastic survival time. Patients diagnosed in 1971 or later received more intensive chemotherapy and had significantly longer postmetastatic survival time than those diagnosed in 1970 or earlier (P = 0.002). Patients whose metastasis occurred 13 or more months after diagnosis had signicantly longer postmetastatic survival time than those whose metastasis occurred during the first 12 months after diagnosis (P = 0.005). Life-table regression analysis revealed an interaction between "year of diagnosis" and "months to metastasis" which provided a postmetastatic survival advantage for those having metastasis after diagnosis over metastasis at diagnosis for patients diagnosed in 1971 or later but not for those diagnosed in 1970 or earlier (P = 0.093).

Adolescent↗
PubMed1978

Significance of the 48-hour plasma level in high-dose methotrexate regimens.

Plasma methotrexate (MTX) concentrations at 48 hours were determined for 40 patients with osteosarcoma who received 256 infusions of high-dose methotrexate-citrovorum rescue (HD-MTX-CF) regimen. Five manifestations of toxicity (dermatitis, stomatitis, myelosuppression, liver dysfunction, and kidney dysfunction) were considered in the assessment of the overall toxicity. Logistic regression analysis was applied to study the effect of number of prior infusions, age, and 48-hour MTX plasma level on the risk of moderate or severe overall toxicity. Each factor had a significant effect with P less than 0.08. The predicted incidence of moderate-severe overall toxicity in the high-risk group (48-hour MTX level greater than 1.00 x 10(-6) mol/l., prior infusions greater than 10, age greater than or equal to 15 years) was 33.2% compared to only 2.4% in the "low-risk" group (48-hour MTX level less than or equal to 1.00 x 10(-6) mol/l., prior infusions less than or equal to 10, age less than 15 years). The plasma MTX determination at 48 hours postinfusion was found to be independent of both dose infused and patient's age.

Adolescent↗
PubMed1977

Evaluation of a MOPP-type regimen in histiocytosis X--a Southwest Oncology Group study.

The overall 38% response rate in histiocytosis X for cyclophosphamide, vincristine (Oncovin), prednisone, and procarbazine was not superior to responses that can be achieved with the component single agents. This is in contrast to the higher response rates that can be achieved by the combination of these agents in Hodgkin's disease. This is the second study of combination chemotherapy with individually effective agents that has failed to improve the response rates in histiocytosis patients with poor prognostic indicators.

Child↗
PubMed1977

FP/MIS: a management information system for a community family planning clinic.

The management information system (FP/MIS) used by the Howard University Center for Family Planning Services, which operates community family planning clinics in Washington, D.C. is described. The system was developed to satisfy program objectives in patient management, program planning and evaluation, resource management, federal reporting systems and clinical, epidemiological and health services research. The data collection forms used in the system and the output from the four data display groups--patient profile, resource management, quality of care and epidemiology-are described along with examples of their use.

Computers↗
PubMed1975

Epidemiologic association between Gonorrhea and prostatic carcinoma.

The curves for death rates from prostatic cancer and gonorrhea incidence rates in Denmark, over a span of thirty years, matched well with a lag period of forty-five years. Moreover, a retrospective study conducted in the United States involving 75 cancer patients and 75 age-matched controls demonstrated a statistically significant association between gonorrheal infection and subsequent development of prostatic carcinoma. Two postulates are presented: the viral-venereal and the chronic infection theories. The recent increase in incidence of prostatic cancer in the United States could be the beginning of an epidemic in which astronomically high rates may be reached.

Adolescent↗