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Biomedical subjects

J P Obrecht

Publications and source records attributed to J P Obrecht.

At least 19 recordsLinked to original sources
PubMed1979

[Non-Hodgkin lymphomas: classification, staging and therapy].

In recent years considerable advances have been made in the treatment of non-Hodgkin lymphomas, yet the results are not so impressive as the progress in treating patients with Hodgkin's disease. This may be partly explained by the lack of standardized histological classification and staging procedures, which are responsible for our incomplete knowledge of the pathogenesis and clinical course of the different lymphoma types. The most important histological classifications and procedures for adequate staging are presented. To the extent of present knowledge the initial manifestations and pathways of dissemination are discussed. So far established data makes it possible to lay down therapeutic principles which differ according to stage and histology. Loco-regional stages should be treated by radiotherapy alone. In advanced phases combined cytotoxic chemotherapy is for the most part the accepted form of treatment. While in prognostically favorable histological types a mild regimen may suffice, aggressive cytotoxic regimens should be preferred in treating unfavorable histological types. Treatment modalities combining radiotherapy and chemotherapy are still experimental. Hodgkin's lymphomas and diffuse histiocytic lymphomas in stages III and IV are potentially curable by chemotherapy.

Antineoplastic Agents↗
PubMed1979

Vindesine. A clinical trial with special reference to neurological side effects.

A good tumoricidal activity of vindesine (VDS) has been reported in a variety of animal tumors and in human leukemias and lymphomas. We treated 22 patients who had received no prior chemotherapy and were suffering from a variety of malignant neoplasms with 0.5 mg/m2 to 3.0 mg/m2 VDS i. v. once or three times at weekly intervals and recorded the clinical, hematologic, and especially, neurological side effects. Clinically we observed fatigue in nine patients, paresthesias in seven, myalgias in three, vertigo and diarrhea in two, and skin pains, tinnitus, gastric pains, alopecia, and tremor in one patient each. There was no obvious dose-action relationship. Paravenous injection caused cellulitis similar to that seen with vincristine. No side effects were apparent in liver (SGPT) and renal (creatinine) function tests. Hematologically there was a clear trend toward leukopenia with higher doses of DVA and a mean increase in the thrombocyte count by 51 X 10(3)/mm3 was found (sign test: P greater than 0.05). The hemoglobin level did not change. Clinical neurological examination and monitoring by electroneurography revealed no changes in tensiometer performance, motor and sensory nerve conduction velocity, motor or sensory nerve action potential amplitudes, or H-reflex responses. There was dose-related diminution of the proprioceptive reflexes, especially in the lower extremities. Even with as little as 2.0 mg/m2 VDS i. v. at weekly intervals for 3 weeks Achilles and patellar tendon reflexes were diminished or absent in all patients.

Action Potentials↗
PubMed1979

[Results of chemotherapy in gastrointestinal malignancies].

The chemotherapy of neoplasias of the gastrointestinal tract is still in an experimental phase. Until now, there are not any effective regimens which could be proposed as a standard therapy. Perhaps gastric carcinoma is an exception. The increasing knowledge concerning tumor evolution and especially concerning prognostic factors, justifies admission of patients to well controlled clinical studies.

Antineoplastic Agents↗
PubMed1978

[Curability of advanced malignant lymphoma under conditions of modern combination chemotherapy].

102 patients from the same oncologic center with malignant lymphomas (52 with Hodgkin's disease, 50 with non-Hodgkin lymphomas) have been analyzed. One population received monochemotherapy only and the other polychemotherapy: the first remission and survival results were published in 1975 on the basis of calculated life expectancy. Now, 3 years later, the same populations are again analyzed and "real" survival data are compared with those calculated. All patients now have a minimal observation time of 6 years. Even if our first published data were too optimistic, polychemotherapy still appears to offer the better life expectancy.

Antineoplastic Agents↗
PubMed1978

[Simultaneous hormonal and drug therapy, compared to hormonal therapy, followed by chemotherapy, in the treatment of metastasizing breast neoplasms. Preliminary results of an ongoing study].

The preliminary results of a still ongoing phase III study in patients with previously untreated metastatic breast cancer are reported. 210 cases are already evaluable. In this study patients are randomized to hormonotherapy either concurrently with combination chemotherapy or alone, chemotherapy being delayed until the occurrence of tumor progression. In both groups patients are further randomly allocated to 3 chemotherapy programs. So far there appear to be differences between remission rates, but not with regard to survival course.

Antineoplastic Agents↗
PubMed1978

[Current state of therapy for gastrointestinal tumors].

For many years, the treatment of malignant gastrointestinal tumors has been disappointing. However, recent results have shown an improvement in the rate of remissions and survival, especially in the treatment of gastric, pancreatic and localized rectal carcinoma. The therapy of cancer of the colon still remains unsatisfactory: the rate of remissions could be increased, but survival remains unaltered. Adjuvant chemotherapy is under investigation in many quarters but cannot yet be recommended as an established method of treatment.

Carmustine↗
PubMed1978

[Specific characteristics of hairy cell leukemia].

Report on a now 58-year-old female patient who presented in 1969 with the following objective findings: anemia, thrombocytopenia, lymphocytosis and hepatosplenomegaly. The first first diagnosis was lymphosarcoma, but up to 1976 nearly ten other diagnoses were established, e.g. reticulum sarcoma, leukemic lymphosarcoma, CML, ALL, CLL and Waldenström's disease. The patient did not respond to combined chemotherapy, but splenectomy brought about significant improvement in anemia and thrombocytopenia. She is now doing well without cytotoxic treatment. Hairy cell leukemia was diagnosed on the basis of electron microscopic findings in peripheral lymphocytes and histologic findings in bone marrow and spleen. The tartrate-resistant acid phosphatase was positive. Immunologic tests in the hairy cells showed surface immunoglobulins of monoclonal origina and the T-cells were shown to be decreased. The tests for phagocytosis and nonspecific esterase were negative. The hairy cells in this patient exhibited no colony stimulating activity in culture studies with bone marrow from 4 normal donors, as compared with the stimulating activity of normal monocytes in the same assay. In the light of this case report the question is discussed whether the hairy cells are mainly cells with lymphocytic (B-lymphocytes) or monocytic characteristics. On this question the findings in our patient support the hypothesis of a B-cell nature for the hairy cells.

Acid Phosphatase↗
PubMed1978

[Kaposi sarcoma. A short review on a rare disease].

Pathological, clinical, epidemiological and immunological aspects of a rare tumor, Kaposi's sarcoma, are briefly discussed. The prevalence of the disease in an African population raises questions about genetic and environmental factors in its carcinogenesis. Immunological data indicate a probable viral origin. The clinical patterns seem to be influenced by alterations of the immune defense mechanisms. Most questions about its biological behaviour remain to be answered yet.

Adolescent↗
PubMed1978

[Optimal care of the oncologic patient: a question of organization].

The rapid development of oncology as a subspecialty in internal medicine presents a dilemma for the specialist and the private practitioner. How can one offer the best technical and scientific care which often requires an institutional setting for its delivery and at the same time maintain a continuous meaningful relationship with a primary care physician? The outpatient clinic of the oncology center of the Basle University clinics as a paragon for the patient care in these changing times may represent one of several possible solutions to this contemporary dilemma.

Ambulatory Care↗
PubMed1978

[Clinical and therapeutic study (phase II) using VP-16/213 and methyl-CCNU in patients with inoperable, recurring or metastasizing carcinomas of the gastriointestinal tract].

We carried out a phase-II-study in patients with tumors of the gastrointestinal tract, in order to test the effectiveness of the combination of VP-16/213 and ME-CCNU. We studied 15 patients (3 carcinomas of the stomach, 12 colon carcinomas) in a mostly advanced state of illness (disseminated, n = 13). One patient with gastric cancer attained a partial remission with a duration of remission of 9.1 months and a survival time of 14.1 months; the other two patients with cancer of the stomach were non-responders. 1 of 12 patients with colon carcinoma showed a partial remission (PR) (= 8.3%, or 12.5% in untreated patients n = 8), 7 patients showed no change (NC = 58.3%) and 4 patients had progressive disease (PD). The median duration of remission was 4.9 months, the median survival time 7.9 months. With reference to the success of therapy the median survival time was 10.5 months for patients with partial remission and no remission compared with 4.7 months for patients with progression. Toxicity consisted of nausea and vomiting (n = 11), loss of appetite (n = 10), granulocytopenia (n = 9), thrombocytopenia (n = 8) and hairloss (n = 8). The results achieved are comparable to those of monotherapy with the nitrosoureas.

Adult↗
PubMed1977

[Cytostatic pneumopathy following chemotherapy for metastasizing breast neoplasm].

A 69-year-old patient treated with anticancer polychemotherapy for metastatic breast carcinoma died of respiratory distress and cardiac failure 3 months after commencement of therapy. At autopsy only a few pleural micrometastases were found. Microscopic study revealed early lung lesions due to cytotoxic drug treatment. While the earlier literature described different lesions associated with different antineoplastic drugs (busulfan, bleomycin), today there is more emphasis on the common pathological features. Therefore, instead of the expressions "busulfan lung" or "bleomycin lung", we suggest the use of the term "Zytostatika-Pneumopathie" (cytostatic drug induced lung disease).

Aged↗