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Biomedical subjects

J R Schlumberger

Publications and source records attributed to J R Schlumberger.

At least 19 recordsLinked to original sources
PubMed1977

Follow-up of the first (1962) pilot study of active immunotherapy of acute lymphoid leukaemia: a critical discussion.

The follow-up of the first active immunotherapy (AI) controlled pilot study on acute lymphoid leukaemia (ALL), started in 1962, is reported: seven patients out of 20 are still in first remission and eight of the AI group are still alive between 10 and 13 years later, while all ten controls have relapsed and died. The methodology of this pilot study is discussed, as well as the results of the later AI trials conducted on ALL. In the light of a critical discussion and of the further trials conducted by the authors or published in the literature, the authors conclude that A1 is efficient in ALL and that its use is indicated as, in several trials, it has been as active as maintenance chemotherapy, as it has induced no deaths in 300 patients contrary to maintenance chemotherapy, which has been responsible for 4 to 28% of deaths in patients in complete remission, and as the authors have registered no late relapses after three years in the AI trials, while such relapses appear in most maintenance chemotherapy trials.

BCG Vaccine↗
PubMed1975

[Active immunotherapy of acute leukemia and leukemic lymphosarcoma. Results of 10 years. Study of 200 cases].

The authors report a ten year study of active immunotherapy using BCG and irradiated allogeneic leukaemic cells in 200 patients. In acute lymphatic leukaemia, 57 out of 168 patients treated in this way remained in primary remission for 18 months to 10 years after active immunotherapy was begun, the relapse rate became low after 18 months and nil after 36 months. The results varied according to prognostic factors: the cytological type, active immunotherapy being above all effective in small cell (microlymphoblastic and prolymphocytic) types with a hope of cure in 50 to 60 p.cent of cases; malignant cellular volume; meningeal deposits. In microlymphoblastic forms the possibility of survival at the 5th year is greater than 90 p.cent. After relapse during active immunotherapy sensitivity to chemotherapy does not seem to be diminished. Trials of active immunotherapy in acute myeloid leukaemia are worthy of further pursuit. The results of active immunotherapy in leukaemic lymphosarcoma show that immunotherapy may be effective in preventing local recurrence, both of tumour as well as in the marrow. Four patients are in apparently complete remission for more than four years. On the basis of these results, trials of active immunotherapy for "residual disease" should be undertaken in the field of cancerology, going beyond the realm of leukaemias.

Adjuvants, Immunologic↗
PubMed1975

Cytology in the classification of diffuse non-leukaemic malignant lymphomata (lympho- and reticulosarcomata).

Cytological examination of smears or imprints of diffuse non-leukaemic lymphomata gives more details of the morphological aspects of the cells than does histological examination. It enables us to distinguish (a) prolymphocytic (but not lymphocytic), (b) lymphoblastic or lymphoblastoid and immunoblastic lymphosarcomata. It helps to diagnose so-called reticulosarcomata from carcinomata and to distinguish two types: (a) cytic and (b) blastic, but it makes us suspicious about the nature of the latter. Light microscopy shows the cells of the blastic type resemble transformed lymphocytes (immunoblasts) more than reticulum cells. Electron microscopy shows many polyribosomes, which enhances the suspicion that some so-called "reticulosarcomata" could be immunoblastic lymphosarcomata.

Cell Transformation, Neoplastic↗
PubMed1975

Leukaemic conversion of non-Hodgkin's malignant lymphomata.

In 143 patients with poorly differentiated lymphosarcoma, leukaemic conversion has been observed in 25. The cytological type was prolymphocytic or lymphoblastic or lymphoblastoid (immunoblastic ?). Twenty-five patients were treated with chemo-radiotherapy, followed by active immunotherapy as if they had primary acute lymphoid leukaemia. A complete remission was obtained in 11. Four are still in first complete remission after 4 1/2 years. Among 136 patients suffering from so-called "poorly differentiated reticulosarcoma", 17 became leukaemic. The cells are cytologically very dystrophic and unidentifiable. A remission was obtained in 7 patients but it was of short duration (median 1 1/2 months, longest 7 months).

Adolescent↗
PubMed1973

Hydroxyurea, leucopheresis, and splenectomy in chronic myeloid leukaemia at the problastic phase.

Forty-three patients with chronic myeloid leukaemia have been treated with hydroxyurea in order to be subjected to leucopheresis for white cell transfusions. Hydroxyurea decreases leucocytosis when it is administered and the blood granulocyte number increases soon after the drug is stopped. The survival of the patients is not different from the survival of the patients treated with conventional chemotherapy (busulphan, mitobronitol) and it is superior to the survival of patients treated with external radiotherapy or with (32)P. Half of the patients were subjected to splenectomy during first remission for a phase II trial. They were not randomized, but the distribution according to age was similar in the two groups. A slight difference appears in favour of splenectomy so far as survival is concerned, but there were three post-operative deaths out of 18 patients. We conclude that a phase II trial on the value of splenectomy is indicated ethically, but that the patients should be operated on and nursed in a microbiologically controlled environment.

Adolescent↗
PubMed1970

Bone marrow graft in man after conditioning by antilymphocytic serum.

Allogeneic bone marrow grafts carried out after previous administration of antilymphocytic serum alone were attempted in 16 patients. Of these, six had acute myeloblastic leukaemia, four acute lymphoblastic leukaemia, and one a blast cell crisis in polycythaemia vera. Ten of these patients were in an overt phase of the disease and resistant to chemotherapy, while nine had complete agranulocytosis. In five of these patients erythrocyte and leucocyte antigenic markers demonstrated the establishment of the graft. One patient had thalassaemia major, and four others had aplasia of the bone marrow, in one case due to chloramphenicol poisoning and in another to virus hepatitis. The grafts were successful in the last two patients and transformed their clinical condition.No signs of early acute secondary disease were noted in any of the patients, either when the donor had been given antilymphocytic serum or when he was untreated. The grafts had no adoptive immunotherapeutic effect on the acute leukaemia. These observations have clearly shown that antilymphocytic serum has an immunosuppressive effect in man when it is used alone.

Acute Disease↗
PubMed1970

The two varieties of lymphoid tissue "reticulosarcomas", histiocytic and histioblastic types.

On the basis of histological sections and cytological smears in 110 cases, the "reticulosarcoma" (exclusive of Ewing's sarcoma and reticulosarcomas of bone marrow) were divided into two varieties: histiocytic types and histioblastic types.The correlation between the histological and cytological evaluation was excellent in each case; only those tumours classified as histiocytic presented a continuous and abundant network of reticulin.The histioblastic type predominated in the male sex. The difference in the clinical expressions of the two varieties is not statistically significant, except as to the frequency of cutaneous lesions: 27.7% in the histiocytic type and 2.6% in the histioblastic type.While the duration of their evolution is not different, only the histioblastic type is transformed into leukaemia, which is of the "monoblastic" type: this transformation was observed in 17.5% of cases, while it was never observed in histiocytic type.

Diagnosis, Differential↗
PubMed1969

Pathogen-free isolation unit--three years' experience.

The results obtained during the first three years of a pathogen-free isolation unit containing five beds have shown that this type of unit can reduce the risk of infection in patients treated with intensive chemotherapy or in those who have granulocytopenia from various causes. It is suggested that treatment of cancer which involves these risks should be carried out routinely in sterile isolation units, and that it is urgent to build many more and much larger units.

Adolescent↗