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J Stachowiak

Publications and source records attributed to J Stachowiak.

50 records · Page 3Linked to original sources

Combination of cyclophosphamide, vincristine, and prednisone, followed by maintenance chemotherapy, with and without radiotherapy, in the management of patients with non-Hodgkin's lymphomas.

Sixty patients with non-Hodgkin's lymphomas were treated with a cyclophosphamide, vincristine, and prednisone (CVP) induction regimen, either alone (stage IV) or in combination with radiotherapy (stages I, II, III). The response rates for lymphocytic and histiocytic lymphomas were 82 and 86%. The complete remission (CR) rates were 66 and 71% with a median duration of 13 and 5.5 months respectively. Nodular types responded better than diffuse ones in both lymphocytic (CR rate 85% vs 45%; median duration 24+ months vs 2.5 months) and histiocytic lymphoma (CR rate 100% vs 0%). In lymphocytic lymphomas, survival in the responder group was 90% at 24 months vs only 20% in the nonresponder group (median survival 14.2 months). In the group with nodular lymphocytic lymphoma responding to therapy, there was a 100% survival rate at 24 months. The median survival for patients treated with chemotherapy alone (stage IV) and not responding to therapy, was 22 months vs 14.5 months in the whole nonresponder group (stages I, II, III, IV), suggesting a detremental effect of rediotherapy in the nonresponder group. In histiocytic lymphomas, the median survivals in the responder and nonresponder groups were 19 months and 3 months respectively. These results corroborate the excellent efficacy of the CVP regimen. They also indicate that, after CVP induction, 2 major prognostic factors are the histologic type and the nature of the response to therapy.

Adolescent↗

[Cyclophosphamide-vincristine-prednisone combination in the treatment of lympho- and reticulosarcomas in adults (60 cases)].

60 patients with non Hodgkin's lymphomas were treated with a CVP induction regimen, either alone (stage IV) or in combination with radiotherapy (stages I, II, III). The response rates for lymphocytic and histiocytic lymphomas were 80 and 86%. The complete remission rates were 68 and 71% with a median duration respectively of 13 and 5.5 months. Nodular types did respond better than diffuse both in lymphocytic (CR rate 85% vs 44%; median duration 24 months +, vs 2.5) and histiocytic lymphoma (CR rate 100% vs 0%). In lymphocytic lymphomas, survival in the responding group was 90% at 24 months, vs 20% only in the non responding group (median survival 14.5 months). In the group with nodular lymphocytic lymphoma responding to therapy, there was a 100% survival rate at 24 months. The median survival for patients treated with chemotherapy alone (stage IV) and not responding to therapy, was 22 months, vs 14.5 months in the whole non responder group (stages I, II, III, IV) suggesting a detrimental effect of radiotherapy in the non responding group. In histiocytic lymphomas, the median survivals were respectively 19 months and 3 months in the responding and non responding groups. These results corroborate the excellent efficacy of the CVP regimen. They also indicate that, faced to a CVP induction, 2 major prognosis factors are the histologic type and the nature of the response to therapy.

Cyclophosphamide↗

[Anatomo-pathologic forms of lymphoid and lymphoreticular fibrosis of the bone marrow].

The development, within the bone marrow, of reticulo-fibrosis with a lymphoid organ structure forms part of a pathological model common to several lympho- and reticulo-proliferative syndromes. Various cytological types develop within this reticulo-fibrous framework: lymphocytes, lymphoblasts, plasmocytes, "hairy cells" and histiocytes. This cytological variety has led to different names: leukaemic reticulo-endotheliosis, lymphoid myelofibrosis, histio-lymphocytosis, malignant histiocytosis, etc. Similar cell type sequence is seen in non-Hodgkins lymphomas, with the same problems of parent and daughter cells. In fact the architectural metaplasia of the bone marrow prevails over the cellular metaplasia in the definition of the single clinical, haematological nature and course of these syndromes which have been too widely dissociated by classical haematology.

Bone Marrow↗

[Acute transformation in 45 cases of chronic myeloid leukemia].

After a chronic phase, the average duration of which in this series was 38 months, the acute phase of myeloid leukemia was very short, not exceeding 7 months. The clinical signs which suggest an acute exacerbation are, in order of importance, increase in the volume of the spleen, changes in general health, fever. The blood signs, which are often found later than the clinical signs, are increased white cell count, anemia and marrow leukoblastosis higher than 20%. The laboratory criteria of acute exacerbation are of lesser importance. Chemotherapy gives very poor results at this stage.

Alkaline Phosphatase↗

[Histological study of the bone marrow in 96 cases of Waldenstrom's macroglobulinemia. An evaluation with clinical, haematological and biological data (author's transl)].

Bone marrow biopsy in Waldenstrom's macroglobulinemia shows three types of lesions: lympho-plasmocytic and reticular infiltration, which is the most common, reticular infiltration, and aplastic marrow, more seldom. In all cases the reticulinic network is increased and thickened. These lesions are diffuse or nodular. Diffuse infiltration is more severe and has a median duration of 62 months instead of 82 months in nodular infiltration.

Age Factors↗

[Lymphomas of the spleen and bone marrow lymphoid nodules (author's transl)].

Many nodular primitive non-Hodgkin's lymphomas of the spleen have a favourable course after splenectomy or chemotherapy. Several observations of this type have been reported in the literature, in which the concept of malignancy is discussed, authors referring to a presarcomatous state or to an idiopathic splenomegaly. The evaluation of the extension of those sarcomas, however, very often show hepatic lesions, and always an increase in the lymphoid marrow nodules. The significance of these nodules is discussed here, with reference to 14 personal observations. These nodules may not always reflect a real extension of the sarcoma to the marrow. From a practical point of view, the presence of lymphoid marrow nodules, when associated with an isolated splenomegaly, is a strong argument to suspect a sarcoma of the spleen, and indicates a splenectomy.

Adult↗

[Bone marrow fibrosis in malignant hemopathies and cancers. Histological study of 2 786 biopsies (author's transl)].

This is a study of myelofibrosis concerning 2.786 bone marrow biopsies in malignant hemopathies, and cancers supposed to be metastatic. In a first group myelofibrosis is a permanent symptom and necessary for the diagnosis: agnogenic myeloid metaplasia, Waldenström's disease, hairy-cell leukemia, marrow extension of Hodgkin's disease and metastatic cancers. In a second group of hemopathies, myelofibrosis varies in frequency. Myeloid leukemia: 33% - Polycythemia: 40% - Thrombocythemia: 27% - Lymphoid leukemia: 17% - Acute leukemia: 20% - Kahler's disease: 30% - Aplastic anemia: 5% - Reticulin myelofibrosis is said possibly regressive. Collagen myelofibrosis is permanent.

Acute Disease↗

[Adriamycin for the treatment of non HOdgkin's lymphomas (author's transl)].

One hundred and thirty one patients with non-Hodgkin's lymphomas (107 lymphomas and 24 histiocytic lymphomas) have been treated between January 1973 and January 1976, by an association of cyclophosphamide, vincristine and prednisone alone (CVP) or combined with adriamycin (CVP-A). All lymphomas stage I and II received CVP + radiotherapy: the actuarial analysis shows a stationary survival from 1 to 5 years at 89%. In the group of lymphoid lymphomas stage III and IV with nodular pattern, the survival is longer for patients who received CVP (69% at five years) than for patients treated with CVP-A (54% at three years). In the group of lymphoid lymphomas stage III and IV with diffuse pattern, the complete remission rate is 25% for the CVP and 67% for the CVP-A (p less than 0.01). However, the median duration of life is not different for the two groups (24 and 26 months respectively). In the group of histiocytic lymphomas, the complete remission rate in 50% for the CVP combination and 83% for the CPV-A. However, the median time of life which is 17 months for the CVP, is not reached for the CVP-A (Stationary survival at 90% from the 12th to the 36th months). These results show that the CVP combination is a good treatment for the lymphoïd lymphoma with nodular pattern. The addition of adriamycin gives hope of long remissions and perhaps cure for histiocytic lymphomas, until now of bad prognosis. For the lymphoid lymphoma with diffuse pattern, the prognosis is still bad although we obtained with adriamycin a better rate of complete remission. The high dose chemotherapy rescued by autologous bone marrow transplantation may be a new possibility for this last type of non Hodgkin lymphomas.

Adolescent↗