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Biomedical subjects

K B Jensen

Publications and source records attributed to K B Jensen.

At least 55 records · Page 3Linked to original sources

CHOP versus prednisolone + chlorambucil in chronic lymphocytic leukemia (CLL): preliminary results of a randomized multicenter study.

Five hundred and fifty consecutive patients with newly diagnosed B-CLL have been registered and classified in a Danish multicenter study. The study includes a protocol for primary treatment of patients in stage B or C (at diagnosis or after demonstrated progression), below 76 years of age, and without complicating serious disease. Until now 144 such patients have been randomized to either prednisolone (PRD) plus chlorambucil (CLB) 5 days every 4 weeks or monthly intensive CHOP treatment. Twenty-nine percent of the treated patients achieved CR on PRD + CLB versus 63% on CHOP (p less than 0.005). No response was found in 29% versus 18%, respectively (NS). A significant difference in survival between patients achieving CR, PR and NR was also demonstrated, whereas to date no difference in survival could be demonstrated between the two regimens. The toxicity was limited, and only 2 treatment-related deaths occurred in approximately 700 CHOP treatment series.

Adult↗

The CLL2 study: preliminary results of flow cytometry immunophenotyping in the first 500 patients.

In the period 1984-1987, 500 consecutive, newly diagnosed patients with chronic lymphocytic leukaemia (CLL) have been registered in the still open Danish CLL2-study. As part of patient work-up, the immunological phenotype was established in all patients by immunofluorescence microscopy, and in 458 patients also by flow cytometry, with a panel of polyclonal and monoclonal antibodies. The majority of cases exhibited a CD5-pos, SmIgMD-pos phenotype with faint SmIg-fluorescence, and there is as yet no significant difference in survival between SmIgD-pos and SmIgD-neg cases. Seventy cases were FMC7-pos, a marker associated with a higher B-cell differentiation, and this was significantly correlated with stronger SmIg fluorescence intensity and splenomegaly (Rai stage II). The survival of the FMC7-pos patients was not significantly different from that of the FMC7-neg. Thus, in this preliminary phenotype analysis of the first 500 patients in the CLL2 study, no important prognostic subgroups were detected, although this might be due to the still short observation time (median observation time 532 days).

Denmark↗

Lack of correlation between methotrexate concentrations in serum, saliva and sweat after 24 h methotrexate infusions.

1 Methotrexate (MTX) concentrations were studied in serum, mixed saliva and sweat during and after 24 h continuous MTX infusions (0.5-6 g m-2) in 14 patients with various malignant diseases. 2 The serum-MTX concentrations declined in a biphasic manner, but the MTX elimination in saliva and sweat varied to a much greater extent. 3 Saliva/serum and sweat/serum ratios during the MTX infusion were 2.3% and 0.55% respectively. The ratios had increased significantly 20 and 44 h postinfusion. 4 No correlations were demonstrated between salivary- and serum-MTX concentrations during the MTX infusion or 20 and 44 h later. 5 Markedly delayed renal MTX excretions were demonstrated in two patients. In one of them the salivary MTX elimination was also retarded, whereas this was not seen in the other one. 6 We conclude that measurements of MTX concentrations in mixed saliva cannot substitute for serum-MTX determinations in the monitoring of patients after 24 h MTX infusions.

Humans↗

Prognostic factors in neuroblastomas treated in Denmark from 1943 to 1980. A statistical estimate of prognosis based on 253 cases.

Multivariate analysis on an unselected patient population consisting of all 253 children treated for neuroblastoma in Denmark during 1943 to 1980 shows that stage, age, and treatment given are independent prognostic variables. Calendar year of diagnosis, sex of the patient, and site of primary tumor were not significant prognostic factors. Further analysis shows that multimodal treatment with surgery, irradiation, and chemotherapy, especially in patients older than 1 year of age with Stage II disease, has influenced the survival significantly. The fact that age at diagnosis and the administration of chemotherapy have independent prognostic significance can be explained by the theory that all neuroblastomas are virtually congenital; therefore, the difference in age at diagnosis largely reflects the difference in growth rates of the tumor. Thus, according to this theory, age may be a measure of the probability of micrometastases in addition to the clinical extent or stage of the disease, as it represents the duration of the disease. Additional chemotherapy may thus have eradicated these micrometastases in the older children, since the age influence on Stage II disease disappeared when multimodal treatment was given in this study. The implications for treatment policy are discussed in view of this theory.

Age Factors↗

Prognostic value of different staging systems in neuroblastomas and completeness of tumour excision.

Two hundred and fifty three patients were retrospectively assigned to eight different staging systems proposed for neuroblastomas, and the prognostic value of each staging system was evaluated individually. The ability of each system to predict prognosis was compared with the others and the system proposed by Evans et al found to be the best predictor, even better than the recently proposed Tumour-Nodes-Metastases staging system. This is probably due to the fact that factors other than the resectability of the tumour play a major role in the survival of these children. Age was found to have independent prognostic significance whatever staging system was used.

Age Factors↗

Neuroblastomas treated at the four major child oncologic clinics in Denmark 1943-1980: an evaluation of 180 cases.

One hundred and eighty cases of neuroblastomas from the four child oncology clinics are reviewed. The overall cure rate was 24%. During the 38-year period, there was a significant increase in survival from 0% during the period of 1943-1950 to 32% during the period of 1971-1980. This improved survival rate is most likely a result of adjuvant chemotherapy. Forty percent of the patients appear chronically ill, which reflects the fact that nearly 60% have metastases when they are first seen. In localized disease (stages I-II), the prognosis was favourable (cure rate 69%), while the prognosis for disseminated disease (stage III-IV) was poor (cure rate 5%). A favourable outcome was seen in patients under 1 year (survival rate 46%), and in patients with primary tumours located in the neck or mediastinum (survival rate 48%). When related to stage, however, the survival rates for the former tumours were not significantly better in patients below 1 year or in patients with cervical or thoracic tumours. As is the case in other studies, we found that survival is significantly poorer in males.

Abdominal Neoplasms↗

99mTc-DTPA gamma-camera renography: normal values and rapid determination of single-kidney glomerular filtration rate.

A method for 99mTc-diethylenetriaminepentaacetate (DTPA) gamma-camera renography is presented. From each renogram, an uptake index (UI) proportional to the single-kidney glomerular filtration rate (SKGFR) is defined. If the proportionality factor between UI and SKGFR is the same in all patients, UI can be used as an accurate measure of SKGFR. In order to test this, 99mTc-DTPA renography was performed in 101 patients with glomerular filtration rates (GFR) varying between 4 and 172 ml/min. The sum of the right- and left-kidney UIs correlated well with the total GFR calculated from the simultaneously measured plasma clearance of 99mTc-DTPA after a single injection. The correlation coefficient was 0.97. The method was tested in a prospective study of 57 patients. The total GFR estimated from the renograms was not significantly different from the GFR calculated from the plasma clearance of 99mTc-DTPA. The coefficient of variation--a combination of inaccuracy and imprecision in the estimates as well as in the reference values-was 11.8% at a GFR of 100 ml/min. It is concluded that, in adults, the SKGFR can be calculated as part of the clinical routine from 99mTc-DTPA gamma-camera renography without determining the injected dose or collecting urine or blood samples. Normal values for some parameters of the renogram obtained in 25 normal subjects are given.

Adult↗

Recurrent herpetic keratitis and HLA antigens.

A non-selected group of 50 patients with recurrent herpetic keratitis, subclassified into groups of stromal or epithelial forms was typed for HLA-ABC antigens. In none of the groups was a statistically significant association to a certain HLA antigen found. When these data are combined with other reviewed reports on HLA types in recurrent herpetic keratitis, a statistically significant association between HLA-B5 and the whole group of recurrent herpetic keratitis, as well as between the subgroup of recurrent stromal keratitis, could be demonstrated. Recurrent epithelial keratitis showed an insignificant association to this antigen.

HLA Antigens↗

Experiences with implantations of the semiflexible McGhan/3M, style 70 anterior chamber lens.

A non-selected group of patients totalling 174 eyes without contraindicating eye diseases had the semiflexible McGhan/3M, style 70 anterior chamber lens implanted as either a primary or a secondary procedure following intracapsular cataract extraction via a corneal incision. Three patients simultaneously underwent a penetrating keratoplasty. Vitreous loss and/or rupture of lens capsule did not contraindicate the lens implantation, and anterior vitrectomy was always performed when vitreous loss occurred. Initially lens implant diameter was calculated too high, causing a lens axial corneal astigmatism in 11 patients. In the remaining patients a reduced anterior chamber lens diameter was used, and corneal astigmatism was accordingly comparable to those of non-anterior chamber implanted controls and did not differ significantly. Technical problems experienced in the procedure are reported and discussed. None of the implants had to be removed due to complications.

Adult↗

Experiences from the National Danish Hodgkin's Study Group (LYGRA) with respect to diagnosis, classification and treatment of Hodgkin's disease.

From September 1971 to April 1983, 1200 patients with newly diagnosed Hodgkin's disease were admitted to the centres which had founded LYGRA (the Danish Hodgkin's Study Group), to undergo uniform staging procedures and treatment. Present problems concerning staging, treatment, and complications, such as the risk of pneumococcal infection following splenectomy, the loss of fertility, and the risk of secondary malignancies, in particular leukaemia, are discussed.

Adolescent↗

Aclarubicin in the treatment of acute nonlymphocytic leukemia refractory to treatment with daunorubicin and cytarabine: a phase II trial.

Aclarubicin (ACR) was administered in a prospective cooperative phase II trial to 44 patients with possibly refractory acute nonlymphocytic leukemia who were previously treated with daunorubicin and cytarabine. Induction treatment consisted of 80 mg/m2 of ACR iv daily for 3 days, followed by 80 mg/m2 iv daily for 2 days in patients not obtaining a complete remission (CR) after 2-4 weeks. CR was observed in eight patients (18%) and partial remission was observed in six (14%). On monthly maintenance chemotherapy with ACR and cytarabine, the duration of CRs varied between 10 and 58 weeks. Achievement of remission was not related to age, presence or absence of Auer bodies, cytogenetic characteristics, or previous response to daunorubicin and cytarabine. Side effects were nausea and vomiting observed in 86% and diarrhea in 34% of the patients, whereas mucositis and alopecia were uncommon. Disturbances of cardiac function arousing suspicion of acute ACR toxicity were observed in seven patients. No case of chronic cardiotoxicity was observed, despite the fact that 20 patients received ACR doses greater than 400 mg/m2, with seven of the 20 having had a previous daunorubicin dose greater than 400 mg/m2. As CR was obtained in four of 14 patients with primary therapy-resistant leukemia and in two of 16 patients with relapse and no response to re-treatment with daunorubicin and cytarabine, ACR does not seem to show clinical cross-resistance to daunorubicin. Evaluation of ACR in first-line chemotherapy of acute nonlymphocytic leukemia appears justified.

Aclarubicin↗

Absorbable intracutaneous skin closure after skin resection in entropion operations.

After resection in the eye region, skin closure is most often performed with non-absorbable single knots. To investigate how far intracutaneous skin closure with Dexon absorbable suture material could demonstrate advantages to the traditional suture technique, 57 patients with senile entropions of the lower eyelid were randomized into one of two treatment groups. After a scaphoidal skin resection and resection of fibers of orbicularis muscle, the skin closure was performed with either continuous intracutaneous Dexon 6 or single knots of silk. This study demonstrates that both methods are easy and safe, but a superiority of the technique with absorbable intracutaneous skin closure was found in regard to immediate cosmetic satisfaction and time-consumption at controls, if necessary, because removal of suture material is not necessary.

Absorption↗