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Biomedical subjects

M A Cornbleet

Publications and source records attributed to M A Cornbleet.

43 records · Page 3Linked to original sources

Mitoxantrone as first-line chemotherapy for advanced breast cancer: results of a European collaborative study.

A total of 134 patients with advanced breast cancer and no prior chemotherapy for advanced disease were treated with mitoxantrone, 14 mg/m2 intravenously every 3 weeks. Of these, 99 could be evaluated for response and all for toxicity. Six patients achieved a complete response and 29 a partial response, the overall response rate being 35% (95% confidence limits 25% to 45%). The median time to treatment failure was greater than 46 weeks. Mitoxantrone was well tolerated. Nausea and vomiting occurred in 40% of patients, but these were seldom severe. Total alopecia occurred in only six patients. Four patients developed clinically significant evidence of cardiotoxicity after cumulative doses of 174 to 256 mg/m2. Mitoxantrone offers comparable efficacy and less acute toxicity than the most active single agents currently used in the treatment of advanced breast cancer.

Adult↗

Treatment of advanced malignant melanoma with high-dose melphalan and autologous bone marrow transplantation.

Twenty-eight patients with advanced life-threatening metastatic malignant melanoma were treated with high dose (140-260 mgm-2) intravenous melphalan and autologous bone marrow. Cyclophosphamide "priming" 300 mgm-2 i.v. was given to 19 patients one week previously and this resulted in clinical but not histological evidence of amelioration of gastrointestinal toxicity. In 11 patients (43%) there was evidence of tumour response to treatment and in 2 patients complete remissions were observed. However in most patients, responses were short-lived and no patient lived longer than 17 months from start of treatment or 24 months from first recorded evidence of distant metastatic disease.

Adult↗

Alpha feta (alpha FP) monitoring of response to adriamycin in hepatoblastoma.

While emphasizing the potential of chemotherapy (particularly adriamycin) in the treatment of hepatoblastoma, Andrassy et al., omit mention of the importance of serial serum alpha FP measurements in determining response and in early detection of recurrence. Serum alpha FP was elevated (range 5,000-1,800,000 micrograms/l) in 10 of 11 children with hepatoblastoma seen at our hospital between 1970 and 1980 and is, as others have emphasized, a potentially useful "marker" for this tumor. We report here the details of one patient in whom alpha FP monitoring was crucial to early detection of pulmonary metastases; complete response to adriamycin was subsequently documented.

Carcinoma, Hepatocellular↗

Immunosuppression and serious infections in children with acute lymphoblastic leukaemia: a comparison of three chemotherapy regimes.

Eighty-four children presenting with acute lymphoblastic leukaemia were entered into a trial designed to test the effect on host toxicity of regular drug-free periods during chemotherapy. Patients received the same total dose of drugs either continuously (daily), intermittently (a 5 d course every 3 weeks) or in an intermediate way between these two (a 14 d course followed by a 7 d gap). Mean neutrophil counts were lower in the intermittent group and fell significantly at 6 week intervals, after courses which included prednisolone and vincristine in addition to methotrexate and 6-mercaptopurine. Mean lymphocyte counts, mitotic response to phytohaemagglutinin and plasma immunoglobulin levels were significantly lower in the continuous group. The results in the intermediate group fell between those of the other two groups. All six remission deaths occurred in the 42 patients in the continuous group, who had a much higher incidence of infections (mostly viral and protozoal) than the other two groups. It is concluded that the intermittent chemotherapy schedule permits the maintenance of a lymphocyte population size and function which provides a satisfactory level of defence against infection without prejudice to its anti-leukaemic effect.

Adolescent↗

Bone-marrow relapse in acute lymphoblastic leukaemia in childhood.

The outcome after bone-marrow relapse was assessed in 53 children with acute lymphoblastic leukaemia (ALL). Twenty-five out of 37 children (67%) whose first remission ended in relapse during treatment (group A) achieved a second remission, as did 15 out of 16 (94%) who relapsed after treatment had been stopped (group B). Nevertheless, the median duration of second remission was only 12 weeks in group A and 35 weeks in group B. The median survival from time of relapse was 32 weeks in group A and 75 weeks in group B. It is concluded that marrow relapse is equally serious whether it occurs during treatment or after treatment has been stopped, and that most children with ALL have a single chance of cure at the time of diagnosis.

Acute Disease↗

Treatment of Ewing's sarcoma with high-dose melphalan and autologous bone marrow transplantation.

Three patients with disseminated, relapsed Ewing's sarcoma refractory to conventional chemotherapy were treated with high-dose melphalan, cyclophosphamide pretreatment, and bone marrow autotransplantation. Two patients achieved complete remission and one achieved partial remission. The two patients who achieved complete remission remain disease-free at 12 and 13 months. High-dose melphalan is effective when conventional approaches have failed.

Adolescent↗