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Biomedical subjects

M J Matthews

Publications and source records attributed to M J Matthews.

At least 73 records · Page 4Linked to original sources
PubMed1979

Cyclic alternating combination chemotherapy for small cell bronchogenic carcinoma.

Sixty-one protocol-eligible patients with small cell bronchogenic carcinoma received cyclic alternating combination chemotherapy with two or three non-cross-resistant drug combinations. No chest or prophylactic brain radiation therapy was used. Twenty-eight months after starting treatment, disease-free survival was 23% for patients achieving a complete response (CR) and 13% overall. Initial treatment consisted of high-dose cyclophosphamide, methotrexate, and CCNU (CMC) for 6 weeks. Patients then received vincristine, adriamycin, and procarbazine (VAP) for 6 weeks. The addition of VAP increased the CR rate from 42% to 74% in limited-disease patients and from 24% to 36% in extensive-disease patients. Half of the patients were randomized to a third combination of VO-16-213 and ifosfamide. These patients were cycled at 6-week intervals through the three drug regimens while the remaining patients were cycled between CMC and VAP. The addition of VP-16-213 and ifosfamide did not increase the CR rate or prolong survival. Only complete responders survived beyond 24 months. Sequential use of non-cross-resistant drug combinations represents one method for increasing the CR rate.

Antineoplastic Agents↗
PubMed1979

Blood and lymph node T lymphocytes in cutaneous T cell lymphoma: evaluation by light microscopy.

Cytology of peripheral blood and lymph node lymphocytes from a group of unselected patients with cutaneous T cell lymphoma (CTCL) was studied by light microscopy. Twenty of 45 patients had circulating lymphocytes with convoluted nuclei recognized in routine Wright-Giemsa-stained peripheral blood smears. Cytocentrifuge preparations of E-rosetted lymphocytes showed that greater than 10% of the T cells had convoluted nuclei in each of 16 patients with positive blood smears and in six of 17 whose blood smears were negative or inconclusive. Peripheral blood involvement with greater than 10% convoluted T cells was most frequent in patients with erythroderma (100%) including those with normal of decreased lymphocyte counts, and was not uncommon in patients with mycosis fungoides in the plaque or tumor phase (42%). The light-microscopic morphology of the abnormal cells found in the patients with the plaque or tumor phase of mycosis fungoides was not distinguishable from that of the erythrodermic patients. Increased percentages (less than 15%) of T cells having convoluted nuclei were also found in the lymph node cell suspensions from CTCL patients with adenopathy (18 of 25 patients). These results suggest that a high frequency of extracutaneous involvement occurs in patient with CTCL, the clinical significance of which remains to be determined.

Humans↗
PubMed1979

Cytogenetic abnormalities in patients with cutaneous T-cell lymphomas.

Cytogenetic studies were conducted in 36 patients with histologically confirmed cutaneous T-cell lymphomas at the National Cancer Institute-Veterans' Administration Medical Oncology Branch. Aneuploidy was observed in 17 (85%) of the 20 lymph nodes, 23 of the 36 peripheral bloods, and five of the 31 bone marros. Aneuploidy was frequently present even when tumor cells were not noted histologically. These findings indicate that cytogenetic studies can be very useful for the early detection of malignant cells even when only a few such neoplastic cells are encountered. In this study, the cytogenetic abnormalities found to be characteristic of the disease included extensive aneuploidy, with both numerical and structural aberrations, a wide range of heteroploidy, and a lack of clone formation until the terminal phase of the disease. The numerical changes most frequently involved chromosomes 8, 15, 11, 17, 21, and 10, and the chromosome most involved in structural aberrations was chromosome 1, followed by chromosomes 7, 14, 16, 6, and 9. Cytogenetic studies demonstrate that neoplasia in the cutaneous T-cell lymphomas commonly involves areas beyond the skin.

Aneuploidy↗
PubMed1979

Simultaneous gastric and plasma immunoreactive plasma carcinoembryonic antigen in 108 patients undergoing gastroscopy.

Simultaneous measurement of plasma and gastric immunoreactive carcinoembryonic antigen (CEA) was performed in 108 patients undergoing upper gastrointestinal endoscopy. Gastric immunoreactive CEA was more sensitive than plasma CEA (92% vs. 65% positive) in patients with gastric cancer. In cancer patients gastric CEA was significantly higher than in all other patient groups. The extent of disease, the histologic type of adenocarcinoma, and the macroscopic appearance of the tumor had no influence on gastric CEA results. Gastric CEA was elevated in 44% of patients with gastritis and 26% of patients with benign gastric ulcers, but was never elevated in patients with no gastric pathology. In patients with benign disorders, elevated gastric CEA was significantly correlated with atrophic gastritis especially of moderate or severe degrees. Elevated levels persisted in patients with pernicious anemia and severe atrophic gastritis but returned to normal with healing of benign gastric ulcers. Simultaneous measurement of gastric total protein or potassium content was necessary to correct for variations in sample collection. We conclude that gastric CEA was not useful for distinguishing between benign and malignant lesions but should be studied further for screening high risk patients, for identifying and following patients with "premalignant" conditions, and for following cancer patients before and after surgery and/or chemotherapy.

Adenocarcinoma↗
PubMed1979

Exposure to chemicals, physical agents, and biologic agents in mycosis fungoides and the Sézary syndrome.

The history of occupational, environmental, and/or iatrogenic exposure to potential carcinogenic agents was obtained at the time of onset of skin disease in 43 of 44 patients with cutaneous T-cell lymphoma (mycosis fungoides and the Sézary syndrome) entering a National Cancer Institute therapeutic trial. A history of multiple exposures to these agents was common, the two most frequent being chemicals (91% of patients) and drugs (86%). Mean duration of expsosure was 13 years for chemicals and 18 years for drugs. The most common chemicals were air pollutants (39%), pesticides (36%), solvents and vapors (30%), and detergents and disinfectants (14%). Increased severity of disease was seen with increaed duration of chemical exposure in stage V cutaneous T-cell lymphomas only. The most frequent drugs besides tobacco (86%) were analgesics (20%), tranquilizers (18%), and thiazides (14%). Second cancers occurred in four patients, including two renal cell carcinomas, and a family history of cancer was present in 11. Fourteen of 22 patients questioned had recurrent herpes simplex. Patients with chronic skin disease who have long-term exposure to combinations of chemicals, physical agents, and biologic agents, are heavy smokers, or have recurrent herpes simplex appear to be prime candidates for developing mycosis fungoides or the Sézary syndrome.

Adult↗
PubMed1978

Serial fiberoptic bronchoscopy during chemotherapy for small cell carcinoma of the lung: early detection of patients at high risk of relapse.

Serial fiberoptic bronchoscopic examinations were performed during intensive chemotherapy with a combination of drugs in 77 previously untreated patients with small cell carcinoma of the lung. Before treatment, bronchoscopic examination revealed evidence of cancer in 93 percent (70) of the 75 patients studied at that time, including 8 percent (six) in whom the tumor was not evaluable on the chest x-ray film. After therapy was initiated, 36 percent (29) of the 81 procedures performed in patients with a complete response radiographically and 62 percent (33) of the 53 bronchoscopic procedures in those with a partial response or no response showed evidence of tumor. In both of these groups, patients with abnormal findings on endoscopic examination had a much higher rate of relapsing tumor of the chest within a 12-week period. Progression of intrathoracic tumor was first detected solely by bronchoscopic examination in 22 percent (seven) of the 32 episodes of progression. In our hands, repeated fiberoptic bronchoscopic procedures during chemotherapy for small cell carcinoma have yielded information not apparent from the chest x-ray film in a significant number of patients.

Bronchoscopy↗
PubMed1978

Small cell bronchogenic carcinoma: a distinct clinicopathologic entity.

Since small cell carcinoma is a treatable disease, with surgery being beneficial in a few cases and with chemotherapy, radiotherapy, and immunotherapy contributing to prolonged survival in patients with inoperable disease, it is essential that the clinical and pathologic features of small cell carcinoma be quickly recognized in a newly presenting patient so that appropriate therapy may be offered.

Carcinoma, Bronchogenic↗
PubMed1977

Cardiac metastases in lung cancer.

Cardiac metastases from bronchogenic carcinoma are not commonly diagnosed prior to death. This study isolates factors associated wtih the development of cardiac involvement. Four hundred eighteen consecutive patients with lung cancer who had autopsies were studied. Twenty-five percent of these patients had cardiac involvement. Factors associated with cardiac metastases were (1) histologic cell type of the tumor, (2) aggressive therapy, (3) extent of disease, and (4) tumor differentiation. The presence of cardiac metatases was not related to the length of survival. Clinical signs of cardiac involvement included an enlarging heart on the chest x-ray film, development of congestive heart failure, or electrocardiographic changes. Suspicion of cardiac metastases in high-risk individuals, prompt diagnostic evaluation, and rapid institution of therapy may improve the outlook for many patients, since reaccumulation of fluid was generally slow.

Adenocarcinoma↗