[Studies of fibronectin levels in recurrences of proliferative diseases of the hematopoietic system in children].
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Biomedical subjects
Publications and source records attributed to M Ochocka.
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The subject of analysis is a group of 111 children with acute lymphoid leukemia (ALL) whose remission has lasted at least 4 years since stopping treatment. Patients were observed from 4 to 18 years after ALL therapy. No symptoms of disease were observed in 110 children; one child had leukemic infiltration of the testes during the fifth year after stopping treatment. In this group of children no changes in physical development have been recorded, but a growth deficiency is sometimes noted. No symptoms of intrinsic organ lesions have been ascertained in most of the patients. All of the patients, except one with schizophrenia, lead normal lives and either attend school or go to work. Seven patients have healthy children, who were born 6-24 years after the beginning of the disease and 3-16 years after cessation of therapy.
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The in vivo effect of thymus factor X (TFX) on the E-rosetting capacity, the absolute peripheral blood lymphocytes and T-cell number per microliter, the skin test reactivity to recall antigens, and the immunoglobulin production was evaluated in 20 children with acute lymphoblastic leukaemia. The in vitro effect of TFX was also tested. The mean percentage of E-rosettes in these patients increased from 50 to 64%. Although absolute peripheral blood lymphocyte and T-cell number per microliter rose significantly, the mean values did not reach those in healthy children. The tests with recall antigens were positive in 13% of patients prior to immunotherapy and 32% following the therapy. The influence of immunotherapy on infectious episodes and on the stabilisation of remission was also evaluated. TFX in vivo appears to restore immunocompetence, decrease infections, and prolong remissions in children with ALL in remission.
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From 1979 to 1982, 97 previously untreated children with non-Hodgkin's lymphoma were treated with the LSA2L2 protocol proposed by Wollner. Staging was done according to the criteria proposed by Wollner and re-staged according to Murphy's criteria. Each patient, regardless of clinical stage and histologic group, was given the same chemotherapy. A total of 28 nonrandomized patients received either cranial irradiation or intermediate-dose intravenous methotrexate as CNS prophylaxis. The complete remission rate was 72.6%. The 3-year actuarial estimate of survival was 73% and the disease-free survival rate was 62% for all responders, and was influenced by stage and main clinical features present at the time of initial presentation. The overall survival rate at 3 years is 52%. Of 26 children who failed to achieve complete remission, 21 had presented with disseminated disease. Also, 20/67 patients who entered remission have suffered relapses: four in the bone marrow, seven in the CNS, and nine with local relapses. Only one of 28 children who received CNS prophylaxis developed CNS disease as the site of first relapse, whereas six of those who received only intrathecal chemotherapy did so. This study confirms the improved outlook in comparison with a historical group for children with non-Hodgkin's lymphoma by the use of an intensive multiple-drug regimen and CNS prophylaxis.
Isoprinosine was given to 15 children with lymphoblastic diseases and 3 adults during infections with herpes viruses - herpes simplex (HSV) and varicella-zoster viruses (VZV). The control group included 7 children who had previously suffered from infections with HSV and VZV without being treated with isoprinosine. The clinical observations showed a significant inhibitory effect of isoprinosine on viral infections, with the duration of the disease being shortened considerably. The authors think isoprinosine treatment to be justified in viral infections, especially in children with neoplastic diseases, because of the immunostimulating action of the drug, rapid clinical improvement and good tolerance of the drug.
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