PubMed HealthSearch

Biomedical subjects

M Teeling

Publications and source records attributed to M Teeling.

14 recordsLinked to original sources

Carboplatin/cyclophosphamide combination chemotherapy for advanced ovarian cancer.

The efficacy and toxicity of combination intravenous carboplatin (300 mg/m2) and cyclophosphamide (600 mg/m2) were evaluated in 70 newly diagnosed patients with advanced-stage epithelial ovarian cancer. Cycles were administered at 4-week intervals for a total of six cycles, and treatment was provided on an outpatient basis without prehydration or forced diuresis. During treatment, patients were assessed by physical, gynecologic, and radiologic examinations. Seventy patients with a median age of 58 years (range, 35 to 77 years) were entered into the study. Most patients had serious cystadenocarcinoma; 78% had stage III or IV disease and 91% had grade II or III histologic subtype. Optimal debulking surgery was performed in only 46% of patients. The overall response rate to carboplatin/cyclophosphamide combination chemotherapy was 81%, with 66% achieving a clinical complete response. The median survival for all patients was 19+ months. For patients who had undergone optimal debulking surgery, median survival was 26 months, compared with a median survival of 13+ months for those who had undergone suboptimal surgery. Treatment was well tolerated by most patients. Significant nausea and vomiting (World Health Organization grades 2 to 3) occurred in only 6% of 377 cycles of therapy. Myelosuppression was mild, with leukopenia (WBC count less than or equal to 2 x 10(9)/L) observed in only 11 of 295 cycles (4%) and thrombocytopenia (less than or equal to 100 x 10(9)/L) in 17 of 279 cycles (6%). Nadir levels generally occurred on day 21 of each cycle. Symptomatic anemia requiring transfusion occurred in 18 of 290 cycles (6%). Moderate alopecia, necessitating use of a hairpiece, occurred in six patients; no signs or symptoms of neurotoxicity, ototoxicity, or nephrotoxicity were observed in any patient. Renal function was normal on follow-up investigation, which was performed a median of 5 months after completion of treatment. This study demonstrates that carboplatin/cyclophosphamide combination chemotherapy is well tolerated in women with advanced-stage epithelial ovarian cancer, and produces overall response rates and median survival times similar to those obtained with cisplatin-containing regimens.

Adult

Non-M CK--a practical measure of creatine kinase isoenzymes in cancer patients.

The individual creatinine kinase (CK) isoenzymes CK-BB and CK-Macro II have previously been investigated as potential tumour markers. We believe there is a need for a system to measure those CK forms not usually present in serum. We have studied a CK-MB immunoinhibition kit which measures all residual CK activity following inactivation of M-subunit activity. In 162 patients with cancer we found no difference in grading (+ or -) between detailed isoenzyme studies and the simple non-M assay. In 33 samples with elevated non-M CK, detailed analysis showed BB alone (45%), Macro II alone (9%), or both (36%). Raised activities were mainly found in patients with small cell lung cancer (SCLC) (17/40; 43%) and GI Tumours (6/11; 55%). In patients with SCLC, elevated activities were associated with disseminated disease. Preliminary evidence indicates that Non-M CK may also be a simple means of monitoring initial treatment response.

Biomarkers, Tumor

Phase II study of carboplatin and cyclophosphamide combination chemotherapy for the treatment of advanced ovarian cancer.

The efficacy and toxicity of intravenous carboplatin (300 mg/m2) and cycloprosphamide (600 mgs/m2) was evaluated in 44 newly diagnosed patients with advanced stage epithelial ovarian cancer. Cycles were administered at four weekly intervals for a total of 6 cycles, and therapy was provided on an out-patient basis without prehydration or forced diuresis. During treatment patients were assessed by physical, gynaecological and radiological examinations. Forty-four patients with a median age of 54 years (range 28-76) were entered into the study. The majority of patients had serous cystadenocarcinoma, 82% had stage III or IV disease and 87% had grade II or III histologic subtype. Optimal debulking surgery was carried out in only 46% of patients. The overall response rate to carboplatin/cyclophosphamide was 73%, with 55% achieving a clinical complete response. The median survival for all patients was 18+ months (range 2-41+). For those patients who received optimum surgery, median survival was 26+ months, compared with 11+ months for those whose lesion could not be completely resected. Treatment was well tolerated by most patients, with significant nausea and vomiting (WHO grade III-IV) observed in only 11% of 226 cycles of therapy. Myelosuppression was acceptale, with a mean nadir white cell count 4.3 x 10(9)/L (range 1.4-9.0) and a mean nadir platelet count of 273 X 10(9)/L (range 39-536) observed on day 21. There were no therapy-related infective episodes. Significant alopecia developed in 4 patients, but significant nephrotoxicity, ototoxicity or neurotoxicity has not been observed in any patients. This study demonstrates that combination carboplatin/cyclophosphamide is well tolerated in women with advanced stage epithelial ovarian cancer and produces overall response rates and median survival similar to those obtained with cisplatin-containing chemotherapy.

Adult

Neuron-specific enolase can be used as the sole guide to treat small-cell lung cancer patients in common clinical practice.

Serum samples were collected from 115 small-cell lung cancer patients before each course of chemotherapy and during follow-up. Levels of neuron-specific enolase (NSE) were measured and compared to the clinical assessments of the course of the disease, which were done by the responsible physician without knowledge of NSE-values. The predictive accuracy of an increase or decrease of NSE for a major response (CR + PR), SD or PD was 98%. Importantly no false-positive rises of NSE were observed. On the basis of this large number of data it seems justified to conclude that in common clinical practice the treatment of small-cell lung cancer patients can be monitored by serial measurements of NSE alone.

Biomarkers, Tumor

The prognostic value of post chemotherapy serum CA 125 in epithelial ovarian cancer.

In a study of 33 newly diagnosed patients with ovarian cancer, we have correlated serum levels of the tumour marker CA 125 with disease stage, response to cytotoxic therapy and survival. Elevated levels were found in 22/28 patients (79%) with Stage III/IV disease, compared with 0/5 patients with Stage I disease and 7/38 patients (19%) with non-ovarian malignancies. Of 15 patients with measurable disease, serum CA 125 levels correlated with clinical response to treatment in 11; the remaining 4 patients had persistently elevated CA 125 levels in spite of clinical response and subsequently developed early relapse. Among the 13 patients with no measurable disease, 11 remained in clinical and radiological remission with treatment, with a fall to normal CA 125 levels; 2 patients who had persistently elevated CA 125 levels developed disease recurrence after completion of chemotherapy. Sequential measurements of CA 125 for up to 2 years in 8 patients showed that rising CA 125 levels preceded clinical relapse by a median of 3 months. The most important prognostic value of CA 125 was the level following 3 cycles of chemotherapy, independent of clinical status--median survival for 15 patients with normal CA 125 at 3 months was 15+ months compared with a median survival of 6 months in 13 patients who had elevated CA 125 at 3 months. These data confirm that 1) serum CA 125 levels are more sensitive than clinical or radiological assessment in monitoring response/relapse in ovarian cancer and 2) the CA 125 level after 3 cycles of chemotherapy is of major prognostic value in predicting survival.

Antigens, Tumor-Associated, Carbohydrate

Levels of neuron-specific enolase after chemotherapy do not predict a response in small cell lung cancer.

Neuron-specific enolase (NSE) was measured in serum samples of 35 patients with small cell lung cancer and 10 control patients. The samples were collected during 10 days after the first course of chemotherapy, in order to investigate whether changes of NSE had a predictive value of tumour response. Three patterns of change of NSE were observed. Pattern 1 showed an increase of serum NSE with a maximum value more than 1.5 times the pretreatment level (n = 17); pattern 2 involved no increase at all or less than 1.5 times the pretreatment level (n = 14); pattern 3 showed a continuous decrease (n = 5). No relationship between the three patterns of change and the tumour response was observed. Only an NSE level less than 10 ng/ml at the time of start of the second course predicted a major response.

Carcinoma, Small Cell

Lymphadenopathy due to fatal histiocytic proliferative disorder containing Michaelis-Gutmann bodies.

A 59-year-old white man had generalized lymphadenopathy, fever, weight loss, and hypercalcemia. Histologic examination of seven lymph nodes from three different anatomic sites revealed a diffuse histiocytic infiltrate containing numerous typical Michaelis-Gutmann (MG) bodies. Histochemical and immunohistochemical results confirmed the histiocytic nature of the predominant cell within the infiltrate. Approximately equal numbers of residual normal B-cells, T-helper, and T-suppressor cells were present. Electron microscopy revealed extracellular and intracellular MG bodies, many of which were membrane-bound. Special stains, electron microscopy, and lymph node culture did not demonstrate microorganisms. The histologic features of the infiltrate were those of malacoplakia. However, the disease behaved like a lymphoma, with the occurrence of lymphadenopathy and a fatal outcome.

B-Lymphocytes

Hepatic function in ankylosing spondylitis.

Values for alkaline phosphatase and gamma glutamyl transpeptidase (GGTP) and the prevalence of their elevation was significantly higher in 35 patients with ankylosing spondylitis (AS) than in 35 age and sex matched controls. The abnormal enzyme levels appeared to reflect a non-specific reaction to inflammation and could thus aid in assessment of disease status.

Adult