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Biomedical subjects

R Gopal

Publications and source records attributed to R Gopal.

At least 109 records · Page 6Linked to original sources
PubMed1989

Hodgkin's disease with bone marrow involvement.

Bone marrow involvement was seen in 11 percent of patients with Hodgkin's Disease which was determined from pre-treatment biopsy specimens using established histopathologic criteria. Analysis of 32 evaluable patients with marrow involvement showed male preponderance with a peak in fourth decade of life. Twenty four cases (75%) had B-symptoms and 15 (46%) presented within six months of onset of symptoms. On categorizing for clinical staging, 21 (65%) belonged to stage III and IV. Hepatomegaly (greater than or equal to 2 cms) was present in seven cases (21%) and splenomegaly in 13 cases (40%). Mixed cellularity and lymphocytic depletion histopathologic subtypes showed the highest frequency of involvement (21 cases; 65%). Out of 28 cases ESR was raised in 27 cases (96%). Eighteen cases (56%) showed elevated serum alkaline phosphatase levels. Serum copper levels were determined in 14 cases, out of which 12 (85%) showed elevated levels. These parameters along with anemia (hemoglobin of 12 g/dl or less) in 26 cases (81%), correlated well with the disease activity. Only four cases had leukopenia at presentation pointing to no hindrance for aggressive chemotherapy. All cases received minimum of six courses of standard combination chemotherapy with or without local radiotherapy. Sixteen cases (50%) relapsed subsequently and were managed accordingly. A five year follow-up revealed a minimal 31 percent overall survival, and 18 percent of patients were disease free and well since the time of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Actuarial Analysis↗
PubMed1989

Cisplatin-based chemotherapy in advanced ovarian cancer: initial experience in an Indian set-up.

Forty patients of advanced ovarian carcinoma were treated with monthly cycles of cyclophosphamide, adriamycin and cisplatin. Debulking surgery was done in 29 cases. Clinical complete response was seen in 70 percent and an overall response in 85 percent of cases. The median follow-up was 30 months. The actuarial overall survival was 45 percent and the disease free survival was 35 percent at 3 years. The present protocol appears to have an important influence on initial control of disease but relapses continue to occur following the treatment. Cytoreductive surgery before or after three cycles of chemotherapy has a favourable influence on disease free survival (DFS). Prolonged follow up will be necessary to determine the overall influence on long term survival.

Actuarial Analysis↗
PubMed1989

Multiple myeloma. Analysis of fifty cases.

Fifty patients of multiple myeloma have been studied. Seventy eight per cent of the patients were in the 5th, 6th and 7th decades of life. Commonest presenting feature was bone pains (76%). 8%, 20% belonged to stage I, II and III respectively. Skull (58%), ribs (52%) and pelvis (24%) were most commonly involved. Immunoelectrophoresis revealed IgG type of myeloma in 76% and IgA type in 10% cases. Bence-Jones proteinuria was seen in 60% of patients; Kappa specificity was commoner than lambda. Overall survival at 30 months was 50%. The survival was adversely influenced by advanced stage, higher plasma cell count in the bone marrow, low haemoglobin and high serum creatinine values.

Adult↗
PubMed1989

Limitations of the therapeutic regimens for myelodysplastic syndrome.

Thirty patients of myelodysplastic syndrome (MDS) were treated over a period of 2 yr using 3 different treatment regimens. Twelve patients received hydroxyurea, 4 were given low dose cytosine arabinoside and 14 others were treated with an aggressive acute myeloid leukaemia (AML) induction regimen. A low complete remission was obtained in the first 2 groups (17 and 25% respectively), whereas 9 (64%) patients attained complete remission with the AML induction regimen. Remission in the latter group was associated with prolonged and severe pancytopenia requiring intensive support. Patients in all the 3 groups had a short duration of remission culminating in death with progressive marrow failure or evolution to AML, indicating the limitations of the current treatment strategies for MDS and highlighting the need for exploring newer therapeutic approaches.

Adolescent↗
PubMed1989

Acute lymphoblastic leukemia in childhood: treatment, results and prognostic factors.

Two hundred and nine children (20 years and below) diagnosed as acute lymphoblastic leukemia between January 1980 and December 1983 were retrospectively analysed to evaluate the clinical features, prognostic factors and the results of therapy. One hundred and eighty one evaluable patients were treated with three different chemotherapy regimens consisting of vincristine and prednisolone (Group-A), vincristine, prednisolone and L-asparaginase (Group B-60 patients), and vincristine, prednisolone and adriamycin (Group C-81 patients). Complete remission was achieved in 152 (84%) patients, remission induction being 75 percent, 85 percent and 88 percent in Group A, B and C respectively. At a median follow-up of 36 months the disease free survival for complete responders was 35.5 patient. The disease-free survival for Group A, B and C was 20 percent, 47 percent 34 percent respectively indicating the superiority of a three drug regimen over the conventional two drug regimen. Patients at standard risk in each group had significantly better survival when compared to those at high risk. A 3-drug treatment regimen was superior to the 2-drug regimen and a low initial leucocyte count was an important favourable prognostic factor.

Adolescent↗
PubMed1989

Idiopathic thrombocytopaenic purpura in patients during remission of Hodgkin's disease.

Four patients with Hodgkin's disease developed thrombocytopaenic purpura during remission phase. The interval at which it occurred following chemotherapy ranged from a period of 4 months to 4 years. Detailed investigations failed to reveal recurrence of Hodgkin's disease. All patients responded well to steroid therapy. In the median duration of one year follow-up Hodgkin's disease remained under control. Thus, the occurrence of thombocytopaenic purpura in patients treated for Hodgkin's lymphoma need not imply recurrence or active Hodgkin's disease.

Adolescent↗
PubMed1988

A prospective, randomized double-blind trial comparing metoclopramide alone with metoclopramide plus dexamethasone in preventing emesis induced by high-dose cisplatin.

We observed 50 patients receiving high-dose cisplatin-based chemotherapy in a prospective, randomized double-blind trial. One group received metoclopramide (MCP) alone (total dose, 6 mg/kg), whereas the other group was given dexamethasone (DMS) (total dose, 60 mg) in addition to MCP. The patient characteristics of the two groups were comparable, confirming satisfactory randomization. Multivariate regression analysis failed to show any statistical significance in the antiemetic response between the two treatment groups. However, female patients receiving Adriamycin (Adria Laboratories, Columbus, OH) concurrently and obese persons exhibited more vomiting. The overall antiemetic response rate was 66%. Because the side effects were minimal, a higher dose of MCP is expected to improve emetic control without increasing toxicity. The use of a 36-hour assessment period in our study gave more meaningful data. An exponential increase in the dose of MCP is probably required, with respect to weight, to obtain the same antiemetic efficacy.

Adult↗
PubMed1988

Treatment of Askin Rosai tumor--need for a more aggressive approach.

Fifteen cases of histologically proven Askin Rosai tumor were treated at Tata Memorial Hospital over a period of 3 years. Patients included 12 men and three women. Clinical features included chest wall mass (14), pain (11), bony involvement (6), fever (4), dyspnoea (4), weight loss (1), cough (1), and hemoptysis (1). Previously treated patients received different treatment protocols, which made evaluation difficult. Of our ten patients who have completed induction therapy, five received vincristine and cyclophosphamide, whereas the other five received more aggressive chemotherapy. Complete remission has been achieved in two and four of these patients, respectively. One patient in each group had recurrence of the disease, in both cases at the local site. Thus, from our preliminary data, we suggest that Askin Rosai tumor should be treated with complete surgical excision followed by an aggressive combination of chemotherapy and local radiotherapy.

Adolescent↗
PubMed1988

Nasopharyngeal carcinoma in India: end-result analysis (1980-1984).

One hundred fifty patients with nasopharyngeal carcinoma were treated at the Tata Memorial Hospital from January 1980 to December 1984. Lymphoepithelioma was the most common histologic subtype. Advanced disease in stages III and IV was seen in 22.66% and 72% of the patients, respectively. Complete remission was obtained in 80 of 120 patients (66.66%) with radiation alone and in 19 of 30 patients (63.3%) who received preradiation chemotherapy and radiation. Age, sex, and histology did not influence the rate of complete remission. The N0-1 nodal status group had a significantly better response of 81% and 36% survival, as compared with the N2-3 group with a 55% response and 20% survival. Only 30 of those who received radiation alone and 10 of those who received preradiation chemotherapy are disease-free for a median period of 24 months. Twenty-six relapses have occurred within a median period of 12 months. The 5-year actuarial disease-free survival is 13%. This indicates the need for an early diagnosis and combined aggressive treatment to improve survival.

Adolescent↗
PubMed1988

Poland's syndrome with acute lymphoblastic leukemia in an adult.

We report a patient with Poland's syndrome who developed acute lymphoblastic leukemia (ALL) at 28 years of age. This is the first time that such an association has been reported from outside the United States or in an adult. The relevant literature is reviewed.

Adult↗
PubMed1988

Head and neck extranodal non-Hodgkin's lymphomas in Indian patients.

Though radiotherapy has traditionally been the treatment of the choice for the patients with localised extranodal lymphomas of the head and neck areas, its adequacy as the sole modality of treatment has come to be questioned. The disease is shown to relapse in other distant extranodal sites especially the gastrointestinal tract. The addition of systemic chemotherapy has been suggested. Fifty-five patients with localised head and neck extranodal lymphomas were treated at the Tata Memorial Hospital during the period 1976-1982, 35 with radiation therapy alone and 20 with combination therapy. The total survival at 5 years was 65% for patients treated with radiation alone and 85% for those treated with combination therapy. The 5 year disease-free survival dropped to 45% for the former group but was 74% for the latter group. This difference was statistically significant (p less than 0.01). We infer that localised extranodal lymphomas be regarded as a systemic disease and be treated by a multimodal approach.

Adolescent↗
PubMed1988

Sudan black B positivity in acute lymphoblastic leukemia.

The records of 458 patients with acute lymphoblastic leukemia (ALL) have been reviewed. The diagnosis of ALL was based on clinical examination and morphological, cytochemical and immunophenotypic characteristics (20% or more blasts reacting with lymphoid monoclonal antibodies) of blood and/or bone marrow. Blast cells of 6 (1.3%) patients showed positive reaction with Sudan black B (SBB) in the absence of reactivity to any other myeloid markers. Positive reaction with SBB stain cannot be considered specific for myeloid series.

Adolescent↗