PubMed Health⌕ Search

Biomedical subjects

R Kuse

Publications and source records attributed to R Kuse.

At least 91 records · Page 5Linked to original sources
PubMed1985

[Non-hematologic toxicity in high-dose cytarabine therapy].

The hence reported non-haematologic toxicity in high-dose cytarabin mainly concerned CNS (cerebellar dysfunction), eyes (keratitis and conjunctivitis), skin (erythema), and gastrointestinal tract (vomiting, diarrhea). It partly depends on dosage and partly on duration of treatment. A dose of 48 g/sq m within one cycle apparently represents a critical upper limit as hence especially the risk of irreversible brain damage increases. Considering the fact that the indication for high-dose cytarabin is given mainly for poor prognostic failures and relapses in acute leukemias toxicity seems to be acceptable.

Acute Disease↗
PubMed1985

Intensified induction and consolidation with or without maintenance chemotherapy for acute myeloid leukemia (AML): two multicenter studies of the German AML Cooperative Group.

In two multicenter trials, a total of 576 patients with acute myeloid leukemia (AML) were treated and found to be evaluable. Two hundred forty-two patients were in a 1978 pilot study and 334 patients were in a 1982 randomized study. Ages were between 15 and 78 years (median, 48). The uniform remission induction therapy in both studies consisted of one to two courses of a 9-day combination of 6-thioguanine (TG) with cytosine arabinoside (ARA-C) and daunorubicin (DNR) [TAD9]. The timing and sequencing of TAD9 was designed according to cell kinetic effects of ARA-C. A complete remission (CR) was achieved in 65% (70% and 61%, respectively) of patients within a median of 33 days, and in 68% of responders after only one course. The CR rate in patients 60 to 78 years of age was 51% (66% and 39%, respectively). In the 1978 pilot study, different protocols of post-remission treatment were applied at the different centers: monthly 5-day maintenance, TAD9 consolidation, both consolidation and maintenance, or no further therapy. The group receiving treatment during CR showed 24% probability of remissions at 4 years v 0% probability of remissions in the untreated group. Between the different post-remission protocols, no significant differences were observed. Remission duration was not influenced by age, WBC, or morphologic cell type, but was longer in patients achieving CR within 30 days (P = .017). In the subsequent 1982 study, 145 patients in CR were randomized for TAD9 consolidation with or without monthly maintenance. The updated life-table analysis revealed a predicted rate of continuous remission at 2 1/2 years of 30% for the maintenance and 17% for the nonmaintenance arm (P = .003). These results of response and remission duration in adult patients of all ages support the validity of intensified induction therapy and of consequent myelosuppressive treatment in remission.

Actuarial Analysis↗
PubMed1985

[Sequential polychemotherapy and large-field radiotherapy of non-Hodgkin's lymphoma].

The combination of polychemotherapy and large-field radiotherapy essentially promoted the improved total results achieved during the period of 1976 and 1982 in 272 patients with non-Hodgkin's lymphomas (NHL) of low and high malignancy. In case of centroblastic-centrocytic (cb/cc) NHL of stages II A/III A, the recurrence-free survival after radiotherapy (n = 21) could be increased by the combined method (n = 25) from 17% to 60%, and the probability of seven-year survival could be improved from 70% to 90%. All of the ten initially irradiated patients in the stages I A/II A/III A of centrocytic (cc) NHL suffered from a recurrence, whereas the development seems to be more favorable in the five patients submitted to combined treatment who had only one recurrence. The recurrence-free seven-year survival of the highly malignant NHL in stage I A/II A increased from 40% after unique radiotherapy (n = 15) to 70% after combined therapy (n = 39), the survival probability increased from 55% to 75%. Despite the partly insufficient therapy results after unique radiotherapy and polychemotherapy, the combined method has largely contributed to achieve after eight years the total survival rates of 76% for cb/cc NHL (n = 123) and of 55% for the highly malignant immunoblastic NHL (n = 57), centroblastic NHL (n = 35) and NHL with uncertain classification, whereas the cc-NHL (n = 36) hitherto has a relatively unfavorable prognosis with only 29%.

Adolescent↗
PubMed1983

[Prognostic differences in low-malignancy germinal center cell lymphomas and immunocytomas. Relationship to histological subtypes, stages and therapy].

Based on repeated interval analyses, radiotherapy and cytostatic drug therapy were stepwise intensified and combined in 264 patients diagnosed between 1976 and 1981 as having histopathologically low-malignant centroblastic-centrocytic (cb/cc; n = 106), centrocytic (cc; n = 34) or immunocytic lymphoma (n = 124). The number of treatment failures and recurrences were clearly reduced. There were three prognostic steps in survival probability: 90% after seven years for stages IA-IVA of the cb/cc lymphoma as well as for the extranodal lymphoplasmocytoid and lymphoplasmocytic immunocytomas, stages I-IV of Ann Arbor, and stages 0-II of the Rai classifications. In the Rai stages III and IV these immunocytomas had a definitely worse prognosis, at 60%. Prognostically most unfavourable, at levels of around or below 30%, were the B forms of cb/cc lymphomas, all stages of centrocytoma and the polymorph-cell immunocytomas. The survival rate of the cb/cc lymphomas was increased by about 33%, compared with cases of Brill-Symmers' disease between 1970 and 1975. The alternating use of cytostatic combinations seems to be more favourable among the previously little affected centrocytomas and the polymorph-cell immunocytomas.

Adult↗
PubMed1981

[Stage IIIB and IVB Hodgkin's disease. Response to chemotherapy, relapses, survival rates (author's transl)].

Thirty-two of 71 (45%) stage IIIB and IVB patients up to the age of 60 achieved a complete remission (CR) by initial COPP-chemotherapy. Twelve additional cases were free of symptoms after COPP, but showed persistent disease at postprimary laparotomy or within 3 months after cessation of chemotherapy. Forty-four per cent (n = 17) of this initial COPP failures could also be brought to CR by ABVD-chemotherapy or/and radiotherapy within 7 to 51 months. Cases with lymphocytic depletion reached CR in only 31% (N = 5/16) in comparison to 80% (n = 44/55) of the three other histological subtypes. Without additional consolidation therapy 60% relapsed, but only 11% after adjuvant total-nodal irradiation. An increase of side effects after therapy has not been observed so far. Patients with once attained CR have a survival probability of 93% after nearly 8 years from diagnosis. For the whole stage IIIB/IVB group the values were 85% up to the age of 30 (n = 28) and 60% for the age group of 31-60 (N = 43). They were clearly higher than in the 1966-1971 patients who showed values o 39% nd 41%, respectively. Beyond the stage of 60 (n = 15) the survival probability of 10% after 3 years in comparison to former 15% revealed no improvement.

Adolescent↗
PubMed1981

[Survival rates in Hodgkin's disease in relation to histological subtypes (author's transl)].

Due to advantages of diagnostic and therapeutic progress the five-year-survival rates for 3 histological subtypes have become comparable in 322 patients with Hodgkin's disease during the years 1972 to 1979. Five-year-survival was 96% for the predominantly lymphocytic type, 90% for the nodular sclerosing type and 77% for the mixed cell type. Survival for all types together was 84% after 5 years and 80% after 7 years. The lymphocytic depletion type had a much worse prognosis with a five-year-survival of 31%. Apart from a reduced incidence of nodular sclerosis after the 40th year of life the histological forms were evenly spread between age groups and sexes On the other hand there were relationships between histological type and clinical stage.

Adult↗
PubMed1981

[Survival rates and reduction or mortality in Hodgkin's disease in relation to age of the patient (author's transl)].

Survival rates were calculated in 550 patients with Hodgkin's disease during the years 1966 to 1979 according to decade of age and were classified into three significantly different groups. The patients have been investigated according to a standard procedure since 1972 and the major part was treated intensively. The five-year-survival rate was 95% for the group under 30 years of age, 75% for the group between 31 and 60 years and 47% for the older group. For the three comparative groups during 1966 to 1971 the rates of 76%, 60% and 40% were markedly lower. Mortality in the young and middle age groups has decreased in Hamburg since 1975. Due to the continued above average death rate after the 60th year of life this development is not sufficiently noticeable in the total group. A similar tendency is shown in the GFR mortality statistics. With increased use of diagnostic and therapeutic possibilities the age of the patient becoming one of the most important prognostic features in Hodgkin's disease.

Adult↗
PubMed1977

[Electronic platelet counting with particular reference to thrombocytopenias (author's transl)].

Platelet counts in platelet-rich plasma without hematocrit dependent correction were performed by following rapid and simple steps: 1. pre-dilution of 20 microliter of whole blood by an isotonic solution 1:25; 2. stabilized low-speed centrifugation with 55 g for 5 minutes; 3. final dilution 1 : 5000; 4. enumeration by use of a TOA platelet counter PL-100 which has been technically improved in comparison to similar machines. Erroneously high results were obtained after a too short or too low centrifugation. As reason for this artifical small pulses due to disturbances of the flow patterns around the aperture (so-called vortex-effect) can be assumed having been caused by large-volumed erythrocytes and leukocytes in the suspension. The routinely used procedure was reliable for all platelet ranges, especially in thrombocytopenias between 100 X 10(9)/l and 25 X 10(9)l. In lower ranges comparisons with visual counts are essential.

Blood Cell Count↗
PubMed1976

Iron storage in macrophages and endothelial cells. Histochemistry, ultrastructure, and clinical significance.

1 hour after i. v. infusion of colloidal iron in iron deficient subjects uniform phagosomal iron granules were observed in macrophages and endothelial cells of several organs. 7 to 10 days later transformation into ferritin coould be visualized in macrophages only. Now, these cells showed diffuse iron staining of the cytoplasm due to dispersed ferritin molecules. Polymorphous lysosomes contained densely packed particles from still unchanged ferric hydroxide to paracristalline ferritin. The macrophageal iron was mobilizable in few days to several weeks. The univorm lysosomal iron granules of endothelial cells disappeared after 1 to 2 years. Endothelial iron siderosis without previous i. v. iron application was a frequent finding in pernicious anaemia and iron overload of diverse origin.

Anemia, Hypochromic↗