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Biomedical subjects

R Schaerer

Publications and source records attributed to R Schaerer.

At least 19 recordsLinked to original sources

[Hepatic metastasis of unknown primary site].

In this retrospective study, 91 patients (30%) out of a series of 304 with metastatic cancer of unknown primary site were found to have liver metastases. The liver was the only metastatic site in 28 (31%) cases and was associated with other sites in 63 (69%) cases. Median age was 62 yr in 61 male patients and 59 yr in 30 female patients. Thirty patients were submitted to an extensive investigation in search of the primary tumor, including systematic endoscopies: no primary cancer was found in these patients. In 61 other patients, only symptom-oriented investigations were performed and the primary cancer was found in 11 cases. The histologic type was adenocarcinoma in 71 (78%) cases, undifferentiated in 11 (12%) cases, epidermoid in 5 (6%) cases and determined by cytology alone in 4 cases. The median survival was 4 months in patients with metastases in the liver only, and 5 months in the other patients. This difference was not significant, so prognostic factors such as the Karnofsky index, weight loss, CEA and LDH levels were evaluated in the entire group; these factors do not have significant prognostic value. By contrast, when patients were able to receive chemotherapy, median survival was better (4 months) than without (median survival: 1 month; P = 0.005). In addition, in the case of objective response to chemotherapy, the median survival was 9 months versus 3.5 months for patients without objective response (P = 0.001). Seventy-three out of 91 patients (80%) were treated with chemotherapy regimen; 65 patients were evaluable: the objective response rate was 11 +/- 7% (7/65). Different regimens were used. With a non-toxic combination of fluorouracil, vinblastine and cyclophosphamide, 3 partial responses greater than or equal to 50% out of 43 patients (7 +/- 8%) were obtained. No significant advantage was observed when adriamycin was added to FU (4/13): 31 +/- 25%. Second- or third line chemotherapy regimen due to progression of the disease after the first-line combination provided only one objective response out of 36 patients. According to this retrospective study we recommend that overinvestigation be avoided in patients, with liver metastases of unknown primary site and that these patients be treated with non-toxic drug combinations.

Adenocarcinoma

[Massive breast involvement in Burkitt's lymphoma].

Massive bilateral breast involvement in the course of a Burkitt's lymphoma is reported as an exceptional occurrence in a 13 year-old girl, in early puberty. It was an extensive form, stage IV, with massive organ involvement but without CNS involvement. Chemotherapy (LMB 84) induced total cure (18 months disease free survival).

Adolescent

[Bereavement].

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Depressive Disorder

Quantitative study of T and B lymphocytes in Hodgkin's disease.

Peripheral blood lymphocytes forming E rosettes in the presence of sheep red blood cells and those bearing surface immunoglobulins (SIg) have been studied quantitatively as an evaluation of T and B lymphocytes in Hodgkin's disease. 62 patients were investigated, 21 of whom before any treatment. It appears that the lymphocytes forming E rosettes are significantly lower in percentage in 86% of the patients and in absolute count in 65%. SIg bearing lymphocytes are elevated in percentile in 61% of the cases, but the absolute count is normal in 50% of the patients and elevated in 30% only. At diagnosis the T/B lymphocytes equilibrium is modified in 13 among 21 patients but, after the initial treatment of the disease, the ratio is modified in 90% of the patients in complete remission and remains unchanged for years even in the absence of relapse or immnunosuppressive treatment. It is suggested that SIg + lymphocytes from the peripheral blood are actually B lymphocytes and not anti-T-antibody coated T lymphocytes or antigen-antibody lacking of membrane markers, which are numerous in one third of the investigated patients, might be T lymphocytes with qualitative abnormality.

Adult

[Trial of androgen therapy in the treatment of non-lymphoblastic acute leukemia. First results].

Addition of a daily dose of androgen in the form of 0.15 mg/kg of Stanzolol, given without interruption, gave an average survival of more than 4 years in patients suffering from granulocyte series acute leukaemias after complete remission was obtained. The simplicity of this treatment is apparent only from the appearance of marked manifestations of androgen impregnation in women from the 8th month of treatment onwards. These results, superior to those obtained up to the present time in the survival of myeloid leukaemias (non-lymphoblastic) were also better in terms of the stability and X "quality" of the remission in comparison to those obtained in acute lymphoblastic leukaemias. Confirmation of these results by controlled clinical trial will open up interesting perspectives, along side immunotherapy which remains of unproven effectiveness in myeloid leukaemias. The effectiveness of androgen stimulation of haematopoiesis as a stabilising factor of complete remissions in acute leukaemias has, in addition, interesting implications with regard to the theory of the leukaemic process.

Age Factors