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Biomedical subjects

V Vecchi

Publications and source records attributed to V Vecchi.

At least 37 records · Page 2Linked to original sources
PubMed1988

Intravascular coagulation phenomena associated with prevalent fall in fibrinogen and plasminogen during L-asparaginase treatment in leukemic children.

12 children affected by acute lymphoblastic leukemia had higher baseline levels of Normotest, Antithrombin III activity (AT III:A) and antigen (AT III:Ag) than those found in the control group, due to increased liver protein synthesis, as shown by the higher values of 305llbumin. Treatment with L-asparaginase (L-Asp) induced a marked decrease in fibrinogen and plasminogen and only a slight but significant reduction in AT III:A, AT III:Ag, protein C and alpha 2 antiplasmin levels. Platelet counts progressively increased. Each single L-Asp administration acutely induced (as recorded in the 2-hour postadministration samples) a significant increase in fibrinopeptide A values and reduction in several factors and inhibitors, due to activation of coagulation and consumption phenomena. It is suggested that these acute changes, but not the marked and selective reduction in fibrinogen and plasminogen, were partly compensated during L-Asp treatment by an overall increase in clotting and nonclotting protein synthesis in the liver.

Asparaginase↗
PubMed1986

Childhood non-Hodgkin's lymphoma and "leukemia-lymphoma syndrome": long-term results with the modified LSA2-L2 protocol.

From June 1976 to December 1984, 48 previously untreated children with non-Hodgkin's lymphoma (NHL) were treated according to the LSA2-L2 protocol, modified by inclusion of cranial irradiation for patients in stage III and stage IV disease. According to the staging system proposed by Wollner, 4 patients were in stage I, 8 in stage II, 11 in stage III, 8 in stage IVA (less than or equal to 25% blasts in the bone marrow), 15 in stage IVB (greater than 25% blasts in the bone marrow), and 2 in stage IV central nervous system disease. The complete remission rate was 95.8%. The relapse-free survival (RFS) rate of 46 complete responders was 76% after a median observation time of 47+ months. Only 1 of 35 high-risk responder patients developed CNS relapse after prophylactic treatment. Clinical stages were related to the RFS: 100% in stage I-II vs. 69% in stage III-IV. All 8 patients in stage IV were alive without evidence of disease with a median observation time of 59+ months. Fifteen patients in stage IVB who had leukemia-lymphoma syndrome attained 59% RFS with a median observation time of 39+ months. After a median observation time of 38+ months, 29 of 37 patients are off therapy. The results emphasize the value of both the histologic and immunologic features and the stage of disease in predicting the outcome of NHL in children. The LSA2-L2 regimen appears to be a very effective protocol for children with lymphoblastic lymphoma, although it may be less efficacious for patients with large bone marrow involvement.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1985

Intellectual function in long-term survivors of childhood acute lymphoblastic leukemia.

21 off-therapy ALL patients treated with chemotherapy plus cranial irradiation were assessed using the Wechsler Intelligence Scale for Children and compared with a group of 15 off-therapy solid tumor children treated with chemotherapy and extracranial irradiation. Children with leukemia achieved lower IQ scores than children with solid tumors. The ALL group was divided in two subgroups, by onset of disease and beginning of treatment: before (13 subjects) and after (8 subjects) 5 years of age. The results indicate that the disturbance of intellectual functioning is produced in ALL children irradiated after 5 years of age. In order to check on a possible delayed intellectual deterioration, all ALL children were also tested twice, with one year interval between the two tests. On the second assessment the scores for each subject were essentially the same as before. Further studies on a large number of long term survivors are being carried out in order to find out whether the deficit is transient or permanent.

Age Factors↗
PubMed1984

Transient optic neuropathy secondary to MOPP chemotherapy in Hodgkin's disease: report of a case.

The authors describe a case of optic neuropathy in a child undergoing MOPP chemotherapy for Hodgkin's disease stage IIISA. Visual acuity improved after substitution of the aforementioned regimen with ABVD chemotherapy, and reached 1 during maintenance therapy with vinblastine. Various neurologic deficits have been ascribed to vincristine, a well-known neurotoxin. This case of optic neuropathy is supposed to be a rare example of involvement of the 2nd cranial nerve due to vinca alkaloids. The absence of neurotoxicity of vinblastine in this case is emphasized.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1984

IV-S neuroblastoma: a cooperative study of 30 children.

The clinical features of 30 children with IV-S neuroblastoma have been reviewed. They were treated at 11 Italian pediatric institutions in the period 1970-1981. Patients with IV-S neuroblastoma comprise 6.1% of all the neuroblastoma cases observed during that period. The age at diagnosis ranged from birth to 11 months (mean, 3 months). The distribution of "primary" lesions was of interest. The adrenal gland was affected most often (57% of patients), but tumors of the chest and neck were also encountered. No specific "primary" lesion was identified in ten children. The most frequent site of widespread disease was the liver (87%). Neither the size of the "primary" tumor, nor the number or size of subcutaneous nodules was of prognostic significance. Unfavorable features were age less than 2 months and clinical signs of pulmonary, renal, or hepatic embarrassment. These data confirm the need for prompt intervention in the infant who is suffering from compression of these vital structures by the enlarged liver. Radiation therapy is to be preferred for this purpose, because of the often severe toxicity that is associated with chemotherapy in infants. One, and possibly two babies in this series died of chemotherapy-related complications.

Adrenal Gland Neoplasms↗
PubMed1982

Neuroblastoma in a pair of identical twins.

Hereditary neuroblastoma in a pair of identical twins is reported. In one of the twins the tumor occurred in fetal life and caused death of the twin before birth; in the other one, the tumor occurred at two months of life as IV-S neuroblastoma in the liver with primary tumor undetected. The unusual clinical course of the latter case is described: twice there was tumor regression, but in spite of treatment, fatal uncontrolled growth occurred. The family history, characterized by neoplasms of dissimilar cell types but without additional cases of neuroblastoma, is also detailed.

Adrenal Gland Neoplasms↗
PubMed1982

Visual evoked potentials (VEPs) in early and late CNS changes due to antileukemia treatment in children. Preliminary report.

VEPs were examined in ALL patients in order to test their usefulness in the detection of early and late CNS changes due to combined cranial X-irradiation and chemotherapy. The results suggest that: a)in patients free from self limited somnolence syndrome and visual symptoms, the VEP latency may be increased, probably because of early subclinical CNS changes due to cranial irradiation. b)late CNS changes (detected by routine neurological examination, EEG and CAT) seem to be correlated with increased VEP latency, even in the absence of visual symptoms.

Antineoplastic Agents↗
PubMed1981

Non-Hodgkin's lymphoma in children: results of treatment with the modified LSA2-L2 protocol.

From June 1976 to May 1980, 25 previously untreated children with non-Hodgkin's lymphoma (NHL) were studied and treated with a protocol modified from the one (LSA2L2) proposed by Wollner [8]. Stage III and IV had, in addition, prophylactic treatment of the central nervous system (CNS) with cranial irradiation (2,400 rad plus intrathecal methotrexate). The complete remission rate is 96%. Of these patients, 76% are disease free surviving after a median observation time of nearly two years. The disease-free actuarial survival is 100% for 6 children with Stage I-II disease and 68% for 19 Stage III-IV children after median observations times respectively 25 + and 19 + months. None of the 19 high-risk patients developed CNS disease after prophylactic treatment. Mediastinal involvement and leukemia conversion at diagnosis were not unfavorable prognostic factors, but primary skeletal or subcutaneous disease and Burkitt-tupe histology were ominous features in patients treated by this regimen. It is concluded that good results are obtained when an aggressive multimodal and multiple drug regimen like the LSA2-L2 is coupled with CNS prophylaxis and is used assiduously to maintain complete remission during the first 12 months of treatment.

Adolescent↗
PubMed1980

Discontinuing therapy in childhood acute lymphocytic leukemia. A multicentric survey in Italy.

The results of discontinuing therapy in children with acute lymphocytic leukemia observed at four associated institutions are presented. Of the 247 patients who achieved complete remission, 122 (49.3%) reached the point of discontinuing therapy after 2-4 years of continuous remission. The median period off therapy was 13 months with a range of 1-69 months. Of the 122 children removed from therapy, 27 (22.1%) relapsed, mainly in the bone marrow; relapses occurred 1-32 months after cessation of therapy (median ten months) with only two relapses occurring later than two years. By actuarial analysis, 57% of the patients are projected in continuous remission after five years from cessation of therapy. Neither selected features at diagnosis nor single modalities of treatment were found to predict whether relapse would occur after discontinuing therapy. Long-term remission and possibly cure can be expected in over one-third of newly diagnosed children with ALL after 2-4 years of antileukemic treatment.

Adolescent↗