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Biomedical subjects

Z Weshler

Publications and source records attributed to Z Weshler.

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

Interstitial pneumonitis in T cell-depleted bone marrow transplantation.

The incidence of interstitial pneumonitis (IP) was reviewed in 80 consecutive patients who received allogeneic T lymphocyte-depleted bone marrow transplantation (BMT) for malignant and non-malignant diseases. Pretransplant conditioning used in malignant disorders included total lymphoid irradiation (TLI) 150 cGy x 4, total body irradiation (TBI) 200 cGy x 6, and cyclophosphamide (CY) 120 mg/kg. In non-malignant diseases conditioning included no TBI, but adjusted doses of TLI in addition to CY (severe aplastic anemia) or CY and busulfan (severe beta-thalassemia major). In the malignant group only one patient developed graft-versus-host disease (GVHD) grade I; IP developed in 12 out of 61 patients (19.7%) and IP-associated fatality occurred in five patients (8.2%). Cytomegalovirus (CMV) was associated with only two of the five fatal IP. In the non-malignant group there was no GVHD; one patient out of 19 (5.2%) had IP, which was fatal and not associated with CMV. These data indicate that fatal IP may appear in the absence of GVHD. The relatively low incidence of IP-related mortality in recipients of allogeneic T lymphocyte-depleted BMT suggests that although prevention of GVHD and elimination of drugs used for GVHD prevention may reduce the incidence of fatal pulmonary complications, other approaches have to be investigated for complete prevention of IP which still represents a major complication in patients with malignant hematologic disorders treated by allogeneic BMT.

Adult↗
PubMed1986

Combined 5-fluorouracil (5-FU) and radiation therapy following resection of locally advanced gastric carcinoma.

Twenty-five patients with locally advanced but resectable adenocarcinoma of the stomach were given concomitant postoperative radiotherapy to the tumor bed and chemotherapy with 5-Fluorouracil (5-FU). Twenty-two of the patients had regional lymph node involvement and seven had residual tumor in the surgical margins. Radiotherapy was delivered to a total dose of 5,000 rads in 7 weeks with a two-week split. 5-FU was given daily the first 3 days of each treatment period and was then continued weekly for a minimum of 1 year. At a median follow-up time of 19 months, 11 patients have relapsed, two locally and nine distally, and all have died. Thirteen patients remain alive, all but one disease-free, for a median of 21 months from diagnosis. One additional patient died of unrelated causes, free of tumor. The actuarial median survival for the whole group stands at 33 months with a projected 5-year survival of 40%. Treatment has been well tolerated.

Adenocarcinoma↗
PubMed1986

Megavoltage radiotherapy using water bolus in the treatment of Kaposi's sarcoma.

Between 1976 and 1983, 28 patients with Kaposi's sarcoma were treated in the Department of Radiation and Clinical Oncology of the Hadassah University Hospital in Jerusalem. Most of the patients (16, i.e. 57%) were Jews of European origin. Eighteen (64.2%) of the patients presented with severe leg edema in addition to multifocal, disseminated skin lesions. Only one patient was free of clinical disease in the lower extremities. Large, ulcerated masses were seen in three patients. The affected limbs were immersed in a water bath and irradiated with two-opposing portals to a total dose of 3000 rads. Total disappearance of the skin lesions was achieved in 89% of the patients, although the limb edema regressed completely in only 56% of the patients.

Adult↗
PubMed1986

Total lymphoid irradiation in refractory systemic lupus erythematosus.

In two patients with systemic lupus erythematosus, conventional therapy was considered to have failed because of persistent disease activity and unacceptable side effects. Both were treated with total lymphoid irradiation without clinical benefit, despite adequate immunosuppression as documented by markedly reduced numbers of circulating T lymphocytes and T-lymphocyte-dependent proliferative responses in vitro. The first patient developed herpes zoster, gram-negative septicemia, neurologic symptoms, and deterioration of lupus nephritis. The second patient developed massive bronchopneumonia, necrotic cutaneous lesions, and progressive nephritis and died 2 weeks after completion of radiotherapy. These observations, although limited to two patients, indicate that total lymphoid irradiation in patients with severe systemic lupus erythematosus should be regarded as strictly experimental.

Adult↗
PubMed1985

Correlation of erythrocyte and plasma levels of zinc, copper, and iron with evidence of metastatic spread in cancer patients.

The level of plasma copper (Cu-Pl) and zinc (Zn-Pl) and the level of erythrocyte iron (Fe-RBC), copper (Cu-RBC), and zinc (Zn-RBC) were determined in the blood of 70 normal donors and 138 patients with various solid tumors by diagnostic x-ray spectrometry (DXS), a technique based on x-ray fluorescence spectrometry analysis. There were no significant changes in the mean values of Zn-Pl, Fe-RBC, and Cu-RBC in the patients when compared with those of normal donors. The mean level of Cu-Pl in the normal donors was 1.34 +/- 0.37 micrograms/ml; it was significantly increased in the patients, ranging between 1.47 +/- 0.34 micrograms/ml for patients without evidence of active cancer (NED) and 1.91 +/- 0.76 micrograms/ml for patients with hepatic metastases. The most significant change observed was an increase in the Zn-RBC found in the patients with clinical evidence of metastatic spread. Whereas the Zn-RBC level in the normal donors was 9.85 +/- 1.47 micrograms/g wet weight, and not significantly elevated in the NED patients, it was elevated to values of 11.37 +/- 1.55 micrograms/g (P less than 0.004) for patients with soft tissue and hepatic metastases and was 12.34 +/- 1.65 micrograms/g (P less than 0.001) for patients with bone metastases. The data suggest a clear correlation between Zn-RBC and metastatic spread in nonlymphomatous human cancer.

Bone Neoplasms↗
PubMed1985

Clinical uses of prosthetic devices in brachiotherapy for oral cavity tumors.

Three different acrylic resin intraoral stents used for radiotherapy are described. They serve multiple functions in the treatment of tumors of the oral cavity. They are prepared individually and are necessary for accurate treatment planning and in order to minimize the exposure of hospital personnel to radiation.

Brachytherapy↗
PubMed1985

Radiation pneumonitis: a complication resulting from combined radiation and chemotherapy for early breast cancer.

Described is a patient with early breast carcinoma who developed clinical radiation pneumonitis during primary radiation therapy and concomitant chemotherapy that included prednisone. This syndrome developed three days following abrupt steroid withdrawal. Retrieval of steroids brought complete resolution of the clinical and radiological findings. Although this syndrome is rare, it is recommended that steroid therapy in a patient previously irradiated to the chest be avoided.

Breast Neoplasms↗
PubMed1985

Secondary myelofibrosis with metastatic breast cancer simulating agnogenic myeloid metaplasia: report of a case and review of the literature.

A patient with carcinoma of the breast, who developed a clinical syndrome resembling agnogenic myeloid metaplasia, is described. She was found to have secondary myelofibrosis with metastatic carcinoma of the marrow, extensive extramedullary hematopoiesis resulting in massive splenomegaly, and leukoerythroblastosis. These findings are rare and myeloid metaplasia with striking extramedullary hematopoiesis causing massive splenomegaly and mimicking agnogenic myeloid metaplasia is seldom seen in patients with metastatic carcinoma. Previous case reports of secondary extramedullary hematopoiesis simulating agnogenic myeloid metaplasia (AMM) in patients with solid tumors are also reviewed.

Adult↗
PubMed1985

Meningeal carcinomatosis due to basal cell carcinoma.

A case of meningeal carcinomatosis due to metastasizing basal cell carcinoma is reported. The patient was a 34-year-old woman who had a recurrent basal cell carcinoma of the upper eyelid with deep invasion. In spite of extensive surgery and radiotherapy, multiple bone metastases developed, and the patient eventually died of meningeal carcinomatosis. The possible pathogenic mechanisms of meningeal the present case, cancer cells reached the leptomeninges from adjacent vertebral metastases. It is suggested that the possibility of meningeal carcinomatosis should be considered in every patient with cancer and multiple vertebral metastases, particularly when neurologic signs involving the brain, cranial nerves, or spinal nerves are present.

Adult↗
PubMed1985

Combined modality treatment for stage III ovarian carcinoma.

Thirty-eight Stage III ovarian carcinoma patients were treated with a combined modality protocol consisting of sequential initial surgery with a maximal tumor reduction, CHAD combination chemotherapy, second look reductive surgery and whole abdominal irradiation. Sixteen patients (42%) had minimal residual tumors (less than 2 cm) after initial surgery (Stage IIIA) and 22 (58%) had large residual tumors (greater than 2 cm) (Stage IIIB). The patients received 3-14 courses of CHAD combination chemotherapy, with a response rate (CR + PR) in the evaluable (Stage IIIB) patients of 91%. Twenty-eight patients had a second attempt of cytoreductive operation (10 Stage IIIA patients and 18 Stage IIIB patients). In 10 patients no residual tumor was found. In another 12 patients residual tumor (less than 2 cm) was found and completely resected, whereas in six patients a complete resection of large residual tumors (greater than 2 cm) was not possible. Twenty-one of the patients also completed a course of whole abdominal radiotherapy. Radiation was well-tolerated with the usual expected amounts of nausea, vomiting, diarrhea and transient leukopenia and thrombocytopenia. 11/21 (52%) of the patients relapsed within the first 18 months after completion of radiotherapy. The actuarial relapse-free survival at 36 months from completions of radiotherapy was 44%. The actuarial survival for the whole group from diagnosis was 43% at 3 years (70% for Stage IIIA and 41% for Stage IIIB). The data indicated that this combined modality protocol is both feasible and well-tolerated but its curative potential for patients with advanced ovarian carcinoma is as yet unknown.

Adenocarcinoma↗
PubMed1984

Elimination of graft-versus-host disease by in-vitro depletion of alloreactive lymphocytes with a monoclonal rat anti-human lymphocyte antibody (CAMPATH-1).

A new monoclonal rat anti-human lymphocyte antibody (CAMPATH-1) which lyses cells with autologous human complement was used for depletion of T lymphocytes from human bone-marrow allografts in vitro before transplantation in 11 high-risk patients. HLA-matched siblings were used as marrow donors. T-cell depletion was substantial when measured by E-rosette formation (0-0.18% residual T cells) and immunofluorescence with a monoclonal anti-T-cell antibody (0-0.5%). No anti-graft-versus-host disease prophylaxis was given after transplantation. Rapid engraftment was reported in all patients, and the post-transplantation course was uneventful. No signs of graft-versus-host disease developed in any of the patients, who were observed for a maximum period of 12 months. The method might be suitable for larger-scale studies in high-risk patients. The late graft failure seen in 2 patients may reflect residual host resistance uncompromised by GvHD.

Adolescent↗