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PubMed1979

The pattern of spread and treatment of metastases in testicular seminoma.

The results of treatment of 199 patients referred to the Royal Marsden Hospital with testiclar seminoma from 1963 to 1975 are described. Of 190 previously untreated patients 16 (8.4%) have died of seminoma, 3 (1.5%) of teratoma and 9 (4.9%) of intercurrent disease. Of 121 Stage I patients the only death was due to a second testicular tumour. In orchiectomy and volume of abdominal node metastases. This was not, however, prognostically significant. Death from seminoma occurred in 6 out of 38 patients (15.8%) with nodal metastases less than or equal to 5 cm in diameter and 3 out of 16 patients (18.7%) with metastases greater than 5 cm in diameter; 2 of 8 Stage III patients died of seminoma. Thus radiation controlled nodal metastases in more than 80% of Stage I, II and III patients. In Stage IV patients and patients referred with disease relapse, 12 out of 16 patients died of seminoma. Chemotherapy experience is briefly reviewed. Cyclophosphamide as a single agent has produced a 50% response rate. There is no evidence to suggest a radiation-related increase in mortality from the group of long-term tumour-free survivors.

Castration↗
PubMed1979

Cytogenetic remission in a Ph1-positive case of chronic myelogenous leukaemia.

Unusual cytogenetic findings in a case of chronic myelogenous leukaemia in the course of an aplastic crisis induced by busulfan therapy are reported. The proportion of Ph1-positive cells in bone marrow aspirates fell from 100% before treatment to 8.6% following aplasia. It increased gradually during recovery, and normal cells still represented 25.7% of the metaphases 20 months later. After a 38-months' remission without therapy the disease relapsed and the Ph1 chromosome was found in 100% of the bone marrow cells.

Adult↗
PubMed1975

An unusual outbreak of brucellosis.

A Brucella melitensis infection involved three persons. The infections were acquired by contact with a culture suspension that had been spilled during a laboratory exercise. One of the patients had only indirect contact with the spilled culture, probably contact with contaminated fomites. Another of the patients developed a clinical remission before treatment with antibiotics and relapsed after six months. This patient also had a positive bone marrow culture when blood cultures were negative. The type of antibody response persisting in the sera of convalescents was studied by treating the sera with mercaptoethanol and rabbit antihuman IgM sera. In the patient who relapsed, IgG antibody predominated, whereas IgM persisted for over two years in the patient without relapsing disease.

Adult↗
PubMed1975

Human antisera detecting leukemia-associated antigens on autochthonous tumor cells.

Leukemia patients in remission were immunized with RAJI lymphoid tissue culture cell lines. Four of 7 patients developed antibody to the immunizing cell as well as to allogeneic leukemia cells. Sera from 3 patients were tested against autochthonous tumor cells either frozen or obtained at the time of disease relapse. Patient's sera were cytotoxic to their own leukemia cells; however, this cytotoxicity was lost at the time of relapse.

Antigens, Neoplasm↗
PubMed1979

Clonal identification in acute lymphoblastic leukemia.

In a case of acute lymphoblastic leukemia, two distinct types of leukemia blast cells could be identified throughout the course of the disease. The initially dominant type of blast cell was sensitive to chemotherapy; the other was drug-resistant, gradually becoming dominant as the disease progressed. The cell types could be clearly separated by their morphologic and surface membrane marker characteristics. The same chromosomal constitution was present in both types of blast cells, indicating a common clonal origin. Additional chromosomal abnormalities were present in the later stages of the disease, demonstrating that a distinct subclone had proliferated. This study illustrates that in some cases of acute leukemia, disease relapse is caused by growth of drug-resistant subclones that may be clearly identified by changes in morphology and surface membrane marker characteristics.

Adult↗
PubMed1979

Role of plasma carcinoembryonic antigen in evaluating patients with breast cancer treated with adjuvant chemotherapy.

Serial plasma carcinoembryonic antigen (CEA) levels were determined in 84 patients with breast cancer who were receiving postsurgical adjuvant chemoimmunotherapy or adjuvant chemotherapy. CEA values were correlated with clinical status, scintiscans, alkaline phosphatase, LDH, and SGOT. CEA values greater than 2.5 ng/ml were considered abnormal. Thirty patients had normal serial CEA values; all remain disease-free. In 54 patients one or more abnormal CEA values were recorded; nine of 54 developed overt metastatic disease. Relapses occurred in four of 38 patients in whom values up to 5 ng/ml were recorded, in three of 14 patients in whom values up to 10 ng/ml were recorded, and in two of two patients in whom values greater than 10 ng/ml were recorded.

Antineoplastic Agents↗
PubMed1978

[Eye tuberculosis].

At present the eye tuberculosis still occurs only in its reactive form. But also these pathological processes may quite considerably disturb the vision. In the first place are chorioiditis (uveitis posterior), iritis and iridocyclitis (uveitis anterior), uveitis totalis and periphlebitis retinae are by far less frequent. Number and severity of the pathological processes considerably decreased during the last years, above all also the new diseases. Relapses are still increasedly observed. The problems of diagnostics and the necessary therapeutic measures are described.

Adult↗
PubMed1979

Facilitated light microscopic cytochemical diagnosis of acute myelogenous leukemia.

Hydroperoxidase-positive Phi bodies and rods are much more prominent and prevalent than rods visualized with a Romanovsky-type stain (Auer rods) in immature leukocytes of patients with active acute myelogenous leukemia (AML). They are readily observed with the light microscope in peripheral blood or marrow films of AML patients stained to show their peroxidatic activity. In many of these patients, Auer rods, which apparently constitute only a small subpopulation of the hydroperoxidase-positive Phi bodies and rods, were detected with difficulty, if at all. The hydroperoxidase-positive Phi bodies and rods were observed in 92% of 36 patients with active disease. They were never observed in leukocytes of patients with other hematopoietic disorders or of normal individuals. Thus, they facilitated the distinction of AML from acute lymphocytic leukemia and chronic granulocytic leukemia in blast crisis. They were absent in full clinical remission after chemotherapy and were greatly diminished in partial remission. They were present in disease relapse and reappeared in five patients who had been in full remission. These results suggest that these hydroperoxidase-positive enlarged particles are pathognomonic of AML and that monitoring them with the light microscope may aid in guiding its clinical management.

Adolescent↗
PubMed1979

Pathologic stage I and II Hodgkin's disease, 1968--1975: relapse and results of retreatment.

Sixty-seven previously untreated patients with Hodgkin's disease, pathologic stages I and II, seen during a 7-year period were evaluted with respect to initial staging and treatment, as well as relapse and retreatment results. The initial treatment consisted of radiation therapy (RT) to an involved field (IF) or an extended field (EF) for patients with stages IA and IIA, or RT and, in recent cases, combination chemotherapy [cyclophosphamide, Oncovin, procarbazine, and prednisone (COPP)] for patients with stages IB and IIB. Nineteen of the 67 patients relapsed (28%), including 11 of 56 patients with stages IA and IIA (20%) and 8 of 11 patients with stages IB and IIB (73%). Seventeen of the 19 relapses occurred within 24 months after completion of the initial therapy (89%). The relapse-free survival at 5 years was 75% for the A patients and 25% for the B patients. The actuarial survival of stage IA and stage IIA patients at 5 years was 91%; there was no significant difference between patients treated initially with either IF or EF. The actuarial survival at 5 years for the patients with stages IB and IIB was 88%, as most responded to a second program of induction therapy. No correlation could be found between the pattern of relapse and the initial pathologic stage or the mode of treatment.

Adolescent↗
PubMed1977

Value of thyroid-stimulating-antibody determinations in predicting short-term thyrotoxic relapse in Graves' disease.

Thirty consecutive patients with hyperthyroid Graves' disease received a 6-month course of antithyroid drugs. Sixteen patients relapsed within 6 months of the withdrawal of antithyroid therapy. All patients with high levels of thyroid-stimulating antibodies (TSAb) at the time of drug withdrawal relapsed within 2 months of discontinuing the antithyroid treatment while all patients with low or undetectable TSAb activity at the time of drug withdrawal remained in remission. It was not possible to predict the disease course in patients who had intermediate levels of TSAb when antithyroid therapy was stopped.

Adult↗
PubMed1979

Prolonged disease-free survival in Hodgkin's disease with MOPP reinduction after first relapse.

Thirty-two patients with Hodgkin's disease who relapsed after a first complete remission induced by nitrogen mustard, vincristine, procarbazine, and prednisone (MOPP) were retreated with MOPP chemotherapy. Nineteen patients achieved a second complete remission. Median duration of the second complete remission was 21 months. The likelihood of achieving a second complete response could be predicted by the duration of the first response. Fourteen of 15 patients whose first complete remission was longer than 12 months achieved a second complete response in contrast to five of 17 patients whose initial complete remission lasted less than 12 months (P less than 0.001). Median survival of all patients in this study who were re-treated with MOPP was longer than 4 years after their first relapse. We conclude that patients with Hodgkin's disease who relapse after a first complete remission induced by MOPP are not necessarily resistant to further MOPP therapy and can achieve long-term survival with MOPP reinduction.

Adolescent↗
PubMed1978

Low dose steroids and clinical relapse in Crohn's disease: a controlled trial.

The long-term effect of prednisone in Crohn's disease has been examined in a double-blind controlled trial. Clinical relapse, recurrence, and extension of the disease were examined in 64 patients followed-up for up to three years. Fourteen patients were withdrawn because of severe symptoms (eight on prednisone and six controls); the withdrawal rate in both groups was 30% at three years. Nine other patients had radiological recurrence or extension of disease (five prednisone and four controls). Prednisone did not improve the relapse rate, nor did it affect recurrence or extension of disease.

Adolescent↗
PubMedDate not supplied

[Long-standing remission following relapse in Hodgkin's disease in 2 children].

Combined three-drug (case I) and four-drug (case II) therapy and radiation was applied for control of relapse in two children with Hodgkin's disease. Remission was maintained with chemotherapy type MVPP (9 courses of treatment) and vinblastin administered between these courses. The survival is 106 months in one case and 90 months in another and the time from beginning of treatment of recurrence is 78 and 81 months respectively. The observation after the end of treatment is 31 and 43 months respectively.

Adolescent↗
PubMed1978

Patterns of relapse in advanced Hodgkin's disease treated with combination chemotherapy.

One hundred sixty-one patients with advanced Hodgkin's disease achieved complete remission after combination chemotherapy. Of these, 52 (32%) have subsequently relapsed and the patterns of relapse have been studied. The probability of relapse increases with increasing stage and particularly with the presence of systemic symptoms. Patients with Nodular Sclerosis histology are more likely to relapse than those with other histologies. Patients relapse primarily (92%) in sites of previous disease and particularly in nodal sites (75%). Nodal sites most frequently involved at relapse are the central nodal areas and the left supraclavicular area. When patients relapse in new sites they tend to be either adjacent to sites of previous disease which relapse or to be contiguous with previously involved sites of disease. In the small number of patients who received prophylactic radiation therapy to sites of nodal disease after complete remission, the pattern of relapse was not significantly altered.

Adolescent↗
PubMed1979

Patterns of relapse in patients with small cell carcinoma of the lung treated with adriamycin-cyclophosphamide chemotherapy and radiation therapy.

Twenty-seven patients with small cell carcinoma of the lung were treated sequentially with induction chemotherapy (adriamycin and cyclophosphamide), radiation therapy (chest and whole-brain), and then maintenance chemotherapy for 2 years. Twenty responding patients were followed to relapse and patterns of recurrence were observed. This combined treatment resulted in a complete remission rate of 80% and a median survival of 565 days in limited-disease patients. Relapse overwhelmingly occurred in the chest, but patients receiving higher-dose radiation (4000-4500 rads in split-course) had a significant prolongation of time to recurrence compared to patients receiving 3000 rads in a single course of radiation (540 versus 270 days). Despite a long mean survival, only one limited-disease patient relapsed outside of the brain or chest, suggesting that chemotherapy had a good protective effect against micrometastatic disease. Three patients relapsed in the brain at 330, 450, and 520 days, suggesting that in future studies the prophylactic whole-brain radiation (3000 rads) should be intensified.

Carcinoma, Small Cell↗
PubMed1975

[Activity of some serum enzymes in calves suffering from white muscle disease].

The paper described the findings of the activity of aspartate amino transferase (GOT) and alanine amino transferase (GPT), lactate dehydrogenase (LDH), alkaline phosphatase (AP), and aldolase in the blood serum of calves examined for white-muscle disease (WMD). Relapsing mass accurrence of the disease was reported from various agricultural enterprises where calves were fed a milk replacer without vitamin E. In comparison with clinically healthy calves fed a feed mixture with vitamin E, calves suffering from the clinical form of WMD showed an alkaline phosphatase level decrease from 32.3 +/- 7.6 u. K. A. to 15.1 +/- 8.2 u. K. A. On the other hand, the activites of ALD, GOT, GPT, and LDH showed a statistically significant increase. The acute and sub-acute course of the disease increased enzyme activities as follows: ALD from 4.2 +/- 1.1 mumol (= 70.0 +/- 17.0 i.u.) to 9.7 +/- 2.1 mumol (= 163.0 +/- 33.2 i. u.), GOT from 0.9 +/-0.5 mumol (= 68.0 +/- 5.8 i.u.) to 16.7 +/- 11.7 mumol (= 567.0 +/-40.0 i. u.) GPT from 0.2 +/- 0.8 mumol (= 5.0 +/- 12.4 i. u.) to 9.8 +/- 2.8 mumol (= 330.0 +/- 40.4 i.u.), LDH from 46.1 +/- 5.4 mumol (= 765.0 +/- 40.0 i.u.) to 72.7 +/- 24.3 mumol (= 1,207.0 +/- 403.0 i.u.). In WMD-affected herds, similar enzyme activity fluctuations were observed even in calves showing no clinical signs of the disease. It follows from the study that the examination of serum enzymes provides a method to demonstrate the clinical and pre-clinical forms of white-muscle disease and that it can be included in the set of tests for the diagnosis of diseases in calves. The significant differences in all calves in the affected herds show that the disease is a danger to all animals in the herd fed a deficient mixture.

Alanine Transaminase↗