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Biomedical subjects

A Chybicka

Publications and source records attributed to A Chybicka.

52 records · Page 3Linked to original sources
PubMed1993

Relapses after termination of therapy of acute lymphoblastic leukemia in children.

In the past 16 years, 2004 children with acute lymphoblastic leukemia (ALL) have been treated in the Polish Pediatric Group centers. Eight hundred and eighty-seven (44.3%) of these patients discontinued treatment after the first remission. Acute lymphoblastic leukemia relapse occurred in 180 patients (20.3%). This group was analyzed for the method of treatment and its influence on long-term survival, the time between cessation of treatment and relapse, the character and localization of relapse and later follow-up. It was shown that the patients with the best chance of a second remission are those with late testicular relapse. The most frequent and prognostically poor are bone marrow (BM) relapses which warrant intensive chemotherapy with BM transplantation. Patients with ALL relapse still have the possibility of a second remission and long-term survival.

Adolescent↗
PubMed1993

[Acute lymphoblastic leukemia in infants--results of treatment according to infant leukemia protocol--POG 8493].

Analysis was made of ALL treatment results according program POG 8493 in 9 infants. In 4 children WBC exceeded 100.0 G/l, and in 5 children CNS was affected. Eight infants had remission, six had relapse (mainly BM): early up to 8 month in 5, late--in 52 month in one girl. Four children died after relapse, four are still living: 2 I RC (2 and 23 months), 2 in II RC (1 month and 23 month). Probability of 4-year EFS was 0.25 and that survival--0.44. In view of continuing poor ALL prognosis, in infants it is necessary to look for more effective methods of treatment.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1992

[Second cessation of therapy in children with acute lymphoblastic leukemia].

In the group of 63 children in whom a relapse of ALL after first suspension of treatment occurred, and in whom a repeated cessation of therapy had place, 46.2% of patients had probability of a prolonged symptomless survival. The children with an isolated extramedullary relapse had a greater chance for a DFS of 7 years, than those with a relapse in the bone marrow (p = 0.05). The patients with a relapse occurring after the first cessation of treatment of ALL should be treated as intensively as newly diagnosed cases, because they have a real possibility for a prolonged survival during remission phase of disease.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1991

[The fate of children after discontinuation of treatment for acute lymphoblastic leukemia].

Among 1879 children with the diagnosis of acute lymphoblastic leukaemia made up to Dec 31 1987 in 863 cases (45.92%) treatment was discontinued. They were followed up till Dec 31 1989. The median follow-up was 3 years and 14 months. In 811 cases the treatment was discontinued during the first complete remission, in 56 cases after a relapse during initial treatment. In the time period when the programmes St. Jude and LSA2L2 were used the per cent of children with treatment withdrawal was 38.22%, but it rose to 53.01% when a more intensive programme BMF had been introduced. The probability of 7-year disease free survival after treatment discontinuation was 69.5% and 76.2% respectively. In 186 cases (21.6%) relapses developed., mostly in the first year after treatment discontinuation, but even after 7 years the risk of relapse was 2.46%. Ninety-six children (11.2%) died, 761 (88.8%) are alive, among them 671 in the first complete remission. Apart from therapy intensity, a statistically significant beneficial effect on disease free survival had discontinuation of treatment during the first complete remission, and sex--the prognosis was better in girls. In three cases secondary neoplasms were found.

Adolescent↗
PubMed1981

Immunologic status of children with Hodgkin's disease (HD).

Concentration of serum immunoglobulins IgG, IgM, IgA, E-, EAC-rosette forming lymphocyte counts and phagocytic activity of granulocytes to Staphylococcus aureus were studied in venous blood of 12 children with HD and 15 normal controls during the combined long term radio- and polichemotherapy. The decrease in E- and EAC-rosette forming lymphocyte counts at diagnosis and during the combined radio- and chemotherapy single cycle and long-lasting treatment were found. The quantity of serum immunoglobulins IgA and IgM was above normal limits at diagnosis and decreased during 2 years of treatment. The impairment of phagocytic activity before treatment and during long term therapy was found. Analysis of the survival rate curves suggests the prognostic value of the initial T- and B-lymphocyte numbers in peripheral blood.

Adolescent↗
PubMed1981

Immunological follow-up of non-Hodgkin's lymphoma (NHL) in children.

Concentrations of immunoglobulins IgG, IgM, IgA, E-, EAC-rosette forming lymphocyte counts and phagocytic function of granulocytes to Staphylococcus aureus were studied during the long-term polychemotherapy in 19 children with NHL and in the control group consisting of 15 healthy children. The decrease in levels of IgA and IgM, E and EAC rosetting lymphocyte counts following intensive long therapy was observed. No significant variations in immunoglobulin subclasses levels before and after single cytostatic cycle were found. The granulocyte phagocytic activity in NHL patients was above normal range. For evaluation of the prognostic value of NHL immunological classification survival rate curves were analyzed. It has been demonstrated that T-lymphoblasts proliferation is an unfavorable prognosis marker.

Adolescent↗
PubMed1978

The study of T-lymphocytes, granulocyte's phagocytic activity, and adherent cells in patients with acute lymphoblastic leukemia during levamisol therapy.

12 children with acute lymphoblastic leukemia remaining in remission for 1-3 years, were studied during levamisol therapy. T-lymphocytes count, phagocytic activity of granulocytes the adherent cell number were investigated. The clinical state of patients before, during and after levamisol treatment was evaluated. The increased resistance to infections after levamisol therapy was noted. The rise of T-lymphocyte and phagocyting granulocytes number was observed in 70% of patients after 6 weeks of therapy. At the same time the decrease of phagocytic index was found. No essential variations in adherent cells count were noted. The patients who did not respond to the levamisol treatment relapsed in 2-3 months.

Adolescent↗
PubMed1978

The study of T-, B-, O- lymphocytes in acute lymphoblastic leukemia.

The T-, B-, and O-lymphocyte count changes were studied during the long-term intensive therapy of 43 ALL children. The control group consisted of 17 healthy children. The T-lymphocytes were identified by spontaneous formation of rosettes with sheep erythrocytes, the B-lymphocytes by EAC-rosette test. Patients were treated according to different program of multiple drug therapy and prophylactic cranial irradiation. During the study the applied therapeutic protocol produced the marked reduction of T- and B- lymphocytes. The decrease of B- lymphocytes was especially pronounced. The preliminary analysis suggests correlation between the reduction of T- and B- lymphocytes and prognosis.

Adolescent↗
PubMedDate not supplied

[Treatment regimen for children and adolescents with Hodgkin's disease designed to decrease late complications of radiotherapy].

Between 1997 to 1999 in 9 centres of the Polish Paediatlic Leukemia/Lymphoma Study Group, 167 children and adolescents (aged 2-19 years) with stage 1 to IV Hodgkin's disease (HD) were treated according to a regimen with a limited use of radiotherapy (RT). All patients received B-DOPA and MVPP chemotherapy. The number of cycles of chemotherapy was adjusted in respective risk groups. In 13 children with stage IA and IIA disease with favourable prognostic factors chemotherapy alone was used. In other patients the dose of RT applied to lymphatic regions was 15-46,4 Gy. In case of a small tumour at presentation and good response to initial chemotherapy the RT dose was 15-16 Gy. In other cases doses of 25-30 Gy were planned. The use of higher doses, particularly exceeding 35 Gy, in eleven patients, was not justified. Among all the 167 patients, three oftliem (1.2%) with advanced disease (Stage III-1V) did not achieve first remission. The 4-year overall survival (OS), relapse free survival (RFS) and event free survival (EPS) were 99%. 93% and 90%, respectively. Relapses occurred in 8 children (first remission lasted for 4-29 (median = 9 months). All 13 children in whom chemotherapy alone was used remain in first remission. In the group of children who received RT in the dose of 15-16 Gy relapse occurred in one child. Our preliminary analysis indicates that limited use of RT in selected cases of HD in children and adolescents did not show worse results of treatment. However, the assessment of possible influence of this regimen on the decreased rate of late complications requires longer follow-up.

Adolescent↗
PubMedDate not supplied

[Recurrences after completion of the treatment of acute lymphoblastic leukemia in children].

Within the past 16 years, 2004 children with the acute lymphoblastic leukemia were treated at the Centres of the Polish Pediatric Study Group. The treatment was completed in 887 patients (44.3%) with the first remission. Recurrence was noted in 180 children (20.3%). This group was analysed in view of the type of therapy and its effect on the survival rate, significance of recurrence following therapy, character and localization of recurrent disease, and further fate of patients. It was found, that patients with isolated late nuclear recurrence have greatest chances to achieve subsequent remission. Most frequent and severe is recurrent bone marrow involvement which requires intensive chemotherapy combined with bone marrow transplantation due to unfavourable prognosis. Patients with the first recurrence of the acute lymphoblastic leukemia have a chance to achieve subsequent remission and long-term survival.

Adolescent↗
PubMedDate not supplied

Acute lymphoblastic leukemia in children below two years of age.

From among 1464 children with ALL 167 (11.4%) at diagnosis had two or less than two years, 53 of them were infants. Most of them had a great tumor bulk, 15 had initial CNS infiltration and 31 WBCc greater than or equal to 100000/ML. 66 were treated according to St. Jude or LSA2L2 programs (the I group), 101 according to BFM programs (the II group). Complete remission was obtained in 85% of patients. In 63 children relapses occurred in the course of treatment whereas in 5 after the therapy cessation. In majority of cases, there were isolated relapses, mostly, they involved bone marrow. CNS involvement was found, in both mixed and isolated relapses, in 28 children (20%). 64 children are alive, in 43 of them the therapy was stopped. Kapla-Meier estimates for event free survival (EFS) after 8 years were 19 +/- 4.7% in the first group vs 37.38 +/- 6.3% in the second group. Due to therapy intensification the treatment results have been improved (p = 0.05) but still they are not satisfactory, particularly in case of infants and children with WBC greater than or equal to 100000/ML. Analysis of the lot of children showed that apart from age at ALL diagnosis and the initial WBC the methods of treatment are also the prognostic factors.

Antineoplastic Combined Chemotherapy Protocols↗