Search PubMed⌕ Search

Biomedical subjects

A M Mauer

Publications and source records attributed to A M Mauer.

At least 73 records · Page 4Linked to original sources
PubMed1981

A clinical perspective on cell markers in acute lymphocytic leukemia.

Two hundred consecutive new patients, with acute lymphocytic leukemia (ALL) have been studied with a battery of five cell marker assays to determine if a classification system with prognostic significance can be developed; 182 have been classified among four groups as follows: 33 T-cell, 3 B-cell, 126 common, and 20 undifferentiated ALLs. Patients with T-cell disease are likely to have unfavorable clinical prognostic features and a poor response to therapy. Rare patients with B-cell disease are closely related clinically to non-Hodgkin's lymphoma. Those with common ALL infrequently have unfavorable clinical features and have a superior outcome to that of T-cell patients. Children with undifferentiated markers seem to respond less well to treatment than do those with common ALL, yet may not be identifiable as poor risk by clinical features. What remains to be resolved with further observation is whether these marker patterns are more reliable indicators of prognosis than the usual clinical determinants predisposing to treatment failure (high white blood cell count, mediastinal mass, and central nervous system disease). At the present time, it appears that in the absence of poor-risk clinical prognostic features, patients with common ALL are more likely to have lasting remissions than those with erythrocyte-rosette-positive T-cell disease or those with ALL that is undifferentiated by markers.

Antigens, Neoplasm↗
PubMed1979

A reappraisal of the results of stopping therapy in childhood leukemia.

We examined the results of stopping therapy in children with acute lymphocytic leukemia. Of 639 patients in eight consecutive "total therapy" studies, 278 (44 per cent) had all treatment stopped, usually after 2 1/2 years of complete remission. About one fifth (55 of 278) of this group have relapsed, mainly in the bone marrow. The relapse rate for the first year off therapy was higher than that for the next three years (0.16 vs. 0.04, P less than 0.01). The life-table estimates of the four-year relapse rates were 0.24 for all patients and 0.22 for patients receiving adequate central-nervous system prophylaxis. Boys had a higher relapse rate than girls (0.33 vs. 0.15 P less than 0.01). None of the 79 patients who remained in complete remission for at least four years off therapy have yet relapsed. Acute lymphocytic leukemia appears curable in over one third of all newly diagnosed patients who receive treatment for approximately 2 1/2 years.

Antineoplastic Agents↗
PubMed1979

Kinetic studies of cells in childhood leukemias.

A review of cell kinetic studies in acute childhood leukemia with a comparison of leukemic transformation of non-Hodgkin's lymphoma is presented in this paper. Leukemic cell populations have a longer cell cycle than their normal cell counterparts. The cell populations are comprised of proliferating and resting fractions and are capable of self-maintaining growth. Growth regulation is determined primarily by the size of the proliferating cell population or growth fraction. The growth fraction can vary as to site of disease, the clinical phase, following chemotherapeutic perturbation, and most importantly is related to the specific tumor cell type. Within a specific type of leukemia there is considerable variability of proliferative activity at time of diagnosis, but this variability bears no relationship to the subsequent clinical course. Those leukemias, such as the E rosette-positive form of lymphocytic leukemia characterized by rapid tumor growth and large tumor bulk, are also associated with tumor cell populations having larger growth fractions than standard lymphocytic leukemia. There is evidence for growth regulation of leukemic cell populations on systemic, regional, and, perhaps most importantly of all, intrinsic cell levels. It is this area of growth regulation for these tumor cell populations which currently needs the greatest research attention.

Acute Disease↗
PubMed1978

Treatment of acute leukaemia in children.

As can be seen, there are many problems yet to be solved in the development of optimal therapy for acute leukaemia in children. For patients with ALL we must be able to identify clearly the standard and the varieties of high risk patients. For the patient with standard risk features life expectancy is long and therapy regimens must be designed to provide optimal control of the disease with minimal short and long-term toxicity. For patients with the high risk features of those varieties of ALL associated with poor prognosis methods must be found to circumvent the problem of early acquisition of drug resistance by the leukaemic lymphoblasts. For children with AML the results of remission induction regimens must still be improved to match those obtained in ALL. The major problem awaiting solution, however, is the maintenance of remission once obtained. As disease-free survival in AML is improved then consideration of CNS prophylaxis and the timing of cessation of therapy must be considered.

Acute Disease↗
PubMed1978

Factors leading to delay in the diagnosis and affecting survival of children with head and neck rhabdomyosarcoma.

Rhabdomyosarcoma of the head and neck often presents with vague symptoms which mimic other disease conditions. These factors lead to undue delay in the establishment of the correct diagnosis and the delivery of acceptable therapy, including surgery, radiation therapy, and chemotherapy. There is, however, evidence of improved results of treatment of these tumors since the addition of multiple drug chemotherapy to surgery and radiotherapy.

Adolescent↗
PubMed1978

Current treatment of acute leukemia.

For patients with ALL we must be able to identify clearly both standard and high-risk patients. For standard-risk patients in whom life expectancy is long, therapy regimens must be designed to provide optimal control with minimal short- and long-term toxicity. For patients with high-risk ALL, methods must be found to circumvent the problem of early acquisition of drug resistance by the leukemic lymphoblasts. For patients with AML, more work must be done to improve the results of remission induction. But the major problem for these patients is the maintenance of a remission once it is obtained. Perhaps one of the critical factors in AML is the interrelationship of normal and leukemic marrow elements in therapy response. Disease-free survival time must be improved before considerations of CNS prophylaxis and cessation of therapy can be approached.

Bone Marrow Transplantation↗
PubMed1977

Current progress in the treatment of the child with cancer.

Treatment for the child with cancer has increasingly been on a rational rather than an empiric basis. An understanding has developed of the importance for determining clinical and laboratory features present at diagnosis as an aid not only to establish a prognosis but also to design specific treatment regimens. A system has been developed for bringing new chemotherapeutic agents into clinical trials as effectively as possible. Through both clinical and laboratory studies, an increasing understanding of the biology of cancer is being developed. This understanding will provide the basis for more rational treatment programs in the future. Physicians of different specialty interests have learned to work together to develop coordinated programs of treatment so important to optimal care. By far the most important lesson learned, however, is that cancer in children is not of necessity a fatal disease, even when dissemination has occurred. For the furture, it will be necessary to develop even more effective methods of treatment, and research must provide a better understanding of this disease that may offer the opportunity for prevention, which, after all, is the number one interest of the pediatrician.

Adolescent↗