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Biomedical subjects

A Stacher

Publications and source records attributed to A Stacher.

At least 19 recordsLinked to original sources
PubMed1989

[Risk-adapted therapy of highly malignant non-Hodgkin's lymphomas with COP-BLAM/IMVP-16: a prospective multicenter study].

In a prospective multicenter therapy trial the remission-inducing potential of the COP-BLAM (5 courses) and the possibly not cross-resistant IMVP-16 (2 courses) regimen for advanced diffuse large cell lymphomas were investigated. Inadequately responding patients were switched early after 2-3 courses to the IMVP-16 protocol. Between January 1986 and August 1988 349 previously untreated patients were recruited who fulfilled the entry criteria: age 15-75 (mean 56 years), stage II-IV. A first restaging after 3 courses of chemotherapy was documented for 280 cases, a second restaging following 7 courses of chemotherapy or a final report was available for 221 patients, 130 of which where in CR (59%). These figures include 29 cases who died already during induction-chemotherapy of progressive disease (n = 17) as well as of therapy-related complications in CR (n = 12). Thirty-three patients were switched early to IMVP-16 due to incomplete response at the first restaging; 13 of those achieved CR by the new regimen (39%), 9 achieved a partial remission which was turned into CR by additional radiotherapy in 5 cases. Dose reductions and interval prolongations were necessary at increasing rates with subsequent chemotherapy courses (20-50% of the cycles). Relapses have occurred in 32 patients so far (14 early, 18 after stop of treatment). The median survival was 24 months (n = 309 patients). These data show that this treatment strategy is effective in a large unselected group of patients of relatively high age. However, patients showing only delayed response with this protocol probably need more aggressive regimens to obtain durable remissions.

Adolescent↗
PubMed1988

[Multicenter prospective risk-adapted study on the therapy of non-Hodgkin's lymphomas of high malignancy. Use of COP-BLAM/IMVP-16 and randomized adjuvant radiotherapy--study concept and preliminary results].

In a multicenter prospective randomized therapeutic trial in advanced (stage II-IV disease, Ann Arbor classification) high-grade malignant non-Hodgkin's lymphomas (NHL, Kiel classification) a sequential combination of the COP-BLAM (5 cycles) and the IMVP-16 (2 cycles) protocols was employed. Response was first determined after 2-3 cycles. In a response-adapted manner the therapy was immediately switched to IMVP-16 if only a partial remission or no response was obtained as evidenced by the first restaging. The aim of the study is the investigation of the efficiency of this concept to induce stable remissions. In an additional randomized trial, involving all patients reaching complete remissions after chemotherapy (second restaging), the prognostic relevance of adjuvant radiotherapy as compared to therapy-free follow-up is evaluated. Eighty percent of the 191 recruited qualified patients have so far become evaluable. Complete clinical remissions were achieved in 76/148 (51%) of the patients up to the first, in 52/85 (61%) of the patients up to the second restaging. Only in a few cases did the expected toxicity of intensive polychemotherapy reach WHO grade 3-4, including nausea and diarrhea, infections, septic complications, myelotoxicity, and stomatitis. Four of the 29 deaths recorded so far occurred in complete remission due to treatment-related complications, whereas 22/29 (76%) died in progression and 3 of unrelated causes.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

Lymphomatoid papulosis: remission following intravenously administered acyclovir.

In a 54-year-old male patient suffering from Hodgkin's disease, lymphomatoid papulosis occurred. Complete clearing of the skin lesions was observed immediately after intravenously administered acyclovir. The patient had numerous relapses of his skin eruption with complete responses after each course of intravenously applied acyclovir. This striking therapeutic effect parallels reports of regression of mycosis fungoides and chronic generalized lymphadenopathy after acyclovir application. The mode of action of acyclovir in these disorders is not known. They all are characterized by involvement of the T cell system, and in all these diseases, a virus etiology has been proved or is suggested. Thus, a specific effect of acyclovir on T lymphocytes or selectively on helper T cells is discussed. Alternatively, the virustatic effect of acyclovir could be responsible for the therapeutic success.

Acyclovir↗
PubMed1985

Progress in the management of high risk non-Hodgkin's lymphomas. 10 years of experience of the 3rd Medical Department of Hanusch Hospital, Vienna.

An analysis of 173 cases of non-Hodgkin's lymphoma (NHL) admitted to our hospital from January 1973 to January 1983 is presented. Of the 173 cases, 124 patients suffered from NHL of high grade malignancy according to the Kiel classification (37 centroblastic lymphoma (CB), 30 immunoblastic lymphoma (IB), 43 lymphoblastic lymphoma (LB), 14 NHL high grade malignancy unclassifiable). In addition, 26 patients with secondary high grade malignant NHL were included in the analysis (14 secondary CB, 10 secondary IB, 2 secondary LB). Also investigated were 23 patients with anaplastic centrocytic lymphoma (CC) (20 primary CC, 3 secondary CC), an entity originally classified as low grade malignant lymphoma, but showing a poor outcome and need for aggressive therapy. Symptoms at presentation of all patients are described. Of the 173 patients, 71% had an advanced stage of the disease at the time of diagnosis (Ann Arbor stage III or IV). B-symptoms were observed in 81%. Extranodal involvement, (exceptive bone marrow involvement), determined by clinical examination was seen in 55%. Survival of patients changed significantly after replacing initial radiotherapy with aggressive chemotherapy (P less than 0.001). Improvement of survival statistics was due to the better outcome of patients with localized stages (Ann Arbor stages I and II) as compared to those with generalized disease (P less than 0.002). Prognostic factors influencing survival were elevation of lactic dehydrogenase (P less than 0.0001) and response to therapy (P less than 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

[Leg ulcers in congenital dyserythropoietic anemia].

We report on an 18-year-old male patient suffering from leg ulcers due to congenital dyserythropoetic anemia and thrombocytosis. Based on this case, we discuss the importance of hematologic disorders for the development of leg ulcers as well as the pathogenetic mechanisms involved.

Adolescent↗
PubMed1984

[Clinical aspects and therapy of iron deficiency].

Iron deficiency and iron deficiency anemias are very common disturbances of the hematopoiesis. Although symptomatology and therapeutic possibilities are well known, one should keep in mind that iron deficiency is a symptom and not a diagnosis. The causes of iron deficiency are iron loss, malabsorption and insufficient supply. The best therapy is peroral treatment with well absorbable preparations, whereby the bioavailability has to be taken into consideration. Only in few cases a parenteral therapy which has more side effects is necessary. A overview about the possible therapy is given.

Adult↗
PubMed1983

[Alcohol and changes in the hematopoietic system; an epidemiological contribution to the problem of alcoholic anemia].

In the course of the "Vienna Health Study 1979" 1261 males and 1548 females divided into 3 age categories (25, 40 and 60 years), were investigated for serum iron level, RBC, leucocytes, haemoglobin, haematocrit, MCH, MVC, MCHC, GOT, GPT and AP. These parameters were evaluated in correlation to the drinking habits of each proband. Significant correlations were found between alcohol consumption and serum iron (elevation in most cases), RBC (decrease), MCV (elevation) and GOT (elevation).

Adult↗
PubMed1982

[Chemotherapy of non-Hodgkin's lymphomas].

Guidelines for the treatment of non-Hodgkin's lymphoma are laid down in this paper. Low-grade lymphomas diagnosed at an early stage be cured by adequate extended field radiotherapy, although this is a rare occurrence. Advanced stages are treated only on progression of the disease, whereby these measures can merely be regarded as palliative. Lymphomas of high-grade malignancy should be treated by massive chemotherapy from the very beginning, with additional supportive therapy for any complications which may arise, as necessary. After full remission has been achieved by means of chemotherapy, radiotherapy is applied to the previously worst-affected areas. This strategy aims at cure, as in the case of the acute leukaemias, although it is only very rarely successful. It is becoming increasingly possible to achieve remissions through applying various chemotherapeutic regimens, but the question of optimum maintenance therapy, both with regard to type and duration is still unsettled and urgently requires elucidation.

Age Factors↗
PubMed1980

[Clinical relevance of the Kiel classification of non-Hodgkin's lymphomas (author's transl)].

The Kiel classification of non-Hodgkin's lymphomas, based on morphological, cytochemical and functional criteria, differentiates between lymphomas of low-grade malignancy and high-grade malignancy, which are themselves subdivided into several distinct entities. The probability of survival, the symptomatology and some important laboratory parameters are described in 138 cases of malignant non-Hodgkin's lymphomas, classified according to the Kiel classification. The results show that this classification has not only prognostic and clinical relevance, but also explains some uncommon clinical courses of malignant lymphomas. It is to be hoped that this classification will also promote further progress in therapy.

Adolescent↗
PubMed1980

[Morphology and index of nucleoli in malignant lymphomas].

The significance of morphology and the number of lymphocyte nucleoli was evaluated by electronmicroscopic sections of malignant lymphomas. It was not only the number and the size of nucleoli which characterized malignant lymphomas differing in histological respect, but above all the different morphology of the nucleoli. The prognostic significance of the nucleolus can be illustrated, if malignant lymphomas of a low grade malignancy with a preponderance of micronucleoli and a low nucleolar index are compared with a significantly higher nucleolar index and markedly increased macronucleoli. These differences are further supplemented by additional morphological properties of nucleoli in malignant lymphomas.

Cell Nucleolus↗
PubMed1979

[A clinical study of the non-Hodgkin's lymphomas according to the Kiel classification (author's transl)].

A study of 138 patients with Non-Hodgkin's lymphomas was performed. The results were compared with retro- and prospective investigations of patients of the Kiel lymphoma study group. The aim of the study is to evaluate the value of the Kiel classification for the therapy and prognosis of malignant lymphomas. The malignant lymphomas of low- and high-grade malignancy differ significantly in their biological behaviour. Especially the clinical progress of the disease and the response to therapy are different. The lymphomas of low-grade malignancy may not need any treatment for long periods in some patients. In contrary, patients with lymphomas of high-grade malignancy need an active treatment immediately after the establishment of the diagnosis. In stages I and II radiotherapy is sufficient, in stages III and IV chemotherapeutic regimens are necessary. Each type of malignant lymphoma may be accompanied by leukemia. Most of the malignant lymphomas, particularly the immunocytomas, may produce monoclonal gammopathies, most of them being macroglobulinemias. Thus the macroglobulinemia Waldenström is just a clinical necessary to evaluate the significance of the subtypes of the Kiel classification for the planning of specific treatment.

Adolescent↗
PubMed1979

[Anemias resulting from iron metabolism disorders].

For the most part iron deficiency, but also disturbances of distribution, transport and utilization of iron, are able to cause anemias. To understand the origin of such anemias, firstly iron metabolism, then the clinical symptomatology as well as the laboratory parameters necessary for diagnosis and finally the usual therapies are described.

Anemia, Hypochromic↗
PubMed1977

Treatment of acute non-lymphoid leukemias: comparison of two protocols.

The results of treatment of 57 patients suffering from acute non-lymphoid leukemia by two protocols are compared. The more aggressive Coap protocol rendered a higher remission rate (57.1%), than the mild Guyer protocol where the remission rate has been 25%. The best results have been achieved in the former group in the younger population; in the latter group there has been no age-effect relationship. Although the remission rate differed in both protocols there has been no statistically significant difference in survival.

Cyclophosphamide↗
PubMed1977

[Retrospective analysis of the clinical relevance of the Kiel classification of malignant non-Hodgkin's lymphomas (author's transl)].

405 cases with non-Hodgkin's lymphomas have been diagnosed according to the Kiel classification and analysed retrospectively. 314 patients with non-Hodgkin's lymphomas of low-grade-malignancy (chronic lymphocytic leukemia, lymphoplasmacytoid, centrocytic, centrocytic, centroblastic-centrocytic lymphoma) manifested significantly higher median survival times than the 91 patients with non-Hodgkin's lymphomas of high-grade malignancy (lymphoblastic and immunoblastic lymphoma). Within the group of patients with low-grade malignant lymphomas distinct prognostic differences were found whereas survival times in patients with lymphoblastic or immunoblastic lymphomas were rather similar. The lymphoblastic lymphoma showed a bimodal curve of age distribution whilst all other lymphomas had a maximum of incidence in the seventh decade of life. Increased frequency of B-symptoms did not necessarily represent an unfavorable prognostic factor for the lymphoma entity concerned. Except for chronic lymphocytic leukemia the highest incidence of initial bone marrow involvement was seen in lymphoplasmacytoid, centrocytic and lymphoblastic lymphomas. Centrocytes have been observed in peripheral blood of patients with centrocytic and centroblastic-centrocytic lymphomas, even though lymphocytosis did not exist. Monoclonal hypergammaglobulinemia was found in only 43% of the sera from patients with lymphoplasmocytoid lymphoma. In this disease, it was possible to differentiate between a lymphonodal, a splenomegalic and an extranodal manifestation.

Age Factors↗