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Biomedical subjects

B Asselain

Publications and source records attributed to B Asselain.

At least 181 records · Page 10Linked to original sources
PubMed1982

Analysis of criteria in staging in multiple myeloma.

One hundred and thirty patients suffering from multiple myeloma were reviewed for retrospective study of their classification according to Durie and Salmon's staging system. No significant difference was found in survival between patients in stage I, II and III. Since then, each criterion developed by Durie and Salmon was evaluated separately. Only the Hb level showed a significant influence; a Hb level under 8.5 g/dl or corrected calcaemia above 3 mmol/l were never found separately. When survival according to the number of criteria was considered there was no difference. These findings agree with the well-founded classification of Durie and Salmon but the real importance of each criteria is questionable.

Calcium↗
PubMed1982

[Metastatic breast cancers: comparison of the prognostic significance and the sensitivity to chemotherapy according to the presence of estradiol and progesterone receptors].

102 patients with disseminated breast cancer entered this retrospective study. An estrogen receptor (ER) assay was realized in 91 patients and a progesterone receptor (PgR) assay in 90 cases; 44 per cent of the patients were considered as ER+ and 29 per cent as PgR+; 56 per cent were considered as ER- PgR-. The objective response rate to cytotoxic chemotherapy after 4 months of treatment was 66 per cent for ER-, 73 per cent for ER+, 67 per cent for PgR- and 74 per cent for PgR+. However, the mean duration of response was significantly shorter for ER- patients, and no difference appeared between PgR+ and PgR- patients. The acturial survival curves demonstrated a favorable prognostic significance of ER+ as compared to ER- p = 0,03), but the difference was slightly more significant for PgR+ as compared to PgR- (p = 0,008). The prognostic significance of PgR in patients with advanced breast cancer treated with cytotoxic chemotherapy does not appear to be related to the sensitivity to this treatment.

Antineoplastic Agents↗
PubMed1981

[Autoimmune thrombocytopenic purpura. Clinical and therapeutic retrospective study of 544 cases (author's transl)].

A retrospective study of 544 patients with autoimmune thrombocytopenic purpura showed that 81 had immunological abnormalities (antinuclear factors and/or positive direct Coombs; test and/or anti-smooth muscle antibodies). After one year, 58-8% of all patients were still in complete remission, irrespective of treatment. The outcome of the disease was studied in relation to therapeutic regimens. Prognosis was worst in patients with immunological abnormalities, since 11% died as compared with 4% of the whole patient population. Most relapses occurred during the first two years following remission.

Adolescent↗
PubMed1981

[Long-term evolution of nodular lymphoma. Outcome in 85 patients treated between 1968 and 1975 (author's transl)].

Eighty-five patients with nodular lymphoma diagnosed between 1968 and 1975 were followed up for long periods and were treated by either conventional methods (local radiotherapy and single drug chemotherapy) or by more intensive therapeutic regimens, such as initial combined M.O.P.P. therapy and maintenance treatment with chlorambucil with or without further courses of M.O.P.P. Long-term follow-ups have brought to light some interesting points concerning the prognosis. Dissemination of the disease and large-cell histological pattern were, as already known, unfavourable factors. Neither age nor sex, nor bone-marrow involvement seemed to have any influence. Obtaining complete remissions improved the prognosis, but intensifying the initial and maintenance treatments proved disappointing: the survival rate remained the same, and the incidence of drug induced leukaemias was high. Indeed, relapses appeared to be less responsive to treatment when the patient had initially received multiple chemotherapy. However, in view of the high death rate of the disease (one-third of the patients in this series died within the first 5 years), trying new therapeutic regimens in the hope of obtaining better results, as has been done in Hodgkin's disease, would be fully justified.

Acute Disease↗
PubMed1981

[Possibilities of treatment of reduction in Hodgkin's disease. III. Can polychemotherapy when combined with radiotherapy of localised stages be reduced? (author's transl)].

The effectiveness of three and six cycles of MOPP (chlormethine, vincristine, procarbazine and prednisolone) as initial chemotherapy in 108 patients with Hodgkin's disease at clinical stages II nA, IIB, IIIA and B was compared in a study of two groups, one of them treated in six cycles (October, 1972--December, 1976), the other in three cycles (January, 1977--October, 1979). The clinically complete remissions obtained by this schedule and findings at exploratory splenectomy were chosen as measures of effectiveness. The frequency of clinically complete remission was similar in both groups. In 96% (97% for the second group) of patients in whom the three (six) MOPP cycles of cytostatic treatment achieved clinically complete remission, exploratory splenectomy failed to reveal any infradiaphragmatic involvement. In patients in stage IIA and IIB one can, therefore, consider reducing primary cytostatic treatment to three MOPP cycles. Exploratory splenectomy and prophylactic infradiaphragmatic radiotherapy can be omitted in these patients, if one accepts the 5% risk of infradiaphragmatic involvement. Splenectomy can also be omitted in patients in stage III, but not infradiaphragmatic radiotherapy, including that no the spleen.

Adult↗
PubMed1981

Chemotherapy-radiotherapy versus chemotherapy in Hodgkin's disease with bone marrow involvement. Retrospective analysis of 32 cases.

A retrospective analysis was performed on 32 patients suffering from Hodgkin's disease with bone marrow involvement treated between 1972 and 1976. After 6 courses of chemotherapy (MOPP for 25 patients), we observed 20 complete remissions (62.5%), 8 lymph node partial remissions (bone marrow sterilization but persistence of pathological lymph nodes) and 4 failures. among the 28 complete or partial responders, 17 received maintenance chemotherapy alone, 9 were submitted to 40 Gy and 2 to 20 Gy irradiations. 15 patients died and 8 relapses occurred - all in previously involved lymph node areas. Survival of complete and partial responders is significantly different (p = 0.01) according to whether they received maintenance chemotherapy alone (34.5%) or irradiation (75.7%). Disease-free duration is also significantly different (p = 0.05) according to whether the patients received maintenance chemotherapy alone (42.1%) or 40 Gy irradiation (100%).

Adolescent↗
PubMed1981

[Disseminated breast carcinoma. Study of activity of immunotherapy with BCG and duration of the phase of intensive chemotherapy. Results of a randomized trial (author's transl)].

144 patients with disseminated breast cancer entered into a 4 arm randomized trial. They received a chemotherapy protocol combining monthly administration of adriamycin (40 mg/m2 on day 1), vincristine (1,2 mg/m2 of day 2), cyclophosphamide (400 mg/m2 on days 3, 4, 5), 5 fluorouracil (500 mg/m2 on days 3, 4, 5). Patients in groups I and III were given 6 courses at monthly intervals and patients in groups II and IV were given 10 courses. Then they were given indefinitely a monthly course of cyclophosphamide (100 mg/m2/day for 7 days), melphalan (2,5 mg/m2/day for 7 days), methotrexate (25 mg/m2/week for 3 weeks). Patients in groups III and IV were given 3 applications of living BCG disposed on a scratched area between courses of chemotherapy. The overall response rate was 73 per cent (105/144) and was comparable in each treatment group. The mean duration of response and the mean survival times were comparable in each treatment group. The mean duration of response and the mean survival times were comparable in the 4 treatment arms. The initial tumor mass, serial levels of CEA and skin responses to recall antigens were of prognostic significance. Age, hormonal status, initial lymphocytes count had no prognostic significance.

Adult↗
PubMed1981

[Inflammatory breast carcinoma treated with a combination of chemotherapy and radiation therapy. Results of a randomized trial studying the therapeutic role of an immunotherapy with BCG (author's transl)].

Seventy-seven patients with inflammatory breast carcinoma were included in a randomized trial between march 1977 and september 1979. All patients were treated with the same association of chemotherapy and radiation therapy. Chemotherapy included adriamycin on day 1 (45 mg/m2), vincristine on day 2(1,2 mg/m2), cyclophosphamide on days 3, 4 and 5 (400 mg/m2/day) and 5 fluoro-uracil on days 3, 4, and 5 (500 mg/m2/day). Each course of chemotherapy was repeated every 28 days for one year. Patients were then given a maintenance course of chemotherapy for one year. Radiation therapy with CO60 was applied after 4 courses of intensive chemotherapy. The dose distributed was 70 Gy over seven weeks. During radiation therapy, chemotherapy was administered according the same scheme, but adriamycin was excluded. All the patients were randomly distributed into two groups before treatment: group I patients received chemotherapy and radiation therapy alone; group II patients received chemotherapy and radiation therapy plus living BCG vaccinations. After chemotherapy, inflammatory manifestations disappeared in 51% of cases. The mean of disease-free interval was 26 months and the overall survival mean 34 months. No difference in favor of the BCG treated group was noted. Lymph node involvement, age, hormonal status, response to tuberculin, and disappearance of inflammatory signs after 4 months of chemotherapy are of insignificant prognostic value.

Adult↗
PubMed1980

[Acute myeloblastic leukaemia in the course of non-Hodgkin's lymphoma (author's transl)].

Five cases of acute myeloblastic leukaemia (AML) arising in the course of non-Hodgkin's lymphoma (NHL) are described. The initial lymphoma was nodular lymphoid poorly differentiated in 4 cases. All patients were under chemotherapy for at least 28 months, and 3 of them were irradiated. AML was diagnosed 44 to 78 months after NHL and was heralded in 3 cases by a preleukaemia phase of pancytopenia. The leukaemia was typically myeloblastic in 2 cases and difficult to classify in 3 cases. Death occurred rapidly in 4 patients. The actuarial risk was 4.5% at 5 years. Since AML's occur mainly in NHL's, the management of this type of lymphoma with favourable prognosis ought to be reevaluated.

Acute Disease↗
PubMed1980

Chemotherapy--radiotherapy association in Hodgkin's disease, clinical stages IA, II2A: results of a prospective clinical trial with 166 patients.

One hundred sixty-six patients with clinical stages IA, II2A Hodgkin's disease were treated between April 1972 and December 1976 with three courses of multiagent chemotherapy (methylchlorethamine, vincristine, procarbazine, prednisone) followed by mantle irradiation--excluding mediastinum for those with initial upper cervical presentation and absence of mediastinal involvement--or inverted Y radiotherapy. None had staging laparotomy. With a follow-up of 12--84 months, median 40 months, the overall survival is 93.5% and the overall relapse-free survival 89.9%. Eight patients died, three of them with evident disease. Ten patients relapsed; four are now free of disease after retreatment. With chemotherapy-radiotherapy sequence, staging laparotomy is not indicated. Results and side effects of this treatment strategy are compared with those of other treatment policies.

Adolescent↗
PubMed1980

Qualitative criteria in therapeutic evaluation and decision-making in oncology.

Two problems are envisaged: --the relationship between the "statistical decision" and the individual decision. Long before the existence of decision-making aids, medical knowledge has always been of a statistical nature. Ever since medicine became an organised science, the treating of a patient and not just the illness has been a constant problem. At present, it is by no means certain that we have the right to apply the strategy recommended by a well organised therapeutic trial, with our eyes shut. If for no other reason, simply because the criteria of judgment of the trial may not necessarily be the criterion best adapted to the patient concerned. --how to implicate in decision and evaluation non-quantitative criteria such as the quality of survival. Having recalled the distinction made by Wood--impairment, disability, handicap--an attempt is made to specify the state of sanometric research providing physicians with health indexes that are finer than the simple Boolean criteria of Life/Death. In conclusion, the question can be raised as to how pertinent, it is to consider death as the lowest level of health, and as to what role should be left to the patient in the choice of decision-making criteria for problems directly concerning his own fate.

Decision Making↗
PubMed1979

[Possibilities of radiation-dose reduction in the treatment of Hodgkin's disease. I. Exclusion of the mediastinum from the radiation field in primary high-cervical or infradiaphragmatic involvement and stage I or II (author's transl)].

A retrospective analysis on 482 patients with localised Hodgkin's disease revealed that none of those with primary high-cervical or primary infradiaphragmatic involvement had any infiltration of the mediastinum, either at the time or later. As a result, prophylactic mediastinal radiation was not practised if high-cervical or infradiaphragmatic lymph-nodes had been affected first. None of these patients had any mediastinal recurrence after at least seven years.

Adolescent↗
PubMed1979

Axillary Hodgkin's disease in manual workers.

Between 1965 and 1974, 16 patients were clinically staged as having unique axillary localizations of Hodgkin's disease. Sex ratio (4.3), mean age (40.8 years) and professional occupations (12 out of the 16 patients were engaged in manual work) were significantly different from that of all patients observed during the same period. These facts lead us to suppose the existence of a link between manual work and initial axillary localizations.

Adult↗