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Biomedical subjects

C A Coltman

Publications and source records attributed to C A Coltman.

174 records · Page 10Linked to original sources
PubMedDate not supplied

Autologous bone marrow transplantation in adults with non-Hodgkin's lymphoma: a Southwest Oncology Group study.

Patients with non-Hodgkin's lymphoma (NHL) who fail conventional chemotherapy have a dismal outcome. Reports from single institutions utilizing high-dose chemoradiotherapy plus Autologous Bone Marrow Transplantation (ABMT) in this setting suggest three-year disease-free survival between 15-60 per cent. From 1985 to 1989 the Southwest Oncology Group performed a prospective multi-institutional study involving ABMT in relapsed/refractory NHL. Forty-five patients, ages 6-60 (median 38), with relapsed NHL were treated with high-dose cyclophosphamide (60 mg/kg/d x 2), total body irradiation (200 cGy/d x 6), and autologous unpurged bone marrow. Histologic subtypes included high grade lymphoma (10), intermediate grade lymphoma (33), and low grade lymphoma (2). Disease status pre-ABMT was sensitive relapse (16), resistant relapse (13), and untreated relapse (16). The actuarial three-year event-free survival and overall survival for all patients were 27 per cent and 38 per cent respectively. Causes of failure included regimen-related deaths (4), lack of response (10), or tumour progression (20) which occurred at a median of 5 months (1-22) post-ABMT and usually at previous sites of involvement. Response to salvage therapy pre-ABMT, a reflection of a tumour's biological behaviour, was the most important predictor of good outcome post-ABMT. This study confirms that a significant number of patients with recurrent NHL can achieve prolonged disease-free survival after ABMT.

Adolescent↗
PubMedDate not supplied

Southwest Oncology Group strategies in prostatic carcinoma.

The Southwest Oncology Group Genitourinary Committee evolved in 1978 from a combined gynecologic-urologic cancer committee. A significant catalyst in this development was the growing interest in prostatic carcinoma, with an initial focus on hormone refractory disease. Clinical studies have expanded into combined androgen blockade, untreated metastatic disease and localized prostate cancer. Since 1978, more than forty trials in prostatic carcinoma have been conducted. Currently, seven are in progress or under development. Conclusions and future directions are reviewed.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Hydroxyethyl starch and prednisone as adjuncts to granulocyte collection.

A total of 232 leukaphereses were performed with a continuous flow (CFC) of 89 donors related to recipients to obtain granulocytes for infected granulocytopenic recipients. One hundred fifteen runs were done without pretreatment of the donors and were used as controls. Pharmacological pretreatment of the remaining one hundred seventeen donors included Prednisone, given in an oral dose (50 mg) the evening prior to the run, and/or 250ml of 6 per cent hydroxyethyl starch added to the input line of the CFC throughout the run. A median of 9.2 liters of donor blood was processed with each run. The pretreatment of the donors with Prednisone plus the addition of HES to the input line significantly increased the number of granulocytes collected. Donors tolerated the leukapheresis procedure well, and no significant side effects were associated with Prednisone or HES administration. Early and frequent use of such granulocytes was effective in the short-term control of fever in the granulocytopenic recipients who failed to respond to 48 hours of broad spectrum antibiotic coverage.

ABO Blood-Group System↗
PubMedDate not supplied

Adjuvant chemotherapy.

Explore the source record for details and available documents.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Platinum analogs in recurrent and advanced head and neck cancer: a Southwest Oncology Group and Wayne State University Study.

Cisplatin combinations are active in patients with epidermoid cancer of the head and neck. Because of the incidence of dose-limiting toxicity and the need for hospitalization for iv hydration and mannitol diuresis, the search for active analog(s) with less of such toxicity has been intensive. In a limited institution study of Wayne State University and the Southwest Oncology Group, a clinical trial of carboplatin (CBDCA) and iproplatin (CHIP) in patients with recurrent head and neck cancer was carried out. Sixty-four patients were entered and 63 were evaluated, 29 receiving CBDCA and 34 receiving CHIP therapy. These patients were stratified according to important prognostic factors. The response rate to CBDCA was 24% (seven responses among 29 patients; three complete responses and four partial responses), and to CHIP was 12% (four responses among 34 patients; one complete response and three partial responses). Both drugs were administered without prior hydration or mannitol diuresis on an outpatient basis. The major side effect was myelosuppression, which was reversible but cumulative and dose-limiting. Less severe vomiting occurred as compared to the incidence of this toxicity with cisplatin and no significant renal or hearing loss occurred. It was concluded that further evaluation of these agents with other active drug(s) in patients with head and neck cancer is warranted.

Adult↗
PubMedDate not supplied

Phase II evaluation of teniposide and ifosfamide in refractory adult acute lymphocytic leukemia: a Southwest Oncology Group Study.

The Southwest Oncology Group undertook a phase II study of teniposide (VM-26) and ifosfamide in refractory adult acute lymphocytic leukemia. The 49 evaluable patients were heavily pretreated; 15 of these had received only one prior induction attempt. Two treatment regimens were used. Eighteen patients received VM-26 (30 mg/m2) on Days 1-5 and ifosfamide (1000 mg/m2) by continuous iv infusion on Days 1-5. When acceptable toxicity was observed, the dose of VM-26 was increased and 30 patients received VM-26 (50 mg/m2) on Days 1-5 in addition to ifosfamide. Complete remission (CR) was observed in two patients who received the lower-dose VM-26 regimen and in six patients who received the higher-dose regimen. Of the eight patients who achieved CR, six were found among the 15 patients who had received only one prior induction therapy. Hematologic toxicity was the major toxic effect observed, with 41 patients (84%) having wbc counts less than 1000/microliter during induction therapy. Nonhematologic toxicity was dose-limiting in seven patients for the following reasons: hematuria (four patients), neurological disturbance (one), and mucositis (two). The combination of VM-26 and ifosfamide is capable of producing CR in refractory acute lymphocytic leukemia in adults with manageable toxicity. Inclusion of the combination in a multidrug consolidation regimen for newly diagnosed patients is an appropriate avenue for further study.

Adolescent↗
PubMedDate not supplied

Phase II evaluation of cis-dichlorodiammineplatinum(II) in lymphomas: a Southwest Oncology Group Study.

The Southwest Oncology Group has evaluated the activity of cis-dichlorodiammineplatinum(II) at a dose of 75 mg/m2 given as an iv bolus injection every 3 weeks to 25 fully and partially evaluable patients with advanced Hodgkin's disease and non-Hodgkin's lymphoma. One complete response, two partial responses, and one improvement less than a partial response were noted. Myelosuppression, in the form of leukopenia and thrombocytopenia, was identified and seemed to be more prevalent and more severe than in previous studies. We have attributed this to the extensive prior treatments which these patients had received and to the presence of tumor-bearing marrow which was observed in some of them. The anticipated toxic effects which were noted included nausea and vomiting, anorexia, diarrhea, renal injury, and hyperuricemia. The precise role of cis-dichlorodiammineplatinum(II) in the management of human lymphomas awaits elucidation.

Bone Marrow↗
PubMedDate not supplied

Phase II evaluation of amsacrine (m-AMSA) in solid tumors, myeloma, and lymphoma: a University of Arizona and Southwest Oncology Group Study.

A phase II trial was conducted to determine the clinical activity of amsacrine (m-AMSA) in patients with heavily pretreated solid tumors, myeloma, and lymphoma at the University of Arizona Cancer Center. Additionally, m-AMSA was evaluated at other Southwest Oncology Group institutions in breast cancer, myeloma, melanoma, and oat cell cancer of the lung. At a dose of 120 mg/m2 given iv every 28 days, 12 partial responses were observed in 221 patients evaluable for response. Some antitumor activity was observed in breast cancer (four responses of 65 patients), non-Hodgkin's lymphoma (three of nine), Hodgkin's disease (two of five), and sarcoma (two of 15). A partial response was also documented in one of two patients with cervical cancer. Among the 135 patients treated at the University of Arizona who were extensively evaluated for toxic effects, only myelosuppression and anemia were seen in a significant number of patients. At this dose and schedule, 29% of patients developed leukopenia of less than 3000 cells/mm3, 16% developed a thrombocytopenia of less than 100,000 cells/mm3, and 29% had an acute fall in hemoglobin of greater than or equal to 2 g/100 ml. In addition, two patients suffered grand mal seizures which were not clearly drug-related. These results suggest that further study of m-AMSA in lymphoma, sarcoma, and cervical cancer is warranted.

Adolescent↗