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Biomedical subjects

C Kalifa

Publications and source records attributed to C Kalifa.

At least 145 records · Page 8Linked to original sources
PubMed1986

High-dose methotrexate and continuous infusion Ara-C in children's non-Hodgkin's lymphoma: phase II studies and their use in further protocols.

Twenty-three children with refractory or relapsed non-Hodgkin's lymphoma (NHL) received high-dose methotrexate (HD-MTX), and 9 received Ara-C by continuous intravenous infusion, as phase II studies. They all had previously received a protocol including vincristine, adriamycin, cyclophosphamide, IV push Ara-C, asparaginase, intrathecal MTX, and cranial irradiation, and had failed to respond or had relapsed. HD-MTX was given at the dose of 6 g/m2 or more with leucovorin rescue, Ara-C at the dose of 100 mg/m2/day by continuous infusion over 10 days. Among the 22 evaluable patients receiving HD-MTX, 10 responses (7 CR; 3 PR) were observed. Among the 9 patients receiving Ara-C, 4 responded (1 CR; 3 PR). Toxicity in those previously heavily treated patients was acceptable. These two drugs are now successfully included in childhood NHL treatment protocols.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

Modified chemotherapy with carmustine, cytarabine, cyclophosphamide, and 6-thioguanine (BACT) and autologous bone marrow transplantation in 24 poor-risk patients with acute lymphoblastic leukemia.

Twenty-four poor-risk patients with acute lymphoblastic leukemia received a modified regimen of carmustine, cytarabine, cyclophosphamide, and 6-thioguanine (BACT) followed by autologous bone marrow transplantation (ABMT). Nineteen patients were in second or subsequent complete remission (CR) when treated with this regimen; 3 died early, 2 died of pneumonia in CR, 11 relapsed within 3 months (median), and 3 remain in CR with no maintenance therapy 14-24 months after ABMT. Of the 5 patients with measurable disease who were treated, 3 had CR and 1 remains in CR without maintenance therapy more than 28 months after ABMT. The toxicity of this regimen was acceptable, but late pulmonary toxic effects remain a major concern. These results are poor in terms of efficacy, and new effective methods of eradicating acute lymphoblastic leukemia in patients with poor prognosis should be investigated.

Adolescent↗
PubMed1986

Infantile choriocarcinoma with cutaneous tumors. An additional case and review of the literature.

Choriocarcinoma is a malignant growth of trophoblastic cells characterized by the secretion of human chorionic gonadotropin. Primary choriocarcinoma arising in the placenta during a seemingly normal gestation is rare. Very few choriocarcinomas occurring simultaneously in mother and child have been reported so far. We describe an additional case of placental choriocarcinoma metastasizing to the newborn and showing many different cutaneous tumors. The primary tumor was found in the placenta. In the newborn, diagnosis was performed by skin biopsy only a few days after birth (by optic and electron microscopy). Immunohistochemical localization of human chorionic gonadotropin was performed by the immunoperoxidase technic with the use of monoclonal antibodies. This report describes an additional case and summarizes previously reported cases of placental choriocarcinoma metastasizing to the infant, as well as cases of skin metastases from malignant gestational trophoblastic disease.

Adult↗
PubMed1986

[Middle-term course of craniopharyngiomas in children as a function of initial therapeutic choice].

Despite numerous studies and publications, the treatment of craniopharyngiomas in children remains controversial. The present series of 33 cases, followed for the last 10 years, is analysed according to therapeutic protocols jointly defined, case by case, from each patient's features and in restricting the extent of surgical excisions. In agreement with other recently published series, two options give superior results: complete excision, when the risk is low; in the other cases, partial excision or rather a simple biopsy or decompression, followed by irradiation. Risks of relapse are thus quite reduced and mortality greatly reduced. The unavoidable consequence of hypopituitarism is easily treated. However, the frequency of psychic and/or neurologic sequellae as well as the risk of post-radiation complications should not be disregarded when selecting treatment.

Adolescent↗
PubMed1985

Problems and pitfalls in the use of computed tomography for the local evaluation of long bone osteosarcoma: report on 30 cases.

Forty-eight, computed tomography (CT) examinations undertaken in 30 patients with osteosarcoma of long bones were studied in detail, their diagnostic information being compared with that obtained from corresponding plain films. The latter were of more value in assessing peripheral bony involvement, by cortical extension and periosteal reaction, while the former, in general, permitted more accurate observation of extensions into adjacent soft tissues. Recognition of such extensions, however, was vitiated when they arose in relation to the proximal ends of the tibia, fibula, and humerus and when a haematoma had developed as a result of a biopsy. Plain films were also of more value in appreciation of response to chemotherapy. On the other hand CT is the only examination which permits a satisfactory study of intramedullary extensions of the tumour and in consequence is invaluable in determining the exact sites required for local resection. No cases of skip metastases were observed in our series, although similar appearances due to nutrient vessels or bony ridges, remote from the primary tumour, were noted on several occasions. Differentiation of these densities proved to be easy, particularly in the case of nutrient vessels when examination of the contralateral bone showed them to be symmetrical. Several authors have described the role of CT in the evaluation of local extensions. This paper reports the difficulties and errors encountered by us.

Bone Neoplasms↗
PubMed1985

[Chemotherapy of osteogenic sarcoma].

Functional results and survival have been improved in osteosarcoma during the last ten years, thanks to better conservative surgical techniques and more efficient drugs to prevent metastases. Of the several possible programmes of chemotherapy, the authors considered that the T10 programme of Rosen is the most reliable, this author claiming a survival rate of 90 p. 100 with an average follow-up of twenty months. This programme was adopted by the authors in the Paediatric Department of the Gustave Roussy Institute (Villejuif). Thirty one patients were treated and assessed after an average follow-up of 19 months. The results were favourable, only three patients presenting with metastases. One died. Amongst the thirty surviving patients, twenty-three were treated by local resection and eight by amputation.

Adolescent↗
PubMed1985

[Radiotherapy of carcinoma of the nasopharynx in children after previous chemotherapy. Preliminary results on 21 cases treated at the Institut Gustave-Roussy between 1978 and 1981].

Between 1978 and 1981, 21 children were treated at IGR for a poorly differentiated carcinoma of the nasopharynx. In hopes of diminishing the radiation doses and the incidence of metastases, the treatment began by either single agent or combination chemotherapy. The total dose of irradiation could be reduced to 50 Gy in 17 patients. The short term results are available for 18 cases. There were 2 isolated local recurrences, 2 isolated nodal recurrences and 1 combined local and nodal recurrence. In march 1983 the overall results revealed the following: of 21 patients initially treated, 10 are alive without local-regional recurrence (but 1 with metastases); 2 are dead metastases; 9 are lost to follow up with metastases.

Adolescent↗
PubMed1984

Hypercalcemia preferentially occurs in unusual forms of childhood non-Hodgkin's lymphoma, rhabdomyosarcoma, and Wilms' tumor. A study of 11 cases.

Unusual clinical, radiologic, or histologic findings were found in 11 of 17 cases of hypercalcemia associated with childhood tumors. Four children had undifferentiated lymphoblastic lymphoma with extensive bone involvement, but no visceral or neurologic involvement. At diagnosis, four adolescents with rhabdomyosarcoma had numerous metastases, particularly in the breasts and bone marrow. Three infants had renal tumor without bone metastases. Histologically, their tumors differed from classical nephroblastoma and resembled the malignant rhabdoid tumors of the kidney. These findings allow individualization of three distinct groups of tumors with unusual features which may suggest the presence of hypercalcemia. These tumors appear to have a poor prognosis since all patients but one died of their malignancy.

Adolescent↗
PubMed1984

Necrotising leukoencephalopathy complicating treatment of childhood leukaemia.

Nine children treated for acute leukemia or lymphosarcoma developed subacute encephalopathy starting with listlessness, depression and impairment of speech. Walking difficulties, ataxia, spasticity and sphincter disorders developed later. Transient intracranial hypertension and abnormal movements respectively developed in two patients. EEG frontal slow waves, raised CSF protein, abnormal white matter radioisotope uptake and CT scan hypodensity with patchy contrast enhancement were evident at the onset. Later, dilated ventricles and calcification appeared in the younger patients. Post-mortem neuropathological studies of three patients disclosed predominantly perivascular myelin loss in areas of white matter necrosis, abnormalities of small vessels and numerous axonal swellings. The spinal cord showed secondary degeneration of the corticospinal tracts. Analysis of the aetiological factors in this series points to the prevailing danger of cranial radiotherapy, probably increased by the young age of patients and by associated drug administration.

Acute Disease↗
PubMed1984

High-dose polychemotherapy with autologous bone marrow transplantation in children with relapsed lymphomas.

Sixteen children with non-Hodgkin's lymphoma (NHL) who had relapsed were treated with high-dose chemotherapy with BCNU, cyclophosphamide, cytarabine, 6-thioguanine (high-dose chemotherapy [HDC]) and autologous bone marrow transplantation (ABMT). Eleven complete responses were obtained and five patients remain in prolonged complete unmaintained remission 77+ to 152+ weeks after treatment. The best results were obtained in patients with CNS involvement and when this regimen was used after complete remission or partial response was obtained by other means. The results appear to be better in B-cell than in T-cell lymphomas, but the numbers are too small for statistical assessment. The use of ABMT rendered the pancytopenic period short and safe, despite the use of drug doses higher than those previously described for this HDC. The frequency of interstitial pneumonitis, possibly related to pulmonary toxicity of chemotherapy, remains a major concern. These results show that this regimen can help to cure some patients but its toxicity prohibits its use in primary therapy.

Adolescent↗
PubMed1984

Pulmonary evaluation of patients with osteosarcoma: roles of standard radiography, tomography, CT, scintigraphy, and tomoscintigraphy.

Sixty-one radiologic evaluations were performed on 32 patients with possible pulmonary metastases from osteosarcoma. CT scanning was performed 61 times; standard chest radiography, 58; tomography, 36; scintigraphy, 40; and tomoscintigraphy, 33. Using CT as a reference (positive or negative results only), the sensitivities of the other examinations were 57% (32% of total metastases) for standard radiography, 88% (48%) for tomography, 21% (5%) for scintigraphy, and 41% (8%) for tomoscintigraphy. Of the 193 metastases, 98 were subpleural and 95 were parenchymatous. Five patients had surgery and the others had follow-up. One false-positive CT scan was thus detected. The authors' current evaluation of patients with metastases from osteosarcoma includes chest radiography and CT; the other three examinations are performed only before surgery.

Adolescent↗
PubMed1984

[2nd malignant tumors in children. Study of 38 cases].

Thirty-eight children, followed in the pediatric Department of Institut Gustave-Roussy, developed second malignant neoplasms. Intervals between the two neoplasms ranged from 1 to 26 years. The second neoplasms were defined as having a different histologic diagnosis than the first ones: osteosarcoma, fibrosarcoma, thyroid carcinoma, leukemia were the most frequent second neoplasms. The potential carcinogenic part of chemotherapy and radiotherapy is emphasized. In addition, some genetic susceptibility may enhance the carcinogenic effects of therapy. Nevertheless the incidence of second malignant neoplasms is low. Its estimation is discussed here.

Adolescent↗
PubMed1982

[Management of pulmonary metastases from osteosarcomas].

The management of pulmonary metastases from osteosarcomas rests at present on thoracic surgery combined with chemotherapy. Until the beginning of the seventies chemotherapy proved very disappointing. With adriamycin, methotrexate in high doses followed by folinic acid and, more recently, platinum cis-dichlorodiamine, remissions, which are usually partial, are obtained in a significant proportion of patients (at least 30%). The addition of less active agents such as vincristine, cyclophosphamide, actinomycin D and bleomycin is helpful. Among 31 patients with pulmonary metastases from treated osteosarcomas seen at the Gustave Roussy Institute, 18 underwent thoracic surgery as the first treatment; in 10, surgery was followed by chemotherapy with adriamycin, vincristine, methotrexate in high doses + folinic acid + cyclophosphamide. Five patients are in complete remission 27, 30, 49, 50 and 77 months after the surgical procedure. 12 patients were initially treated with a similar chemotherapeutic regimen; a subsequent thoracic surgical procedure was undertaken in two patients who died 18 and 30 months after the pulmonary metastases had appeared. In one patient, the metastases were treated by irradiation. These results are compared to previous reports in the medical literature.

Humans↗
PubMed1982

[Adjuvant therapy in the management of osteosarcomas: the O3 trial (EORTC and ISPO) ].

The European Organization for Research on the Treatment of Cancer (EORTC) and the international Society of Pediatric Oncology (ISPO) have set up a randomized controlled trial designed to compare three different regimens of adjuvant therapy applied after treatment of the primary tumor (usually by radical surgery): a prolonged course of chemotherapy (41 weeks) combining adriamycin, methotrexate in high doses followed by folinic acid, vincristine, and cyclophosphamide; radiotherapy delivering 20 grays to the lungs; and a short course of chemotherapy (8 weeks) combining adriamycin, methotrexate in high doses, folinic acid and vincristine, associated with irradiation of the lungs as in the preceding protocol. At the time being, 156 patients have been included in this study. If conclusions are to be drawn from this trial, a total of 300 patients seems necessary.

Antineoplastic Agents↗