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Biomedical subjects

C Pochedly

Publications and source records attributed to C Pochedly.

At least 37 records · Page 2Linked to original sources
PubMed1984

Dr. James A. Wolff. III. First pediatric hematologist at Babies Hospital.

Since there was no position for a full-time pediatric hematologist, Dr. Wolff practiced general pediatrics for 10 years while he volunteered as director of the hematology clinic at the Babies Hospital. He was appointed full-time Director of Pediatric Hematology in 1959. His early clinical studies were concerned with treatment of erythroblastosis fetalis and use of frequent transfusions and desferroxamine in children with thalassemia. The combined tumor clinic at the Babies Hospital, established in 1952, was one of the first to use the multidisciplinary approach to treatment of the child with cancer. In 1957, the Children's Leukemia Group A, later called the Children's Cancer Study Group, was established by Dr. Joseph Burchenal. Dr. Wolff was one of the first members. This group led to the establishment of various national intergroup committees for clinical study of cancers in children. In 1954, Farber began to use dactinomycin for treatment of Wilms' tumor. At first this drug was used only for treatment of metastatic tumors, but later it was also used to prevent metastases. Subsequently, other childhood tumors were found to be amenable to chemotherapy.

Hematology↗
PubMed1979

Prophylactic CNS therapy in childhood acute leukemia: review of methods used.

By use of prophylactic CNS therapy in children with ALL, the incidence of central nervous system relapse was dramatically reduced and the length of the initial bone marrow remission was significantly prolonged. Following thin's Research Hospital. Ten additional CNS therapy regimens were found which gave results equivalent to, but not better than, the St. Jude results. Our knowledge of CNS leukemia in general has greatly increased, but the last 8 years have brought us no further significant progress as to an improved regimen for prophylactic CNS therapy. Thus, 5--10% still show CNS relapse and one-third of children with ALL still have hematological relapse within the first 5 years following initiation of therapy.

Antineoplastic Agents↗
PubMed1978

Immunochemotherapy in advanced neuroblastoma.

Twenty-two children with advanced (Stage III and IV) neuroblastoma have been treated in a nonrandomized fashion, half with a three-drug regimen consisting of vincristine, adriamycin, and cyclophosphamide, and half with this same drug combination plus the nonspecific immunostimulatory agent, MER/BCG. The addition of MER to the three-drug combination appeared to improve the duration of survival in this pilot study. The median duration of response was less than one year in the combination chemotherapy alone arm. The median duration of complete remission in children treated with the addition of MER has yet to be reached at 24 months.

Antineoplastic Agents↗
PubMed1977

Neurotoxicity due to CNS therapy for leukemia.

CNS symptoms ranging from mild to lethal have occurred following CNS radiotherapy and intrathecal chemotherapy. Cranial radiotherapy often produces signs of mild encephalopathy, with predominance of somnolence. In rare cases, it appears that CNS radiotherapy may be followed by progressive encephalopathy. Intrathecal methotrexate frequently causes symptoms of meningeal irritation. Occasionally cases of weakness and paralysis, and rare instances of severe encephalopathy, may occur. However, in leukemic children treated with intensive chemotherapy and CNS radiotherapy who develop neurological complications, it is often difficult to determine which of many possible factors may be causing the CNS symptoms. The pathogenesis of the various forms of methotrexate neurotoxicity is poorly understood. The best-established cause for these symptoms is high concentrations of methotrexate in the CSF or porlonged exposure of the brain to low CSF concentrations of methotrexate. These elevated concentrations of the drug may in turn be due to impaired elimination of the drug from the cerebrospinal fluid (usually due to overt CNS leukemia) or to increased dosage in relation to cerebrospinal fluid volume (due to adolescent age). Leukoencephalopathy is occasionally found at autopsy in children given intensive therapy with CNS radiotherapy and intrathecal methotrexate, together with intensive systemic chemotherapy. It was proposed that alteration of the blood-brain barrier by cranial radiotherapy allows systemically administered anti-leukemic drugs to enter the brain and to cause necrotic changes in the CNS white matter. Leukoencephalopathy also occurs following intraventricular administration of methotrexate. CNS-toxicity due to intrathecal cytosine arabinoside is clinically similar to the symptoms seen following intrathecal methotrexate.

Adolescent↗
PubMed1976

How does leukemia invade the central nervous system?

Prolongation of survival of children with acute leukemia by systemic therapy has brought a marded increase in incidence of CNS leukemia. In mice inoculated with leukemia cells, CNS i nfiltrates are rare unless life is prolonged by chemotherapy. Available evidence seems to indicate that leukemic cells in the CNS in most cases originate in bone marrow or lymph nodes.

Acute Disease↗
PubMed1976

Treatment of meningeal leukemia.

Chemotherapy via the intrathecal and intraventricular routes with the use of up to three drugs plus radiotherapy have produced remissions so prolonged that it is now practical to think of a "cure" rather than simple palliation of this disease. A promising treatment protocol is described in which radiotherapy is combined with and followed by intraventricular methotrexate and cytosine arabinoside.

Catheterization↗