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Biomedical subjects

D Crowther

Publications and source records attributed to D Crowther.

At least 253 records · Page 14Linked to original sources
PubMed1970

Combination chemotherapy using L-asparaginase, daunorubicin, and cytosine arabinoside in adults with acute myelogenous leukaemia.

Cytosine arabinoside and daunorubicin used in an intensive intermittent regimen have been shown to be an effective combination for the induction of complete remissions in 14 out of 23 adult patients with acute myelogenous leukaemia. This gives an overall complete remission rate of 60%. A further patient had a good partial remission. The addition of L-asparaginase to the regimen has not increased the incidence of remission and there were more side effects in the L-asparaginasetreated group. Of the 10 patients treated with L-asparaginase in addition to cytosine arabinoside and daunorubicin, five achieved a complete remission. Of the 13 patients treated with cytosine arabinoside and daunorubicin without L-asparaginase, nine achieved a complete remission and one a good partial remission.

Adolescent↗
PubMed1970

Combination chemotherapy in generalized Hodgkin's disease.

Fifty-two patients with generalized Hodgkin's disease were treated with a combination of mustine hydrochloride, vinblastine, procarbazine, and prednisolone. Complete remissions were obtained initially in six out of seven patients (86%) who had previously received no treatment, in 15 out of 19 (79%) who had had only radiotherapy in the past, and in 9 out of 26 (35%) who had previously been given chemotherapy with or without radiotherapy. Of these 30 patients in whom a complete remission was obtained 22 have been free of any symptoms or signs of disease for periods ranging from 4 to 22 months. The response to treatment was rapid, and toxicity was not a major problem, except in those who had previously been treated with cytotoxic drugs used continuously and not in courses. A comparative trial of radiotherapy and combination therapy in the treatment of Stage III Hodgkin's disease is strongly recommended.

Antimetabolites↗
PubMed1970

L-asparaginase in treatment of acute leukaemia and lymphosarcoma.

L-Asparaginase was used to treat 40 patients with acute leukaemia or lymphosarcoma. Fifteen with acute lymphoblastic leukaemia either untreated or in relapse after previous therapy were given "Squibb," "Bayer," or "Porton" L-asparaginase. Five of these patients had complete remission of their disease, and four had good partial remission. Eleven patients with acute myeloid leukaemia were treated for a short period with L-asparaginase alone. None of them went into remission though a pronounced fall in the numbers of circulating white cells was seen. Six patients with lymphosarcoma received L-asparaginase, two of them having good partial remissions.The toxic side-effects of the L-asparaginase from the three sources seemed to vary, and L-asparaginase from Erwinia carotovora appeared to be antigenically different from the enzyme produced by Escherichia coli.The way in which leukaemic cells become resistant to the action of the enzyme requires further investigation. To overcome this resistance asparaginase should be used in combination with other drugs in the treatment of acute leukaemia.

Acute Disease↗
PubMed1969

Active immunotherapy in treatment of acute leukaemia.

Active non-specific immunotherapy has been used to prolong remissions in acute lymphoblastic leukaemia. The series reported here used Bordetella pertussis vaccine in a controlle trial after intensive chemotherapy. Possibly immunotherapy delayed the onset of relapse in the treated patients, but no long-term remissions were obtained. Further work is needed to establish the role of immunotherapy in general, and the use of B. pertussis vaccine in particular, in the treatment of acute leukaemia.

Acute Disease↗
PubMed1969

Lymphoid cellular responses in the blood after immunization in man.

A combined morphological and metabolic study has been made of the lymphoid cells in the blood during the immune response in man. Similar changes were observed in both primary and secondary responses to a number of different microbial antigens. The cellular response involved an increase in numbers of three types of cell; hyperbasophilic medium lymphocytes, plasma cells, and large lymphoid cells. The large lymphoid cells were about 20 micro in diameter with large nuclei, prominent nucleoli, and an intensely basophilic cytoplasm with numerous polyribosomes. About 30% of these cells were in the DNA synthetic phase of cell growth. Electron microscopy has shown that many of the basophilic medium-sized cells have sufficient well-organized endoplasmic reticulum to be included in the plasma cell series. The hyperbasophilic cells labeled more heavily with tritiated uridine and tritiated leucine than the normal small and medium lymphocytes from the peripheral blood of patients not under antigenic stimulation. The evidence in this paper supports the argument that the atypical mononuclear cells first described by Türk and others in the blood of patients with infections are immunoblasts, plasma cells, and other reactive lymphoid cells representing a circulating population of lymphoid cells derived from lymphoid tissue responding to antigenic stimulation. The presence of such cells may be a valuable indication that an immunological reaction is in progress when direct proof is lacking.

Antibody Formation↗
PubMedDate not supplied

Factors affecting remission and survival in patients with advanced Hodgkin's disease treated with MVPP.

One hundred and fourteen patients with clinical or pathological stages IIIB and IV Hodgkin's disease have been treated with MVPP chemotherapy followed by radiotherapy to sites of previously bulky disease. The minimum follow-up is 2 years with a median of 5 years. The overall remission rate was 92 per cent with 74 per cent achieving CR. A discriminant analysis showed that the presence of bulky disease was the only independent factor that predicted a lower chance of CR (66 per cent vs 82 per cent, P = 0.045). The 5-year survival was 70 per cent overall and 85 per cent for CR patients. A Cox multivariate analysis demonstrated that stage III disease, age less than 36 years and female sex were all variables which independently predicted a more favourable prognosis in terms of overall survival. However, a similar analysis for survival of CR patients showed that age less than 36 years and the absence of bulky disease were the only two factors to independently predict a more favourable outcome. Of 14 patients who did not receive the chemotherapy according to protocol 5 have relapsed compared to 7 of 70 who did. A Cox analysis confirmed that this variable was the only one of significant prognostic import in predicting relapse-free survival. Using the Cox analyses we have been able to devise a scoring system which accurately predicts the outcome for these patients. This model may be useful in determining which patients have a worse prognosis following treatment with MVPP thus allowing more intensive therapy to be given to such patients while minimising treatment for those with favourable features.

Adolescent↗