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Biomedical subjects

D Crowther

Publications and source records attributed to D Crowther.

260 records · Page 15Linked to original sources

VAD chemotherapy--toxicity and efficacy--in patients with multiple myeloma and other lymphoid malignancies.

Thirty-three patients with multiple myeloma (11 untreated, 15 refractory and seven relapsed patients) have received vincristine and adriamycin infusion therapy with oral dexamethasone (VAD). The median number of course received was five. In addition 16 patients with lymphoid malignancy have received a median of four courses of VAD. Three patients who relapsed after VAD have received further VAD therapy making 52 patient treatments assessable for toxicity. Ten per cent had nausea, 4 per cent vomiting, 4 per cent total alopecia, 25 per cent constipation, 33 per cent paraesthesiae, 8 per cent proximal myopathy, 33 per cent dyspepsia, 23 per cent proven bacteraemia, and 19 per cent chest infections. Infections were not usually associated with neutropenia. Shingles was seen in four patients with myeloma, but none of the patients with lymphoid malignancy. The response rate in myeloma was 9/11, for previously untreated patients, 3/7 for relapsed, and 8/15 for refractory patients. Responses have been seen in other lymphoid malignancies-1/2 patients with relapsed acute lymphoblastic leukaemia had a complete remission. Two out of seven patients with chronic lymphocytic leukaemia achieved a partial remission, and a further three had a clinical improvement. Three out of six patients with non-Hodgkin lymphoma and one patient with macroglobulinaemia achieved a partial remission.

Adult↗

Complementary therapy in practice.

Dorothy Crowther describes the evolution of the Wirral Holistic Care Services, a company dedicated to helping people cope with cancer. Based on a recognition that such patients want more than the standard NHS fare, initial evaluations suggest that the company is going some way to meeting the extra needs of this group. Available therapies include aromatherapy, kinesiology, reflexology and meditation, incorporating a model of care which endorses putting the patient first.

Adaptation, Psychological↗

Effects of BCG and Corynebacterium parvum on immune reactivity in melanoma patients.

Sixteen patients with disseminated melanoma were immunised with either BCG (8 cases) or C. parvum (8 cases) on three occasions at 21 day intervals. Blood for assay was taken immediately before the first immunisation and weekly for eight weeks thereafter. Total white count tended to increase but little change was seen in lymphocyte and monocyte counts. Serum IgG increased after BCG BUT NOT WITH C. parvum, serum IgA and IgM did not alter. The 'E' rosette % did show some increase mainly after C. parvum, and 'B' lymphoid cells (sIg staining) increased slightly after BCG; the 'EA' rosette % fell following C. parvum but not after BCG. Lymphocyte PHA blastogenesis increased after immunisation, particularly with BCG. Non-specific lymphocytotoxicity (51 Cr Chang target) demonstrated dramatic increases for 'non T' and 'K' cell function and a smaller increase in 'T' cell cytotoxicity following immunisation. These increases in cytotoxicity were maintained by the 21 day immunisation schedule.

BCG Vaccine↗

A phase I study of recombinant human interleukin-4 administered by the intravenous and subcutaneous route in patients with advanced cancer: immunological studies.

The effects of recombinant human interleukin-4 (rhu IL-4) on immunological parameters in patients receiving increasing doses of IL-4 in a Phase I trial were investigated. Peripheral blood mononuclear cells were phenotyped for a variety of lymphocyte markers, but no consistent effects were observed. However, increases in HLA Class II expression on monocytes were detected in four patients. NK and LAK activity were neither induced nor augmented by IL-4 treatment. Slight increases in proliferative responses to mitogens and cytokines were observed in some patients. The latter observations and other clinical studies suggest that a combination of IL-4 with IL-2 may be more effective in Phase II clinical trials.

Cell Division↗

Treatment of lymphoid cell malignancy with In-114m labelled autologous lymphocytes.

This paper is a preliminary report of a clinical trial for the treatment of patients with refractory chronic lymphocytic leukaemia, using autologous In-114m-labelled lymphocytes. Fourteen patients have been treated so far with doses ranging from 69 to 211 MBq. All patients had progressive low grade NHL, resistant to chemotherapy and conventional radiotherapy. Following the intravenous administration of radiolabelled autologous lymphocytes 53% (range 33-92%) of the activity accumulated in the spleen, 35% (21-64%) in the liver and 5% in the bone marrow. The initial response in all patients was a rapid decrease in lymphocyte count in peripheral blood. 10 of the 14 (72%) patients showed a response to the treatment. In 2 patients, there was a complete response which lasted 24 and 36 months respectively, 8 patients showed a partial response of 2 to 17 months duration. None of the patients experienced any subjective toxicity although myelosuppression was seen in all patients. This is a novel concept for the administration of therapeutic radiation in a selective way for the treatment of lymphoid cell malignancy and has produced significant antitumour effect in patients with highly resistant disease. The trial is ongoing and a full report will be published on its completion.

Aged↗