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Biomedical subjects

D D Karp

Publications and source records attributed to D D Karp.

32 records · Page 2Linked to original sources
PubMed1989

Acute hypotensive reaction to etoposide with successful rechallenge: case report and review of the literature.

Hypotension, bronchospasm, and facial flushing associated with an intravenous infusion of etoposide occurred in a 38-year-old man with advanced testicular cancer. The reaction began within three minutes after the initiation of the infusion and was reversed with intravenous fluids and diphenhydramine. He was successfully retreated with four additional doses of etoposide after pretreatment with diphenhydramine and dexamethasone. The literature concerning similar anaphylactoid reactions to intravenous etoposide is reviewed.

Acute Disease↗
PubMed1987

Acute cerebellar syndrome, conjunctivitis, and hearing loss associated with low-dose cytarabine administration.

An unusual reaction associated with chronic low-dose cytarabine is described. A 77-year-old man complained of three to four weeks of hearing loss and progressive inability to walk without assistance. He had received two courses of cytarabine 100 mg sc/wk for the management of myelofibrosis myeloid metaplasia over 21 months. He received a total of 3 g over seven months during his first course followed ten months later with a 1.2 g over four months. Conjunctivitis was also identified on physical examination at the time of his admission. He was admitted to the neurology service where a complete neurological work-up with consultations from the ophthalmology, audiology, hematology, and ear, nose, and throat services failed to identify a cause of his symptoms. Cytarabine was discontinued on the suspicion that his symptoms were drug induced. The conjunctivitis resolved completely with ophthalmic antibiotics and corticosteroids. His hearing slowly improved over three to four weeks, and he was able to ambulate with a walker. He continued to improve at home although some hearing loss remained three months after his initial presentation. Although conjunctivitis and neurotoxicity are well-known complications of high-dose cytarabine, there are no prior reports of these reactions after low-dose therapy. Hearing loss, which has not been previously reported with cytarabine alone, appears to be a new complication of cytarabine administration.

Aged↗
PubMed1986

Staging with CT.

Explore the source record for details and available documents.

Humans↗
PubMed1985

Treatment of the blastic transformation of chronic granulocytic leukemia using high dose BCNU chemotherapy and cryopreserved autologous peripheral blood stem cells.

Seven nonsplenectomized patients with blastic CGL have received high dose BCNU chemotherapy followed by cryopreserved peripheral blood stem cells (PBSC). The PBSC obtained at diagnosis were stored in the vapor phase of liquid nitrogen in 10% dimethyl sulfoxide for 11-46 months prior to use. Patients received 2.9 X 10(8) (1.9-7.8) thawed washed mononuclear cells/kg over 30 minutes with minimal morbidity. One patient was not rendered pancytopenic and died with blastic leukemia at 4 months. One patient, previously treated with daily busulfan, died of progressive hepatic failure 2 months after high dose BCNU. Restoration of the chronic phase of CGL was observed in the remaining five patients. Peripheral blood counts returned to normal ranges after a median of 19 days. Median survival for all patients is 11 months. Cytogenetic studies revealed elimination of acquired aneuploid cell lines in four of seven patients with persistence of Ph1. We conclude that: 1) frozen PBSC retain their viability for up to 4 years after cryopreservation and 2) the use of autologous PBSC following ablative chemotherapy may be associated with both symptomatic and karyotypic improvement in patients with blastic CGL.

Adolescent↗
PubMed1985

Elevated plasma von Willebrand factor levels and arterial occlusive complications associated with cisplatin-based chemotherapy.

Factor-VIII-related von Willebrand factor (vWF) multimers are synthesized by endothelial cells, and plasma vWF antigen levels are elevated in some disorders associated with endothelial cell perturbation. We studied 13 patients during cisplatin-based combination chemotherapy for squamous cell carcinoma of the head and neck, esophagus, or lung. Before therapy, 3 of the patients had vWF antigen levels that were greater than or equal to 400% of normal; and further elevations occurred during chemotherapy. Two of these patients had cerebrovascular accidents, and the third had complications similar to the hemolytic-uremic and acute respiratory distress syndromes. No abnormalities in plasma vWF patterns were detected. Elevated plasma vWF antigen levels before therapy may identify a subgroup of patients at special risk for arterial occlusive complications following cisplatin-based chemotherapy.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1982

Pulmonary complications during granulocyte transfusions: incidence and clinical features.

The use of granulocyte transfusions in profoundly neutropenic patients has increased markedly in recent years. Whenever a pulmonary infiltrate develops during the course of these transfusions, the question arises as to what role the transfusions are playing and whether the transfusions should be discontinued to prevent pulmonary deterioration. We have analyzed our recent experience of 593 granulocyte transfusions in 93 patients. 18 patients (19%) developed respiratory compromise or pulmonary infiltrates at some time during the course of granulocyte transfusion. 6 of the 18 cases were reactions to the granulocytes while the remainder were due to fluid overload or other causes. The risk of pulmonary complications did not correlate with the development of cytotoxic leukocyte antibodies, length of transfusion, or concomitant use of Amphotericin. They appeared to be more common in patients with active sepsis. Acute life-threatening pulmonary reactions were rare. Patients receiving granulocyte transfusions should be monitored carefully for pulmonary infiltrates, but other cases should be sought before the transfusions are discontinued.

Acute Disease↗
PubMed1981

Anticoagulants, venous thromboembolism, and the cancer patient.

The records of 32 cancer patients who were treated with heparin sodium and warfarin sodium for thromboembolic disease were reviewed. Standard techniques for anticoagulation were neither safe nor effective. Sixteen patients experienced 21 different hemorrhagic complications. Eight patients had major hemorrhages that led to cessation of therapy or death. Six of 32 patients had pulmonary embolisms while receiving anticoagulants. It is suggested that venous interruption may be a safer and more effective method of prophylaxis against pulmonary embolism in cancer patients.

Adolescent↗
PubMed1981

Chronic granulocyte leukemia with respiratory distress. Efficacy of emergency leukapheresis.

In the absence of preexisting pulmonary disease, progressive respiratory failure caused by leukostasis associated with uncontrolled chronic granulocytic leukemia developed in two patients. The conditions of both patients improved dramatically with aggressive leukapheresis. Clinical improvement correlated with decreased pulmonary wedge pressure, while vascular volume remained constant. Continuous-flow cell separation removed numerous immature myeloid cells, replaced them with oxygen-carrying erythrocytes, and maintained a constant blood volume. The course of these two patients demonstrates the use of continuous-flow leukapheresis in an intensive care unit to reduce leukocyte count and manifestations of leukostasis rapidly, while improving the oxygen-carrying capacity of blood, without exposing the patients to dangerously large shifts in fluid volume.

Emergencies↗
PubMedDate not supplied

Adrenal corticosteroids as antiemetics during cancer chemotherapy.

Adrenal corticosteroids were first reported in 1979 to have antiemetic effects during cancer chemotherapy. Since then considerable numbers of trials have been conducted to evaluate their activity alone and in combination with other agents. The majority of the research has centered on dexamethasone, although other corticosteroids have been studied. Dexamethasone as a single agent is superior to placebo and appears to be more effective than standard doses of prochlorperazine when administered with highly emetic agents. Dexamethasone is comparable to metoclopramide against moderately emetogenic agents and low-dose cisplatin, but less effective than metoclopramide against highly emetic agents or high-dose cisplatin. Dexamethasone improves the activity of prochlorperazine and metoclopramide and may reduce some of the side effects associated with the latter. Current trials continue to explore the role of corticosteroids alone and in combination with antiemetics.

Antineoplastic Agents↗
PubMedDate not supplied

Role of chemotherapy in the multidisciplinary approach to advanced head and neck cancer: potentials and problems.

Chemotherapy as initial treatment for advanced squamous carcinoma has received much recent attention. Despite sparse experimental data supporting its usefulness, such chemotherapy is now used for a variety of advanced malignancies. This experience is conceptually reviewed, with special emphasis on squamous carcinoma of the head and neck. Factors which influence treatment results, such as drug dosage, radiation treatment planning, and surgical resection, will require careful analysis in the evolution of the multidisciplinary approach to advanced head and neck cancer.

Antineoplastic Agents↗