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Biomedical subjects

D Hammond

Publications and source records attributed to D Hammond.

161 records · Page 9Linked to original sources
PubMedDate not supplied

CytoGam infusions at home.

CytoGam is a hyperimmune globulin created specifically for prophylactic use when a cytomegalovirus seronegative patient receives an organ from a seropositive donor. CytoGam is derived from human pooled plasma rich with cytomegalovirus antibodies, immunoglobulin G, and trace amounts of immunoglobulin A and immunoglobulin M. Clinical studies show a marked decrease in the development of cytomegalovirus when transplant recipients are treated with CytoGam. CytoGam also has undergone trial testing for use in decreasing the instance of cytomegalovirus in patients with human immune deficiency virus (HIV). CytoGam therapy may continue for several months, making home intravenous care essential.

AIDS-Related Opportunistic Infections↗
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Dibromodulcitol (NSC-104800) compared with cyclophosphamide (NSC-26271) as remission maintenance therapy in previously treated children with acute lymphoblastic leukemia or acute undifferentiated leukemia: possible effectiveness in reducing the incidence of central nervous system leukemia.

Dibromodulcitol and cyclophosphamide are both alkylating agents. In this study, these two drugs were compared for their effectiveness as remission maintenance therapy for childhood acute lymphoblastic leukemia or acute undifferentiated leukemia. Toxic effects were similar in both groups of patients although cystitis did not occur with the dibromodulcitol treatment. The duration of remission was slightly shorter for dibromodulcitol than for cyclophosphamide (P = 0.04). There was, however, a lower incidence of CNS leukemia in the patients treated with dibromodulcitol, which did not seem to be related to a basic difference in the patient groups.

Blood Cell Count↗
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5-(3,3-Dimethyl-1-triazeno)imidazole-4-carboxamide (NSC-45388) in the treatment of solid tumors in children.

5-(3,3-Dimethyl-1-triazeno)imidazole-4-carboxamide (NSC-45388) was administered to 46 children with various solid tumors which were resistant to conventional therapy. Two or more courses of NSC-45388 were administered to 13 of 18 children with neuroblastoma, seven of 11 children with rhabdomyosarcoma, three of four children with Wilms' tumor, one of three children with Ewing's tumor, and six of ten children with miscellaneous neoplastic disorders. Major toxic effects included nausea, vomiting, decreased hemoglobin level, thrombocytopenia, and leukopenia. A therapeutic regimen of 200-450 mg/m2/day for 5 consecutive days can be administered safely every 22 days. Objective responses were observed in three children with neuroblastoma and in one child with rhabdomyosarcoma. This drug has minimal but definite activity as a single agent in children with advanced neuroblastoma and rhabdomyosarcoma and should be evaluated further in combination therapy.

Adolescent↗
PubMedDate not supplied

Phase II study of VP-16-213 in childhood malignant disease: a Children's Cancer Study Group Report.

VP-16-213, a semisynthetic podophyliotoxin, was tested for antitumor and clinical toxicity in 126 children. The drug was administered iv daily x 5 days every 2 weeks at a starting dose of 75 mg/m2/day. The dose was increased by 25 mg/m2/day/course until clinical response or significant toxicity occurred. The only major toxicity was hematologic, with neutropenia as the most predominant feature. There was one local allergic reaction at the site of injection. No systemic allergic responses were reported. The drug demonstrated significant activity in acute myelomonocytic leukemia with four responses among 19 patients, less activity in acute myelocytic leukemia with two responses among 44 patients, and little activity in acute lymphocytic leukemia with only one partial response among 12 patients. Objective partial responses occurred in ten of 48 patients with solid tumors: two each with Wilms' tumor, lymphoma, and histiocytosis X, and one each with rhabdomyosarcoma, neuroblastoma, Ewing's sarcoma, and undifferentiated carcinoma. The inclusion of VP-16-213 in combination chemotherapy for childhood acute myelomonocytic leukemia and acute myelocytic leukemia appears indicated in patients relapsing after initial therapy. For solid tumors this is an interim report, with further patient accrual required before specific comments can be made.

Bone Marrow↗
PubMedDate not supplied

Use of prognostic factors in improving the design and efficiency of clinical trials in childhood leukemia: Children's Cancer Study Group Report.

Prognostic factors are exerting an increasingly apparent and important influence on the results of comparative treatment regimens in childhood leukemia. Since February 1975, 883 previously untreated children with acute lymphocytic leukemia were entered in a protocol designed to evaluate prognostic factors that influence induction rate, remission duration, and survival and to identify subsets of patients with a high risk of early failure. Stratification was based upon the initial wbc count, and standard and more intensive induction and maintenance therapy programs were compared. The combination of older age (> 10 years), high initial wbc counts (greater than or equal to 20 x 10(9)/liter), and low serum IgG is associated with a significantly lower rate of induction of complete remission. The following factors were associated with an unfavorable prognosis with regard to bone marrow relapse and death: wbc count of greater than or equal to 20 x 10(9)/liter; age > 7 years old; CNS disease at diagnosis; L2 lymphoblasts; hemoglobin level greater than or equal to 11 g/dl; decreased concentration of serum immunoglobulin; and M3 marrow on Day 14 of induction. None of the 41 patients in the low-risk prognostic group (3-7 years old with an initial wbc count of < 10 x 10(9)/liter) with L1 blast cells, normal Ig, and M1 marrow on Day 14 has sustained an adverse event. Identification of prognostic factors should permit more efficient and effective design of future protocols by refining the classification of acute lymphocytic leukemia, decreasing the toxic risk to patients with a better prognosis, and improving the relatively poor remission duration and survival for patients with a poor prognosis.

Age Factors↗
PubMedDate not supplied

Phase II trail cisplatin in refractory childhood cancer: Children's Cancer Study Group Report.

A total of 114 children with solid tumors refractory to conventional therapy were evaluated for response and/or toxic effects after receiving cisplatin at doses of 3.0-4.5 mg/kg with aggressive hydration and mannitol diuresis every 3 weeks; a minimum of two courses was required for evaluation of response (110 patients). Objective responses were noted in 18 patients: rhabdomyosarcoma (three), Wilm's tumor (three), osteogenic sarcoma (three). Ewing's sarcoma (two), neuroblastoma (one), undifferentiated sarcoma (one), hepatoblastoma (one), ovarian teratoma (one), hepatocellular carcinoma (one), embryonal carcinoma of the mediastinum (one), and thymoma (one). Twenty-six patients had some evidence of renal toxicity. Asymptomatic hearing loss was commonly found when audiometry was performed (eight of 18 patients tested). Eight additional patients had symptomatic hearing problems--tinnitus or hearing loss. Myelosuppression was mild. Hypomagnesemia and/or hypocalcemia were common but only one patient had symptoms. Cisplatin, administered at a dose of 3.0 mg/kg with aggressive hydration and mannitol diuresis, is reasonably well-tolerated. Its role in the therapy for those tumors against which it shows activity remains to be determined.

Adolescent↗
PubMedDate not supplied

Comparison of the therapeutic response of patients with childhood acute lymphoblastic leukemia in relapse to vindesine versus vincristine in combination with prednisone and L-asparaginase: a phase III trial.

One hundred and seventy-nine previously treated children with acute lymphoblastic leukemia in relapse considered not "resistant" to vincristine (VCR) were randomly allocated to receive reinduction therapy with either vindesine (VND) or VCR, in combination with prednisone and L-asparaginase. Complete remission rates were 57% for both regimens and were significantly greater for first relapsers (69%) than for subsequent relapsers (43%). No significant difference in response rates by regimen was observed within relapse groups. Patients treated with VND experienced significantly greater hematologic toxicity. These data suggest that there is no advantage to using VND instead of VCR in standard reinduction therapy for childhood acute lymphoblastic leukemia in relapse.

Asparaginase↗
PubMedDate not supplied

Phase II evaluation of diglycoaldehyde (Inox) in children with acute leukemia: a children's cancer study group report.

A phase I trial of diglycoaldehyde (Inox) in children with leukemia established that the maximum tolerated dose of a 5-day schedule was 1.5 g/m2/day. A phase II study was undertaken by the Children's Cancer Study Group to evaluate the efficacy of this dose. Forty-seven children with acute leukemia refractory to conventional forms of therapy were entered in the study: 29 patients with acute lymphocyte leukemia/acute undifferentiated leukemia and 18 with acute nonlymphocytic leukemia. Inox was administered at a dose of 1.5 g/m2 as a 4-6 hour iv infusion daily for 5 days every 14 days. Toxic effects included myelosuppression, proteinuria, nausea, vomiting, diarrhea, local tissue reactions, hypocalcemia, transitory serum amylase elevation, and transitory hypotension. There was one life-threatening episode of drug-related renal toxicity. Of the 27 patients who received a minimum of two courses, partial remissions were observed in two patients with acute nonlymphocytic leukemia. Inox was inactive against advanced acute lymphocytic leukemia.

Acute Disease↗
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Cyclophosphamide (NSC-26271) maintenance therapy after a second remission of childhood acute lymphoblastic leukemia: comparative clinical trial (standard dose versus intermittent high dose versus cyclophosphamide plus cytosine arabinoside (NSC-63878)).

Children with acute lymphoblastic leukemia who had experienced only one relapse were reinduced into remission using a 6-week induction course of prednisone and vincristine. One hundred fifty-one children who achieved a second complete marrow remission were randomly assigned to one of three cyclophosphamide treatment groups for maintanence. Forty-one children received standard-dose cyclophosphamide (3 mg/kg/day), 55 received intermittent high-dose cyclophosphamide (10 mg/kg/day for 4 days out of 14), and 55 received a combination of oral cyclophosphamide (3 mg/kg/day) plus cytosine arabinoside (3 mg/kg/week im). The standard-dose cyclophosphamide regimen resulted in a remission maintenance time of 109 days and was the least toxic of the three maintenance regimens. Giving cyclophosphamide on an intermittent high-dose schedule or combining it with cytosine arabinoside did not increase the remission maintanence time (105 days).

Bone Marrow↗
PubMedDate not supplied

Home intravenous antibiotics. The safety factor.

Home intravenous antibiotic infusion now is a safe and effective alternative to patient hospital admittance. With careful guidelines to provide appropriate patient selection, education, care planning and device selection, home antibiotic infusion can reap impressive results. Patients are more satisfied when they receive i.v. antibiotic therapy in the comfort of their homes. Intravenous nurses provide the skill and expertise necessary for quality home i.v. antibiotic infusions. Home health agencies venturing into the world of home infusion will benefit from this article. These guidelines are appropriate for most types of home i.v. therapy, not merely antibiotic therapy.

Community Health Nursing↗