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Biomedical subjects

E Benhamou

Publications and source records attributed to E Benhamou.

At least 73 records · Page 4Linked to original sources
PubMed1989

Hemorrhagic cystitis following high-dose chemotherapy and bone marrow transplantation in children with malignancies: incidence, clinical course, and outcome.

Two hundred ninety-one courses of high-dose chemotherapy (HDC) with bone marrow transplantation (BMT) in children with malignancies were reviewed in order to assess the incidence, clinical course, outcome, and predisposing factors of hemorrhagic cystitis. Hemorrhagic cystitis occurred in 19 HDC courses (6.5%). Three patients had grade I hematuria linked to thrombopenia, nine had grade II hematuria despite platelet levels greater than 50 x 10(9)/L, and seven had grade III hematuria with clots and bladder obstruction. Severe complications occurred in grade III patients, but no deaths were directly linked to the cystitis. Fourteen patients recovered within two to 120 days of onset. The other patients died before the cystitis resolved, either of a relapse of the malignancy or of infection. Predisposing factors were age (increased incidence in older children), conditioning regimen containing cyclophosphamide, previous vesical irradiation, association with prolonged aplasia, and hepatic complications. The role of busulfan was also probable. No viral agent was found.

Adolescent↗
PubMed1989

Varicella-zoster virus infections after autologous bone marrow transplantation in children.

We report a retrospective analysis of children who underwent autologous bone marrow transplantation (ABMT) and subsequently developed a varicella-zoster virus (VZV) infection. Among 236 patients transplanted between January 1979 and December 1987, 54 (23%) aged 2 to 18.5 years (mean 7.2) developed 60 VZV infections (25%); there were 10 cases of chicken-pox in 10 patients, 43 zoster infections in 41 patients and seven disseminated zoster infections in seven patients. Eighty-seven percent of VZV infections occurred within the first 6 months after bone marrow transplantation, with a mean interval of 89 days. No significant risk factors for the development of zoster infections were identified. The incidence of VZV infections following ABMT was similar to that observed after allogeneic bone marrow transplant but the onset was earlier after ABMT (3 vs 5 months) and there were fewer complications (2 vs 18%). Acyclovir and/or adenine arabinoside were administered to 46 patients. One child who had had chicken-pox died of interstitial pneumonitis due to VZV despite antiviral therapy. No other symptomatic visceral dissemination was observed.

Adolescent↗
PubMed1989

Hemopoietic reconstitution after repeated autologous transplantation with mafosfamide-purged marrow.

Twenty-nine children (median age: 41 months) with advanced solid tumors received, as consolidation therapy, two consecutive courses of high-dose chemotherapy (HDC) followed by mafosfamide-purged autologous marrow transplantation (ABMT) with a 3- to 4-month interval between each course. The malignancies were neuroblastoma (n = 22), Ewing's sarcoma (n = 5) and rhabdomyosarcoma (n = 2). Patients received a preparatory regimen consisting of combined high-dose melphalan before each ABMT, with the exception of five patients who received busulfan and cyclophosphamide before the second ABMT. Prior to HDC, bone marrow sufficient for two transplantations was harvested in remission, treated with mafosfamide (50 micrograms/ml) and cryopreserved. Following incubation with the drug, a consistent inhibition (greater than 99%) of granulocyte and macrophage colony-forming units was observed. Despite the elimination of measurable hematopoietic progenitors, all patients underwent engraftment within a similar period of time after the first and the second ABMT. However, peripheral leukocyte and granulocyte recovery was delayed (median 26 and 28 days, respectively, after the first graft; median 27 and 28 days after the second graft). No difference was observed in the bacterial infections following the first and second ABMT. One patient died after the second transplant with diffuse aspergillosis. Recovery to 50 x 10(9) platelets/l occurred after a median 42 days (range 19-71) after the first ABMT and 43 days (range 14-110) after the second. Two patients died of recurrent disease before attaining a normal platelet level. One patient remained thrombocytopenic and died from visceral failure at day 200. These results demonstrate the feasibility of repeated ABMT with mafosfamide-treated marrow.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

[Hepatic complications after high-dose chemotherapy and bone marrow autograft in solid tumors in children].

Two-hundred and thirty-six courses of high-dose chemotherapy with bone marrow transplantation for solid tumors in children were reviewed in order to assess the incidence of hepatic abnormalities and their etiology. Bacterial and fungal hepatitis were excluded from this study. Hepatic complications occurred after 43 courses (20 per cent) in 39 patients. Four patients had hepatic abnormalities after two consecutive courses. Predisposing factors were found to be conditioning regimen including busulfan and previous high dose chemotherapy. Veno-occlusive disease occurred in 11 children and had a fatal outcome in 4. In 9 children, hepatitis was a symptom of diffuse viral infection. In the other 23 courses, hepatitis was isolated but it was difficult to determine whether its etiology was viral (cytomegalovirus, Epstein-Barr virus, adenovirus, HBs, non A non B) or toxic. In these latter forms, the outcome was always good.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1988

Cancer of the larynx/hypopharynx, tobacco and alcohol: IARC international case-control study in Turin and Varese (Italy), Zaragoza and Navarra (Spain), Geneva (Switzerland) and Calvados (France).

A case-control study on larynx and hypopharynx cancer was carried out in 6 populations including the city of Turin and the province of Varese (Italy), the provinces of Navarra and Zaragoza (Spain), the canton of Geneva (Switzerland), and the département of Calvados (France). This report presents an analysis of the risk associated with alcohol and tobacco consumption based on 1,147 male cases and 3,057 male population controls. Special attention was given to the study of the risk at various sites of larynx and hypopharynx. The effect of tobacco is similar for all sites and the risk associated with ever smoking is on the order of 10. The risks from alcohol drinking depend on site. They are similar for epilarynx and hypopharynx (RR = 4.3, for more than 80 g/day) and lower for endolarynx (RR = 2.1, for more than 80 g/day). For all sites the risk decreases after quitting (RR = 0.3 after 10 years); exclusive use of filter cigarettes is protective (RR = 0.5 relative to smokers of plain cigarettes only) as is exclusive use of blond tobacco (RR = 0.5 relative to smokers of black tobacco only). Inhalation increases the risk of endolaryngeal cancer but not that of hypopharynx or epilarynx. The relative risks for joint exposure to alcohol and tobacco are consistent with a multiplicative model.

Adult↗
PubMed1988

Cosmetic results following lumpectomy, axillary dissection and radiotherapy for small breast cancers.

Between 1970 and April 1982, 592 women with T(1), small T2, N0, N1, M0 breast cancer were managed by lumpectomy, axillary dissection and radiotherapy at the Institut Gustave-Roussy (IGR). The overall cosmetic result and the degree of asymmetry, fibrosis and telangiectasia of the treated breast were assessed by the radiation oncologist at each follow-up visit. The changes in these cosmetic parameters with time are shown. At 5 years the overall cosmetic result was excellent in 59%, good in 38% and fair or poor in 8%. A multivariate analysis was performed of the factors associated with a cosmetic defect. The most significant factors were tumour size, the presence of defect after surgery and the daily applied dose per fraction to the breast. Surgical and radiotherapy technique (especially alternate day fractionation) can significantly affect the cosmetic result obtained.

Axilla↗
PubMed1988

Nonbacterial nonfungal interstitial pneumonitis following autologous bone marrow transplantation in children treated with high-dose chemotherapy without total-body irradiation.

Between February 1979 and May 1986, 165 children were treated with autologous bone marrow transplantation after high-dose chemotherapy without total-body irradiation for a hematologic malignancy or a solid tumor. Nonbacterial nonfungal interstitial pneumonitis was observed in 24 children and was the cause of death in 11 cases. Of the 24 cases of interstitial pneumonitis, 14 were considered to be idiopathic. Cytomegalovirus was the major pathogenic agent detected in the 10 other cases of interstitial pneumonitis (n = 5), followed by Herpes zoster (n = 2), Pneumocystis carinii (n = 1), tumor (n = 1), and adenovirus (n = 1). The only factor found to correlate significantly with the increased rate of interstitial pneumonitis was the use of high-dose 1-3 bis chloroethyl-1 nitrosourea (BCNU) (600 mg/m2), whereas BCNU at a dose of 300 mg/m2 did not affect this rate. These data, when compared with the literature, show a lower incidence of interstitial pneumonitis than in allogeneic transplantations, and an incidence similar to that observed in syngeneic transplantations, although there was no radiation toxicity in this series.

Adenovirus Infections, Human↗
PubMed1988

Occupational risk factors of lung cancer in a French case-control study.

A case-control study of 1625 histologically confirmed cases of lung cancer and 3091 controls matched for sex, age, hospital admission, and interviewer was conducted in France between 1976 and 1980. The results presented concern the effects of different occupations on the occurrence of lung cancer among 1334 male cases and 2409 matched controls. Occupations were coded blindly according to the International Standard Classification of Occupations. An excess risk of lung cancer was observed for the following occupations after adjustment for cigarette exposure: farmers (RR = 1.24, p less than 0.06), miners and quarrymen (RR = 2.14, p less than 0.02), plumbers and pipe fitters (RR = 1.80, p less than 0.04), motor vehicle drivers (RR = 1.42, p less than 0.01).

Agricultural Workers' Diseases↗
PubMed1988

Veno-occlusive disease of the liver following high-dose chemotherapy and autologous bone marrow transplantation in children with solid tumors: incidence, clinical course and outcome.

Two hundred and thirty-six consecutive courses of high-dose chemotherapy with autologous bone marrow transplantation in children with solid tumors were reviewed in order to assess the incidence, clinical presentation and outcome of veno-occlusive disease (VOD) of the liver. Patients conditioned with total body irradiation were excluded from this study. Eleven patients (4.6%) met the diagnostic criteria for VOD. The clinical course included sudden weight gain, jaundice, hepatomegaly and ascites. Renal dysfunction and refractoriness to platelet transfusions occurred in the most severe forms. Seven patients recovered within 7-29 days of onset and four patients died, all with renal failure and fluid overload. The time of onset appeared to determine two patterns of outcome: mild forms with early onset (before day 11) and more severe forms with onset after day 17. Analysis of pretransplant factors revealed no significant association with an increased risk of VOD. However, all the patients with severe VOD had received a conditioning regimen containing cyclophosphamide which might be involved in the pathogenesis of VOD.

Adolescent↗
PubMed1988

[Prophylaxis of Gram-positive infections after bone marrow graft. Controlled study of the 6-day administration of vancomycin. Intermediate analysis of 60 patients].

We prospectively evaluated after randomization in 60 consecutive recipients of bone marrow transplantation the efficiency of a short administration of vancomycin (10 mg/kg I.V. q 6 H, day -5 to +1). Thirty-three patients were randomized as controls and 27 were designed to receive vancomycin. Both groups were similar in terms of age, diagnosis, status, allogeneic or autologous graft, in vitro marrow treatment or not. Eighteen patients (30%) experienced bacteremias: 15/18 bacteremias were due to Gram positive organisms, including 11 streptococci. These infections occurred with a similar frequency in both groups, the relatively low incidence of bacteremias in this study needs further evaluation in new patients to insure the prophylactic effects of a course of vancomycin in bone marrow transplant recipients.

Adolescent↗
PubMed1988

[Metastatic neuroblastoma: consolidation treatment with 2 courses of high-dose chemotherapy followed by a bone marrow autograft].

Among 62 children over 1 year of age at diagnosis who were treated for stage IV neuroblastoma, 33 entered remission after conventional therapy. They received high-dose chemotherapy and in vitro purged bone marrow transplantation as consolidation therapy. Fifteen patients received one course and 18 two courses. At present, 16/33 grafted patients are alive in CR with a median follow-up of 28 months. Toxicity of this regimen was tolerable. Under this treatment, actuarial disease free survival is improved compared with that observed under conventional therapy.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1988

[Comparison between single-dose and hyperfractionated total-body irradiation for the conditioning of allogenic grafts of the bone marrow. A retrospective study of 54 patients with malignant hematologic diseases].

The present study is a retrospective analysis of 54 patients with hematological malignancies who were treated by total body irradiation (TBI) and allogenic bone-marrow transplantation from 1982-1986. Patients were not randomly assigned to receive either single dose total body irradiation (STBI) (10 Gy x 1-4 cGy/min-lung dose 8 Gy) or hyperfractionated total body irradiation (HTBI) (1,20 Gy x 11-3 fractions/day-lung dose 9 Gy). Thirty one patients received STBI and 23 a HTBI regimen. Despite the presence of a large proportion of patients with a high risk of leukemic relapse in the HTBI group, the incidence of relapse did not differ significantly in the two groups: STBI (16%), HTBI (21%). Lung and liver toxicity were predominant in the STBI group. Interstitial pneumonitis occurred in 45% of the STBI patients versus 13% in the HTBI group. This difference remains significant when adjusted to the incidence of graft versus host disease (GVHD) in the two groups. Three cases of veino-occlusive disease were observed (10%), but only in the STBI group. Even when differences in age and the frequency of GVHD are considered in the two groups, these findings suggest that HTBI is at least as effective as STBI and that toxicity is reduced with this schedule.

Actuarial Analysis↗
PubMed1987

Management of the axilla in conservatively treated breast cancer: 592 patients treated at Institut Gustave-Roussy.

Between June 1970 and April 1982, 592 patients with unilateral T1 and small T2 breast cancers were managed conservatively at the Institut Gustave-Roussy. The treatment policy for the axilla was to perform a lower axillary dissection and to proceed to axillary clearance ( +/- radiotherapy) in patients with axillary invasion by tumor (N+). Some N+ patients had only lower axillary dissection and radiotherapy. Five hundred fifty-eight patients underwent axillary surgery which was a lower axillary dissection in 374 patients (67%) and axillary clearance in 184 patients (33%). There was axillary invasion in 198 cases (36%). Only five patients relapsed in the axilla and the probability of axillary relapse at 5 years was 1.2%. There were no axillary relapses in N+ patients who had had an axillary clearance whether irradiated or not. The incidence of upper limb complications was significantly greater in patients undergoing axillary surgery and radiotherapy compared with axillary surgery alone (p less than 0.0001). It is concluded that a lower axillary dissection accurately identifies N-patients and an axillary clearance in N+ patients ensures good local control and avoids the morbidity associated with axillary irradiation.

Adult↗
PubMed1987

Lung cancer and women: results of a French case-control study.

Ninety-six women with histologically confirmed lung cancer and 192 matched controls were involved in an international case-control study conducted from 1976 to 1980. The aim of this study was an examination of the effects of different smoking habits, especially the type of cigarettes smoked (light or dark tobacco and filter or nonfilter use) on the occurrence of lung cancer in French females. All these patients were either nonsmokers or lifetime cigarette smokers. Matched relative risk (RR) of smokers compared to nonsmokers was found to be increased for both Kreyberg I (RR = 6.6) and Kreyberg II (RR = 2.1) categories; however, this increase was significant (P less than 0.0001) only for Kreyberg I lung cancer. A significant increase (P less than 0.0001) in matched RR was found with early age at first cigarette smoked, daily consumption, duration of smoking, frequency of inhalation, use of dark tobacco and use of nonfilter cigarettes. Matched RR associated with smokers not always using dark tobacco and those smoking only dark tobacco as compared to nonsmokers were significantly increased (trend test P less than 0.0001). On the contrary, the increase of RR was not significant when either daily consumption, or duration of smoking, or age at first cigarette was taken into account. Lung cancer appeared to be associated with daily consumption and use of nonfilter cigarettes in a matched logistic regression.

Adult↗