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Biomedical subjects

E Bouffet

Publications and source records attributed to E Bouffet.

149 records · Page 9Linked to original sources

Isolated intraspinal relapse of neuroblastoma after autologous bone marrow transplantation.

Neuroblastoma may present with spinal cord compression due to dumbbell extension of thoracic or abdominal disease. Isolated intraspinal involvement as the sole site of relapse is rare. Two infants with poor-prognosis stage IV neuroblastoma presented early after high-dose therapy and autologous bone marrow transplant with isolated spinal relapse heralded by misleading symptoms. The rarity of such isolated relapses is reviewed, and an etiologic hypothesis is proposed.

Bone Marrow Transplantation↗

Initial management of advanced Burkitt lymphoma in children: is there still a place for surgery?

This retrospective study compared the overall survival, the event-free survival, and the timing of chemotherapy in patients with advanced Burkitt lymphoma with and without laparotomy. Thirty-five patients with advanced abdominal Burkitt lymphoma treated at least partially at the Centre Léon Bérard between 1981 and 1992 were included in this study. The diagnosis was obtained by laparotomy (LAP group) in 21 patients (17 stage III, 4 stage IV) and by other methods (non-LAP group) in 14 patients (5 stage III, 9 stage IV). The overall survival (71 and 93%) and the event-free survival (66 and 79%) were similar in the LAP and non-LAP groups, and the relapse rate was five (three local) in the LAP group compared with three (none local) in the non-LAP group. The local complication rate (9 of 21 versus 2 of 14) and the toxic death rate (2 of 21 versus 1 of 14) were slightly higher in the LAP group. Laparotomy also caused delays in therapy and increased the overall hospital stay. The mean interval from diagnosis to the start of the fourth course of chemotherapy was 57 days compared with 48 days and the average hospital stay was 44.4 days compared with 39 days for the LAP and non-LAP groups, respectively. Because advanced Burkitt lymphoma can be diagnosed by fine-needle aspiration, and chemotherapy cures more than 80% of the patients, there is no need for initial surgery, apart from acute emergencies. Furthermore, laparotomy delay chemotherapy and might reduce the survival rate.

Adolescent↗

Can MIBG scan replace the need for bone marrow assessment at diagnosis and reassessment in stage 4 neuroblastomas?

UNLABELLED: Complete staging (extensive marrow investigation and meta-iodo benzylguanine (MIBG) scan) is considered as mandatory both at diagnosis and after chemotherapy for assessment of metastases in neuroblastomas. However the correlation between bone marrow invasion and uptake of MIBG at metastatic sites remains unclear. This study investigates whether MIBG alone is sufficiently sensitive to make these procedures redundant. PATIENTS AND METHODS: 20 children over one year of age, with histologically proven metastatic neuroblastoma were studied. Extensive bone marrow assessment and MIBG bone scan performed both at diagnosis and after completion of induction chemotherapy were reviewed. RESULTS: At diagnosis metastases were detected by marrow investigation alone in 2, MIBG alone in 2 and both procedures in 16. After induction chemotherapy metastases were detected by only marrow investigation in 2, by only MIBG in 3, by both procedures in 6 patients, and by none in 9. CONCLUSIONS: Whether marrow investigations and MIBG scan explore the same phenomenon remains unclear. However it appears that marrow disease that is histologically detectable may remain MIBG negative both at diagnosis and after treatment. Both procedures are still justified at time of diagnosis and evaluation of response.

3-Iodobenzylguanidine↗

[Massive chemotherapy and purged bone marrow autograft in severe neuroblastoma. Preliminary results apropos of 5 cases].

Massive chemotherapy with in vitro purged autologous bone marrow transplantation has benefited from better understanding of massive chemotherapy for solid tumors, and better search for bone marrow involvement; it may now be used for treatment of poor prognosis neuroblastomas. Authors report preliminary results of 5 cases (4 IV and 1 p III b stage of TNM classification) completely treated in one institution (Centre Léon-Bérard, Lyon, France). Three patients are in complete remission, and 2 have relapsed (median follow up: 18 months). Authors comment on these results.

Adrenal Gland Neoplasms↗