Bone marrow transplantation-1979.
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Biomedical subjects
Publications and source records attributed to F A Greco.
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Oat cell lung cancer is a common disease which is usually disseminated by the time it is diagnosed. Treatment with cyclic combination chemotherapy (cyclophosphamide, doxorubicin, vincristine) administered concurrently with radiotherapy to the chest lesion and subsequent prophylactic brain irradiation was investigated in 36 patients with oat-cell carcinoma of the lung. Complete remissions occurred in 26 of the patients (15 of the 16 with limited-stage disease and 11 of the 20 with extensive-stage disease). Symptomatic improvement occurred in all patients. Twelve of the 16 patients with limited disease remained well and free of disease for over a year. The results were equivalent to those of a similar though more intensive regimen, but the toxicity was much less (there were no treatment-related deaths). Transient granulocytopenia with the risk of infection was the most serious complication. Survival and quality of life have been improved for all patients, particularly those with limited disease, who have previously responded poorly to treatment.
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Nineteen patients with non-small-cell carcinoma of the lung were treated with high-dose methotrexate and leucovorin rescue. Two partial responses (10.5%) were observed, lasting 13 and 17 weeks. Toxicity was acceptable. It is concluded that the occasional benefit of high-dose methotrexate with leucovorin rescue at this dose and according to the schedule described for these patients does not warrant further study.
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Three similar cases are described of an unusual combination of malignant lymphoma and extensive non-necrotic granulomas. The three patients presented with prominent splenomegaly without peripheral lymphadenopathy. They had normal or moderately elevated lymphocyte counts, abnormal lymphoid cells in the peripheral blood and bone marrow, and abnormalities of serum immunoglobulins. The lymphoid tumor was difficult to recognize but it was best identified in abdominal lymph nodes, it was composed of small atypical lymphocytes proliferating in a vaguely nodular pattern. The presence of multiple epithelioid granulomas obscured the neoplastic proliferation in the spleens and misled or delayed the final interpretation of the malignant disease. Abdominal lymph nodes and liver also contained granulomas although to a lesser extent. Studies of the lymphocyte surface characteristics in one patient suggested that the neoplasm derived from a monoclonal proliferation of B cells. The relationship between the exuberant epithelioid granulomas and the underlying neoplastic lymphoid proliferation is not clear. Regardless of whether it represents a distinct clinicopathological entity, recognition of this remarkable association has important practical implications since the lesions may be erroneously interpreted by the pathologist.
Lithium carbonate (Li2CO3) increases circulating polymorphonuclear leukocytes (PMN) and perhaps granulopoiesis in man. 25 patients with advanced malignancies ingested Li2CO3 during a cycle of intermittent combination chemotherapy. Weekly hemoglobin, platelet, total white blood cell (WBC) and lymphocyte counts in the evaluable patients were not significantly different from cycles before and after the Li2CO3 cycles. However, the mean absolute PMN nadir while on Li2CO3 was 26% and 40% higher than the control cycles before and after Li2CO3 respectively. When compared individually, the PMN nadirs were significantly higher during the cycle with Li2CO3, than before (p = .05) or after (p = .05). The clinical and biological significance of this observation is presently unclear.
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