We have performed laparotomy and splenectomy for seventy patients with Hodgkin's disease. Among 43 stages I or II before exploration, primary laparotomy revealed ignored abdominal localizations in 16 cases (37,2%). Involvement of the spleen occurred in 13 of these 16 patients, lonely (5 cases), associated with positive nodes (4 cases) or associated with positive nodes and liver involvement (4 cases). Among 4 stages III before exploration, no regression was found. Among 9 patients with presumed stages I or II above the diaphragm and previously treated by radiotherapy, delayed laparotomy revealed abdominal relapse in 6 cases. At last, among 14 patients with obvious stages II or IV and previously treated by combination chemotherapy, laparotomy, caused by persistent evolutive signs, showed residual localizations under the diaphragm in 8 cases. According to these results, we preconise immediate laparotomy in almost all presumed stages I or II above the diaphragm. About third of these subjects have their staging advanced to stage III or IV and, according to us must be treated by combination chemotherapy while the remaining cases justify of radiotherapy. In obvious stages III and IV delayed laparotomy may be useful in some circumstances, after chemotherapy.

Cobalt Radioisotopes↗

PubMed1976

[Little known treatment of primary polycythemia: pipobroman (apropos of 19 cases)].

Explore the source record for details and available documents.

Adult↗

PubMed1975

[Cardiac insufficiency caused by the use of daunorubicin. Clinical and developmental study of 4 recent cases].

Out of a total of 126 patients with acute lymphoblastic leukemia, including 69 children aged less than 15 years, and 57 adults aged less than 60 years, who were treated with daunomycin (D.N.R.) initially and with several courses of reinduction, we noted 4 cases of decompensated heart failure (3.1%). 3 cases occurred in children aged 4, 5 and 5 years, and in the last case, in a young adult, of 19 years. Three of these patients were in complete remission of the blood and were only undergoing courses of reinduction. The 4th was in incomplete remission. When symptoms first occurred, about 2 months after the last injection of D.N.R. the total dose administered varied between 14 and 31 mg/kg, extending over periods of 5 to 16 months (average monthly dose 1.9 to 2.8 mg/kg). Except in one case, the course only mildly influenced by the symptomatic treatment and death occurred in 3 patients within from 15 days to 5 months after the onset of the first symptoms. The last patient is still alive and seems stabilised with a follow up period of 9 months. The responsibility of D.N.R. in the development of this myocarditis appears very likely. The unforeseable character of such complications, which are independent of age, and not necessarily linked to any excessive dosage, should be taken into consideration in the indications for D.N.R. in spite of their relative rarity.

Adult↗

PubMed1975