[Neuroblastoma study NBL 79 of the German Society for Pediatric Oncology. Report after 2 years].
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Child↗
Biomedical subjects
F Lampert
Publications and source records attributed to F Lampert.
[DNA-ploidy and proliferation in metastatic neuroblastoma].
Nuclear DNA contents of tumor cells were measures by fluorescence cytophotometry in bone marrow and touch preparations of 26 children with neuroblastoma, registered in the NBL79 study of the German Pediatric Oncology society. In all cases tumor cells were found to have a higher DNA-content as compared to the normal diploid (2c) DNA-value of granulocytes in the same preparation. Average ploidy values of the histograms of bone marrow metastases were in the tetra- to hypertetraploid (4c-5c) range and showed unimodal distribution in the majority of cases. In the primary tumors there was also a wide distribution of DNA-values in the aneuploid range. A bimodal distribution with stemlines at 2,5c and 5c was found in a stage I, grade I, differentiated primary tumor. Various ploidy patterns found at different sites in the large tumor mass of a newborn might be interpreted as an expression of different degrees of differentiation within the same tumor. In 2 of 4 patients where primary tumor and metastatic lesions could be examined there was a higher ploidy in the 5c to 6c, or even in the 8c range in the metastatic cell population. It appears, thus, that clonal evolution of tumor cells occurs during growth and spread of neuroblastoma.
Bone Marrow↗
[Expression of CD44-standard in 182 primary neuroblastomas].
182 untreated neuroblastomas were examined for the expression of the adhesion molecule CD44s by immunohistochemistry; all tumors were also tested for amplification of the oncogene N-myc by conventional Southern blot analyses. Positive CD44s immunoreactivity correlated not with a more favorable prognosis in contrast to an absence of CD44s expression in stage dependent or independent evaluations. All patients with stage 4S disease (n = 16) expressed CD44s on a high level and had an event-free survival probability of 82%. In undifferentiated neuroblastoma subgroups could be defined, depending on the expression of CD44s (p < 0.01). In 93% of N-myc non-amplified tumors CD44s expression was detected, whereas only 62% of N-myc amplified tumors were positive for CD44s expression. These results point to CD44s expression as a new histological marker in neuroblastoma, having prognostic impact in tumors of undifferentiated morphology.
Biomarkers, Tumor↗
Severe cardiotoxicity of high-dose 5-fluorouracil in combination with folinic acid, cisplatin and methotrexate in a 14-year-old boy with nasopharyngeal carcinoma (Schmincke tumor).
Cardiotoxicity by 5-fluorouracil has been reported as a rare complication in treatment protocols for adult patients with different malignant diseases. The combination with folinic acid as a biomodulatory substance and other cytotoxic drugs has been introduced to render protocols more effective and less toxic. We report severe but completely reversible cardiotoxicity of a treatment protocol for nasopharyngeal tumor (Schmincke tumor) of pediatric patients consisting of 5-fluorouracil, methotrexate, cisplatin and folinic acid in a 14-year-old boy who had no preexisting cardiac disease. The pathomechanism is briefly discussed.
Adolescent↗