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Biomedical subjects

F S Morrison

Publications and source records attributed to F S Morrison.

At least 37 records · Page 2Linked to original sources
PubMed1984

Response of chronic myelogenous leukemia patients to COAP-splenectomy. A Southwest Oncology Group study.

Eighty-seven patients from 18 institutions with a confirmed diagnosis of chronic myelogenous leukemia were registered on a Southwest Oncology Group protocol for multiagent induction and single-agent maintenance chemotherapy, with randomization to an immunotherapy arm. Elective surgical splenectomy was performed for 42 patients at the completion of 3 months of induction therapy. Final analysis of the study revealed statistically significant survival advantages were correlated with age, splenectomy, the absence of hepatic leukemic infiltrate at the time of splenectomy, and race.

Adolescent↗
PubMed1984

Mitoxantrone in refractory nonHodgkin's lymphoma. A Southwest Oncology Group study.

A phase II study of mitoxantrone in nonHodgkin's lymphoma was conducted by the Southwest Oncology Group between July 1981 and May 1982. The study involved 37 patients with histologically proven nonHodgkin's lymphoma, who were not eligible for higher priority protocols but had clearly measurable disease. Patients received mitoxantrone, 12 mg/m2 at intervals of 3 weeks, with a 10% increase in dose in the absence of myelosuppression and a 17% reduction for a WBC of less than 2 X 10(9) cells/L or a platelet count of less than 50 X 10(9)/L. The median number of previous regimens was three. Doxorubicin, in a median dose of 242 mg/m2 (range 12 to 650 mg/m2) had been previously given to 34 of the 37 patients. The Pathology Panel for Lymphoma Clinical Studies reviewed 31 (84%) of the lymphomas. Four of the ten follicular, small cleaved cell lymphomas responded compared with one of nine diffuse, large cell lymphomas. The median duration of response was 231 days. A median of two doses of mitoxantrone (range 1 to 18) was given. The median WBC nadir was 5.1 X 10(9)/L (range 04. to 9.4 X 10(9)/L), and the median lowest WBC for all doses was 2.4 X 10(9)/L (range 0.4 to 16 X 10(9)/L). Among 17 patients with a first WBC nadir of less than 3 X 10(9)/L, there were three partial responses compared with four responses (one complete, three partial) from nine patients with a WBC over 3 X 10(9)/L. There were seven responses (one complete, six partial) among 23 patients who had received up to three previous regimens, whereas only two of 14 patients receiving more than three previous regimens responded (one complete, one partial response). The response rate was independent of the previous dose of doxorubicin with five responses out of 23 patients who received a total dose of less than 300 mg/m2 and four responses out of 14 patients who received greater than 300 mg/m2. These data are compatible with the hypothesis that mitoxantrone alone is active against previously treated low-grade lymphomas and that the response rate is independent of the total dose of prior doxorubicin received and the degree of myelosuppression. Mitoxantrone may not be cross resistant with doxorubicin.

Anthraquinones↗
PubMed1983

Improved complete remission rates and survival for patients with large cell lymphoma treated with chemoimmunotherapy. A Southwest Oncology Group Study.

Between 1974 and 1977, 652 patients with non-Hodgkin's lymphoma without prior chemotherapy were randomized to 1 of 3 combination chemotherapy programs designed to induce complete remission (CR): COP-bleomycin (180 patients), CHOP-bleomycin (232 patients) or CHOP plus immunotherapy with Bacillus Calmette Guerin (BCG) (240 patients). With mature follow-up, the major effect of BCG immunotherapy was observed in patients with large cell lymphomas (diffuse or nodular "histiocytic") and not in other common lymphoma subtypes. CR rate for 65 patients with large cell lymphoma treated with CHOP-BCG was 68% compared to 48% in 61 patients treated with CHOP-bleomycin (P = 0.02) (two-tailed test) or 44% for 45 patients treated with COP-bleomycin (P = 0.02). CR duration for both CHOP-based regimens was similar and superior to that produced by COP-bleomycin (P = 0.03). Survival of patients with large cell lymphoma treated with CHOP-BCG was better than that observed with CHOP-bleomycin (P = 0.02) or COP-Bleomycin (P = 0.002). Although the explanation for the favorable effect of BCG remains unclear, further clinical trials to evaluate the combination of chemotherapy and other "biologic response modifiers" is warranted for patients with lymphoma.

Antineoplastic Agents↗
PubMed1983

Acute leukemia and infections: perspectives from a general hospital.

The incidence and etiology of infections in 210 acute leukemics at the University of Mississippi Medical Center between 1962 and 1978 were reviewed. Infections episodes occurred 269 times in 148 patients. In 193 infections, potential pathogens were cultured. Infection was a contributing cause of death in 89 patients. E. Coli, S. aureus, K. pneumoniae, and P. aeruginosa accounted for 58% of the isolates. No unusual patterns of antimicrobial resistance were observed. The outcome of the infections was related to the absence or resolution of neutropenia. Among 48 patients febrile on first admission, four cases of gram-negative pneumonia, two cases of fungal pneumonia, and two cases of pseudomonas cellulitis were diagnosed. We conclude that the etiology of infections was similar to that of cancer centers; multidrug-resistant gram-negative organisms were not prevalent; absence or resolution of neutropenia indicates a good prognosis for outcome of infection; and untreated acute leukemics may acquire opportunistic infections.

Acute Disease↗
PubMed1983

Mitoxantrone hydrochloride (NSC-310739) in lymphoma. A Southwest Oncology Group study.

The members of the Southwest Oncology Group have treated thirteen patients with Hodgkin's disease and thirty-seven with non-Hodgkin's lymphoma with mitoxantrone on the every three week schedule. While the result (3/13 responses in Hodgkin's; 9/37 responses in non-Hodgkin's lymphoma) is not striking, there is a definite antitumor activity in a very heavily pretreated group of patients. Toxicity was acceptable. Additional trials in lymphoma are planned using mitoxantrone in combination with BCNU.

Anthraquinones↗
PubMed1983

The treatment of acute leukemia with continuous infusion L-Alanosine.

L-Alanosine, an antitumor antibiotic was administered by members of the Southwest Oncology Group (SWOG) to 22 patients with resistant acute non-lymphocytic leukemia. The drug was administered by continuous infusion for five days at a starting dose of 125 mg/m2/day. Mucositis was dose-limiting in 15 patients and no marrow aplasia was attained. As administered, L-Alanosine is not an effective single agent in acute leukemia.

Acute Disease↗
PubMed1983

Clinical correlations of leukemic clonogenic cell chemosensitivity assessed by in vitro continuous exposure to drugs.

This study was performed to assess the value of prolonged, as opposed to short-pulse, in vitro exposure of leukemic cells to chemotherapeutic drugs in leukemic clonogenic assay for prediction of clinical response. In 21 patients with acute nonlymphocytic leukemia treated with intensive combination chemotherapy based on an anthracycline and 1-beta-D-arabinofuranosylcytosine infusion, chemotherapy sensitivity of leukemic clonogenic cells was assessed in comparison with that of normal myeloid clonogenic cells by the in vitro continuous exposure to drugs throughout the entire culture period. Analysis of these in vitro data in terms of prediction of achieving clinical complete remission was carried out in comparison with data on 22 cases in which in vitro sensitivity was assessed by the pulse 1-hr exposure. The in vitro sensitivity index, expressed as a log odds ratio, was positive (greater than 0) in 8 of 11 patients achieving complete remission and negative (less than 0) in 7 of 10 patients failing to achieve complete remission, with an overall correlation of 71%. This is at least as good as the pulse exposure method, which has a correlation of 68%. If sensitivity indexes of marginal magnitudes (--1.0 approximately +1.0) are excluded, the correlation increases to 92% (12 of 13 patients). The correlation appears to improve especially for 1-beta-D-arabinofuranosylcytosine by the continuous exposure method (71%) as compared with the pulse method (57%). This study establishes the feasibility of an in vitro chemotherapy sensitivity testing of leukemic clonogenic cells by continuous in vitro drug exposure and suggests that the continuous exposure method may be better than the pulse method for antimetabolites such as 1-beta-D-arabinofuranosylcytosine. The data also suggest that simulation of the in vivo drug schedule may be important in this in vitro test.

Adult↗
PubMed1982

A Southwest Oncology Group: chemotherapy versus chemotherapy plus radiotherapy in treatment of stage III Hodgkin's disease.

The Southwest Oncology Group (SWOG) performed a randomized study (SWOG 7518, CAR 2) of chemotherapy using ten courses of nitrogen mustard, vincristine, procarbazine, and prednisone (MOPP) plus low-dose bleomycin (LDB), versus three courses of combined therapy, MOPP + LDB plus radiotherapy (XRT) from October, 1974, to April 1980, in pathologic stage III Hodgkin's disease. The present report includes data on 136 registered patients, of whom 112 are fully or partially evaluable. At this preliminary analysis, complete remission rates are 82% for chemotherapy alone and 82% for combined treatment. There are no statistically significant differences in survival or relapse-free survival between the two treatment programs, and no specific trends for stage IIIA versus IIIB. The estimated 3-year survival rate for all patients was 82%. Toxicities are comparable when considering the highest grades. There was one case of acute myeloblastic leukemia on combined treatment. Preliminary evidence suggests that patients with nodular sclerosis histologic type are more likely to relapse on chemotherapy alone than on combined treatment.

Bleomycin↗
PubMed1982

Adriamycin combined with 10-day Ara-C, vincristine, and prednisone (10-day ADOAP) in the treatment of adult acute leukemia patients under fifty years of age. A Southwest Oncology Group Study.

In a twelve-month period, 56 consecutive patients with acute leukemia, aged 15-50, were treated by administration of a 10-day continuous infusion of Ara-C in combination with adriamycin, oncovin and prednisone (10 day ADOAP). Of 50 evaluable patients, there were 39 complete remissions (78%) with a median remission duration of 71 weeks. After adjustment for age and other known prognostic factors, the complete remission rate is still 10% higher than that found using a similar regimen without adriamycin.

Acute Disease↗
PubMed1982

Rubidazone in combination with Ara-C, vincristine and prednisone (ROAP) in the treatment of adult acute leukemia. A Southwest Oncology Group Study.

In an 18-month period, 340 consecutive adult patients with acute leukemia were treated using a 7-day continuous infusion of Ara-C in combination with rubidazone, vincristine and prednisone (ROAP). Of 334 (96%) evaluable cases, 77% were 50 years of age or older. The complete remission (CR) rate was 51% with a standard error of 3%. After adjustment for known prognostic factors this overall CR rate is 10% higher than the predicted CR rate when compared to the last completed SWOG study which used adriamycin in combination with a similar regimen of Ara-C, vincristine, and prednisone. The CR rate in patients over 50 years of age was particularly noteworthy. Using rubidazone, the CR rate was 46.1% (116/256) compared to 37.4% (91/243) for the adriamycin study in this poorly responding age group. The median survival time achieved was 27 weeks. However, in the age groups 40-49 years and 50-59 years the median survival was 70 and 44 weeks, respectively.

Acute Disease↗
PubMed1982

Chemotherapy sensitivity assessment of leukemic colony-forming cells with in vitro simultaneous exposure to multiple drugs: clinical correlations in acute nonlymphocytic leukemia.

For 13 patients with acute nonlymphocytic leukemia receiving four-drug combination chemotherapy (14 chemotherapy trials), leukemic bone marrow cells were obtained before treatment and were exposed in vitro to all four-drug-mixture solutions simultaneously followed by the survival assessment of leukemic colony-forming cells (L-CFU). Survival of normal marrow colony-forming cells (CFU-C) was also assessed concurrently, and the sensitivity index (SI) of leukemic cells was determined as the ratio of the survival of CFU-C to that of L-CFU. Correlations of in vitro results to clinical results were excellent: four of five trials resulting in complete remission had high SI and eight of nine trials without complete remission had low SI (P = 0.02). The potential advantages of this method of exposing cells to drug mixture are discussed in terms of detecting drug synergism and improving the efficiency of in vitro chemotherapy sensitivity studies.

Acute Disease↗
PubMed1981

Effect of schedule on activity and toxicity of 5-azacytidine in acute leukemia: a Southwest Oncology Group Study.

One-hundred-fifty-four patients with acute leukemia and extensive prior chemotherapy were treated with 5-Azacytidine and evaluated according to five different schedules. One-hundred-twenty patients received adequate trials; 34 patients died within 14 days of onset of treatment. Nine patients achieved a complete remission (CR) and two achieved a partial remission. Although two of the treatments have a higher remission rate, the data were not statistically significant. The median time to CR was 48 days (range 21-173). The median duration of CR was 65 days (range 39-369). There was no difference in response rate according to cell type. The median age of responders was 31 years, and 39 years for nonresponders. Proportionately there were more women among responders (5M/6F) and more men (70M/39F) among nonresponders. At onset of therapy the median leukocyte counts were similar between responding (5.4 X 10(3)) and nonresponding (5.7 X 10(3)) patients, but the proportion of leukemic cells was significantly higher among nonresponding patients (46% vs. 7%). Toxicities included nausea, vomiting, diarrhea, skin rash, myalgias, prolonged myelosuppression, hypotension, and central nervous system stupor and/or coma. Lower dose continuous infusion schedules of five-, seven-, and ten-days duration appear effective and were associated with less toxicity.

Acute Disease↗
PubMed1979

Superiority of adriamycin-containing combination chemotherapy in the treatment of diffuse lymphoma: a Southwest Oncology Group study.

As a part of an ongoing prospective controlled trial, the Southwest Oncology Group compared the results of treatment of advanced non-Hodgkin's lymphoma with two CHOP regimens (cyclophosphamide, adriamycin, vincristine and prednisone with either low-dose bleomycin or BCG by scarification) to a COP regimen (cyclophosphamide, vincristine and prednisone) with low-dose bleomycin (COP-Bleo). The study design emphasized histopathology review and systematic restaging to define complete remission (CR). Confirmed rates of CR for 443 evaluable patients were 59% for 286 patients receiving the CHOP regimens and 59% for 157 patients receiving COP-Bleo. Rates of CR were higher for patients with nodular lymphoma (69%) compared to those with diffuse lymphoma (54%) (p = 0.005). For patients with nodular lymphoma there was no difference in CR rates according to treatment. For patients with diffuse lymphomas the CR rate was higher with the CHOP programs (58%) than with COP-Bleo (44%) (p = 0.10). Overall duration of CR and survival was significantly longer for patients with nodular lymphoma compared to diffuse lymphoma (p less than 0.01). At this time, remission duration and survival were similar regardless of induction regimen used in patients with nodular lymphoma. However, in patients with diffuse lymphoma, the duration of CR and overall survival were improved by treatment with the CHOP regimens compared to COP-Bleo (p = 0.02). Thus, in this controlled study we have demonstrated that initial combination chemotherapy employing the CHOP regimen was a superior remission induction therapy for patients with diffuse lymphoma.

Antineoplastic Agents↗