[Association of chronic myeloid leukemia and lymph node sarcoma. Study of 2 additional cases].
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Biomedical subjects
Publications and source records attributed to G Duhamel.
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This is a study of myelofibrosis concerning 2.786 bone marrow biopsies in malignant hemopathies, and cancers supposed to be metastatic. In a first group myelofibrosis is a permanent symptom and necessary for the diagnosis: agnogenic myeloid metaplasia, Waldenström's disease, hairy-cell leukemia, marrow extension of Hodgkin's disease and metastatic cancers. In a second group of hemopathies, myelofibrosis varies in frequency. Myeloid leukemia: 33% - Polycythemia: 40% - Thrombocythemia: 27% - Lymphoid leukemia: 17% - Acute leukemia: 20% - Kahler's disease: 30% - Aplastic anemia: 5% - Reticulin myelofibrosis is said possibly regressive. Collagen myelofibrosis is permanent.
One hundred and thirty one patients with non-Hodgkin's lymphomas (107 lymphomas and 24 histiocytic lymphomas) have been treated between January 1973 and January 1976, by an association of cyclophosphamide, vincristine and prednisone alone (CVP) or combined with adriamycin (CVP-A). All lymphomas stage I and II received CVP + radiotherapy: the actuarial analysis shows a stationary survival from 1 to 5 years at 89%. In the group of lymphoid lymphomas stage III and IV with nodular pattern, the survival is longer for patients who received CVP (69% at five years) than for patients treated with CVP-A (54% at three years). In the group of lymphoid lymphomas stage III and IV with diffuse pattern, the complete remission rate is 25% for the CVP and 67% for the CVP-A (p less than 0.01). However, the median duration of life is not different for the two groups (24 and 26 months respectively). In the group of histiocytic lymphomas, the complete remission rate in 50% for the CVP combination and 83% for the CPV-A. However, the median time of life which is 17 months for the CVP, is not reached for the CVP-A (Stationary survival at 90% from the 12th to the 36th months). These results show that the CVP combination is a good treatment for the lymphoïd lymphoma with nodular pattern. The addition of adriamycin gives hope of long remissions and perhaps cure for histiocytic lymphomas, until now of bad prognosis. For the lymphoid lymphoma with diffuse pattern, the prognosis is still bad although we obtained with adriamycin a better rate of complete remission. The high dose chemotherapy rescued by autologous bone marrow transplantation may be a new possibility for this last type of non Hodgkin lymphomas.
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