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Biomedical subjects

G Schellong

Publications and source records attributed to G Schellong.

At least 91 records · Page 5Linked to original sources
PubMed1980

[Treatment of relapse in acute lymphoblastic leukaemia of childhood (author's transl)].

Intensive chemotherapy according to the West Berlin protocol was given in 15 children with acute lymphoblastic leukaemia with bone marrow recurrence after an initial remission period of 12 months or longer. Treatment of first episode had followed the 1971 recommendation of the German working group for research and treatment of childhood leukaemia (Memphis VII protocol). One child died from Pseudomonas septicaemia during relapse treatment, the other 14 achieved renewed complete remission for 4 to 50 months. All 5 children in whom the initial remission had lasted less than 20 months had another recurrence after 12 to 17 months. Four out of the 9 patients with an initial remission period of 20 months or longer had another bone marrow relapse after 5 to 36 months. Five children are in continuing second remission for 26 to 50 months, 4 of them already off treatment (for the last 5 to 12 months). The results show that in certain cases of relapse of acute lymphoblastic leukaemia of childhood a new chance of long-term remission and perhaps cure exists, particularly after long initial remission, when a suitable intensive treatment regime is followed.

Bone Marrow↗
PubMed1980

[Andrenogenital syndrome (author's transl)].

Radioimmunologically estimated diurnal profiles of 17-hydroxyprogesterone (17-OHP) showed clearly increased values in 15 patients with adrenogenital syndrome aged 9-19 years who had been treated for at least 4 1/2 years with cortisol. Increases were pronounced in the morning: at 8 hours 58.6 nmol/l, at 12 hours 22.2 nmol/l, at 18 hours 23.7 nmol/l on average. By changing cortisol medication, in particular due to split doses, morning 17-OHP peak values could be lowered and the whole daily profile could be improved: at 8 hours 17.9 nmol/l, at 12 hours 9.3 nmol/l, at 18 hours 8.1 nmol/l on average. The total cortisol dosage had to be increased only marginally from an average of 26.7 to 30 mg/m2 body surface, however, the evening dosage was increased from 20% to 38% on average of the total dose. Measurement of serum 17-OHP diurnal profile is thus advantageous in treatment of adrenogenital syndrome with cortisol when compared to values obtained from 24-hour urine collections.

Adolescent↗
PubMed1980

[Treatment of malignant tumours of the genitalia in young girls (author's transl)].

This is a report about three cases of malignant tumours in young girls (botryoid sarcoma--rhabdomyosarcoma and an endodermal sinus tumour). The surgical treatment consisted of radical excision of the tumour with subsequent lymphadenectomy. The ovaries remained in place. Chemotherapy has resulted in an improvement of 5 years survival of malignant tumours in children. Ultraradical surgery, the treatment of choice until 5 years ago seams to dispensable.

Age Factors↗
PubMed1979

Endodermal germ cell carcinoma (endodermal sinus tumor) of the vagina in infant girls.

An endodermal sinus tumor (endodermal germ cell carcinoma) was diagnosed in a 1-year-old girl in the vagina after hemorrhage; the tumor was completely removed by radical abdominal surgery. Postoperative polychemotherapy was performed for two years with Actinomycin D, Adriamycin, Vincristin, and Cyclophosphamide. The infant is now tumor-free for 26 months, showing almost normal somatic and psychic development. The characteristic histological patterns and clinical course of this strongly malignant tumor are demonstrated, based on 25 published case reports of endodermal sinus tumors in the vagina of little girls (aged 5-26 months). This neoplasm in early infancy has to be separated from the clear-cell adenocarcinoma of the vagina which occurs after puberty in adolescent girls and young women, and is induced by stilbestrol therapy to the mother during early pregnancy.

Adenocarcinoma↗
PubMed1979

EEG-changes during intensified induction-therapy of acute lymphoblastic leukemia.

In 49 children with acute lymphoblastic leukemia serial EEGs were performed during the course of treatment. Therapy in the first four weeks consisted of: Prednisone, vincristine, daunorubicine and L-asparaginase. In the second month 6-mercaptopurine, cytosin-arabinoside, cyclophosphamide, methotrexate-i. th. and cranial irradiation were administered. Maintenance-therapy consisted of 6-mercaptopurine, cyclophosphamide and methotrexate i.v. Before treatment only 24% of patients showed normal EEG-findings, whereas 57% presented sly induced by leukemic infiltrations and partly due to the impaired clinical state. At the end of the first phase of therapy, the combined toxicity of vincristine and L-asparaginase led to the finding of 23% severely and 37% moderately slowed EEGs. Slightly disturbed EEGs were found in 29% and normal ones in 11% of children. Regression occurred duirng the phase of CNS-prophylaxis. At its end 37% of recordings were normal and 57% slightly abnormal. After maintenance-therapy of 1/2 to 1 year duration, there were 65% normal findings. Moderate and severe disorders were no longer demonstrated. Paroxysmal activity developed twice, each during the first phase of therapy and accompnaying convulsions. In both cases we saw slowing of background-activity and signs of increased excitability still months after. In one of these patients, the probable cause was a vincristin-encephalopathy, the cause of the second case remained unknown. EEGs of two furtehr patients with rubella-encephalitis and subarachnoideal hemorrhage exhibited severe unspecific changes.

Adolescent↗
PubMed1979

[The prognostic value of measuring cell size in acute childhood leukemia (author's transl)].

Prior to treatment we studied leukemia cell diameters in bone marrows of 89 children with acute lymphoblastic leukemia (ALL) and 26 children with myeloblastic leukemia (AML). Patients were treated according to the West-Berlin protocol. The median cell diameter (+/- S) in ALL measures 11,3 (+/- 1,1)mu, in AML 15,3 (+/- 1,1)mu. Both forms of leukemia show some overlapping of cell diameters in the range of 13,8--14,3 mu. with ALL, no difference is shown in the cell diameters of those who remained in complete remission or went into relapse. Likewise, there is no significant difference in cell-diameter, when correlating them to the following parameters: initial peripheral leucocyte count, acid phosphatase- and PAS-reaction, T-cellmarkers. The risk of relapse is the same in patients with more than 20% macrolymphoblasts (diameter greater than 12mu) and in those less than 20% macrolymphoblasts. In 11 patients with ALL cellmeasuring was performed during the first hematological relapse. The median cell-diameter in 10 of these cases is higher than in the initial bone marrow.

Acute Disease↗
PubMed1979

[Concordant leukemia in identical twins (author's transl)].

We report female monozygous twins who developed acute lymphoblastic leukemia at the age of 5 1/2 years. The diagnosis in the first twin was made after pallor, lethargy, and petechiae developed. The diagnosis in the second twin was made two days later when a whole blood count was taken. The lymphoblasts of both patients showed with the exception of the PAS-reaction identical morphological, cytochemical, and immunological results. The PAS-reaction was positive in 55% of the lymphoblasts in one twin, negativ in the lymphoblasts of the other twin. Both patients are in continuous complete remission 14 months after diagnosis. The risk of leukemia is high in the other monozygous twin when one of the twins has already developed leukemia. In the literature it is estimated to be 1 : 5. The diagnosis after the second year of life is rarely made at the same time. There is only one previous report of this occuring in a case of acute myeloblastic leukemia in 4 1/2 year old monozygous twins.

Child, Preschool↗
PubMed1979

[Prognosis improvements in children with acute myelocytic leucemia after more intensive induction therapy (author's transl)].

Between October 1974 and October 1978 23 children with acute myelocytic leucemia (AML) received intensive therapy in the Univ.-Kinderklinik Münster: 4 children were treated according to the ALGB-protocol consisting of 5-7 day courses of ARA-C-infusion and 3 DNR-injections. 19 patients received the West-Berlin-protocol: The first 7 the original ALL protocol, 11 the modified form of AML, which will be presented here as AML-therapy-study BFM 78. 4 of the 23 patients died with early acute cerebral bleeding. 2 patients were nonresponders. 17 children went into remission. One girl died in remission of septicemic aspergillosis. 4 children had a relapse. In November 1978 there were still 12 patients in continuous complete remission, 3 of them already without therapy. 13 of the 19 patients, who were treated with the West-Berlin-protocol went into remission. 1 had a relapse. At present there are 11 patients in continuous complete remission. The above results and those found in the literature could signify that the long term prognosis of children with AML will be improved. To coordinate efforts toward this goal a cooperative AML-therapy-study in the "Deutsche Arbeitsgemeinschaft für Leukämieforschung" (BFM-group) using the here presented therapy protocol was formed in November 1978.

Adolescent↗
PubMed1977

[Combination chemotherapy of acute lymphoid leukaemia in children combined with prophylactic cranial irradiation (author's transl)].

From June 1971 to May 1974, 41 children, aged four months to eleven years, with acute lymphoid leukaemia were treated by a schedule which included prophylactic cranial irradiation and intrathecal methotrexate injection after remission (phase II) and combination cytostatic treatment for 2 1/2 years (phase III). Induction of remission (phase I) was usually achieved with vincristine and a corticosteroid. Complete remission, now lasting 18 to 54 months, was obtained in 18 patients (44%), in nine of them without treatment for up to 24 months. Twelve patients (29%) had bone-marrow recurrence, five (12%) CNS and three (7%) testicular recurrence. One child died of liver failure in complete remission. Another nine patients, who had been pretreated according to a different schedule and were in their first remission for six to twelve months, were added to the programme from phase II onwards. Three of them now are in complete remission for 60 to 88 months, seven to 30 months after treatment had been stopped. The results indicate a significantly improved prognosis of acute lymphoid leukaemia in children.

Adrenal Cortex Hormones↗
PubMed1977

[Treatment and results of the first relapse of acute lymphatic leukemia in childhood (author's transl)].

In our experience the prognosis of hematological relapse in patients with acute lymphatic leukemia treated according to the Pinkel programme is very bad. It may be a little better for patients in whom relapse occurred after the end of therapy and who were submitted to intensified cytostatic treatment. The chances for achieving a second long-term remission, if the relapse is confined to the CNS, are also better. This is true particularly for those patients who in addition were given radiotherapy. In recurrence in the testes radiotherapy alone will not suffice and additional intensified cytosatic treatment should be considered.

Bone Marrow Diseases↗
PubMed1977

[The development of children following intra-uterine transfusions in severe Rh-erythroblastosis (author's transl)].

The development of 18 children who had received 1--3 intra-uterine transfusions (IUT) because of severe Rh-erythroblatosis was followed over the first few years of life and finally checked when they were 2--6 years old. All of them were premature, 2 were born with hydrops, 1 with pre-hydrops. There were many other perinatal riskfactors (asphyxia, trouble with respiration, acidosis, severe anemia, hyperbilirubinemia). Examination (general and neurologic) was supplemented by EEG and psychologic testing )Kramer test, Vineland maturity scale, Denver development scales). No child showed signs of severe cerebral damage. 2 children had unequivocal pathologic signs (slight to medium spastic diplegia or hemipegia with corresponding focal findings in EEG). 3 further children showed minimal cerebral signs without disability. Development of intelligence was notably good throughout. Observations showed abnormal neurologi-signs more often during the first 2 years of life than later. Psychologic examinations, too, showed clear improvement with age. Results are satisfactory and confirm that IUT as a prenatal treatment with very severe Rh-Erythroblastosis is justified.

Age Factors↗
PubMed1976

[Haemolytic disease of the new-born by blood-factor incompatibility other than Rh(d) and ABO (author's transl)].

Rare forms of incompatibility were observed over a period of 20 years in 41 (2%) of 2088 new-borns with haemolytic disease. Antibodies involved were anti-c (n = 27), anti-E (n = 6) and anti-K (n = 4), as well as one case each of anti-E + Fya, -C, -Fya and -Jka. Amniotic fluid was examined during pregnancy in nine cases, three children were given intra-uterine infusions, while in the remainder the haemolytic process was mild or only moderately severe. One infant died of toxoplasmosis, another one of immaturity and respiratory distress syndrome. Kernicterus was always prevented. In haemolytic disease of the newborn caused by anti-c and anti-E, prenatal damage is markedly rarer than with D erythroblastosis, but must be considered during the pregnancy. In anti-K haemolytic disease the severity of the disease is similar to that of D erythroblastosis. All three incompatibilities may lead to kernicterus in the first few days after birth so that exchange transfusions are often necessary. In most of the other incompatibilities the course is similar to that seen with ABO erythroblastosis.

Adult↗