Biomedical subjects

H Behrendt

Publications and source records attributed to H Behrendt.

At least 37 records · Page 2Linked to original sources

PubMed1998

Determination of histamine and leukotrienes from basophils in cell supernatants by high-performance liquid chromatography.

A reversed-phase high-performance liquid chromatographic method with gradient elution for the separation of the mediator substances histamine and the leukotrienes C4 (LTC4), D4 (LTD4), and E4 (LTE4) is described. The detection occurs fluorimetrically after automated precolumn derivatization with o-phthaldialdehyde. All components are chromatographically separable. Because of the different excitation and emission wavelengths, only the most important biological active mediators histamine and LTC4 are determinable in one parallel chromatographic run. The method is examined by linearity and precision tests and is applicable to biological sample matrices like cell supernatants of human basophils enriched by Percoll-density gradient centrifugation and stimulated for mediator release by anti-IgE. The established method is suitable to separate the mediators from other matrix components. The determination limit for histamine is 55.0 micrograms/L and that for LTC4 16.0 micrograms/L, referring to the reference solutions. Therefore, a fast, economical method for the common determination of the most important mediators histamine and LTC4 is established. This method is also suitable for high sample amounts in routine medical analysis.

Basophils↗

PubMed1997

Airborne particulate matter modulates the production of reactive oxygen species in human polymorphonuclear granulocytes.

Causal relationships between airborne particles (especially particulate matter < 10 microm in diameter) and increases in prevalences and symptoms of respiratory diseases have been postulated in many epidemiologic studies. Polymorphonuclear leukocytes (PMN) in the nasal or bronchial epithelium can be exposed to particulate matter (PM) and may upon exposure produce reactive oxygen species (ROS). Release of ROS can result in cellular and tissue damage and initiate or exacerbate inflammation. To elucidate the effect of PM on inflammatory reactions, we exposed human PMN to PM extracts. PM were collected with high volume samplers in two cities, Dusseldorf and Duisburg, in Germany and reflect sites with high traffic and industrial emissions respectively. The collected particles were extracted using water and then dichloromethane, resulting in an aqueous and an organic extract. The production of ROS was determined using luminol-enhanced chemiluminescence (LCL) of resting and zymosan-stimulated PMN. The present study shows that extracts of PM alone significantly stimulated the production and release of ROS in resting PMN. The effects of the PM extracts were inhibited by superoxide dismutase (SOD), catalase and sodium azide (NaN3). Zymosan-induced LCL was, however, diminished by coincubation with PM extracts. The chemical composition is important when considering the effects of particles. Our study shows that only organic substances adsorbed to particles stimulate LCL. SOZ-induced LCL is inhibited by both types of extracts, but aqueous extracts have a stronger inhibitory effect. It is at present unclear which substances are responsible for these effects.

Air Pollutants↗

PubMed1997

The Bax alpha:Bcl-2 ratio modulates the response to dexamethasone in leukaemic cells and is highly variable in childhood acute leukaemia.

Bcl-2 over-expression has been shown to inhibit apoptosis induced by a variety of stimuli, whereas a predominance of Bax alpha to Bcl-2 accelerates apoptosis upon apoptotic stimuli. We sought to study the relevance of these apoptotic regulating gene products in leukaemia. In a panel of leukaemia and lymphoma cell lines (HL60, DoHH2, CEM C7, L1210 and S49), the Bax alpha-to-Bcl-2 ratio as assessed by Western-blot analysis correlated with sensitivity to dexamethasone treatment. In addition, in HAbax alpha-transfected CEM C7 clones, a similar correlation was found for dexamethasone and thapsigargin sensitivity. In bone-marrow aspirates from patients with childhood acute lymphoblastic or myelocytic leukaemia (ALL, n = 48; AML, n = 8), the Bcl-2 and Bax alpha levels were highly variable, but well within the range found in the Bax alpha transfectants and in the established cell lines. Bcl-2 levels were lower in T- than in B-lineage ALL, which could be ascribed to simultaneous inverse relation between Bcl-2 and WBC. By contrast, Bax alpha:Bcl-2 was independent of any presenting feature and was largely dependent on Bax alpha levels. Results suggest that Bax alpha:Bcl-2, rather than Bcl-2 alone is important for the survival of drug-induced apoptosis in leukemic cell lines and ALL.

Apoptosis↗

PubMed1997

Treatment of isolated testicular recurrence of acute lymphoblastic leukemia without radiotherapy. Report from the Dutch Late Effects Study Group.

BACKGROUND: The isolated recurrence of testicular leukemia in boys with acute lymphoblastic leukemia (ALL) is considered to be an ominous sign, heralding generalized recurrence. In general, treatment is comprised of systemic retreatment and local radiotherapy to one or both affected tests. METHODS: In this study, the authors report five boys with a late isolated testicular recurrence of ALL during sustained bone marrow remission, in whom radiotherapy had been omitted. High dose methotrexate was included in the treatment regimen. RESULTS: No further recurrences occurred after cessation of therapy. The follow-up period ranged from 1-15 years (median, 8 years). CONCLUSIONS: These cases show that there is a subpopulation of boys with recurrence of testicular leukemia who can be treated without radiotherapy. Therefore, the authors propose a treatment regimen for boys with late isolated recurrence of testicular leukemia in which conventional reinduction maintenance treatment is given in combination with high dose methotrexate. Radiotherapy should be withheld until subsequent testicular recurrence occurs.

Antimetabolites, Antineoplastic↗

PubMed1997

Treatment of Hodgkin's disease in children with alternating mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) and adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD) courses without radiotherapy.

Since the introduction of mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) chemotherapy, children with Hodgkin's disease (HD) have been treated with chemotherapy alone. The occurrence of side effects related to irradiation (especially secondary solid tumors) is less likely to occur. Alkylating agents in the MOPP chemotherapy combinations are, however, known for their late effects, i.e., gonadal dysfunction and secondary malignancies. Combination with non-alkylating and non-cross-resistant drugs (as in the adriamycin, bleomycin, vinblastine, and dacarbazine [ABVD] combination: may give superior treatment results and possibly a decrease in the occurrence of side effects. From 1988 to 1993 all children presenting with HD were treated with alternating MOPP and ABVD courses (3 x MOPP, 3 x ABVD). Twenty-one children (7 females, 14 males), ages 5-18 years (median 14 years) were included; their clinical stages were 1, 7 patients; II, 8 patients; III, 5 patients; IV, 1 patient. Their pathology revealed 2 lymphocytic predominance, 17 nodular sclerosis, 1 mixed cellularity. In 1 patient only cytology was done and thus histopathologic subclassification was not possible. Two children have relapsed; disease-free survival is 90%. Analysis of toxicity revealed no decrease in cardiac function by ultrasound examination and no pulmonary effects noted by carbon monoxide diffusion. In 1 of the 10 children tested, mild hypogonadism was noted. No secondary tumors occurred. From this small population of children with HD we conclude that treatment with MOPP/ABVD for 6 cycles without radiotherapy may be adequate. The occurrence of gonadal dysfunction may be less frequent than with 6 cycles of MOPP. However, more patients and further follow-up are needed.

Adolescent↗

PubMed1997

Characterization of Ambient Air Particle Size Fractions in Three GermanCities with the Aid of Electron Microscopy

Multistage-filtration samplers offer the opportunity toanalyze dust fractions deposited on corresponding stages of the sampler. Inthis investigation, a typical two-stage sampler was used in the cities ofDortmund (mining and steel industry), Dusseldorf (lesser industrialactivities), and Duisburg (steel industry), North Rhine Westphalia. Thepurpose of this study was to compare the composition of dust fractions withthe aid of analytical electron transmission microscopical methods. Theparticle size distribution was similar in the cities, the 50% value ofthe equivalent diameter was 0.8 μm. Analytical results are presented fordifferent mineral classes with approximately 30 single minerals in allcities. The highest concentration values in the fine dust fraction weresilicate minerals, while the sulfate content was very high in the coarse dustfraction in all cities.

Journal Article↗

PubMed1997

Rearrangement status of the malignant cell determines type of secondary IgH rearrangement (V-replacement or V to DJ joining) in childhood B precursor acute lymphoblastic leukemia.

Immunoglobulin heavy chain (IgH) oligoclonality in childhood B precursor acute lymphoblastic leukemia (ALL) as determined by Southern analysis is found in 30-50% of patients and has been shown to be the result of ongoing IgH rearrangement (mostly V(H)-replacement and V(H) to D-J(H) joining) after malignant transformation. It is unknown however, what determines the type of secondary rearrangement. Also the biological basis of the variable degree of oligoclonality observed in childhood ALL is poorly understood. We analyzed in detail the IgH rearrangement status of the leukemic cells for a random panel of 18 childhood B precursor ALL patients by polymerase chain reaction (PCR)/sequencing analysis and by Southern analysis. By Southern analysis 10/18 (55.6%) patients were considered oligoclonal and 8/18 (44.4%) monoclonal. In contrast, by PCR minor clonal rearrangements were detected in 14/18 (77.8%) patients. V(H)-replacement was found in 7/14 patients, V(H) to D-J(H) joining in 6/14 patients and an unusual type of secondary rearrangement, V(H)-D to J(H) joining, in one patient. Only a single type of secondary rearrangement was detected in each patient. The type of secondary rearrangement (V(H)-replacement or V(H) to D-J(H) joining) depended on the rearrangement status (VDJ/VDJ or VDJ/DJ, respectively) of the dominant leukemic clone as determined by Southern analysis. We found that in addition to a more 'advanced' IgH rearrangement status patients with V(H)-replacements also have a more 'advanced' TCRdelta rearrangement status, which possibly reflects exposure of both the IgH locus and the TCRdelta locus to recombinase activity in a preleukemic clone. Finally, we investigated a putative relationship between oligoclonality by Southern analysis and S-phase fraction of the leukemic cell population. We found a significantly lower percentage cells in S-phase for oligoclonal patients as compared to monoclonal patients. Our data add to the understanding of ongoing rearrangement of antigen receptor loci in childhood ALL and have implications for the monitoring of minimal residual disease by PCR.

Adolescent↗

PubMed1997

Gramineae pollen as trigger factors of atopic eczema: evaluation of diagnostic measures using the atopy patch test.

After contact with grass pollen, seasonal exacerbations of eczematous skin lesions have been described in a subgroup of patients with atopic eczema (AE). Epicutaneous patch testing with aeroallergens (atopy patch test. APT) has been used to investigate these patients. We performed comparative APT in 79 patients with AE and 20 control subjects (14 non-atopic volunteers and six patients with grass pollen allergic rhinoconjunctivitis). Subjects were tested with grass pollen allergen extract in petrolatum and with unprocessed native dry pollen of Dactylis glomerata. Results after 48 h were compared with the patient's history, corresponding skin prick test and specific IgE. Fifteen of the 79 AE patients showed clear-cut eczematous reactions to unprocessed D. glomerata pollen; 14 of these had an elevated serum IgE to D. glomerata and 13 had a positive skin prick test. Twenty patients had a positive APT reaction to grass pollen allergen extract, including 12 of the D. glomerata reactive subjects (P < 0.001). Positive patch test reactions to D. glomerata were seen in 66.7% of cases with and 10.5% of patients without a predictive history of exacerbations during the pollen season. For the standardized extract, these percentages were 75% vs. 16.4% (P < 0.001). No side-effects were observed. Control subjects showed no positive reactions. We conclude that grass pollen preparations may be used to investigate trigger factors for eczematous skin lesions in a subgroup of patients with AE.

Adolescent↗

PubMed1997

PCR-positivity in harvested bone marrow predicts relapse after transplantation with autologous purged bone marrow in children in second remission of precursor B-cell acute leukaemia.

Purging of autologous bone marrow (BM) grafts of children in second remission after a relapse of precursor B acute lymphoblastic leukaemia (ALL) in the BM has been carried out in our laboratory since 1987, initially by complement mediated cell lysis. This protocol was extended by performing an immunorosette depletion before lysis with complement. The aim of the present study was to assess by polymerase chain reaction the presence of residual leukaemic cells in the BM grafts before and after purging. The results were then correlated to clinical outcome. In 24/28 patients a PCR product was obtained by amplification of IgH and/or TcR junctional regions. BM before purging was available for analysis in 13 patients. We found that leukaemic cells could be detected in 8/13 (62%) of these grafts before purging . All these eight patients experienced a relapse, regardless of whether the purging procedure had been successful (defined as achievement of PCR-negativity) or not. In contrast, none of the five patients with PCR-negative grafts before purging relapsed (P = 0.0008). One patient died due to transplant-related toxicity. Of the remaining 23 patients, nine patients received a PCR-positive BM graft after purging. All these nine patients experienced a relapse as compared to 6/14 whose BM was PCR-negative after purging (P = 0.0072). Two of eight PCR-positive BM grafts could be purged to PCR-negativity. Thus, improvements both in treatment of leukaemia and in purging efficacy are still needed.

Adolescent↗

PubMed1997

Experiences with the severity scoring of atopic dermatitis in a population of German pre-school children.

Severity scoring of atopic dermatitis (SCORAD) was introduced as a standard tool but has not been used in a population-based epidemiological study; the objective of the present study was to determine the practicability of this instrument in this setting. We assessed the distribution of the severity of atopic eczema in the community and investigated differences between east and west Germany. A factor analysis was then carried out to characterize the variables of this scoring system and to analyse possible relationships within them. A multicentre cross-sectional study was carried out in five east German and two west German locations in 1994; pre-school children (5-6 years old) were investigated and cases of atopic eczema identified by a dermatological examination. The SCORAD was used to determine the severity of atopic eczema and the results assessed using analysis of variance and principal component analysis (varimax rotation). In all, 1511 (76.2%) of the children originally contacted participated and 11.3% were diagnosed with atopic eczema at the time of examination. The median severity scores was 21.4 (interquartile range 13.5) and there was a tendency to higher scores in west Germany for the mean overall score, the intensity score and the extent. 'Erythema' (1.30 vs. 1.06; P = 0.006) and 'excoriation' (0.77 vs. 0.36; P = 0.002) were significantly more prominent in children with eczema from west Germany (adjusted for observer). Interobserver variabilities of the SCORAD parameters were calculated, adjusted for location and were in accordance with earlier findings. Principal component analysis identified three independent factors accounting for 54.1% of the total variance. A severity factor, characterized by 'extent', 'lichenification', 'excoriation' and 'pruritus', was separated from a factor with an acute eczema-type profile ('erythema', 'oedema', 'oozing') and a factor whose major characteristics were 'extent', 'dryness', and 'sleep loss'. We conclude that atopic eczema is frequent in pre-school children. The SCORAD proved to be readily applicable and useful in epidemiological studies, but further validation is needed.

Analysis of Variance↗

PubMed1997

Treatment of childhood Hodgkin's disease without radiotherapy.

BACKGROUND: To minimize the side effects of treatment in children with Hodgkin disease (HD), chemotherapy was given without radiotherapy. PATIENTS AND METHODS: From 1975 to 1984, 21 patients with HD having lymph nodes < 4 cm were treated with six MOPP courses. From 1984 to 1987, all children presenting with HD (n = 17) were given six ABVD courses. From 1987 to 1993 all children (n = 21) were treated with six alternating ABVD and MOPP courses. RESULTS: MOPP-treated children showed an event-free survival (EFS) of 91%, overall survival, 100%; ABVD-treated children had an EFS of 70%, overall survival, 94%; ABVD-MOPP-treated children had an EFS of 91% and an overall survival of 91%. Two cases developed a second malignancy. Toxicity was low. CONCLUSIONS: In children, ABVD-MOPP treatment gives a good survival, and toxicity is low. Radiotherapy is not needed to treat HD in children.

Adolescent↗

PubMed1996

Irreversible gonadal damage in male survivors of pediatric Hodgkin's disease.

BACKGROUND: Gonadal damage in adult patients after chemotherapy for Hodgkin's disease is well documented, but data of patients treated before adulthood are scarce. METHODS: Gonadal and hormonal function were studied in 19 male long term survivors of Hodgkin's disease who were treated with mechlorethamine, vincristine, procarbazine, and prednisone (MOPP chemotherapy) before (n = 15) or during puberty (n = 4). The studies were performed a median of 10 years after treatment and repeated in the majority of the patients at the time of yearly visits. RESULTS: Germ cell damage was present in all patients. Semen analysis revealed azoospermia in 12 patients and oligospermia in 6; no recovery of spermatogenesis was seen at follow-up. Testicular size was small in all but one patient. Follicle-stimulating hormone levels were elevated (mean, 14.4 +/- 7.8 U/l) and increased over time (mean, 21.1 +/- 10.5 U/l, P < 0.001). In seven patients, luteinizing hormone (LH) was elevated, indicating Leydig cell dysfunction; also in four of those patients, plasma testosterone was decreased. In three other patients, the response of LH to gonadotropin-releasing hormone was exaggerated with a normal basal LH and testosterone. Comparing testicular function of prepubescent versus pubescent state at time of treatment appears to show a trend for improved outcome in the younger patients. CONCLUSIONS: Gonadal function of long term survivors of pediatric Hodgkin's disease treated with MOPP chemotherapy is severely impaired permanently.

Adolescent↗

PubMed1996

Treatment of childhood Hodgkin's disease with ABVD without radiotherapy.

Seventeen previously untreated children with Hodgkin's disease were treated with six courses of the combination adriamycin, bleomycin, vinblastine, and DTIC (ABVD), without radiotherapy, from 1984-1987. In all patients, complete remission was attained. After a median follow-up period of 73.5 months (range 59-98 months) five patients had a relapse after 4, 5, 11, 21, and 34 months, respectively, from attainment of complete remission. In 12 patients with stages I and II, two relapses occurred. Three out of five patients with stage III and stage IV developed a relapse. Based upon these results, we conclude that ABVD might be an appropriate treatment for newly diagnosed children with Hodgkin's disease stages I and II. However, for children with stages III and IV more intensive treatment is needed. Radio-therapy should be withheld for children with refractory disease, residual disease, or relapse.

Adolescent↗

PubMed1996

Triple immunofluorescence staining for prediction of relapse in childhood precursor B acute lymphoblastic leukaemia.

In this study we describe a fast and sensitive method using three-colour immunofluorescence for the detection of cells with phenotypes that are rare in normal bone marrow (BM) but occur frequently in children with precursor B acute lymphoblastic leukaemia. We show that, in the first year after initiation of therapy, in 17/18 patients (10 patients were analysed after first diagnosis and nine patients after first BM relapse; one patient was analysed on both occasions) the percentage of CD10+ CD19+ cells and CD20- CD22+ cells in the CD34+ cell population indicated the likelihood of relapse. A suppression of cells expressing these phenotypes after initiation of therapy was followed by an outgrowth of normal precursor B cells after 12 months. Therefore this early test for impending relapse (which occurred 10-28 months after starting chemotherapy) was only applicable in the first year after beginning the treatment. However, despite this predictive value, comparison of fluorescence data with PCR results obtained from the same BM sample indicated that only a subpopulation of the CD34+ CD10+ CD19+ and CD34+ CD20- CD22+ cells above the determined threshold value represented malignant cells. A large prospective study to confirm the predictive value of this three-colour immunofluorescence assay is warranted.

Burkitt Lymphoma↗

PubMed1996

Atopic eczema and other manifestations of atopy: results of a study in East and West Germany.

Within an environmental health study, dermatologic examination of 1273 pre-school-age children (5-7 years old) was carried out in selected areas of East (n = 287) and West (n = 987) Germany in spring 1991. On the basis of comparable genetic background, the influence of a different exposure to air pollutants on the manifestation of atopic diseases was investigated. Halle an der Saale (East Germany) and Duisburg (North/South) as well as Essen (West Germany) were chosen as polluted study areas, whereas the countryside town of Borken (West Germany) served as a control region. Outdoor pollution with particles and SO2 was significantly higher in Halle an der Saale. Of the total study group, 12.9% suffered from atopic eczema at the time of examination. The prevalence was highest in East Germany (17.5%; adjusted odds ratio [OR] 1.39, confidence intervals [GI] 0.77-2.52, compared to Borken). The reported frequencies of hay fever and asthma in the total study population were 2% and 1.3%, respectively, without significant differences between study sites. Some 34.7% of the children showed at least one positive skin prick test reaction; significantly (P < 0.001) higher sensitization rates were obtained in western regions (Essen, Duisburg-South) than in the control region (Borken) and East Germany. Multivariate analysis of the prevalence of atopic eczema showed associations with parental predisposition (OR 1.52, CI 1.03-2.25), sex (for boys, OR 0.63, CI 0.43-0.92), location (Duisburg-South vs Borken OR 0.52, CI 0.30-0.96), month of investigation (May vs April, and March vs February OR 0.55, CI 0.37-0.81), contact with rabbits (for girls, OR 2.90, CI 1.36-6.19), animal fur in bedrooms (2.17, 1.01-4.67), indoor use of gas without hood (1.68, 1.11-2.56), and distance of homes from a busy road (< 50 m 1.71, 1.07-2.73). Nonsignificant associations were observed for history of helminthic infections (OR 1.61, CI 0.98-2.64) and high parental education level (OR 1.83, CI 0.83-4.02). In East and West Germany, atopic eczema seems to follow a course different from that of respiratory allergic diseases and specific sensitization, a fact which underlines the need for a differentiated analysis.

Air Pollutants↗

PubMed1996

Ifosfamide in the treatment of pediatric malignancies.

Neuroblastomas, nephroblastomas, malignant mesenchymal tumors, including rhabdomyosarcomas, Ewing's sarcomas, osteosarcomas, brain tumors, and non-Hodgkin's lymphomas respond to ifosfamide monotherapy. Ifosfamide has found an established place in the treatment of these pediatric malignancies. Ifosfamide has been shown to be an especially valuable agent in brain tumors in patients with a poor-prognosis medulloblastoma. The combination of ifosfamide with other cytotoxic drugs is more effective than ifosfamide medication alone. Ifosfamide has to be given with mesna to prevent bladder toxicity, but other toxic side effects, such as neurotoxicity, nephrotoxicity, and gonadal damage, are more difficult to prevent. Ifosfamide has proven to be an important asset in the treatment of cancer in children.

Antineoplastic Agents, Alkylating↗

PubMed1996

Clonal evolution of immunoglobulin heavy chain rearrangements in childhood B-precursor acute lymphoblastic leukemia after engraftment in SCID mice.

We grafted childhood B-precursor acute lymphoblastic leukemia (ALL) bone marrow (BM) cells into mice with severe combined immunodeficiency (SCID), in order to study the clonal evolution of immunoglobulin heavy chain (IgH) rearrangements in the absence of selective pressure by chemotherapy. BM cells from nine patients (six diagnosis samples and three relapse samples) were intravenously injected into SCID mice (three mice for each patient). All mice injected with cells from four patients developed a leukemia-like illness 12-40 weeks after injection. By PCR, new subclones that were the result of ongoing IgH rearrangement according to the mechanism operative in the injected cell populations (VH-replacement or VH to D-JH joining) were detected in the engrafted cell populations for all four patients. Subclones were mouse-specific, suggesting that subclone formation is a continuous process. Southern analysis after engraftment was unaltered as compared to the injected cells for one patient and revealed changes indicative of altered clonal composition for three patients. For two patients the observed changes possibly reflect the initial engraftment of a limited number of cells and occurred without changes in other parameters of the engrafted cell population, such as time needed for the development of leukemia, macroscopic organ involvement, immunophenotype and S-phase fraction. In one patient, we demonstrated the selective outgrowth of only a single cell type present at diagnosis, as characterized by IgH rearrangements. Our data show that evolution of clonal IgH rearrangements in B-precursor ALL may occur without the selective pressure of chemotherapy. Additionally, in some patients subclones present at diagnosis, as defined by IgH rearrangements, also possess different biological properties.

Animals↗

PubMed1995

Mitoxantrone is effective in treating childhood T-cell lymphoma/T-cell acute lymphoblastic leukemia.

BACKGROUND: T-cell malignancies in childhood are highly malignant diseases usually treated with intensive multidrug chemotherapy. In these regimens, anthracyclines, which are considerably cardiotoxic, are used. Mitoxantrone is structurally related to the anthracyclines, but it is considered to be less cardiotoxic. Therefore, the effectiveness of mitoxantrone in treating childhood T-cell malignancies was studied. METHODS: Fourteen newly diagnosed children with T-cell malignancies (12 T-cell non-Hodgkin's lymphoma, 2 T-cell acute lymphoblastic leukemia) initially were treated with one bolus injection of mitoxantrone, 12 mg/m2 intravenously, 1 week before standard induction therapy was begun. The effect of mitoxantrone was evaluated at Day 8, just before standard induction therapy was begun. RESULTS: Of 12 evaluable patients, 11 had significant positive responses with regard to the size of the primary tumor, the size of the involved peripheral lymph nodes, and the presence of lymphoblasts in the peripheral blood. The toxicity of mitoxantrone was mild. CONCLUSIONS: Mitoxantrone is effective in treating childhood T-cell malignancies. Its efficacy needs to be compared with the anthracyclines in a future randomized study.

Antineoplastic Agents↗