Search PubMed⌕ Search

Biomedical subjects

H E Wilson

Publications and source records attributed to H E Wilson.

At least 37 records · Page 2Linked to original sources

Adriamycin versus adriamycin plus cis-diamminedichloroplatinum (DDP) in advanced transitional cell bladder carcinoma. A Southwest Oncology Group study.

Patients with advanced transitional cell bladder carcinoma were randomized to receive either adriamycin alone, or adriamycin plus DDP. Overall response (CR + PR) was 8/41 (19%) for adriamycin alone versus 16/37 (43%) for the combination (p = 0.02). Median response duration was 14 weeks for adriamycin versus 25 weeks for the combination (p = 0.17). Median survival was 28 weeks on adriamycin versus 31 weeks on the combination (p = 0.82). Median survival of responders was 43 weeks, and for patients with stable disease it was 29 weeks. This was significantly better than for those with increasing disease at 15 weeks (p = 0.02). Increased frequency of leukopenia and gastrointestinal toxicity were seen with the combination. Cardiotoxicity and nephrotoxicity were not prohibitive.

Carcinoma, Transitional Cell↗

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↗

Specific antiemetics for specific cancer chemotherapeutic agents: haloperidol versus benzquinamide.

Sixty-four patients receiving cancer chemotherapy known to induce severe emesis entered a randomized double-blind study of the antiemetic efficacy of haloperidol (Haldol) and benzquinamide (Emetecon). Patients preferred haloperidol for control of emesis induced by cis-platinum (78 vs. 22%) or nitrogen mustard (67 vs. 16%). Patients receiving Doxorubicin preferred benzquinamide by a small margin (46 to 38%). Individual patients who experienced no relief with their first antiemetic (13 of 15) usually got some relief with the other after crossover. Haloperidol was more effective than benzquinamide (54 vs. 29%) in patients previously unrelieved by prochlorperazine (Compazine). Complete relief of vomiting was obtained in 14 of 45 patients receiving haloperidol but only five of 41 patients receiving benzquinamide experienced no vomiting, again dependent on the anticancer agent used. Although haloperidol is a more effective antiemetic agent overall, efficacy is related to the anticancer treatment and probably to individual patient characteristics.

Adult↗

Progress in the chemotherapy of small cell carcinoma of the lung.

A comparison was made between six different approaches to the chemotherapy of small cell carcinoma of the lung. The value of single-agent chemotherapy was compared to combination chemotherapy and radiation therapy, and with cyclic alternating combination chemotherapy in 161 patients. Cyclic alternating chemotherapy with modest radiation therapy to the primary site provided significant advantages over single-agent or combination chemotherapy. A combination of VP-16 + Adriamycin + vincristine seemed particularly effective in inducing an initial objective tumor response rate of 83%, with a projected median survival of 13.2 months. Of patients treated with cyclic alternating therapy, 51% were alive at one year. It thus appears that where complete response is achieved, prolonged disease-free survival can be expected.

Antineoplastic Agents↗

Chemotherapy of extensive large cell and adenocarcinoma of the lung: a randomized trial in 210 patients.

Two hundred ten patients with advanced adenocarcinoma of the lung were entered into a two-arm randomized trail. Cytoxan + CCNU + methotrexate was compared to Adriamycin and procarbazine. The tumor response to CCM was significantly higher than the tumor response to Adriamycin and procarbazine. No significant difference existed between the two treatments with respect to survival. Initial performance status, weight loss prior to therapy, and response to therapy were all found to be significant prognostic factors. Median survival time relative to responders in both treatment groups was 31.7 weeks and 15.8 weeks for non-responders.

Adenocarcinoma↗

Combination therapy protocol for stage III or IV carcinoma of the oral cavity, oropharynx and hypopharynx.

Combined therapy programs have improved recurrent and nodal metastatic rates but have not controlled distant metastases. A pilot study undertaken at Ohio State University evaluated the feasibility of adding chemotherapy to a combined modality regimen. The first phase determined that the toxicity of a four-drug combination chemotherapy yielded a favorable risk/benefit ratio and justified its inclusion in a protocol for untreated cancers. The second phase evaluated chemotherapy followed by surgery and postoperative irradiaation for untreated Stage III and IV epidermoid carcinoma of the oral cavity, oropharynx or hypopharynx. The overall chemotherapy response rate is 88% (22/25) with 6 complete and 16 partial responses. Evaluation of pathology specimens revealed 7 of 14 primary sites and 4 of 15 neck specimens had no histologic evidence of carcinoma. In the 10 patients who received all 3 modalities, 9 are free of disease (6 to 17 mo. follow-up).

Carcinoma, Squamous Cell↗

Therapy of advanced squamous carcinoma of the lung: cyclophosphamide vesus "COMB".

The four-drug combination of cyclophosphamide, vincristine, methyl CCNU and bleomycin was compared to CTX alone in a prospective randomized trial. Only one of 20 patients treated with COMB and one of 27 patients treated with CTX achieved a partial response. CTX was associated with a significantly better survival than COMB among patients who were ambulatory at onset of therapy. Survival among non-ambulatory patients was similar with both regimens.

Aged↗

Phase II evaluation of bleomycin. A Southwest oncology Group study.

Bleomycin given intravenously (i.v.) or intramuscularly (i.m.) in twice-weekly doses of 10 mg/m2 was evaluated for efficacy and toxicity in 382 patients. Responses were observed in 11/27 Hodgkin's diseases, 10/30 lymphomas, 9/22 squamous cell cancers of ectodermal origin, 12/26 germinal cancers, and 3/8 renal adenocarcinomas. The i.m. route is less likely to casue pulmonary toxicity or hypotension than the i.v. route. Advanced age and total doses exceeding 200 mg were associated with a higher risk of lung toxicity. All responders had shown at least improvement upon receiving 200 mg; higher total doses should be used only in responding patients.

Adenocarcinoma↗

Hydroxyldaunomycin (Adriamycin) combination chemotherapy in malignant lymphoma.

Combination chemotherapy with CHOP (cyclophosphamide, Adriamycin, vincristine, and prednisone) and HOP (Adrimycin, vincristine, and prednisone, was used as treatment for patients with pathologically staged, advanced non-Hodgkin's lymphoma. Among 204 evaluable patients treated on CHOP there were 71% complete remissions with 92% overall responses. Among the 216 evaluable patients on HOP there were 61% complete remissions and 88% responses. Complete remission rates among patients with histiocytic lymphoma were comparable to those of patients with lymphocytic disease. Patients with nodular lymphoma had higher rates of complete remission than their counterparts with diffuse lymphoma. This was noted with both CHOP (78% vs. 67%) and HOP (67% vs. 60%) induction therapy. Rapid responses were common, as more than 14% of complete remissions and 66% of overall responses were achieved with the first course of treatment. Patients in complete remission have been maintained with either cyclophosphamide, vincristine, and prednisone (COP) or arabinosyl cytosine, vincristine, and prednisone (OAP). After 1 year, 86% of patients on COP and 80% on OAP are projected to be free of disease.

Cyclophosphamide↗

Altered mitogenic responsiveness of chronic leukemic lymphocytes and normal human lymphocytes treated with dimethyl sulfoxide.

Peripheral lymphocytes from patients with chronic lymphocytic leukemia display a delayed and lowered response to stimulation by PHA, as compared with the lymphocytes from normal donors. This response was determined by measuring the incorporation of tritiated thymidine. The addition of DMSO in concentrations of 0.1%, 0.25%, 0.5%, 1.0%, and 2.0% (v/v) to the culture fluid of normal cell cultures that had been stimulated, with PHA elicited a 3- to 4-fold increase in the rate of incorporation of labeled thymidine at the 3-day test period. The addition of 2.0% DMSO proved to be preferentially cytotoxic to cultures of leukemic cells after 48 hours, as compared with the virtual absence of cytotoxicity for cultures of normal lymphocytes. The addition of 0.1%, 0.25%, 0.5%, and 1.0% DMSO to cultures of leukemic cells stimulated with PHA (as were normal cell cultures) resulted in a 6- to 6.5-fold increase in the rate of uptake of tritiated thymidine at 3 days.

Culture Media↗

Cellular immunity in neoplasia. Antigen and mitogen responses in patients with bronchiogenic carcinoma.

Cellular immune responses of patients with histologically confirmed lung carcinoma were assessed in vivo using cutaneous response and in vitro with a microlymphocyte blastogenic transformation (LBT) assay. In addition, correlation of the cutaneous response with the migration inhibitory factor (MIF) assay and LBT response was examined. The results indicated that cutaneous responses seen in patients with cancer of the lung were consistently lower than similar responses in normal controls (p less than 0.001). Similarily, the percentage of positive cutaneous responses seen with patients included in this study was lower than the frequencies reported by others. Stimulation of cells from lung cancer patients by PHA-M was also depressed when compared to similar lymphocytic responses in normal volunteers (p less than 0.001). The correlation between cutaneous response to tuberculin and the in vitro assays was high. The few instances of disparity demonstrate the need to utilize more than one assay in evaluating cellular immune functions. These data would support the work of others that indicate a depression of cellular immunity in advanced malignancy.

Antigens, Neoplasm↗

Hypomagnesemic hypocalcemia secondary to renal magnesium wasting.

Two patients developed severe hypomagnesemia, hypocalcemia, and hypokalemia as a result of renal wasting of magnesium and potassium shortly after being treated with large doses of gentamicin. When therapy with gentamicin was discontinued renal loss of magnesium and potassium ceased, and serum calcium, magnesium, and potassium returned toward normal. Serum immunoreactive parathyroid hormone levels were inappropriately low during the episodes of hypocalcemia. Both patients represent examples of hypomagnesemic hypocalcemia induced by inappropriate magnesuria, possibly caused by gentamicin. These observations suggest that serum calcium, magnesium, and potassium should be monitored during gentamicin therapy.

Aged↗