Biomedical subjects

H Eghbali

Publications and source records attributed to H Eghbali.

At least 55 records · Page 3Linked to original sources

PubMed1988

Non-Hodgkin's malignant lymphomas in patients older than 80. 70 cases.

In two centers (a comprehensive cancer center and a university hospital) 1300 patients with non-Hodgkin's lymphomas (NHL) were observed during the past 15 years. Seventy patients (5.4%) were diagnosed after they were 80 years old. Thirty-four patients had low-grade NHL, eight had intermediate grade, and 28 had high-grade NHL. The majority of them were classified as Stage I (n = 24) or II (n = 18), and the rest as Stage III (n = 16) or IV (n = 12). Treatment varied with grade of NHL, tumoral extension, and performance status. Forty-seven patients were given chemotherapy, 37 radiotherapy, and six patients had surgery. Overall, treatment was considered to be optimal in 12 patients, good in 34 patients, and limited in 24 patients. Toxicity was minimal in 62 patients, treatment-limiting in two patients, and lethal in six patients. Thirty-seven patients achieved a complete remission (CR), 21 a partial remission, five experienced stabilization, and seven failed to respond. For all patients, the median survival (MS) was 18 months. In contrast to younger patients, malignancy grade had no significant influence. The only significant parameter is CR (P = 0.02). In conclusion, very old patients must be treated correctly but carefully. Better tolerated treatments are needed to improve results that are neither very poor nor as good as in younger patients.

Age Factors↗

PubMed1988

Localized follicular lymphomas: prognosis and survival of stages I and II in a retrospective series of 103 patients.

From 1966 to 1985, 103 patients with a localized (stages I and II) follicular lymphoma (Kiel classification) were treated at the Fondation Bergonié. Clinical staging was performed using, after physical examination, chest X-rays (100%), bipedal lymphangiography (98%) and unilateral bone marrow biopsy (BMB) (51.5%). The patients were then treated by radiotherapy with or without chemotherapy. Overall survival (OS) at 5 and 10 years is 69 and 56.3%, respectively. Relapse-free survival (RFS) is 53.7 and 49%. Unifactorial analysis shows three prognostic parameters to be independently significant in terms of OS: age, stage and B symptoms. In terms of RFS, only 2 factors are significant: age and B symptoms. Multivariate analysis (Cox model) shows that age is a more important prognostic factor than stage.

Adult↗

PubMed1988

Brief chemotherapy associated with extended field radiotherapy in Hodgkin's disease. Long-term results in a series of 102 patients with clinical stages I-IIIA.

From 1972 to 1976, 102 patients with stages I-IIIA Hodgkin's disease (HD) were treated by chemotherapy with cyclophosphamide, vinblastine, procarbazine and prednisone (CVPP: two courses) associated with extended field radiotherapy. Staging included neither laparotomy nor splenectomy (clinical staging). Treatment included neither splenic irradiation nor maintenance therapy. Complete remission was achieved for 98 patients and 11 of them recurred up to 94 months after treatment. Median follow-up of this controlled study is 13 years. Disease free survival (DFS) is 87% at 6 years and 84% at 10 and 15 years. Overall survival is 77% at 10 and 74% at 15 years. Disease specific survival is better (91% at 10 and 87% at 15 years) since only 38% (10/26) deaths were due to HD. The other deaths (16/26) with no evidence of HD were due to second cancer and intercurrent disease. Prognostic analysis of DFS by log-rank test gives significance to the following factors: contiguous extra-nodal involvement (P = 0.008), more than 3 involved sites (P = 0.01), signs of compression (P = 0.02), clinical stage IIIA (P = 0.03), infradiaphragmatic stages I-II (P = 0.04). The potential risk of secondary cancer is difficult to assess.

Adult↗

PubMed1988

[New combination of epirubicine, bleomycin, vinblastine and prednisone (EBVP II) before radiotherapy in localized stages of Hodgkin's disease. Phase II trial in 50 patients].

A new regimen of chemotherapy was used to reduce toxicity of EBVP I: the number of injections and the doses of bleomycin and vinblastine were reduced by half, the duration of treatment by third. Fifty patients with Hodgkin's disease stage I to IIIA, previously untreated, received three courses of this regimen before radiotherapy. Gastro-intestinal toxicity was similar and alopecia was more marked than with EBVP I. Immediate efficacy is similar, with 90% of complete remission and only one failure. This regimen is shorter and more intensive than EBVP I. It deserves larger comparison with previously used chemotherapy in a more extensive controlled trial.

Adolescent↗

PubMed1988

Interleukin-2 receptor is functionally linked with in vitro activation of B cells isolated from non-Hodgkin's lymphomas.

Proliferation and differentiation of B cells can be promoted by a number of inducing factors, including interleukin-2 (IL-2). In vitro-stimulated normal B cells usually express IL-2 receptors (TAC). Furthermore, it has been reported that some minor sub-populations of B cells in normal lymphoid tissue also express TAC antigen, as do some leukemic B cells. In the present study, the reactivity of 20 specimens of non-Hodgkin's lymphoma or B-cell origin was examined for a wide panel of monoclonal antibodies (MAb), including an anti-TAC MAb. The ability of the isolated and purified B cells to proliferate in the presence of B-cell mitogens and culture supernatants (containing various growth factors, including IL-2) was also investigated. These experiments provided some evidence that the TAC-negative cells remained unreactive, whereas the TAC-positive cells entered the cell cycle and proliferated. IL-2 responsiveness of neoplastic B cells is therefore discussed.

Antibodies, Monoclonal↗

PubMed1987

Distinct entities among low-grade non-Hodgkin's malignant lymphomas. Analysis of a series of 377 cases.

A series of 377 low-grade non-Hodgkin's lymphomas, observed in the same Institute, was analysed. Pathological types following the Kiel classification were crossed with the usual parameters of patients (sex, age) and disease (tumoural extension, main anatomical involvement, biological data, course of the disease). Small differences appeared for the survivals for the overall series. By contrast many significant differences were observed for sex, age, dissemination of the disease, special tissue involvement, monoclonal gammopathy, complete remission rate and further involvement in case of relapse. These parameters allow one to distinguish different clinicopathological entities after the morphological cellular features. Such correspondences appear meaningful and might be offered by any other classification which should not be based only on the prognosis.

Age Factors↗

PubMed1987

Secondary involvement of the central nervous system in malignant non-Hodgkin's lymphoma. A study of 30 cases in a series of 498 patients.

Of 498 patients with non-Hodgkin's lymphoma (NHL), 30 showed secondary central nervous system (CNS) involvement. Of these 30 patients, 26 had high-grade malignancy and 21 lymphoblastic lymphoma, mainly convoluted (n = 8) or Burkitt (n = 6) type according to the Kiel classification. In half of the 30 patients, CNS involvement was associated with progressive lymphoma. Bone marrow involvement was found in half of the patients before or at the time of the diagnosis of CNS involvement, which was 12 months (mean) after the diagnosis of NHL. Eight patients received CNS prophylaxis. Results of treatment for CNS involvement are poor (mean survival time from CNS involvement: 3.5 months). The Kiel classification allows good identification of patients at high risk of CNS lymphoma: systematic CNS prophylaxis is indicated only in the convoluted and Burkitt types. An efficient prophylaxis must be found and results must be confirmed by other studies.

Adolescent↗

PubMed1987

[The combination of epirubicin, bleomycin, vinblastine and prednisone (EBVP) before radiotherapy in localized stages of Hodgkin's disease. Phase II trials].

A new regimen of chemotherapy was used to reduce toxicity of ABVD: adriamycin is replaced by epirubicin and dacarbazine by prednisone. Thirty eight patients with Hodgkin's disease, stage I to IIIA, previously untreated, received three courses of this regimen before radical radiotherapy. Gastro-intestinal toxicity and alopecia appeared less marked than with ABVD. Immediate efficacy is similar with 80% of complete remission (one third observed at day 28) and only 2 failures. This regimen appears thus as a clear improvement in the treatment of patients with Hodgkin's disease and deserves larger comparison with previously used chemotherapy in a more extensive controlled trial.

Adolescent↗

PubMed1986

[Prognosis of follicular lymphoma in a series of 180 cases].

In this series, the prognosis and the course of 180 cases of follicular lymphomas, classified according to Kiel's classification, seen before any treatment, treated and followed in the same institution were analyzed. In the first part, 6 primary prognostic factors were identified: compression, age of patient, stage, general symptoms, pathological subtype, lymphography. The most significant parameter (p less than 10(-10], obtained secondarily, was complete remission obtained in 63.9% of patients. In the second part, a multivariate analysis permitted to identify a few groups of patients for whom the probability of complete remission varied between 25 and 100%. Knowledge of these prognostic parameters may help to tailor treatment to each case and to obtain the best survival possible.

Adult↗

PubMed1986

[Data collection from patients treated for Hodgkin's disease. Relation to quality of life].

One hundred and fifty patients treated for Hodgkin's disease (stage I to IIIA) in a cooperative trial, answered a questionnaire dealing partly with their information, after 2 to 7 years of complete remission. This information appears insufficient for the majority of patients (52%), at least as far as treatment and its complications are concerned. There are many significant relations with other parameters which suggest that a good level of information may improve quality of life of patients. These observations tend to increase information of patients with Hodgkin's disease, provided it is adapted to each patient.

Follow-Up Studies↗

PubMed1986

[Psychosocial repercussions of the the treatment of Hodgkin's disease. Assessment by questionnaire with 150 patients].

One hundred and fifty patients, treated for Hodgkin's disease (stages I-IIIA) in a cooperative trial and remaining in complete remission after 2 to 7 years, answered a questionnaire dealing with psychosocial status and quality of life. Many informations were gathered and studied by multiparametric methods. Quality of life of patients appears determined by three kinds of parameters: patients' characteristics (age, sex, family and work status); stage of the disease determining the intensity and duration of treatment; practical conditions of treatment. These last parameters may be improved by therapeutic team and all care-takers to decrease bad consequences of disease and treatment and also to increase quality of life after cure.

Adolescent↗

PubMed1985

Tentative dose-monitoring of doxorubicin in lymphoma patients.

We have investigated the feasibility of individual dose-monitoring of doxorubicin in lymphoma patients. The purpose was to overcome the large variability of the early-phase kinetic parameters of the drug. We have used a test-dose and calculated for 32 patients a therapeutic dose which could allow us to obtain a predetermined early drug exposure. Such a predetermined drug exposure was obtained in 24 patients of the study. Important variations of the early clearance occurred in 8 patients.

Adolescent↗

PubMed1985

Pharmacokinetics and metabolism of epirubicin during repetitive courses of administration in Hodgkin's patients.

We studied the pharmacokinetics and metabolism of epirubicin (4'-epidoxorubicin) in ten patients suffering from Hodgkin's disease and receiving three successive injections of epirubicin at 15-day intervals in a combined chemotherapy regimen. Doses were either constant (35 mg/m2) or escalated from 25 to 35 and 50 mg/m2. Epirubicin metabolism was characterized by the presence of high levels of epirubicin glucuronide in plasma and urine. The area under the time-concentration plasma curve of epirubicin glucuronide reached almost that of unchanged epirubicin (mean ratio = 0.7-0.85), whereas the cumulative urinary excretion of epirubicin glucuronide was one-half of that of epirubicin (mean ratio = 0.45-0.51). Repeating or escalating the doses did not change the levels of the glucuronide significantly. Only a trend towards higher relative levels of glucuronide could be noticed at the lowest dose. The pharmacokinetic parameters of epirubicin were characterized by a high total plasma clearance (mean value: 70-85 1/hr) and a mean elimination half-life of 25-35 hr. Repeating or escalating the doses was followed by a slight increase of the total plasma clearance in most patients, without changes of the elimination half-life. The cumulative urinary excretion was 11-12% of the dose administered and did not vary significantly as a function of time or dose.

Adult↗

PubMed1985

Extended versus involved fields irradiation combined with MOPP chemotherapy in early clinical stages of Hodgkin's disease.

From 1976 to 1981, 335 patients with untreated Hodgkin's disease, clinical stages I, II, and IIIA, have been treated by MOPP (nitrogen mustard, vincristine, procarbazine, prednisone) chemotherapy, three to six cycles according to the prognostic factors, combined with radiotherapy. Irradiation was always performed after the first three cycles of chemotherapy, and was randomized between extensive radiotherapy, ie, mantle and paraaortic areas for supradiaphragmatic presentations, and radiotherapy restricted to the involved areas. No significant difference was observed between the two randomized branches for the disease-free survival (86% after six years in the involved field branch v 90% in the extended field branch), and none for the overall survival. Most of the relapses occurred in nonirradiated areas in the first group, and in irradiated areas in the second. Relapses were especially frequent in the IIE stages with pulmonary extension; extranodal relapses occurred with osseous and cutaneous localizations. Two cases of secondary leukemia were observed after three- or six-cycle MOPP plus radiotherapy limited to the involved areas.

Adolescent↗

PubMed1984

Hodgkin's disease in the elderly. A series of 30 patients aged older than 70 years.

Thirty patients aged older than 70 years formed 6.9% of all cases of previously untreated Hodgkin's disease seen in Bordeaux Cancer Center over a 20-year period. The subtype of mixed cellularity was predominant in this age group (P = 0.00035). One patient received no treatment; 20 patients received primary chemotherapy (14 polychemotherapy); all but 2 of the 18 patients in clinical Stages I or II received radical radiotherapy. Median survival for all patients is 15 months. In five cases the treatment could be held responsible for death. Eleven patients died of Hodgkin's disease within a 36-month period. Five patients are alive and the nine other patients died from other causes. The disease-free survival figures showed that one third of the patients could be considered as cured.

Age Factors↗

PubMed1984

Lymphoblastic lymphoma with convoluted nuclei. A report of 19 cases.

A clinically homogeneous population of patients who presented with lymphoblastic lymphoma of convoluted nuclear type was isolated using a histopathological criterion that can easily be applied by trained pathologists. This disease type preferentially affects young male patients, in over half of whom there is initial mediastinal involvement. There is a tendency for the disease to become leukemic and to invade the central nervous system. In spite of heavy chemotherapy and early neuromeningeal prophylaxis, the prognosis is poor.

Adolescent↗

PubMed1983

[Quality of life during and following radiochemotherapy for Hodgkin's disease. Evaluation of 60 patients].

Sixty patients treated for Hodgkin's disease by radio + chemotherapy and remaining in complete remission with a median follow-up of 26 months answered a questionnaire dealing with their quality of life during and after treatment. Their main request was to be better informed about their disease, treatment and its side effects. Therapeutic toxicity is mainly due to chemotherapy and is digestive in nature (nausea and vomiting) symptoms. The majority of patients complained of disturbances in their personal and professional lives. It is concluded that more complete knowledge of all patients' disorders may help doctors to improve treatment planning in order that the patient's quality of life be less disturbed.

Adolescent↗

PubMed1983

[Pharmacokinetic study of doxorubicin in the treatment of malignant non-Hodgkin's lymphomas].

We have studied the plasma kinetics of doxorubicin treatment in nine patients with non-Hodgkin's malignant lymphoma. Four patients were studied following the first two injections of this drug, the other five patients were studied only after the first injection. Our results corroborate the existence of three successive phases of doxorubicin plasma decay, with mean half-lives of 3.81 min, 1.19 h and 29 h. We observed an important variation of the pharmacokinetic parameters related to the distribution volumes. The total plasmatic clearance ranged between 32 and 67 l/h. The kinetics of doxurubicin are time-dependent, i.e. an important variation of the pharmacokinetic parameters related to the distribution volumes. The total plasmatic clearance ranged between 32 and 67 l/h. The kinetics of doxurubicin are time-dependent, i.e. an important variation of the pharmacokinetic parameters existed after the 2nd injection of the drug in three out of four patients. These 3 patients showed either an increase of the elimination half-life (1 case) or an increase of the distribution volume (1 case) or a decrease of the distribution volume (1 case) after the 2nd injection. We observed a significant correlation between the age of the patients and the early clearance of the drug, the youngest patients eliminating the drug more rapidly than the oldest ones. This observation may lead to the administration of different dosages of doxorubicin according to the age of the patient.

Adolescent↗