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Biomedical subjects

H Gerhartz

Publications and source records attributed to H Gerhartz.

At least 37 records · Page 2Linked to original sources
PubMed1989

Amsacrine, cytarabine and thioguanine (AAT) versus daunorubicin, cytarabine, thioguanine (DAT) in adults with untreated acute non-lymphoblastic leukemia (ANLL). Austrian-German results.

69 patients (median age 53 years, 19-79 years old) with untreated acute non-lymphoblastic leukemia (ANLL) were randomized to receive either a regimen of amsacrine, cytarabine, thioguanine (AAT) or daunorubicin, cytarabine, thioguanine (DAT). AAT consisted of amsacrine 200 mg/m2/day x 5, thioguanine 100 mg/m2/12 h p.o. x 10; DAT was daunorubicin 50 mg/m2/day x 3, cytarabine 200 mg/m2/day x 5, thioguanine 100 mg/m2/12 h p.o. x 10. After one or two induction courses the patients subsequently received 2 consolidation courses. 17 patients were not assessable for response to therapy due to exitus during induction treatment. Complete remission could be obtained in 14/24 (58%) of DAT patients respectively. Patients less than 60 years of age achieved CR in 63% (AAT) vs 65% (DAT), whereas patients greater than or equal to 60 years obtained a CR in 50% (AAT) vs 13% (DAT). Toxicity appears not to be increased significantly with amsacrine. These data indicate that amsacrine could replace daunorubicin in remission induction regimens of ANLL containing cytosin arabinoside and thioguanine without decreasing the response rate.

Adolescent↗
PubMed1988

Prognostic risk factors in advanced Hodgkin's lymphoma. Report of the German Hodgkin Study Group.

In a national multicentre trial in the FRG patients with Hodgkin's lymphoma in stages CS/PS III B/IV were entered into the HD 3 protocol and received induction chemotherapy with 3 x (COPP + ABVD). Patients in complete remission (CR) received consolidation therapy by either radiotherapy (20 Gy IF) or chemotherapy (COPP + ABVD). Patients not in CR received salvage therapy (40 Gy in case of persisting nodal disease, else 4 x CEVD chemotherapy). Between July 1983 and May 1987 230 untreated patients aged 15 to 60 qualified for this HD 3 protocol. This analysis is based on the first 137 patients evaluable for response. Of these, 86 (63%) achieved CR after induction chemotherapy. Including salvage therapy a total of 104 patients (76%) achieved CR. Univariate and multivariate prognostic risk factor analyses were performed using freedom from treatment failure (FFTF) as endpoint. Sex, age, splenectomy, bone marrow, liver and bone involvement had no prognostic impact nor had stage according to the Ann Arbor classification. In contrast, a pretreatment erythrocyte sedimentation rate (ESR) above 80 mm/h and a serum alkaline phosphatase (AP) above 230 IU/ml appeared as significant risk factors (p less than 0.01, relative risk 2.3). The two parameters were not independent. Comparing a group A (ESR less than or equal to 80 and AP less than or equal to 230) versus a pooled group B (ESR greater than 80 and/or AP greater than 230) increased the difference (p less than 0.001, relative risk of 2.8) which was also significant for survival (p less than 0.04).

Adolescent↗
PubMed1988

[Multicenter prospective risk-adapted study on the therapy of non-Hodgkin's lymphomas of high malignancy. Use of COP-BLAM/IMVP-16 and randomized adjuvant radiotherapy--study concept and preliminary results].

In a multicenter prospective randomized therapeutic trial in advanced (stage II-IV disease, Ann Arbor classification) high-grade malignant non-Hodgkin's lymphomas (NHL, Kiel classification) a sequential combination of the COP-BLAM (5 cycles) and the IMVP-16 (2 cycles) protocols was employed. Response was first determined after 2-3 cycles. In a response-adapted manner the therapy was immediately switched to IMVP-16 if only a partial remission or no response was obtained as evidenced by the first restaging. The aim of the study is the investigation of the efficiency of this concept to induce stable remissions. In an additional randomized trial, involving all patients reaching complete remissions after chemotherapy (second restaging), the prognostic relevance of adjuvant radiotherapy as compared to therapy-free follow-up is evaluated. Eighty percent of the 191 recruited qualified patients have so far become evaluable. Complete clinical remissions were achieved in 76/148 (51%) of the patients up to the first, in 52/85 (61%) of the patients up to the second restaging. Only in a few cases did the expected toxicity of intensive polychemotherapy reach WHO grade 3-4, including nausea and diarrhea, infections, septic complications, myelotoxicity, and stomatitis. Four of the 29 deaths recorded so far occurred in complete remission due to treatment-related complications, whereas 22/29 (76%) died in progression and 3 of unrelated causes.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1988

[Therapy of Hodgkin's lymphomas. Results of the German Hodgkin's Disease Study Group].

Between July 1983 and May 1987 143 untreated patients with Hodgkin's lymphoma in stages I-IIIA with risk factors qualified for the HD1 protocol, and 230 patients in stages IIIB/IV qualified for HD3. Patients in HD1 received a combined chemo-radiotherapy (2 x COPP + ABVD + 20 Gy EF vs. 40 Gy EF). Patients in HD3 received induction chemotherapy (3 x COPP + ABVD) and were randomized into consolidation by radiotherapy (20 Gy IF) vs. chemotherapy (1 x COPP + ABVD). In HD1, 73 of 89 evaluable patients (82%) achieved a complete remission. The survival of patients in stages I-IIIA with risk factors treated according to HD1 is as good as the survival of patients in stages I and II without risk factors. In HD3, 86 of 137 patients (63%) achieved complete remission after induction chemotherapy with 3 x COPP + ABVD. This is significantly better than the 31% complete remission rate observed in a pilot study with COPP alone (p less than 0.01). Including salvage therapy (radiotherapy in case of persisting nodal disease; chemotherapy with 4 x CEVD in case of persisting disseminated disease), a total of 76% complete remissions in stages IIIB/IVAB were achieved. An ESR greater than 80 mm/h was the most significant single risk factor in stages IIIB/IV for induction of CR and freedom from progression.

Adolescent↗
PubMed1987

[Therapy studies of the German Hodgkin's Study Group. Intermediate results of the study protocols HD1, HD2, and HD3].

Between July 1983 and September 1986 358 untreated patients with Hodgkin's lymphoma qualified for the protocols HD1 (stages I to IIIA with risk factors), HD2 (stage IIIA), and HD3 (stages IIIB and IVAB). Patients in HD1 received a combined chemo-radiotherapy (2 X COPP/ABVD + 40 Gy EF vs. 2 X COPP/ABVD + 20 Gy EF). Patients in HD2 were randomized into radiotherapy (TNI 40 Gy) vs. combined chemo-radiotherapy (2 X COPP/ABVD + 20 Gy IF). Patients in HD3 received induction chemotherapy (3 X COPP/ABVD) and were randomized into consolidation by radiotherapy (20 Gy IF) vs. chemotherapy (1 X COPP/ABVD). In HD1, 51 out of 65 evaluable patients (78%) achieved a complete remission. The survival of HD1 patients is as good as the survival of patients in stages I and II without risk factors. In HD3, 58 out of 93 patients (62%) achieved complete remission after induction chemotherapy with COPP/ABVD. This is significantly better than the 31% complete remission rate observed in a pilot study with COPP alone (p less than 0.01). Including salvage therapy (radiotherapy in case of persisting nodal disease; chemotherapy with 4 X CEVD in case of persisting disseminated disease), a total of 71% complete remissions in stages IIIB/IVAB were achieved. The progression-free survival of HD3 patients who received consolidation therapy is significantly longer than of patients who refused consolidation therapy.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

[Value of noninvasive and intraoperative diagnosis of malignant mediastinal tumors].

Among malignant tumors of the mediastinum lymphomas are no indication for operation. In our experience, however, fine needle puncture, computed tomography (CT), nuclear magnetic resonance, mediastinoscopic biopsy of lymph nodes and intraoperative freeze section histology can only rarely differentiate between lymphomas and other tumors of the mediastinum. Only CT-guided or direct parasternal biopsy including immunhistochemistry can yield a reliable preoperative diagnosis and prevent unnecessary operation of lymphomas.

Biopsy↗
PubMed1985

Granulopoietic progenitor cells (CFU-C) in patients with acute leukemia: a comparison of two different culture techniques.

Determination of colony formation has become a powerful tool in investigating hematopoiesis in patients with acute leukemia. Reports in this field, however, are somewhat controversial. This might be due to the use of different stimulation techniques. We compared the conventional feeder-layer technique with a method using human placental conditioned medium (HPCM) for stimulation of colony forming cells (CFU-C) in 31 patients with acute leukemia at various stages of their disease. Statistical analysis showed that the numbers of clusters and colonies determined by each of the methods were comparable and correlated significantly. Thus, in demonstrating granulopoiesis in leukemia patients, each method can be reliably used. The HPCM-technique offers the advantage of better standardization and is more convenient.

Acute Disease↗
PubMed1984

[New aspects in the antiemetic therapy of cytostatic drug-induced vomiting].

The present intensification of cancer chemotherapy has resulted in increased toxicity. Nausea and vomiting are often severe and prolonged, rendering a patient unfit for further treatment. This review summarizes the current understanding of the physiology of vomiting and the pharmacology and efficacy of the antiemetics in clinical use. It also discusses new approaches with agents, such as cannobinoids, high-dosage metoclopramide, and high-dosage corticosteroids. The new agents are superior to standard antiemetic drugs as demonstrated in a number of trials.

Antiemetics↗
PubMed1984

Cytogenetic studies in dogs after total body irradiation and allogeneic transfusion with cryopreserved blood mononuclear cells: observations in long-term chimeras.

Cytogenetic studies were performed on two dog groups after total body irradiation and allogeneic transfusion with cryopreserved blood mononuclear cells. The first group of dogs was transfused with unseparated leukocytes and suffered from graft-versus-host disease (GvHD). Cytogenetic studies demonstrated only cells of donor origin in all dogs of this group. The second group of animals was transfused with fraction 2 of a discontinuous albumin gradient. The dogs of this group did not develop GvHD, and the cytogenetic studies showed the presence of a mosaic of cells from donor and recipient origin in all of them. These results suggest that the GvHD may suppress autochthonous regeneration.

Animals↗
PubMed1984

[Cytostatic therapy of advanced squamous cell carcinoma of the head and neck. A randomized study comparing cis-dichlorodiammineplatinum(II) and bleomycin with methotrexate and vindesine].

79 patients were randomized and treated either with cis-DDP 33 mg/kg i.v. day 1 and BLM 15 mg/m2 i.v. continuously day 2-6 (arm A) or less aggressively with MTX 30 mg/m2 i.v. day 1 + 6 and VDS 3 mg/m2 day 2 + 7 (arm B). Patients with inadequate response were further treated with the alternative regimen ("cross over"). Regarding response rates therapy A was superior to B (p = 0.01) respectively p = 0.05 for the cross over patients. Not pretreated in comparison to pretreated patients demonstrated not significantly better results. Pretreated patients had statistically superior response rates with arm A than with arm B (p = 0.05). All other prognostic factors were without any influence on treatment results. CR induced by chemotherapy (2 X) in not pretreated patients could be increased by additional surgery and X-ray therapy (CR = 26X). Survival times demonstrated no difference between both regimes. Chemotherapy was of less influence on median survival times after 39 months than in comparison to post-chemotherapeutically performed surgery +/- radiotherapy in 44 not pretreated patients. Chemotherapy: CR + PR to MR + NC + PD 16 respectively 13 months with 38 respectively 48% survivors (p = 0.25). Surgery +/- radiotherapy: CR + PR median not reached yet, MR + NC + PD 13 months with 60 respectively 18% survivors (p = 0.001).

Adult↗
PubMed1983

Dipeptidylaminopeptidase IV (DAP IV) activity in normal and malignant T-cell subsets as defined by monoclonal antibodies.

The activity of dipeptidylaminopeptidase IV (DAP IV) was investigated by a cytochemical method in isolated fractions of normal peripheral blood mononuclear cells and malignant cells from 9 patients with chronic T-cell leukaemia. A positive DAP IV reaction was observed in 52% of normal T cells, a consistent negative reaction in normal B cells and monocytes. 2 distinct T-cell subsets, helper/inducer cells (T4+/T8-) and cytotoxic/suppressor cells (T4-/T8+), were negatively selected by complement-mediated cytolysis utilizing the monoclonal antibodies OKT4 and OKT8. On examination of these T-cell subsets a positive DAP IV reaction was restricted to the majority of normal T4+/T8- cells. The malignant cells from 3 patients with T-chronic lymphocytic leukaemia, expressing the cytotoxic/suppressor phenotype (T4-/T8+) lacked DAP IV activities. In contrast, almost all leukaemic cells from 3 other cases, expressing the helper/inducer phenotype (T4+/T8-), were strongly positive. Despite their T4+/T8- phenotype, the malignant cells from 3 patients with Sézary syndrome were completely DAP IV negative. These findings suggest that the DAP IV reaction may be helpful in the further characterization of normal and malignant T-cell subsets.

Aged↗
PubMed1983

[2d interim evaluation of a chemotherapy study on patients with squamous cell carcinomas of the head-neck area. A comparison of 2 therapy regimens: cis-diamminedichloroplatinum (II) and bleomycin versus methotrexate and vindesine].

52 patients with epidermoid cancer of the head and neck region were either treated with cis-DDP and bleomycin (arm A) or with methotrexate and vindesine (arm B). In case of resistance patients were further treated with the alternative regimen (A leads to B or B leads to A). Treatment results are superior in arm A. Complete and partial remission were in A: 54%, in B: 31%, after crossover 46% and 0%, respectively. Status of pretreatment (operation and/or radiotherapy) is of minor importance for arm A than for the "soft" treatment of arm B. Preliminary analysis of survival and remission duration shows no significant difference in regard to A or B and status of pretreatment. However, those patients resistant to B and further treated with A have an increase of median survival from 3 to 9 months (p = 0.02). With primary chemotherapy inoperable tumors can be made operable with curative intention.

Adult↗
PubMed1983

Hemorrhagic infarction of the basal ganglia. An unusual complication of acute leukemia.

Hemorrhagic infarction of the basal ganglia was observed in 2 young adult patients with acute leukemia who presented with progressive hemiparesis combined with severe mental alterations. In case 1 (AML) lethal infarction due to thrombosis of both internal cerebral veins occurred during induction therapy for relapsed leukemia; in case 2 (cALL) a devastating stroke probably due to deep cerebral venous thrombosis happened during the third remission. Neither of them had hyperleukocytosis, signs of infection, disseminated intravascular coagulation or CNS leukemia. We discuss long-term glucocorticoid therapy (case 1) and combined prophylactic CNS treatment (case 2) as possible risk factors for cerebrovascular thrombosis in acute leukemia.

Acute Disease↗
PubMed1980

Rosette-formation with mouse red blood cells in chronic lymphocytic leukemia and leukemic non-Hodgkin's lymphomas.

Peripheral blood lymphocytes from 30 patients with chronic lymphocytic leukemia (CLL) and 18 patients with malignant non-Hodgkin's lymphomas in leukemic phase were studied for rosette-formation with neuraminidase-treated mouse erythrocytes. The proportion of rosette-forming cells in CLL was significantly higher (p < 0.001) than in 12 cases of lymphoplasmacytoid malignant lymphoma (LPL). Our results suggest that this test may be a helpful method in the differentiation of CLL from leukemic LPL, which usually can not be distinguished by morphological criteria alone.

Animals↗
PubMed1980

[Prolymphocytic leukemia: clinical, cytologic and immunologic findings].

The clinical development and progress of disease in two women with prolymphocytic leukaemia are reported. The morphology of the leukaemic cells was the most important diagnostic criterion in both cases. In one patient the disease was characterized by immunological methods as being a B-cell leukaemia, in the other a T-cell leukaemia. At the time of diagnosis one patient showed the typical clinical symptoms like excessive lymphocytosis and splenic enlargement. In the other case no splenomegaly and only a slight lymphocytosis was found. During a period of 20 months without treatment the disease was only slightly progressive. Due to the favorable course of the disease in this case it may be concluded that the clinical picture of prolymphocytic leukaemia with distinct lymphocytosis and splenic enlargement is preceeded by a relatively long symptom free period.

Aged↗