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Biomedical subjects

I T Magrath

Publications and source records attributed to I T Magrath.

At least 19 recordsLinked to original sources
PubMed1979

Cure of Burkitt's lymphoma. Ten-year follow-up of 157 Ugandan patients.

192 Ugandan patients with Burkitt's lymphoma were treated with various regimens containing high-dose cyclophosphamide. 21 patients died during induction therapy, and 14 died after partial responses. Of 157 patients who responded completely to treatment, 16 were lost to follow-up (10 in 69 died and 72 (51%) are alive and disease-free. 31 of the long-term survivors have relapsed at least once and have been successfully retreated. Overall, 34 surviving patients had central-nervous-system involvement, also successfully treated. It is concluded that Burkitt's lymphoma is curable in at least 50% of patients, and that relapse and central-nervous-system involvement are not incompatible with long survival.

BCG Vaccine↗
PubMed1979

Ultrasound evaluation of American Burkitt's lymphoma.

Burkitt's lymphoma is a childhood disease that characteristically produces large, bulky abdominal tumors. Although these are potentially curable, chemotherapy can produce rapid tumor lysis, with subsequent life-threatening metabolic abnormalities, especially in those patients with large tumors or those who have compromised renal function. Twenty-two patients with proven Burkitt's lymphoma were evaluated by ultrasound. Thirteen patients had abdominal masses. These masses tended to be large, solitary, and acoustically homogeneous. Although most of these tumors were found in the pelvis, upper abdominal and retroperitoneal tumors were also encountered. None of the patients had the typical paravertebral mantle of enlarged nodes seen in other types of lymphoma. In 11 patients with abnormal intravenous pyelograms, ultrasound successfully distinguished between renal lymphoma, hydronephrosis, and, by exclusion, metabolic renal disease. The absence of lymph node disease and the presence of bulky homogeneous extranodal tumor are characteristic ultrasound findings in Burkitt's lymphoma. By locating and quantifying tumor mass and distinguishing between renal lymphoma and hydronephrosis, ultrasound proved to be clinically useful in the management of this disease.

Abdominal Neoplasms↗
PubMed1979

Tumor lysis pancreatitis.

Rapid tumor lysis may produce acute complications including systemic metabolic disturbances and hemorrhage in sites involved by tumor. We have observed two cases of acute pancreatitis induced by the lysis of lymphoma that involved the pancreas. This previously unreported cause of pancreatitis must be added to the list of potential complications associated with effective cancer chemotherapy.

Antineoplastic Agents↗
PubMed1978

Prolonged complete remission following high dose chemotherapy of Burkitt's lymphoma in relapse.

Fourteen patients with American Burkitt's lymphoma resistant to conventional chemotherapy were treated with high-dose combination chemotherapy and intensive supportive care. Four patients died shortly after chemotherapy, 3 of an acute carditis. All ten remaining patients demonstrated tumor regression and 3 remain in prolonged complete unmaintained remission 29+, 19+, and 9+ months after treatment. These findings demonstrate that high-dose chemotherapy will benefit some patients with Burkitt's lymphoma unresponsive to conventional chemotherapy, but the medullary and extramedullary toxicity of this treatment strategy remains a formidable obstacle.

Adolescent↗
PubMed1978

Epstein-Barr virus-associated and other antiviral antibodies during intense BCG administration to patients with Burkitt's lymphoma in remission.

Patients with Burkitt's lymphoma in chemotherapy-induced remission received through dermal scarifications one or two doses per week of approximately 3 X 10(8) living BCG organisms (Pasteur Institute vaccine). This treatment was always followed by usually rapid increases by 1--4 log2 steps in the antibody titers to Epstein-Barr virus (EBV)-associated cell membrane antigens. Titer increases of less than 2.5 log2 steps within the first month after the start of BCG treatment correlated with a significantly elevated frequency of extradural relapse as compared to that seen in patients with larger titer rises. During this time, antibodies to EBV-associated viral capsid antigens and early antigens of D and R specificity, as well as antibodies against herpes simplex, varicella, cytomegalovirus, measles, and respiratory syncytial virus antigens, did not show any consistent or impressive changes.

Antibodies, Viral↗
PubMed1978

Sequential combination chemotherapy (containing high-dose cyclophosphamide) for metastic osteogenic sarcoma.

Eleven patients with metastatic osteogenic sarcoma were treated with cyclophosphamide, adriamycin, and, in some cases, high-dose methotrexate. In the event of metastatic progression, the dose of cyclophosphamide was escalated by increasing the number of consecutive daily infusions (dose, 45 mg/kg/day). The results indicate that metastatic osteogenic sarcoma is marginally responsive to adriamycin and cyclophosphamide but rarely responsive to high-dose methotrexate as administered in this trial. The response of metastatic lesions was not improved by escalating the dose of cyclophosphamide.

Adolescent↗
PubMed1977

Epstein-Barr virus and human malignancy.

The association of the Epstein-Barr virus and two human malignancies, Burkitt's lumphoma and nasopharyngeal carcinoma, is reviewed. Seroepidemiologic, virologic, and immunologic evidence is summarized, and several hypotheses regarding a possible etiologic role for the Epstein-Barr virus in these tumors are presented. With our current state of knowledge we cannot conclude that the Ipstein-Barr virus is oncogenic in man, nor can we yet ascertain the biological and clinical significance of its association with Burkitt's lymphoma and nasopharyngeal carcinoma.

Antibodies, Viral↗
PubMed1976

Immunosuppression in Burkitt's lymphoma. II. Peripheral blood lymphocyte populations related to clinical status.

We have studied peripheral blood lymphocyte populations, defined in terms of their E and EAC' rosette-forming capacity in patients with Burkitt's lymphoma and controls. Total lymphocyte counts were reduced in patients compared to controls (p less than 0.005), and correlated with clinical stage and disease status. Presenting patients with Stage D tumours had the lowest levels, while patients in remission for at least 18 months had total lymphocyte counts similar to those of controls. Absolute numbers of both E and EAC' rosette-forming cells (RFC) were reduced, compared to controls, in tumour-bearing patients (p less than 0.0005 for both E and EAC' RFC) and also, to a lesser extent, in patients in remission (p less than 0.025 and less than 0.05 for E and EAC' RFC respectively). In the case of E RFC a significant reduction was present even when patients in remission for over 18 months were considered alone (p less than 0.05). Non-RFC were present in similar numbers in patients and controls, so that the reduction in total lymphocyte count can be accounted for entirely by the reduced numbers of RFC. As anticipated by this, percentages of RFC were also reduced in patients compared to controls, EAC' RFC to a lesser extent than E RFC. Non-RFC percentages were correspondingly increased. Tumour-bearing patients had significantly impaired PHA responses and cutaneous reactivity, which correlated significantly with very low levels of RFC. One possible explanation for these results is that immunoreactive lymphocytes are sequestered within the tumour. This is consistent with the immunosuppression observed in tumour-bearing patients, and would also result in difficulty in detecting even a powerful tumour-specific immune reaction by means of an assay dependent upon the participation of peripheral blood lymphocytes.

Adolescent↗
PubMed1976

Treatment of Burkitt's lymphoma: randomized clinical trial of single-agent versus combination chemotherapy.

A randomized clinical trial designed to compare the effectiveness of cytoxan (CTX) alone versus a combination consisting of CTX, vincristine (Oncovin) and methotrexate (COM) in the treatment of Burkitt's lymphoma (BL) was carried out. Nineteen patients were selected at random to receive CTX alone while 21 received COM. The two treatment regimens were equally effective in inducing remissions, and complete response rates of 83.3% and 84.3% were observed for CTX- and COM-treated patients, respectively. The relapse frequencies were also equal but the pattern of relapse was clearly different. Seven out of 8 (87.5%) in the CTX group relapsed with systemic and central nervous system (CNS) tumor, while 8 out of 10 (80%) in the COM group relapsed with CNS disease only. This difference is highly significant p = 0.008. The remission durations and survival to date are the same.

Burkitt Lymphoma↗
PubMed1976

Failure of BCG immunostimulation to affect the clinical course of Burkitt's lymphoma.

A controlled randomised trial was carried out to evaluate the efficacy of BCG immunotherapy in preventing relapse in patients with Burkitt's lymphoma in whom remission had been induced with cyclophosphamide. Twenty-one patients were treated with BCG, and 19 were controls. Eleven patients in each group relapsed during a follow-up period long enough to make it unlikely that further relapses would occur. There were no significant differences in the length of remission or the site of relapse that could be attributed to treatment. Eleven patients died: of these none of the six patients in the BCG group but all of the five in the control group had stage D lymphomas. BCG treatment increased the rate of recovery from tumour-induced immunosuppression, but within the BCG group immunocompetence improved most rapidly in the patients who relapsed-a finding that appears to contradict the tenet retionalising the use of immunological adjuvants as treatment.

Adjuvants, Immunologic↗
PubMed1976

Management of Burkitt's lymphoma involving the central nervous system.

The clinical features and pathogenesis of CNS involvement in Burkitt's lymphoma have been reviewed, with an emphasis on the relevant therapeutic approaches. Certain "prophylactic" measures have been suggested and several are currently undergoing clinical trial. These include the use of CCNU, a nitrosourea which effectively crosses the blood-brain barrier, and the use of craniospinal irradiation early in the course of treatment. Malignant pleocytosis can be palliated by the use of intrathecal chemotherapy, but malignant cells in peripheral nerves or deep in the sulci of the brain parenchyma will be relatively inaccessible to drugs in the circulating cerebrospinal fluid (CSF). A bilateral approach (i.e. simultaneous systemic plus intrathecal chemotherapy) may kill cells lodged in this anatomic sanctuary, and the increased use of cytotoxic drugs crossing the blood-brain barrier may facilitate this approach.

Antineoplastic Agents↗
PubMed1975

HL-A and Burkitt's tumour--a study in Uganda.

Thirty-one Burkitt's patients and forty-eight matched controls from Uganda were HL-A typed to investigate possible antigen frequency differences which could suggest association of an HL-A antigen with disease susceptibility. Cells were shipped in tissue culture medium from Uganda to Oxford where they were HL-A typed using sera from the Fifth International Histocompatibility Workshop in the cytotoxic fluorochromatic assay. No significant frequency differences between patients and control were found.

Adolescent↗