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Biomedical subjects

J Debray

Publications and source records attributed to J Debray.

At least 55 records · Page 3Linked to original sources
PubMed1984

[Treatment of advanced ovarian cancer].

Forty patients with stage III or IV ovarian epithelial carcinoma, mean age 61 +/- 12 years, were treated either with cyclophosphamide-methotrexate-5-FU or with cisplatinum-adriamycin-5-FU-hexamethylmelamine. Median survival from initial surgery was 16 months, 18 months in stage III and 2 months in stage IV disease. 15 patients over 70 years had a median survival of 9 months. Median survival was higher with the regimen without cisplatinum (18 months against 13 months). Clinical response rate was 62.5%. Ten patients clinically free of disease underwent second look laparotomy which showed persistent disease in six. Based on these results and on a review of the literature, a new therapeutical approach is discussed.

Aged↗
PubMed1984

[Abnormality of chromosome number 1 in 3 cases of acute transformation of chronic myeloid leukemia].

The authors report three cases of Ph1-positive chronic myelogenous leukemia (CML) with chromosome no 1 abnormalities. Such abnormalities have seldom been reported: three cases out of 42 in blast crisis and none of the 70 patients in the chronic phase in our series. In case no 1 a translocation: (t(1q;14q) was noted. In case no 2 the rearrangement was more complex: partial duplication of the long arm of chromosome no 1 and presence of a 21q+ corresponding to chromosome no 21 on which a part of the long arm of chromosome no 1 was transferred. In case no 3 a double translocation was noted between chromosomes no 1 and no 11, involving either the p or q arm. A review of the literature shows that abnormalities of chromosome no 1 are more frequent during the blast crisis that in the chronic phase of CML. Chromosome no 1 abnormalities are found in a number of myeloproliferative syndromes but even more frequently in solid tumors. The rearrangement sites are reviewed by the authors. Such rearrangements of chromosome no 1 may indicate an increased potential of malignancy.

Adult↗
PubMed1983

Two cases of acute leukemia following treatment of malignant glioma.

Two female patients, 42 and 30 years old, respectively, died of acute nonlymphocytic leukemia 43 and 38 months, respectively, after a subsequent treatment: chemotherapy for one and irradiation and chemotherapy for the other, following excision of a malignant glioma. At the time of death, both seemed to be in complete remission of their brain tumor. Both had been treated with procarbazine and nitrosoureas. The latter were responsible for severe myelosuppressive episodes and seem to have played an essential role in the induction of the leukemia. In one case, a myelodysplasia was observed before the onset of the AL and the diagnosis of refractory anemia with excess of blasts seemed warranted. Secondary acute leukemias are rare in the evolution of malignant gliomas and the usefulness of subsequent radiochemotherapy cannot be questioned at the present time. The risks involved in this therapy are minor when compared to the short-term fatal prognosis of this type of tumor.

Acute Disease↗
PubMed1983

[Hematologic and cytogenetic study of 7 cases of preleukemic state or acute leukemia following the treatment of a first malignancy].

The authors present 7 cases of preleukemic state and/or acute leukemia following the treatment of a first malignancy (3 malignant lymphomas, 3 epithelial cancers and one polycythemia vera). A preleukemic state was found in all patients. In 6 cases it was followed by an acute non-lymphoblastic leukemia which was rapidly fatal; in one case, death occurred during the preleukemic phase. A karyotype was prepared during the preleukemic phase in 6 out of 7 patients and in 4 out of 6 during the leukemia. Karyotypes prepared during the preleukemic state presented at least one of the abnormalities which are characteristic of secondary hematopoietic disorders: -5/5q; -7/7q; involvement of 17. The same major clone was found in 3 of the 6 patients who were karyotyped during the acute leukemic phase. These karyotype abnormalities are not only characteristic of secondary acute leukemias but also of secondary dysmyelopoietic syndromes.

Adult↗
PubMed1983

[Anti-smooth-muscle antibody activity of monoclonal IgM in Waldenström's disease].

The authors report a case of Waldenstrom disease in which the IgM kappa immunoglobulin had an anti-smooth-muscle activity at a very high titre (1/100 000). This activity was found in the purified IgM but not in the Fab fragment; nevertheless, the immunofluorescence inhibition by this fragment is evidence in support of the anti-smooth-muscle activity of the IgM. The IgM specificity in this patient is different from the anti-smooth-muscle antibodies already described.

Antibodies, Monoclonal↗
PubMed1983

[Association of Kaposi's sarcoma with acute myeloblastic leukemia. Apropos of a case].

The authors report the case of a 73-year-old woman from Central Europe with acute myeloid leukemia and Kaposi's sarcoma. The two diseases were discovered simultaneously. The inefficacy of leukemia chemotherapy and the widespread cutaneous diffusion of the Kaposi's sarcoma explain the unfavorable outcome. The different pathogenic hypotheses which can account for the association of these two different malignancies are reviewed.

Aged↗
PubMed1983

[Paroxysmal nocturnal hemoglobinuria. Increase in proteins of the alternative complement pathway].

Increased activity of the complement alternative pathway proteins C3, B and H was found in the sera of 16 patients with paroxysmal nocturnal haemoglobinuria (PNH). This increased activity might depend on protein hypersynthesis secondary to in vivo low-grade complement consumption by abnormal erythrocytes in PNH patients, despite the fact that serum levels of C3d were found to be normal. B and H activities were directly related; however, the B/H ratio was higher in patients whose sera had been taken early after an episode of haemoglobinuria. Activation of the alternative pathway, which is known to result in vitro lysis of PNH erythrocytes, only accounts for part of the events leading to chronic haemolysis and haemoglobinuria in vitro.

Adult↗
PubMed1983

Hematologic and cytogenetic study of two cases of acute leukemia associated with breast cancer.

The authors present two cases of patients with breast cancer with lymph node extension and who both had surgery. As a pancytopenia with hypercellular bone marrow was discovered at the same time in the first patient, she received no complementary treatment; 4 months later, she presented with an acute lymphocytic leukemia (ALL) for which a remission was easily induced, but she died of a pulmonary infection. The second patient received local radiotherapy (50 grays) and adjuvant chemotherapy (Alkeran for 26 months). Forty-seven months after the diagnosis of breast cancer and 16 months after the end of the treatment, an acute nonlymphoblastic leukemia (ANLL; M6) was diagnosed after 8 months of a preleukemic state. Treatment did not produce any results and death occurred on the 17th day. Cytogenetic studies on the bone marrow cells of both patients were performed. In the first patient in the ALL phase normal cells coexisted with a 47 chromosome clone, the extra chromosome being a D (+ 13?). In the second patient, several karyotype abnormalities were already present in the preleukemic state and also during the acute leukemic phase. No normal mitoses were found; hypodiploidy was present as well as major abnormalities such as markers, rings, and, among others, the systematic loss of a #5 and a #7. The first patient seems to have presented with a de novo ALL, associated with the malignant tumor; whereas, the second patient showed all the characteristics of an induced ANLL. The clinical, hematologic, and cytogenetic characteristics of these two patients are analyzed and compared to those of other cases in the literature.

Adenocarcinoma↗
PubMed1983

Chronic myelogenous leukemia with a Philadelphia chromosome resulting from a complex translocation (2; 9; 22), following an undifferentiated acute leukemia.

This case report concerns a patient with acute leukemia considered at diagnosis to be undifferentiated. Unfortunately, because of the failure of the culture, a cytogenetic evaluation was not possible at that stage. A full remission was induced, but 17 months after the onset of the disease the patient developed chronic myelogenous leukemia. The karyotypes prepared at that time and during the follow-up revealed the presence of a Philadelphia chromosome (Ph1) in all examined cells. This Ph1 resulted from a complex translocation involving chromosomes No. 2, 9, and 22.

Adult↗
PubMed1983

[Hemoglobinopathies and arterial pathology].

Mutation of the hemoglobin molecule which characterises sickle cell anemia causes the falciformation under conditions of slow oxygen pressure, an increase in blood viscosity and premature destruction of the red blood cells. The vascular disorders, which are of variable nature, intensity and gravity, influence to a great extent the disabling character of the disease. Vaso occlusive crises are often associated with intercurrent infection. The retinopathy (well demonstrated by fluorescein angiography) is the most typical arteriolar disorder. In homozygotic patients, stenosis of the proximal portions of the large arteries leads to cerebrovascular complications, probably related to microcirculatory defects, responsible for variable clinical problems and some Moya-moya syndromes of childhood. From the therapeutic point of view, early treatment (transfusion and rehydration) allows regression without sequelae. Prevention is based on patient education to avoid triggering factors and a number of investigations, none of which has yet provided an absolute solution.

Anemia, Sickle Cell↗
PubMed1982

[Acute leukemia associated with breast cancer (author's transl)].

Two cases of acute leukemia in patients with breast cancer are reported. In the first patient, erythroleukemia occurred three years after breast cancer was treated by mastectomy, followed by local radiotherapy ; complementary chemotherapy (melphalan) has been given for twenty-six months. The second patient had onset of acute lymphoblastic leukemia four months after breast cancer was treated by surgery only. This patient subsequently has complete remission. Both patients died shortly after onset of leukemia. In the first patient, bone marrow cytogenetic studies evidenced major abnormalities at an early stage of the disease, with abnormal mitoses in all the cells, whereas, in the second patient, only minor abnormalities were found. A review of previously published cases of breast cancer with acute leukemia was done. Our findings suggest that the association of leukemia with breast cancer may result from therapy is some cases (secondary induced acute leukemias) while in others it may occur spontaneously.

Aged↗
PubMed1982

[Psoriatic arthritis with renal amyloïdosis. A case-report. Review of the literature (author's transl)].

A case of severe psoriatic arthritis with both spinal and peripheral joint involvement is reported. The patient, an HLA B27-positive man, was thirty-one years old at onset. Both antiinflammatory drugs and immunosuppressive agents (chlorambucil followed by azathioprine) were ineffective and the patient became bed-ridden. Thirty-three months after onset a severe nephrotic syndrome developed. Renal biopsy let to diagnosis of secondary renal amyloïdosis. The patient died five months later in spite of chemotherapy with melphalan and prednisone. Autopsy could not be performed. A review of the literature showed twelve other cases of psoriatic arthritis with secondary amyloïdosis. Men are affected more often than women. Twelve years was the average interval between onset of joint involvement and diagnosis of amyloïdosis. In three instances, however, this interval was less than thirtyeight months. Arthritis often included both spinal and peripheral joint involvement. Amyloïdosis was evidenced by a nephrotic syndrome in eight out of twelve cases. Prognosis is poor with a fourteen months average interval between onset of clinical amyloidosis and death.

Adult↗
PubMed1982

[Hypertrophic pulmonary osteoarthropathy with paraneoplastic secretion of four hormones. Considerations on pathogenesis (author's transl)].

The case of a patient with small-cell carcinoma of the lung, bone marrow metastases, and hypertrophic pulmonary osteoarthropathy is reported. Normal growth hormone serum concentrations contrasted with significant increases in ACTH, beta-MSH, calcitonin, and gastrin. A hormonal etiology has previously been suggested for hypertrophic pulmonary osteoarthropathy. Our findings indicate that the hormone responsible for hypertrophic pulmonary osteoarthropathy may be an APUD polypeptidic substance, that differs from immunoreactive GH but is related to somatomammotropins.

Adrenocorticotropic Hormone↗
PubMed1982

[Cytogenetic study of preleukemic phases and of acute leukemia secondary to chemo-and/or radiotherapy. Review of the literature (102 cases)].

A review of the literature upon 102 cases with cytogenetic study of preleukemic states (Prel.) and/or acute secondary leukemia (ASL) following chemotherapy and/or radiotherapy treatment has been made. The karyotype was almost always abnormal (91%) of cases). There was a predominance of hypodiploidy with abnormalities including chromosome number 5 (-5 ou 5q-) and/or number 7 (7- or 7q-) (chromosomes studied with banding). The abnormalities were present in preleukemia state. The pattern of the acute secondary leukemia was particularly different from that acute leukemia de novo: high frequency of preleukemia state, ANLL type of leukemia, very bad prognosis, importance of cytogenetic abnormalities. There was a great interest in the study of the karyotype for the previous detection in ASL: this allowed their discovery as soon as the preleukemia state.

Acute Disease↗