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Biomedical subjects

J L Ziegler

Publications and source records attributed to J L Ziegler.

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

Radiographic manifestations of Burkitt's lymphoma in American patients.

Radiographic manifestations of Burkitt's lymphoma in 40 American patients are presented. Pleural effusions were the most common intrathoracic abnormality and were correlated with abdominal ascites more often than with intrathoracic tumor. Tumor involved bone in four patients had intrinsic bowel involvement; nine instances were in the ileum. Intrinsic renal tumor was seen in only two patients. Both ultrasound and computed tomography were useful.

Adolescent↗
PubMed1979

The present state of development of cancer chemotherapy.

Cancer chemotherapy has evolved through 3 decades of remarkable progress. At the present time over 40 drugs and biologicals are employed in the treatment of cancer, and hundreds of promising compounds and analogs await their turn in the clinic. The medical management of cancer patients with chemotherapy has developed into a recognized subspecialty--medical oncology, a discipline that now works closely and effectively with surgery and radiotherapy in planning treatment strategies. Major areas of progress to date include the concept of combination chemotherapy, the development of hematologic and microbiologic supportive care, and the demonstration of effective adjuvant chemotherapy. Further progress is anticipated in a number of areas: rational selection of anticancer compounds based on metabolic or kinetic vulnerability; increased attention to biologic substances that modify neoplastic cell behavior; continued refinement of doses and schedules of active compounds to optimize therapeutic benefit and minimize toxicity; awareness of novel methods of drug delivery; and development of physical or chemical modifications to enhance drug effects.

Antineoplastic Agents↗
PubMed1978

[Long-term, complete remission in non-Hodgkin's lymphoma following high-dosage combination therapy with or without autologous bone marrow transplantation].

22 patients with malignant non-Hodgkin lymphoma resistant to conventional chemotherapy were treated with high-dose combination chemotherapy followed in the first 12 patients by infusion of their cryopreserved autologous bone marrow. The next 10 patients received chemotherapy alone. Four patients died shortly after chemotherapy. Four patients remain in unmaintained remission 40, 30, 20 and 8 months after treatment. Patients receiving cryopreserved marrow recovered leukocyte, granulocyte and platelet function significantly faster and had significantly fewer febrile days than did controls. These findings demonstrate that high dose combination chemotherapy may benefit some patients unresponsive to conventional chemotherapy, and that cryopreserved bone marrow can speed hematopoetic recovery and be of clinical benefit to the patient.

Antineoplastic Agents↗
PubMed1978

Gynecomastia and gonadal dysfunction in adolescent boys treated with combination chemotherapy for Hodgkin's disease.

We studied 19 Ugandan boys with Hodgkin's disease who had been treated with mechlorethamine, vincristine, procarbazine and prednisone and who survived at least two years to assess testicular germ-cell depletion in pubescent boys on combination chemotherapy, as had previously been demonstrated in sexually mature men. Nine of 13 pubertal boys (ages 11 to 16) had moderate to severe gynecomastia and germinal aplasia, a 10-fold increase in mean (+/- S.D.) serum follicle-stimulating hormone (34.8 +/- 20.5 mlU per milliliter), a threefold increase in mean luteinizing hormone (17.8 +/- 9.8 mlU per milliliter) and reduced serum testosterone levels. Gynecomastia was not associated with an increase in either serum estradiol or prolactin concentrations. By contrast, six prepubertal boys (three to 10 years of age), similarly treated, showed no change in serum gonadotropins, and gynecomastia did not develop. The data confirm germ-cell depletion after combination chemotherapy and indicate further that Leydig-cell dysfunction, manifested by gynecomastia, may be a consequence of treatment in adolescent boys.

Adolescent↗
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

Childhood Hodgkin's disease in Uganda: a ten year experience.

Between 1967 and 1977, 48 patients with Hodgkin's disease under 16-years-old were treated with MOPP chemotherapy alone at the Uganda Cancer Institute because radiotherapy facilities are not available. Thirty-eight percent had early stage disease (stages I-IIIA). Prolonged first remissions were achieved in 74% of 42 complete responders. Of 11 patients who relapsed, 5 had prolonged second remissions induced by MOPP. Three patients were lost to follow-up and 15 of the remaining 45 died: 12 of these from progressive Hodgkin's disease, 2 from unrelated causes and 1 from Burkitt's lymphoma after 4 months remission from Hodgkin's disease. Acturial survival for all patients is 67% (75% for stages I-IIIA and 60% for stages IIIB-IV). Treatment complications included Herpes zoster and gynaecomastia. The latter is probably related to gonadal dysfunction. All stages of childhood Hodgkin's disease can be successfully managed with MOPP chemotherapy alone.

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↗
PubMed1978

Successful engraftment of cryopreserved autologous bone marrow in patients with malignant lymphoma.

In an effort to evaluate the possible utility of cryopreserved autologous bone marrow infusions in man, 22 patients with malignant lymphoma resistant to conventional chemotherapy were treated with high-dose chemotherapy. This was followed in 12 patients by an infusion of their cryopreserved autologous bone marrow; 10 patients received chemotherapy alone and serve as controls. Following chemotherapy, severe leukopenia (less than 100 leukocytes/mm3) lasted 6-10 (median 8) days in patients receiving cryopreserved marrow, compared to 10-29 (median 16) days in controls (p less than 0.001). Recovery to 1000 leukocytes/mm3 occurred 10-18 (median 13) days after chemotherapy in autograft recipients but was delayed until 12-38 (median 23) days after chemotherapy in controls (p less than 0.001). Autografted patients also recovered granulocyte and platelet function significantly faster and had significantly fewer febrile days after chemotherapy than did controls. Cryopreserved autologous bone marrow infusions can hasten hemopoietic recovery in man after high-dose chemotherapy; this earlier reconstitution may be of clinical benefit to the patient.

Adolescent↗
PubMed1978

Clinical trial methodology.

A number of recent conferences have emphasized the importance of clinical trials methodology. The most significant of these was the one held in France in January, 1978. Much discussion centered around the use of matched historical controls from the same institution in comparison with randomized, prospectively controlled clinical trials. It was concluded that controlled clinical trials are required to answer comparative therapeutic questions in a convincing manner and that statistical advice is critical at all stages of such trials.

Clinical Trials as Topic↗