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Biomedical subjects

J Weiner

Publications and source records attributed to J Weiner.

At least 127 records · Page 7Linked to original sources
PubMed1979

Effective dose of L-asparaginase for induction of remission in previously treated children with acute lymphocytic leukemia: a report from Childrens Cancer Study Group.

L-Asparaginase, in the dose of greater than or equal to 6000 IU/sq m three times weekly, was demonstrated to be an effective agent in reinduction of remissions in childhood leukemia. Four hundred thirteen children with acute lymphocytic leukemia were treated with L-asparaginase. Doses i.m. ranged from 300 to 12,000 IU/sq m. None of the patients had received prior asparaginase therapy. 6-Mercaptopurine was given p.o. concurrently. All of the patients had experienced several previous relapses, and their disease was not responsive to 6-mercaptopurine. L-Asparaginase was found to be effective in reinducing remissions at the following rates: 9.5% for 300 IU/sq m; 35.1% for 3,000 IU/sq m; 53.5% for 6,000 IU/sq m; and 62.5% for 12,000 IU/sq m. The drug was given three times weekly for four weeks. Hypersensitivity reactions occurred in 6.5% of patients.

Asparaginase↗
PubMed1978

Primary cytomegalovirus and opportunistic infections. Incidence in renal transplant recipients.

Thirty-five renal allograft recipients were studied concerning the relationship between cytomegalovirus (CMV), herpes simplex virus (HSV), and opportunistic bacterial and fungal infections. The incidence of opportunistic infections was determined for patients whose tests prior to transplantation were seronegative in complement fixation and indirect hemagglutination assays of CMV antibody and for those patients whose tests were seropositive. Among the six seronegative patients with seronegative tests, four (66%) experienced active CMV infection within two months, and four died of Candida or Aspergillus infection within six months after transplantation. Among the 22 patients with seropositive tests, only one (4%) had a fungal infection and it was nonfatal (P less than .05). The increased morbidity and mortality due to fungal and bacterial infections in transplant recipients with seronegative CMV tests appears, therefore, to be related to primary CMV infection rather than to generalized immunodeficiency.

Antibodies, Viral↗
PubMed1978

Cyclophosphamide (NSC 26271) versus the combination of adriamycin (NSC 123127), 5-fluorouracil (NSC 19893), and cyclophosphamide in the treatment of metastatic prostatic cancer: a randomized trial.

Twenty-seven patients with a diagnosis of metastatic adenocarcinoma of the prostate were treated in a randomized, prospective trial with either Cyclophosphamide or a combination of Adriamycin, 5-Fluorouracil, and Cyclophosphamide. Doses were either Cyclophosphamide alone (800-1200 mg/m2 iv q 3 weeks) or Cyclophosphamide (150-200 mg/m2 po Day 3-6) plus 5-FU (400-500 mg/m2 iv Day 1, 8) plus Adriamycin (30-50 mg/m2 iv Day 1) given as a 4 week treatment cycle. Patients with compromised bone marrow reserve initially received the lower dose level. Objectively stable disease as defined by a modification of the National Prostatic Cancer Project criteria was seen in 53% of the 15 Cyclophosphamide treated patients and in 50% of the 12 combination treated patients. Survival was not significantly different in the two arms. However, the survival of patients responding to Cyclophosphamide was significantly longer than that of patients responding to the combination (median 18.6 months versus 8.1 months, p less than 0.05). Gastrointestinal and hematologic toxicity was moderate with both regimens. Therefore, in the present study, Cyclophosphamide alone was as effective as the combination of Cyclophosphamide, 5-FU and Adriamycin for patients with disseminated prostatic carcinoma. The moderate hematologic toxicity noted with both regimens suggests further evaluation of drug combinations utilizing higher dosages of active agents in this disease.

Adenocarcinoma↗
PubMed1978

Increased survival in childhood acute nonlymphocytic leukemia after treatment with prednisone, cytosine arabinoside, 6-thioguanine, cyclophosphamide, and oncovin (PATCO) combination chemotherapy.

One hundred-sixty-three children with acute nonlymphocytic leukemia (ANLL) were treated with a multiple-drug induction program (PATCO) consisting of prednisone (PDN), cytosine arabinoside ((Ara-C), 6-thioguanine (6-TG), cyclophosphamide (CPM), and Oncovin (VCR). Ninety-six, 59%, obtained a remission. Remission was maintained with daily 6-TG and four-day pulses of Ara-C and CPM with a single dose of VCR every 28 days. The median duration of remission was 11.5 months. Certain prognostic factors affected induction rate and remission duration. Initial white blood count (WBC) was a significant factor in achieving a remission, whereas age, sex, and type of ANLL had no effect. Initial WBC, age, and sex had a significant effect on remission duration, but type of ANLL had no effect. Relapsing patients were treated with daunomycin and 5-azacytidine. The reinduction rate was 53% with a median second remission duration of 190 days. Overall survival for the 163 patients is 55.4% at 12 months, 31.5% at 24 months, 21.4% at 36 months, and 19% at 48 months.

Acute Disease↗
PubMed1978

Quantitation of HLA-D differences.

The predictability of MLC non-reactivity by HTC typing was tested in a single checkerboard experiment which involved 39 unrelated individuals belonging to 12 different groups of HLA-D identical phenotypes. The strength of one-way MLC reactions in all possible responder-stimulator combinations (39 X 39) was quantitated by the Linear Clustering Analysis Program. Individuals who, by HTC typing, were identical for two HLA-D antigens gave 51% negative, 36% intermediate and 13% strong positive MLC responses. Identity for only one HLA-D antigen resulted in 3% negative, 40% intermediate and 57% strong MLC reactions. When no HLA-D antigen was shared, 88% of the reactions were strongly positive. HLA-D antigens behaved as equipotent stimulators in MLC between half-identical pairs. The only exception consisted of the higher frequency of weak responses displayed by the Dw5 positive individuals against stimulators differing by LD107. The same pattern was observed when LD107 homozygous cells were used as stimulators, suggesting that determinants of this specificity might be partially included in Dw5.

Epitopes↗
PubMed1977

Peripheral B- and T-lymphocyte counts in patients with sarcoma and breast carcinoma.

Peripheral B- and T-lymphocyte counts were studied in 50 patients before they received any therapy for their conditions: 16 had carcinoma of the breast; 8 soft tissue sarcoma; and 26, benign disease. Among 11 males, the six patients with advanced soft tissue sarcoma had significantly lower percentages of T lymphocytes than five patients with benign conditions. And six female patients with advanced breast cancers had significantly higher numbers of B lymphocytes than the 10 patients with early breast malignancies. Pertinent reports in the literature were reviewed and discussed. Presently, the clinical and prognostic values of quantitative study of T and B lymphocytes remain to be defined.

Adolescent↗
PubMed1977

L-Asparaginase, vincristine, and prednisone for induction of first remission in acute lymphocytic leukemia.

L-Asparaginase was added to vincristine and prednisone for induction of first remission in 815 children with acute lymphocytic or acute undifferentiated leukemia. This combination resulted in an overall remission rate of 93%. The addition of L-asparaginse to the standard induction regimen using prednisone and vincristine did not significantly increase the morbidity or mortality rate during the induction period. The most common side effect was transient L-asparaginase-induced hyperglycemia. The safe administration of L-asparaginase i.m. and the dose efficacy of 6000 I.U./sq m were confirmed. For these reasons, L-asparaginase should be combined with vincristine and prednisone for the initial induction of children with acute lymphocytic or acute undifferentiated leukemia.

Adolescent↗
PubMed1977

Adjuvant treatment of colorectal cancer.

Surgical operation remains the most effective method of treatment for patients with cancer of the large bowel. However, innovative surgical techniques have not improved survival rates for colorectal cancer in 25 years. Attempts at increasing survival with chemotherapy as an adjunct to surgical procedures remain inconclusive and controversial. Many adjuvant chemotherapy trials have failed to recognize those prognostic factors-such as nodal involvement, serosal penetration, vascular or perineural invasion, and microscopic invasion at margins of resection-that characterize certain patients at high risk for recurrent cancer. Failure to include only high risk patients in adjuvant chemotherapy is, in part, responsible for the lackluster performance to date. For rectal cancer, preoperative irradiation increases the chances of cure with surgical operation by reduction of pathologic staging, but it has not increased survival in patients with persistent nodal involvement. Immunotherapy is a possibly valuable method of treatment; however, it is clinically untested. An adjuvant immunotherapy protocol for high risk patients is described.

Colonic Neoplasms↗
PubMed1977

Treatment of pyoderma gangrenosum with benzoyl peroxide.

A fifty-three year old woman presented with pyoderma gangrenosum on the right buttock. She had associated intestinal symptoms, but repeated roentgenologic studies revealed no abnormalities. Local treatment with benzoyl peroxide (20 percent) lotion produced clearing of the cutaneous lesion in about six weeks.

Benzoyl Peroxide↗
PubMed1976

Cyclophoshamide treatment of patients with localized and regional neuroblastoma: A randomized study.

A randomized study was conducted to determine the effect of cyclophosphamide on the rate of recurrence and metastases in children with localized and regional neuroblastoma. One hundred and thirty-four patients were entered and 113 were suitable for analysis. All patients had surgical resection of the primary tumor when possible, postoperative irradiation to the tumor bed when indicated for gross residual disease, and 49/113 received cyclophosphamide, 10 mg/kg/day orally for 7-10 days every 28 days for 1 year. A difference was found in the rate of metastases between the patients who did and did not receive chemotherapy; the overall survival of about 80% in both groups was better than anticipated. All relapses occurred during the first year; there were none in 27 Stage I patients, 8/52 in Stage II and 13/34 in Stage III. Toxicity was minimal, with only two patients developing hemorrhagic cystitis that prevented continued therapy.

Child, Preschool↗
PubMed1976

Factors influencing survival of children with nonmetastatic neuroblastoma.

A randomized study was designed to determine the effect of intermittent oral cyclophosphamide on the rate of metastases in children with localized and regional neuroblastoma. Secondary objectives of the study were to determine the value of the proposed staging system, to measure the influence of the peripheral lymphocyte count on prognosis, and to study the effect of the primary tumor site and regional node involvement. Since there was no difference in survival in the two groups of patients, whether or not they received chemotherapy, all 113 children were treated as a single group for the analysis of the secondary objectives. The proposed staging served as a good indicator of prognosis with a significant difference in survival seen between each of three stages. It was not possible to detect a significant influence by the three other prognostic variables studied, peripheral lymphocytes, primary site and regional node involvement. Small numbers in the various subgroups studied may account for the failure of differences to achieve statistical significance.

Age Factors↗
PubMed1976

Combination chemotherapy in murine neuroblastoma.

The C1300 murine neuroblastoma system has been studied to determine its relevance as a chemotherapy model to the human disease. Studies using combination therapy revealed that BCNU/cyclophosphamide combination therapy increased the median lifespan 300% in A/J mice bearing the C1300 tumor. Cyclophosphamide/imidazole carboxamide and adriamycin/imidazole carboxamide combinations were less active, increasing median lifespans 189% and 144%, respectively. Vincristine/bleomycin were inactive even when the schedule was adjusted to coincide with the time of maximum mitoses following vincristine injections. These results suggest the BCNU/cyclophosphamide combination chemotherapy may be effective in human disease.

Animals↗