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Biomedical subjects

M Boiron

Publications and source records attributed to M Boiron.

At least 55 records · Page 3Linked to original sources
PubMed1988

[Residual masses after chemotherapy of non-Hodgkin's lymphoma].

Among 149 patients treated for high grade non-Hodgkin's lymphoma, 22 post-therapy mediastinal and abdominal residual masses were observed (14.7%). In 12 cases, initial histology was malignant lymphoma, diffuse large cell. The follow-up of these patients was similar to those without residual masses. Magnetic resonance imaging may be helpful in distinguishing viable tissue from fibrotic tissue.

Fibrosis↗
PubMed1987

Alpha-interferon in hairy cell leukaemia: direct effects on hairy cells or indirect cytotoxicity?

This report presents the results of a clinical trial on 53 patients with hairy cell leukaemia using low-dose alpha-interferon as therapy. Improvement of cytopenia and/or bone marrow hairy cell infiltration occurred in all but one patient. Often, blood and bone marrow improvements were dissociated and, after 7 or 13 months of therapy, complete remission was only observed in about 40% of patients. Recurrence of the disease was observed in some cases after cessation of therapy. A summary of the following results is presented: alpha-interferon receptor analysis, oncogene expression, study of the sensitivity of hairy cells to natural killer cells, and the effects of interferon on T-cell receptor gene rearrangement and on the function of T-cell clones. Results are also presented which show that myelofibrosis may be due to a release of platelet derived growth factor. The immunological findings and oncogene expression in 2 patients with a variant form of hairy cell leukaemia for which resistance to therapy was observed are also described. All the results show that interferon acts on hairy cells and are consistent with a direct effect by interferon in the treatment of hairy cell leukaemia.

Blood Platelets↗
PubMed1987

Future developments in interferon therapy.

The antitumour effects of interferons in animals and humans are well known. Despite the fact, however, that the 3 types of human interferon, leukocyte alpha-interferon, fibroblast beta-interferon and immune gamma-interferon are available in large amounts through recombinant DNA technology, the practical applicability of interferon therapy in cancer is still not clear. An initial approach to this problem is to determine the mechanism of action of interferons and to find out why, in certain circumstances, they are inactive. There are various ways in which interferon may control tumours--i.e. antiviral action, inhibition of cell growth, stimulation of cell differentiation, changes in cells modulating the susceptibility to immune rejection, or effects on the host immune systems (natural killer system and cytotoxic proteins). The implications of these data in the use of interferon in cancer therapy need to be evaluated. Both alpha- and beta-interferons may have beneficial effects on growth inhibition and differentiation, but gamma-interferon is probably more effective in boosting the immune recognition and rejection of tumour cells. A combination of alpha- and gamma-interferon may give the best results in vivo, since they often act synergistically in vitro. The sensitivity of individual tumour cells to the various types of interferon needs to be evaluated by measurement of oncogenes mRNA inhibition, G0/G1 arrest and increase in various H-La antigens. Finally, the aim of any treatment (antiviral action, tumour regression, prevention of metastasis, decreased tumour growth and increased cell differentiation) should be an important consideration in whether interferon therapy is chosen. A major problem remains in understanding why only a small proportion of patients usually show an objective response to interferon.(ABSTRACT TRUNCATED AT 250 WORDS)

Combined Modality Therapy↗
PubMed1987

Prognostic significance of chromosomal abnormalities in acute nonlymphocytic leukemia: a study of 343 patients.

Clonal chromosome abnormalities of 343 patients with de novo acute nonlymphocytic leukemia (ANLL) have been tentatively correlated with prognosis. All the patients were treated according to therapeutic protocols in the same hospital. The complete remission rate and median survival were generally lower in AA-ANLL (ANLL with only karyotypically abnormal metaphases) when compared with NN- and AN-ANLL. Similarly, AA-ANLL had the poorest prognosis in the majority of the classes of the French-American-British nomenclature. ANLL with inversion and/or deletion of chromosome #16 had the best prognosis, and ANLL with t(8;21) was not particularly favorable, nor was acute promyelocytic leukemia with t(15;17). ANLL with complex chromosomal abnormalities had the poorest prognosis. The conclusion is that chromosomal aberrations do have a prognostic significance in ANLL, but that this significance is dependent on the types of chromosomal aberrations.

Acute Disease↗
PubMed1987

[Interferons in hemato-cancerology].

The anti-tumour effects of interferons (IFNs) in animals and man are well known. However, despite the fact that the three types of human IFNs, leukocyte alpha-IFN, fibroblast beta-IFN and immune gamma-IFN, are available in large amounts through recombinant DNA technology, the practical applicability of IFN therapy in cancer is far from clear. An initial approach to this problem is to determine the mechanism of action of IFNs and, if they do not act, to find out why. There are various ways in which IFN may control tumours, i.e. anti-viral action, inhibition of cell growth, stimulation of cell differentiation, changes in cells modulating the susceptibility to immune rejection, or effects on the host immune systems (natural killer system and cytotoxic proteins). The implications of these data for the use of IFNs in cancer therapy then need to be evaluated. Both alpha- and beta-IFNs may have beneficial effects on growth inhibition and differentiation, but gamma-IFN is probably stronger in boosting the immune recognition and rejection of tumour cells. A combination of these two types of IFNs may give the best results in vivo since they often act synergistically in vitro. The sensitivity of individual tumour cells to the various types of IFN needs to be evaluated to select the best treatment by measuring oncogene mRNA inhibition, G0/G1 arrest and increase in various HLA antigens. Finally, the aim of any treatment (anti-viral action, tumour regression, prevention of metastasis, decreased tumour growth and increased cell differentiation) should be an important consideration in choosing IFN therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Cell Differentiation↗
PubMed1987

[Allogenic bone marrow grafts in chronic myeloid leukemia].

Between August 1979 and April 1986, we treated 70 patients with chronic myeloid leukemia by supralethal chemoradiotherapy followed by bone marrow transplantation (BMT) from HLA identical sibling donors (65 patients) or from identical twins (5 patients). All patients were splenectomized before BMT. To prevent graft versus host disease Cyclosporin alone or associated with Methotrexate was given; in addition 13 patients received a T cell depleted marrow. All patients showed engraftment. Of the 5 patients treated by syngenic BMT, 2 patients relapsed but all are alive in remission, 2 of them after a successful second BMT. Of the 36 patients treated by allogeneic BMT in the chronic phase, 20 are alive in unmaintained remission after a median follow-up of 24 months (range 6 to 58). No patients have relapsed. The actuarial survival at 2 years was 60%. Of the 29 patients with more advanced disease, 19 have survived with the actuarial survival at 2 years 50%. We conclude that the probability of cure after BMT is very high, especially if BMT is performed while the patient remains in the chronic phase. Only 3 patients grafted in accelerated or blast phase died with relapse. The main cause of death was interstitial pneumonitis (15 patients) and 10 patients died from other transplant-related complications.

Adolescent↗
PubMed1987

[Improved results in the treatment of acute monoblastic leukemia: analysis of 91 patients treated in the 01 AM 81 protocol].

A total of 91 patients with acute monoblastic leukemia (AML) were treated following two induction regimens (ARA-C + RBZ, with of without CPA), and a unique maintenance therapy (CNS prophylaxis and reinductions every 6 weeks, for 36 months). Complete remission (CR) was obtained in 84% of patients. The only prognostic factor significantly influencing the CR rate was age, with 92% for the less than 40 years group and 75% for the greater than or equal to 40 years group. CR was not influenced by sex, tumoral syndrome, leukocytosis, cytological subclassification (M5A, M5B), or induction regimen with or without CPA. The duration of CR in these forms which have a traditionally poor prognosis, was no different from other forms of AML (21 months), and the disease-free survival at 50 months was 45%. These results, pertaining to the largest published series treated by the same protocol, are the best reported in literature and confirm the role of induction and maintenance therapy in CR.

Adult↗
PubMed1987

[HIV infections and transfusions].

The prevalence of AIDS now approaches 1% in patients with hemophilia and laboratory evidence of abnormal immunoregulation is found in 50% of patients with severe hemophilia. Current evidence indicates that a human retrovirus HIV/LAV is the etiologic agent which can be transmitted through the administration of blood products. We reported 7 cases in childhood, 5 acute leukemia, 1 metastatic neuroblastoma, and 1 severe aplastic anemia in whom AIDS occurred after administration of blood products. To date 5 patients are alive and 2 have died of infections. It is suggested that the use of steroids or antineoplastic agents increases the incidence of AIDS in patients infected with HIV/LAV because of altered immune suppression. The maintenance treatment is difficult in these patients. The widespread use of HIV serology to screen donated blood should help to prevent AIDS transmission in leukemic patients.

Acquired Immunodeficiency Syndrome↗
PubMed1987

[Acute myelomonocytic leukemia with abnormal eosinophils].

A total of 32 patients with acute myelomonocytic leukemia and abnormal bone marrow eosinophils (LAM4 Eo) have been treated at this Institute since 1977. Abnormalities of chromosome 16 have been noted in 14 of 22 evaluable cases. After a median follow-up of 4 years, median duration of complete remission was 46 months and median duration of survival had not been reached; 8 patients have been receiving no therapy for between 1 and 6 years. These results compare favorably with LAM4 without abnormal bone marrow eosinophils (median duration of complete remission: 12 months; median duration of survival: 14 months). LAM4 Eo constitute a particular entity, with a special hematological presentation, the incidence of abnormalities of chromosome 16, and a particularly good prognosis.

Adolescent↗
PubMed1987

Peripheral T cell lymphoma following angioimmunoblastic lymphadenopathy.

We report 5 cases of peripheral T cell lymphoma (PTCL) which initially presented as angioimmunoblastic lymphadenopathy (AIL). In 4 cases, the delay between the 2 phases was less than 1 year, and 3 patients were under corticosteroid therapy when the second biopsy was performed. Clinical and biological features were very similar during the 2 phases. The initial disease was morphologically characterized by a high cellular pleomorphism with immunoblasts, plasma cells, eosinophils and lymphoid cells of various size with abundant venules; this pleomorphism then regressed, emphasizing the T cell nature of the lymphoma, as proven by immunological staining with monoclonal antibodies raised against T cell subpopulations. In 4 cases, T cell proliferation bore T helper (CD4) and T cytotoxic/suppressor (CD8) antigens and, in 1 case only, CD4 antigen. The entity of AIL and the role of corticosteroid therapy is discussed; the short interval between the 2 diagnose suggests that T cell proliferation was present initially, but was masked by reactive B lymphocytes.

Adult↗
PubMed1987

[Therapy of acute leukemia in the adult. Role of anthracyclines].

Anthracyclines chemotherapy has changed the outcome of adult acute leukemia. Daunomycin, Adriamycin and Zorubicine are the three main analog derivatives. In adult ALL, in randomized study, anthracyclines in induction regimen improve significantly the remission rate up to 80%. In AML, combination chemotherapy of Ara-C and anthracyclines is the standard induction regimen. In randomized study, Daunomycin has the same activity than adriamycin at the same dose with less toxicity. Comparison of Daunomycin: 60 mg/m2 X 3 d with Zorubicin: 120 mg/m2 X 3 d shows the same activity in association with Ara-C with less toxicity. In protocol 01 AM 81, Zorubicin has been used at the dose of 200 mg/m2 X 4 d in association with Ara-C: 200 mg/m2 X 5 d. 444 patients has been included in the study. The complete remission rate is 83% with a mortality rate of 7% and only 11% failure. Zorubicin allows intensification of induction regimen with similar or less toxicity than conventionnal regimens.

Adult↗
PubMed1987

[Propagation of the gastric peristalsis in normal subjects and duodenal ulcer patients].

The velocities of gastric peristaltic waves were measured on fluorographic series made in normal subjects and patients with duodenal ulcer. After an overnight fast, the subjects drank 250 ml of barium suspension. Sequential radiograms were taken every 2 s during 30 s after two pyloric ejections. Peristaltic waves were located and their displacements measured with an Apple Graphic Tablet. Wave progression diagrams and velocity histograms were drawn for each subject. The velocities were calculated every 2 s. A "spread index" Ip was determined for each subject, characterizing the irregularity of propagation. Mean frequency and mean velocity were greater in duodenal ulcer patients (3.6 c/min; 3.7 mm/s) than in normal subjects (2.9 c/min; 2.4 mm/s; p less than 0.001). Nevertheless, no significant difference was found between proximal or midcorpus and antral velocities, in ulcer patients as well as in normal subjects, contrarily to classical data. However, the velocities were not uniform along the stomach. The contractions spread unevenly and displayed transient slopes. The irregularities of propagation were more pronounced in normal subjects, ranging from 0 to 14 mm/s with 28 p. 100 of velocities less than 1 mm/s, then in ulcer patients (0 to 13 mm/s with 12 p. 100 of low velocities). The spread index Ip was greater in normal (ranged from 0.54 to 2.62) than in ulcer patients (ranged from 0.16 to 0.48; p less than 0.001). This study showed that the propagation velocity of the peristaltic waves and its regularity were different in normal subjects and in duodenal ulcer patients.

Adult↗