Search PubMed⌕ Search

Biomedical subjects

M H Cohen

Publications and source records attributed to M H Cohen.

At least 145 records · Page 8Linked to original sources
PubMed1981

Amplification of circulating granulocyte-monocyte stem cell numbers following chemotherapy in patients with extensive small cell carcinoma of the lung.

Circulating numbers of committed granulocyte-monocyte hematopoietic stem cells (CFUc) were measured in the peripheral blood of 20 patients with extensive-stage small cell lung carcinoma during induction chemotherapy. All patients received cyclophosphamide, doxorubicin, VP16-213, and vincristine. CFUc measurements were made either weekly or twice weekly. As leukocytes declined following chemotherapy, circulating CFUc numbers also declined. However, as leukocytes recovered from their nadir levels, circulating CFUc numbers per mononuclear cell and per ml of whole blood became substantially expanded in 19 and 17, respectively, of the 20 patients studied. Per mononuclear cell, the median CFUc expansion was 7.9-fold, and the highest expansion seen was 157-fold. Per mol of blood, the median CFUc expansion was 6.7-fold, and the highest expansion seen was 46-fold. The magnitude of the amplification, its occurrence in 85 to 95% of patients studied, and its association with leukocyte recovery strongly suggest that appropriately timed collections of peripheral blood mononuclear cells obtained during leukocyte recovery from nonablative chemotherapy could be used to provide hematopoietic stem cells in numbers sufficient to effect hematopoietic reconstitution after subsequent marrow-ablative therapy.

Adult↗
PubMed1981

Small cell carcinoma presenting as an extrapulmonary neoplasm: sites of origin and response to chemotherapy.

Eight (4%) of 203 consecutive prospectively staged and treated patients with small cell carcinoma (SCC) had no evidence of pulmonary or mediastinal tumor on chest roentgenogram or at fiberoptic bronchoscopy at the time of diagnosis. There were two distinct clinical presentations in these SCC patients with exclusively extrapulmonary tumors. Four had discrete localized extrapulmonary neoplasms, presumably originating in these sites. In the other 4 cases with either regional or widely metastatic disease, no obvious primary tumor could be documented in the lungs or elsewhere. One complete and two partial responses to chemotherapy (duration 6 to greater than 11 mo) occurred in 6 evaluable patients. Two remaining patients were inevaluable for response because they received adjuvant chemotherapy after irradiation or excision of the primary tumor and are free of disease at 15 and 28 months. Results document two clinicopathologic entities of extrapulmonary SCC, more firmly establish that it can be responsive to chemotherapy, and encourage systemic therapy as part of initial treatment planning.

Aged↗
PubMed1981

Influence of tumor burden on red blood cell deformability in small cell lung cancer patients.

Red blood cell deformability was measured in 54 newly diagnosed patients with small cell bronchogenic carcinoma and in 22 normal hospital employees. Twenty-one small cell cancer patients had disease confined to one hemithorax plus draining lymph nodes (one organ system), 15 had involvement of one additional metastatic site (two organ systems), 12 had two metastatic sites (three organ systems) and 6 patients had 4 organ systems involved. Patients with one or two organ system involvement had red cell deformability results comparable to the normal control group. Patients with tumor extension to 3 or 4 organ systems had significantly decreased deformability relative to patients with lesser tumor burdens. Based on the lowest deformability results in the control population small cell cancer patients were divided into those with normal or impaired red blood cell deformability. The latter patients were significantly more anemic and had higher red cell mean corpuscular volumes than their normal counterparts. Patients with impaired deformability also had significantly elevated blood glucose levels and significantly lower serum inorganic phosphorus and iron binding capacity. Since red cell deformability is the principal determinant of capillary blood flow abnormal deformability may result in decreased tumor oxygenation and decreased, and non-uniform, delivery of chemotherapeutic agents to tumor tissue.

Adolescent↗
PubMed1980

Smoking abstinence and small cell lung cancer survival. An association.

The prognostic implications of cigarette smoking were investigated in 112 patients with small cell lung cancer. Twenty had stopped smoking permanently before diagnosis (NS-Prior), 35 had stopped at diagnosis (NS-Dx), and 57 patients continued smoking (S). Therapies included chemotherapy alone or with radiation therapy, with or without thymosin fraction V. The survival difference among the three groups was statistically significant. The NS-Prior patients had the best survival, followed by NS-Dx patients and finally S patients. No S patient has survived, disease free, more than 96 weeks, while three NS-Prior and three NS-Dx patients are disease free 103 to 220 weeks after start of treatment. Thymosin, 60 mg/sq m, yielded survival benefits for the S group only. Continuation of smoking during the treatment of small cell lung cancer was associated with a poor prognosis, while discontinuation of smoking, even at diagnosis, may have beneficial effects on survival.

Carcinoma, Small Cell↗
PubMed1980

Hepatic involvement in the cutaneous T-cell lymphomas: results of percutaneous biopsy and peritoneoscopy.

Forty-three patients with cutaneous T-cell lymphomas (mycosis fungoides and the Sezary syndrome) underwent routine staging procedures to assess extent of disease prior to therapy. Evaluation of the liver included physical examination, liver function tests, 99mTc-liver-spleen scans, percutaneous liver biopsy, and peritoneoscopy with multiple liver biopsies. Seven patients (16%) had biopsy-documented hepatic lymphoma, histologically defined as focal aggregates of atypical convoluted lymphocytes in portal zones or hepatic lobules. The liver was the most frequently involved visceral site. Involvement of peripheral blood, leukocytosis, and generalized erythroderma were significantly associated with hepatic lymphoma. Biopsy examination was the only accurate method of detecting hepatic involvement, and peritoneoscopy with multiple biopsies appeared to be more sensitive than a single percutaneous biopsy, since the yield of positive biopsies increased from three to seven. In order to better understand the natural history of the cutaneous T-cell lymphomas and the relation of hepatic involvement to survival, histologic evaluation of the liver in patients with the cutaneous lymphomas should be carried out prior to therapy.

Adult↗
PubMed1980

Evaluation of response to chemotherapy with fiberoptic bronchoscopy in non-small cell lung cancer.

Fiberoptic bronchoscopy was performed before and during administration of chemotherapy in 32 patients with unresectable non-small cell carconoma of the lung. Pretreatment findings varied with the histologic cell type. Direct visual and/or pathologic evidence of cancer was obtained in 11 of 11 patients with epidermoid, in 5 of 7 with large cell, and in 9 of 14 with adenocarcinoma. In 5 of the 32 patients, intrathoracic tumor was documented at bronchoscopy but not by chest x-ray. During chemotherapy, one of five episodes of response and eight of 21 episodes of chest tumor progression were detected solely by bronchoscopy, while in an additional two objective responses and six progressions, bronchoscopic and radiographic findings simultaneously improved or deteriorated. The likelihood of documenting disease progression by bronchoscopy also depended upon the histologic type of cancer. Enlarging chest tumor found solely by chest x-ray occurred exclusively in patients with large cell carcinoma and adenocarcinoma. During chemotherapeutic treatment of our pateints, addition of serial bronchoscopic examinations to standard means of assessing tumor response frequently allowed the earlier discontinuation of an ineffective drug regimen.

Adenocarcinoma↗
PubMed1980

Effective treatment of hormonally-unresponsive metastatic carcinoma of the prostate with adriamycin and cyclophosphamide: methods of documenting tumor response and progression.

Combination chemotherapy with Adriamycin and cyclophosphamide was administered to 22 men with progressive tumor following hormonal treatment for metastatic carcinoma of the prostate. Objective partial response was documented in 7 patients (32%); an additional four (18%) had stable disease for a minimum of four months, and 11 (50%) were non-responders. Patients with partial response had a median survival of 14 months and lived significantly longer than those with no response (median five months); survival of men with stable disease approximated that of partial responders. Serial utilization of multiple staging procedures during chemotherapy demonstrated that although no single test allowed identification of all patients with objective tumor response or progression, improvement in median of five parameters could be documented in responding patients. In patients adequately studied at the time of disease progression, deterioration in a median of six tests was found. Serum acid phosphatase radionuclide bone scan, and plasma carcinoembryonic antigen were the most sensitive procedures which detected both objective tumor response and progression. Toxicity of chemotherapy was acceptable except in patients with prior radiation therapy. Administration of Adriamycin and cyclophosphamide was associated with clinical benefit in half of our patients with hormone-resistant prostatic cancer. Tumor response and progression can best be objectively assessed if several staging procedures are serially employed during treatment.

Aged↗
PubMed1980

The carcinomatous neuromyopathy of oat cell lung cancer.

A prospective controlled clinical-neurophysiological-pathological study of 71 patients with oat cell carcinoma of the lung revealed no increased incidence of peripheral neuropathy at the initial stages of illness. All patients developed neuropathy by the time they had lost 15% of their body weight, but the neuropathy was less severe than in 20 age-matched alcoholic patients with an equal degree of weight loss. The weight loss and peripheral neuropathy progressed with atrophy of type II (adenosine triphosphatase-positive) muscle fibers out of proportion to the patient's loss of body weight. By 40% body weight loss, all the patients had moderate symmetrical peripheral neuropathy, 6 had proximal brachial or lumbosacral plexus metastases, and 9 had distal pressure palsies. Mononeuritis multiplex developed in only 1 patient, who had diabetes mellitus. Two patients developed Eaton-Lambert syndrome, which resolved in 1 when chemotherapy controlled the systemic tumor, with no protein in the tumor postmortem which could produce the characteristic electromyographic findings of the syndrome.

Adult↗
PubMed1980

Anaplastic thyroid carcinoma: long-term survival after radical surgery.

Anaplastic carcinoma of the thyroid is a highly malignant disease with few survivors over one year. Radical surgery and laryngectomy are usually considered contraindicated. A 50-year-old woman with a history of papillary carcinoma treated with external radiation developed anaplastic giant-cell carcinoma of the thyroid invading the soft tissues of the neck including the larynx. Since surgery was felt to represent her only chance for survival, she underwent laryngopharyngectomy, right radical-neck dissection, and pharyngeal reconstruction. Three years after the surgery was performed, she is living an active life with only minor handicaps. Nevertheless, multiple nodules were noted in her lungs on recent tomographic examination. Our experience with this woman suggests that there is a role for radical surgery and laryngectomy in selected cases of anaplastic carcinoma.

Carcinoma↗
PubMed1980

Herpes zoster and small cell bronchogenic carcinoma.

In nine of 74 (12 per cent) consecutive, previously untreated patients with small cell bronchogenic carcinoma receiving combination chemotherapy herpes zoster developed. This is the highest frequenzy reported for this viral infection in patients with nonlymphoproliferative solid tumors. Cutaneous dissemination developed in six of the nine patients, but visceral involvement did not occur. The major difference between the patients with herpes zoster and those without was the superior duration of median survival for the infected patients. No relationship could be established between the development of herpes zoster and the extent of neoplastic disease, prior radiotherapy, treatment with specific chemotherapeutic agents or corticosteroids, cutaneous anergy or granulocytopenia. Serum specimens obtained from six of the nine patients prior to their infection demonstrated the preexistence of varicella zoster antibodies. As more effective and intensive chemotherapy prolongs the survival of patients with solid tumors, it is possible that the frequency of herpes zoster infection may approach that observed in patients with lymphoproliferative malignancies.

Adult↗
PubMed1980

Prognostic effect of weight loss prior to chemotherapy in cancer patients. Eastern Cooperative Oncology Group.

The prognostic effect of weight loss prior to chemotherapy was analyzed using data from 3,047 patients enrolled in 12 chemotherapy protocols of the Eastern Cooperative Oncology Group. The frequency of weight loss ranged from 31 percent for favorable non-Hodgkin's lymphoma to 87 percent in gastric cancer. Median survival was significantly shorter in nine protocols for the patients with weight loss compared to the patients with no weight loss. Chemotherapy response rates were lower in the patients with weight loss, but only in patients with breast cancer was this difference significant. Decreasing weight was correlated with decreasing performance status except for patients with pancreatic and gastric cancer. Within performance status categories, weight loss was associated with decreased median survival. The frequency of weight loss increased with increasing number of anatomic sites involved with metastases, but within categories of anatomic involvement, weight loss was associated with decreased median survival. These observations emphasize the prognostic effect of weight loss, especially in patients with a favorable performance status or a limited anatomic involvement with tumor.

Activities of Daily Living↗
PubMed1980

Prospective staging evaluation of patients with cutaneous T-cell lymphomas. Demonstration of a high frequency of extracutaneous dissemination.

A prospective pretreatment staging evaluation was done on 49 consecutive patients with mycosis fungoides or the Sézary syndrome to study patterns of disease spread and prognostic factors. Routine staging procedures included complete blood count, blood chemistries, chest roentgenogram, lymphangiogram, radionuclide scans, bone marrow aspiration and biopsy, liver biopsy, and lymph node biopsy. Special evaluations included cytogenetic analysis, electron microscopy, and T-cell cytology. Extracutaneous lymphoma was documented by light microscopy in 51% of patients and by the three special procedures in 88%. Extracutaneous lymphoma was most frequent in blood and lymph nodes; 18% of patients had visceral involvement. Patients with generalized erythroderma had a higher frequency of extracutaneous disease than did patients with cutaneous plaques and tumors by both light microscopy and special studies. Survival was directly related to the type of skin involvement and the presence or absence of extracutaneous disease. Systemic dissemination of cutaneous T-cell lymphoma is frequent, generally asymptomatic, and develops early via the circulation. These findings may explain why cutaneous therapies are associated with a high frequency of relapse.

Adult↗
PubMed1980

Influence of histologic subtype of small cell carcinoma of the lung on clinical presentation, response to therapy, and survival.

Patients with small cell carcinoma of the lung (SCCL) were histologically subtyped according to the Working Party for Therapy of Lung Cancer classification and were treated with combination chemotherapy. Of the 103 patients studied, 54 had the lymphocyte-like (oat cell) subtype, 41 had the intermediate cell subtype, and 8 had a mixture of the two. No significant difference in initial performance status, extent of disease, chemotherapeutic response rate, or survival (median, 10.2 mo) was noted among the histologic subtypes. When the histologic subtype of the primary biopsy tissue was compared with the subtype of other pathology specimens from the same patient, concordance of subtype was present in 74% of the patients. In the remaining 26%, two or three histologic subtypes were present. This study demonstrates no clinically significant differences among the various histologic subtypes of SCCL in patients extensively staged and treated with aggressive cytotoxic therapy. Because of this and because concurrent biopsy tissues from multiple sites in the same patient may vary in subtype, we conclude that prognostic or therapeutic decisions should not be based on SCCL subtype.

Carcinoma, Small Cell↗
PubMed1980

Randomized trial of chlorpromazine, caffeine, and methyl-CCNU in disseminated melanoma.

One hundred and fifty-seven evaluable patients with advanced metastatic malignant melanoma were randomly assigned to receive either methyl-CCNU (MeCCNU) (200 mg/m2 orally every 6 weeks) (82 patients) or a combination of MeCCNU, chlorpromazine (50 mg/m2 im), and caffeine (600 mg/m2 sc) in the periumbilical area (75 patients). The response rate was 12% for the combination (three complete responses and six partial responses) and 11% for MeCCNU alone (two complete responses and seven partial responses). The median survival was 20 weeks and was the same for both treatments. The data support the hypothesis that caffeine and chlorpromazine do not enhance MeCCNU activity in malignant melanoma, unlike the marked enhancement seen for this drug combination in L1210 leukemia in mice.

Caffeine↗