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Biomedical subjects

M Weil

Publications and source records attributed to M Weil.

At least 181 records · Page 10Linked to original sources

Treatment of acute lymphoblastic leukaemia.

In acute lymphoblastic leukaemia the combination prednisone-vincristine induces more than 85% complete remissions. L-asparaginase which was used in complete remissions, seemed to increase their duration. Actually the best maintenance treatment consists in the combination of 6-mercaptopurine and methotrexate interrupted by reinductions. In other respects C.N.S. prophylaxis with intrathecal methotrexate and craniospinal irradiation is necessary. The well-known prognostic factors are: age, leucocytosis, tumoral syndrome, and cytological type: 216 cases of long remission have been observed. One group of these patients was treated by old methods: this represents 0.8 to 1% of the material, while 20% were treated by recent protocols with reinductions (20%).

Antineoplastic Agents↗

[Polychemotherapy of Hodgkin's disease (author's transl)].

204 patients with Hodgkin's disease not previously treated were given vincristine, chlormethine, procarbazine and prednisone (protocol H2-65) for six months, followed by monthly vinblastine injections. Additional prophylactic radiotherapy was given to 50 non-randomised patients. Three-monthly reinduction treatment was administered to a further 50 patients during the year following the original induction cure, afterwards only every six months, and no treatment after four years. Among 109 patients in stage III complete remission occurred in 53% and partial (incomplete) remission in 36%. Among the 58 patients in stage IV, 21 had complete and one incomplete remission. Among 37 patients in stages I and II, 33 went into remission. The remission curves reached a plateau in the 42nd month in 74 plus or minus 6% of those in complete and 56 plus or minus 8% of those in incomplete remission (P less than 0.03). Increasing age had an unfavourable prognosis: the more progressed the anatomical stage the less favourable the prognosis. Surprisingly, stage IV (lymphocyte-poor) had a better prognosis on polychemotherapy than other histological forms. Signs of clinical activity did not influence prognosis, but biochemical signs of activity are unfavourable for remission duration (P less than 0.01). Patients who also had radiotherapy had longer remissions (P less than 0.01). Exacerbations occurred in 38, never beyond the 42nd month. Recurrence occurred in 21 of them in the dame lymphatic region as was affected at the beginning of the disease, while in the other 17 patients an extralymphatic episode occurred. There was a positive correlation between histological form and type of recurrence.

Adolescent↗

[New data about oligoblastic leukemias. Apropos of an analysis of 120 cases].

We studied 120 aptients within the following condition: moderate bone marrow myeloblastosis (blast cells + promyelocytes less than or equal to 50 p. cent); quantitative and/or qualitative medullary insufficiency; preservation of maturation of the granulocytic line without a gap; WBC count less than 20 000/mm-3. Computer analysis pointed out the following results: 1. This group may be differenciated from the group of acute myeloblastic leukemias by: a) a predilection for subjects older than 60 in 73 p. cent of cases; b) male dominance in 70 p. cent of cases; c) a sharply defined improved prognosis with a median of survival of 15 months and with more than 30 p. cent of survivors for more than two years; d) death in 63 p. cent of teh cases is directly due to a complication of bone marrow insufficiency, and only in 14 p. cent of the cases is related to blastic invasion; e) a complete absence of favourable response to intensive chemotherapy. 2. There are five initial prognostic parameters which are of statistical significance: a) the hemoglobin level; b) the sedimentation rate; c) the platelet count, the level of bone marrow cellularity, and age. 3. Multidimensional analysis makes it appear that the whole population obeys a unidimensional phenomenon and depends on a common "biological axis" constituted by the five prognostic factors which are inter-related. 4. The disease nevertheless may be subdivided into three subgroups; a) High inflammatory hypoplastic forms are a very high risk group; b) The group of slowly invasive acute leukemias in young subjects is a bad or moderately poor risk group; c) The forms with a purely qualitative disorder of myelopoiesis with very low evolutive potential. These observations point to: a) The concept of OBL as an entity of a distinctive type including the preleukemic syndrome, the myelo-monocytic leukemias, and the smoldering leukemias; b) The concept of a unique and basic bone marrow disorder which embraces the OBL and the common acute myeloblastic leukemia.

Adult↗

[Leukemic meningitis].

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Central Nervous System Diseases↗