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Biomedical subjects

N Jaffe

Publications and source records attributed to N Jaffe.

At least 199 records · Page 11Linked to original sources
PubMed1975

Risk of second tumors in survivors of childhood cancer.

A new malignancy was diagnosed in 19 of 414 long-term survivors of cancer in childhood. All but two lesions were attributable to prior radiotherapy; eight were successfully treated. Excluding 4 patients ascertained in connection with the second malignancy, there were 15 in the series who developed a new cancer, in contrast to 0.7 cases expected (p less than 0.001). The 20-year (5-24 years after initial diagnosis) cumulative probability of a second cancer was 12% (S.E. 4%), and the radiation-related cancer rate was 1.8 cases in exposed tissues per million person-years per rad. Host susceptibility may have had an etiologic role, but an oncogenic effect of chemotherapy was not demonstrable. Another 13 study patients developed benign tumors. These findings emphasize the importance of long-term surveillance of children with cancer.

Adolescent↗
PubMed1975

Radiation-adriamycin interactions: preliminary clinical observations.

This communication reports four patients treated with the anthracycline adriamycin and irradiation either concurrently or sequentially, who demonstrated apparent augumentation of radiation reactions. Two of these patients demonstrated the so-called "recall" phenomenon.

Adolescent↗
PubMed1975

Experience with clinical and operative staging of Hodgkin's disease in children.

Accurate staging is critical for the proper treatment of Hodgkin's disease. In the past 5 yr, 60 children with Hodgkin's disease were staged by celiotomy which included splenectomy and biopsy of liver, retroperitoneal lymph nodes, and bone. Fifty children underwent staging celiotomy at initial diagnosis (Group I). Ten others were staged surgically because of suspected reactivation of disease diagnosed and treated before current staging methods were employed (Group II). Forty-one of 50 children in Group I had Stage I or II disease, seven Stage III, and two Stage IV. As a result of operation, therapy was altered in seven children. Three had a higher stag e and four a lower stage than that suspected by clinical evaluation, including two with liver involvement. Of the two patients in Group II, celiotomy revealed unsuspected splenic disease in seven, including one with liver involvement. Celiotomy and splenectomy were well tolerated and no long-term complications have been noted (average follow-up 2 yr). Forty-nine of 50 children in Group I and six of ten in Group II are alive without disease. No cases of sepsis attributable to splenectomy have been observed.

Adolescent↗
PubMed1975

Age-dependent dose response to gentamicin.

Serum gentamicin concentrations were measured 30 minutes after 140 intravenous doses in 60 children and nine adults with normal renal function. Distinct interpatient variation was observed but individual patients tended to have similar pharmacokinetics with repeated doses. Age had a significant effect in that mean peak serum concentrations were 1.58 mug/ml per 1 mg/kg dose in children between 6 months and 5 years, 2.03 mug/ml per 1 mg/kg in those between 5 and 10, and 2.86 mug/ml per 1 mg/kg in children 10 to 15 years of age. The mean calculated single dose of gentamicin necessary to achieve a peak serum concentration between 4 and 5 mug/ml is 2.5 mg/kg for ages 0.5 to 5 years, 2.0 mg/kg for ages 5 to 10 years, and 1.5 mg/kg for individuals over 10 years of age.

Adolescent↗
PubMed1975

Non-Hodgkin lymphoma of the head and neck in childhood.

A retrospective analysis of pediatric patients with non-Hodgkin lymphoma localized to the head and neck revealed a survival rate of 51.7%. This contrasts with a survival rate of 9% computed from the literature for children with local and regional non-Hodgkin lymphoma in various parts of the body. Major factors influencing survival appeared to be: (1) stage of lymphoma (12 of 17 Stage I survived); (2) histology (7 of 7 patients whose lesions were classified as nodular survived as compared to 5 of 17 with lesions classified as diffuse); and (3) anatomic location. Leukemia developed in seven patients with lesions of the diffuse histologic type. Recent experience suggests that aggressive, integrated treatment with surgery, radiation therapy, ano chemotherapy may favorably alter the course of the disease in patients with unfavorable histologic lesions.

Adolescent↗
PubMed1975

Non-oncogenic sequelae of cancer chemotherapy.

The delayed effects of anticancer drugs and late complications in 334 long-term survivors of childhood cancer were reviewed. Sequelae associated with chemotherapy were uncommon. Two men in the series exhibited disorders in reproductive function, possibly due to chlorambucil. A third male patient had cyclophosphamide-induced hematuria which persisted for two years after cessation of therapy. Other abnormalities were renal, hepatic, skeletal and cardiopulmonary, ascribed chiefly to radiotherapy, although the deleterious effect of drugs on irradiated organs cannot be excluded. The data indicate that the skillful and judicious application of chemotherapeutic agents produces a minimum of delayed consequences.

Adolescent↗
PubMed1975

Sternal changes following mediastinal irradiation for childhood Hodgkin's disease.

Sternal changes following mediastinal irradiation are described in 78 children with Hodgkin's disease. Incidence and severity of changes are correlated with total sternal dose. Megavoltage irradiation, with a nearly equal absorbed dose ratio between bone and soft tissue, and improved depth dose characteristics, has markedly decreased the incidence and severity of bone changes. No moderate or severe changes developed following megavoltage techniques, in contrast to orthovoltage therapy.

Adolescent↗
PubMed1975

Adverse effects of intrathecal methotrexate in children with acute leukemia in remission.

A toxic syndrome characterized by fever, headache, and vomiting, lasting 2-5 days, occurred in 61% of 39 children with acute leukemia in complete remission, receiving central nervous system prophylaxis with intrathecal methotrexate, and in 14% of 34 children receiving the same plus cranial radiation. The syndrome was accompanied by pleocytosis with lymphocytes, monocytoid cells, and neutrophils. There was evidence of cumulative Mtx toxicity, since the toxic syndrome occurred mostly after the third and fourth dose and did not recur with longer intervals between doses. The incidence of the syndrome was significantly reduced by the use of Elliott's B solution as Mtx diluent, rather than water or normal saline. The occurrence of pleocytosis and toxic clinical syndrome was also significantly reduced in patients receiving concomitant cranial radiation, probably due to the lympholytic action of radiotherapy and the depressed cellular response of irradiated tissues. The use of Elliott's B solution as diluent for IT Mtx and an appropriate interval between Mtx doses are suggested for prevention of this toxic syndrome.

Adolescent↗
PubMed1975

Effects of therapeutic irradiation delivered in early childhood upon subsequent lung function.

To determine the long-term effects of therapeutic pulmonary irradiation and treatment with actinomycin D during a period of lung growth, 12 patients treated for Wilms' tumor metastatic to the lung and 8 patients treated for Wilms' tumor with no evidence of pulmonary metastases were studied 7 to 14 years after their initial tumor therapy. All patients had received irradiation to the tumor bed and treatment with actinomycin D. Group 1 had received a single course of bilateral pulmonary irradiation; group 2 had received additional pulmonary irradiation and/or thoracic surgery; group 3 had received no therapeutic irradiation directed primarily to the chest. Total lung capacity (TLC) averaged 71% of predicted value in group 1, 58% in group 2, and 94% in group 3. Diffusing capacity in groups 1 and 2 was reduced to the same extent as lung volume. Quasi-static pressure-volume relationships, studied in three of six patients in group 1, were within the normal range when lung volume was expressed as percentage of observed TLC. Airway resistance, evaluated by spirometry, maximum expiratory flow-volume curves, and resistance of the total respiratory system, was normal or reduced. The data support the hypothesis that therapeutic irradiation during a period of lung growth primarily affects the lung parenchyma and produces a decrease in subsequent size of both the lung and chest wall. No effect of actinomycin D alone upon the lung could be demonstrated.

Adolescent↗