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N Schmitz

Publications and source records attributed to N Schmitz.

At least 235 records · Page 13Linked to original sources
PubMed1985

[Fractionated homogeneous whole body irradiation prior to bone marrow transplantation].

At the University of Kiel, myeloid and acute lymphatic leukemia is treated since 1983 by total-body irradiation applied prior to bone marrow transplantation. Dose deviations in the midplane caused by the irregular surface and tissue inhomogeneities of the patient are reduced down to +/- 3.5% compared to the central ray, with the help of CT-based individual compensators. This method prevents above all an excessive dose to the lungs. The radiobiologic advantages of fractionated irradiation have been employed for all patients treated hitherto (n = 9). At present, a total body dose of 12 Gy in six fractions is applied within three days. There were no undesired acute radiogenic reactions except a mild acute mucositis found in all patients. Chronic side effects, especially in the lungs, were not demonstrated, too. However, the average follow-up time of 149 days has been rather short. One patient died from relapse of leukemia after a total dose of 10 Gy, another patient died because the transplanted bone marrow was rejected, and a third died from catheter sepsis. Six out of nine patients are in complete remission with a maximum index of Karnofsky. The limited experiences gained hitherto show that the homogenous accelerated-fractionated total-body irradiation offers essential advantages compared to non-compensated single dose irradiation with respect to the prevention of undesired radiogenic effects in sound tissues and that its therapeutic efficacy is at least the same.

Adolescent↗
PubMed1984

[Analysis of prognostic factors in plasmacytoma].

For analysis of prognostic factors the clinical course of 109 patients with multiple myeloma was evaluated. Survival curves of immunoglobulin (Ig)G- and IgA-myelomas were identical (Fig. 1) with median survival times of 52 and 42 months, respectively, whereas patients with IgD- and Bence-Jones-myeloma had short survival times (median 3 months). Most important risk factors were anemia, renal insufficiency, and hypercalcemia (Figs. 7 and 8). Median survival time dropped from 52 months (Hb above 100 g/l) to 22 (Hb 85-100 g/l) and 1 month (Hb below 85 g/l). Patients with serum creatinine values below 2 mg/dl lived significantly longer than those with values above. Median survival times were 52 and 1 month, respectively. All seven hypercalcemic patients had a renal insufficiency and were in a very poor condition; their median survival time was 1 month. Analysis of the widely used staging system of Durie and Salmon gave disappointing results. Survival curves of the three A-stages ran close together with median survival times of 58, 51, and 36 months. Only the A-B classification according to renal function (A: creatinine under 2 mg/dl; B: creatinine above 2 mg/dl) proved prognostically relevant.

Aged↗
PubMed1984

Acute myelomonocytic leukemia with involvement of eosinophils and inversion of chromosome 16.

A case of acute nonlymphocytic leukemia (ANLL) with abnormal marrow eosinophils is presented. Thorough morphological, cytochemical, and cytogenetic studies confirm the existence of a recently defined new cytogenetic-morphological entity: acute myelomonocytic leukemia with abnormal bone marrow eosinophils (FAB M4), chloracetate esterase- and periodic acid-Schiff-positivity of eosinophilic granules, and pericentric inversion of chromosome 16, in this case combined with trisomy 8. So far 18 such cases have been reported from a single institution. The implications of this new association on the diagnosis of acute leukemia with abnormal eosinophils are discussed.

Acid Phosphatase↗
PubMed1984

Hodgkin's disease.

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Antineoplastic Combined Chemotherapy Protocols↗
PubMed1983

[Problems of intravenous urography in patients with plasmocytoma].

Numerous reports refer to the development of acute renal failure following intravenous urography in patients with multiple myeloma, while other authors consider the risk to be acceptable if abdominal compression and dehydration are avoided and alkalization of urine is carried out. The outcome of 34 intravenous urographies with Conray 70, Conray FL, and Conray 36 has been evaluated in 26 patients with multiple myeloma. No case of acute renal failure was observed. Two patients experienced a mild increase (greater than 0.3 mg/dl) in serum creatinine levels. Mean value of serum creatinine was 1.28 mg/dl prior to and 1.18 mg/dl after urography. In three of four patients with preexisting azotemia serum creatinine levels fell after urography, while in the fourth a mild increase from 2.0 mg/dl to 2.5 mg/dl five days after the examination was observed. Data from the literature in addition to own data are presented. From all the data taken together we conclude that intravenous urography may carry a moderately increased risk of acute renal failure in patients with multiple myeloma. It may be performed if the indication is well established.

Acute Kidney Injury↗
PubMed1982

Prognostic factors in COPP-treated patients with Hodgkin's disease.

In a recently published review of the literature [40] we came to the conclusion that the Ann-Arbor staging classification is of limited prognostic value for chemotherapy of Hodgkin's disease (Table 2). Four risk factors accounted for impaired complete remission rates: stage IVB, lymphocyte depletion or not classifiable histologic type, previous chemotherapy, and older age. Fifty-eight evaluable patients were treated with COPP; 23 reached a complete remission (40%). Disease-free survival was 31%, overall survival 49% after five years [33]. Besides the known risk factors, impaired bone marrow function (leucocyte counts less than 4 X 10(9)/l, platelet counts less than 100 X 10(9)/l) at the start of therapy was associated with poor treatment results: none of six patients achieved a complete remission [41]. Eleven of 16 patients with no and 11 of 23 patients with one risk factor achieved a complete remission, as did only one patient with more than one risk factor. Survival rates after 30 months were: 87% with no, 66% with one, 36% with two, and 13% with more than two risk factors. We can conclude from our results that the prognosis of patients undergoing chemotherapy for Hodgkin's disease depends on the number of risk factors.

Cyclophosphamide↗
PubMed1982

[Results of radiotherapy in case of Hodgkin's disease after primary failure of chemotherapy and recurrence after chemotherapy ].

Until now, the possibility of radiotherapeutic treatment after a failure of chemotherapy has not been systematically investigated. Eight cases with primary failure of chemotherapy or recurrence after chemotherapy could be evaluated. The patients were submitted to curative irradiation; six of them achieved a total remission, four had recurrences. Thus two patients remain to give an example that radiotherapy can bring about long-term total remissions after primary failure of chemotherapy or recurrence after chemotherapy. When the data were evaluated, the total remission times of the two patients were 12 and 18 months, respectively. The toxicity of radiotherapy was justifiable. It was increased especially in regions that had already been irradiated or if a ABVD therapy was applied a short time before or after the radiotherapy. There are only few communications in literature about the success of a radiotherapy after failure of chemotherapy. Most of the patients mentioned had "remissions" (total/partial remissions?). In most of the cases, there are no indications about the further development. On the whole, the data show that there may be some special indications for radiotherapy in case of a failure of chemotherapy.

Adult↗
PubMed1981

[Results of treatment with ABVD in C-MOPP-resistant Hodgkin's disease (author's transl)].

22 Patients were treated with ABVD, 19 (18 stage IV B 1 stage III B) could be evaluated. No patient with impaired but 7 of 13 patients with intact bone-marrow function achieved a complete remission. A complete remission was also achieved by all 4 patients with a treatment- and disease-free interval but only by 3 of 15 without a free interval. Pretreatment, histology, duration of disease, and age showed no clear prognostic significance with respect to induction of remission. Toxicity was severe especially in patients over 50 years of age. 2 patients discontinued therapy because of gastro-intestinal toxicity. 2 of 8 died of treatment-related causes (1 leukemia, 1 sudden cardiac death). In 3 patients with high-dose mediastinal irradiation a pneumonitis secondary to bleomycin contributed significantly to death. Our results suggest that ABVD is an effective salvage-regimen for some subgroups of MOPP-failures.

Age Factors↗