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Biomedical subjects

P Klimo

Publications and source records attributed to P Klimo.

30 records · Page 2Linked to original sources
PubMed1987

Weekly cyclophosphamide and alternate-day prednisone: an effective secondary therapy in multiple myeloma.

Intravenous or oral cyclophosphamide, 150-250 mg/m2 (500 mg maximum), once per week with alternate-day oral prednisone, 100 mg, was given to 57 myeloma patients resistant to melphalan and prednisone (MP). Seven responses in 28 primary MP-resistant patients and ten responses in 29 secondary MP-resistant patients were observed. Previous response to MP was not a significant factor in predicting response to weekly cyclophosphamide and alternate-day prednisone. The results suggest that the regimen of weekly cyclophosphamide and alternate-day prednisone may be as effective as more aggressive regimens in the treatment of patients with myeloma who have failed MP therapy. However, a randomized trial would be required to determine the relative contributions of cyclophosphamide and prednisone to the effectiveness of this regimen.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1985

MOPP/ABV hybrid program: combination chemotherapy based on early introduction of seven effective drugs for advanced Hodgkin's disease.

Seventy patients with advanced Hodgkin's disease, 54 with new disease, and 16 in first relapse after initial radiotherapy, have been treated with a seven-drug, 8-month program: MOPP (nitrogen mustard, vincristine, procarbazine, prednisone)/ABV (Adriamycin [Adria Laboratories of Canada, Mississauga, Ontario], bleomycin, vinblastine) hybrid. A single involved field of radiotherapy was given to selected partial responders after 6 months of chemotherapy. Forty-six of the 52 (88%) evaluable new-disease patients and 14 of the 16 (87%) evaluable patients with relapsing disease reached a complete response. The actuarial overall survival at 49 months for the patients with new disease was 90% (median follow-up from diagnosis was 27 months). For the patients with relapsing disease, the actuarial survival at 54 months was 79% (median follow-up from diagnosis was 27 months). The actuarial relapse-free survival at 41 months for complete responders was 93% for patients with new disease (median follow-up after treatment was 20 months) and 80% for those with relapsing disease (median follow-up after treatment was 27 months). Toxicity was moderate, with two treatment-related deaths and eight episodes of serious infection. These results compare favorably with the best results reported in the literature. Furthermore, they were achieved with a moderate level of toxicity, high drug delivery rates, and a relatively short duration of treatment. The efficacy and toxicity data of the MOPP/ABV hybrid program will now be evaluated in a prospectively randomized multicenter study.

Actuarial Analysis↗
PubMed1985

MACOP-B chemotherapy for the treatment of diffuse large-cell lymphoma.

Between April 1981 and May 1984, 61 patients with advanced diffuse large-cell lymphoma completed treatment with MACOP-B (methotrexate with leucovorin rescue, doxorubicin, cyclophosphamide, vincristine, prednisone, and bleomycin), an innovative pilot chemotherapy program emphasizing weekly treatment, antibiotic prophylaxis, daily corticosteroid treatments, and brief duration (12 weeks). Fifty-one patients (84%) achieved a complete response and 10 patients (16%) had a partial response. Over a median follow-up after treatment of 23 months, the actuarial overall survival for the entire group has been 76%; for complete responders the relapse-free survival has been 90%. Toxicity was modest with one treatment-related death and seven episodes of serious infection. The most frequent toxicity was mucositis. Thus, MACOP-B is an effective treatment for large-cell lymphoma that can be delivered in 12 weeks with an acceptable incidence of toxicity. This regimen can achieve results similar and possibly superior to those of other presently used regimens of longer duration.

Actuarial Analysis↗
PubMed1985

Cyclic alternating chemotherapy for small cell carcinoma of the lung.

Eighty-two previously untreated patients with small cell cancer of the lung were treated with six cycles of two alternating drug regimens: a new combination of mitomycin, methotrexate, and etoposide; and cyclophosphamide, doxorubicin, and vincristine. No maintenance chemotherapy was used. Consolidative thoracic irradiation and prophylactic cranial irradiation were employed. The median survival time for 32 limited-disease patients was 59 weeks, and for 50 extensive-disease patients was 35 weeks. Four-year survival was 12% for limited-disease patients and 2% for extensive-disease patients. These results were not superior to conventional combination chemotherapy regimens.

Adult↗
PubMed1984

Application of aspiration biopsy cytology to lymphomas.

Fine needle aspiration diagnosis is a well established technique. However, its application to lymphomas has been quite limited. From September 1977 to January 1981, the Lymphoma Group at the CCABC performed 213 aspirates. Of the 213, 180 were considered to be diagnostically useful, with 33 being unsatisfactory or no action was taken. Of the 180 considered useful, 170 were positive, and prompted institution of therapy (84), provided guide to appropriate treatment (84), provided rapid solution to clinical situation (65), provided improved understanding of clinical situation (78), and prevented invasive procedure [minor (local anesthetic), 31; intermediate (general anesthetic), 88; major (laparotomy or thoracotomy), 18]. Ten negative results delayed therapy (3), led to unnecessary or inappropriate investigation (1), led to incorrect therapy, (4), and were a source of confusion (10). In most circumstances, the authors tried to avoid fine needle aspirations as the only basis for an initial diagnosis. In a previously diagnosed lymphoma, aspiration aided in staging, in confirming recurrence, in the diagnosis of new and unrelated malignancy or undiagnosed infection and in assessing the evolution of a lymphoma to a more aggressive form. Aspiration diagnosis was considered to be a useful adjunct in the care of patients with lymphoma and it is especially suited to use by a closely working team of clinicians, radiologists, and pathologists.

Biopsy, Needle↗
PubMed1984

Is it an E lesion or stage IV? An unsettled issue in Hodgkin's disease staging.

To determine whether recognized experts in the area of Hodgkin's disease would agree on the determination of stage when various types of extranodal disease are present, we asked senior investigators at 15 major centers to assign a stage to four different patients. In general, these experts agreed in cases representing the extremes of difference between localized and distant extranodal disease. However, when presented with patients with nearby but not contiguous extranodal disease of lung or bone, one half of the experts classified this as an E lesion and one half as stage IV. This disagreement in stage assignment has implications not only for individual patient treatment, but also for reporting of clinical trials. Over-assignment of stage IV has the practical result of "improving" the results of treatment of both low stage (by removing higher risk patients) and advanced stage patients (by including better risk patients). Papers reporting the results of treatment of Hodgkin's disease should include information concerning how patients with extranodal disease were separated into those with E lesions and those with stage IV disease.

Hodgkin Disease↗
PubMed1984

Kappa light-chain myeloma with pleural involvement.

A case of kappa light-chain myeloma with pleural involvement is reported. The diagnosis was made by pleural biopsy, pleural fluid cytology, and urine immunoelectrophoresis. A review of the literature on pleural involvement in multiple myeloma revealed that this is the first reported case in patients with light-chain myeloma.

Adult↗
PubMed1982

Treatment of advanced malignant melanoma with high dose methotrexate and folinic acid rescue.

Twenty-eight patients with advanced malignant melanoma were treated with high dose methotrexate (HDMTX) and folinic acid (FA) rescue. Nineteen patients were treated with 6-hour infusions and 10 patients with 24-hour infusions. One patient in the 6-hour infusion group showed a partial response. In the 24-hour infusion group there were no responses but there was a significant increase in renal toxicity. It is concluded that HDMTX and FA rescue are not useful agents in the treatment of advanced malignant melanoma.

Adult↗
PubMed1982

Multiple myeloma first observed as multiple cutaneous plasmacytomas.

A 62-year-old woman had multiple plasmacytomas of the skin with no roentgenographic or bone marrow evidence of multiple myeloma. Serum IgA-lambda level was increased to 1,000 mg/dL (normal range, 90 to 450 mg/dL). The skin lesions regressed completely when the patient was treated with melphalan. She had recurrence of a skin plasmacytoma and lytic bone lesions ten months later and died of bronchopneumonia 11 months after the was first seen. Solitary skin plasmacytomas are rare, and multiple skin plasmacytomas are even rarer. Occasionally, these lesions may precede roentgenographic and bone marrow evidence of multiple myeloma.

Female↗