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Biomedical subjects

P Lederlin

Publications and source records attributed to P Lederlin.

At least 73 records · Page 4Linked to original sources
PubMed1980

Acute leukaemia after prolonged chlorambucil treatment for non-malignant disease: report of a new case and literature survey.

A case of acute myeloblastic leukaemia is reported in a patient treated with chlorambucil during 72 months for multiple sclerosis. In a review of the medical literature, 43 additional reports of acute leukaemia after chlorambucil therapy for non-malignant diseases were found. Most cases are of a non-lymphoid type and preceded by various blood and bone marrow abnormalities. The prognosis is poor with a short survival. The risk of developing acute leukaemia after long-term immunosuppressive treatment with chlorambucil is emphasized.

Adult↗
PubMed1980

[Pericarditis as the presenting manifestation of acute monoblastic leukemia-Report of a case and review of the literature (author's transl)].

A case of acute monoblastic leukemia in a 68-year-old man is reported in which one of the presenting manifestations was a pericardial effusion. A blood-stained fluid was removed from the pericardium. The pericardial fluid showed blast cells on microscopical examination. The patient was treated with 6-Mercaptopurine and Methotrexate and achieved a short partial remission. He died of general infection, 4 months after the start of his illness. We found in the medical literature 30 additional cases with a mean age of 24 +/- 16 years and a striking male predominance (68. p. 100). We found 15 acute lymphoid leukemias, 9 acute myeloid leukemias, 4 acute indifferentiated leukemias, and 2 acute nontyped leukemias. The leukemic pericardial involvement is often associated with splenomegaly, adenopathy and pleural effusion. The management procedures include pericardiocentesis, general of local chemotherapy, irradiation of the cardiac area. The prognosis is generally poor, with a mean survival of 5 months.

Acute Disease↗
PubMedDate not supplied

[1 alpha 25-dihydroxyvitamin D3 (calcitriol) and malignant hemopathies. Decreased serum levels in acute leukemia: preliminary results].

We used the Amersham radioimmunological method to measure plasma 1 alpha 25-dihydroxyvitamin D3 (calcitriol) levels in patients presenting with one of the following diseases: (i) non-acute myelodysplastic syndrome (39 cases); (ii) acute myeloid leukaemia in blastic phase (43 cases) or in complete remission (15 cases) and (iii) acute lymphoid leukaemia in blastic phase (11 cases). All patients had normal metabolic functions. Compared with our standard laboratory values (15-35 pg/ml), the results of these assays were related to the type of pathology or, in patients with acute myeloid leukaemia, to the stage of the disease (p less than 0.001). Moreover, the mean plasma calcitriol values differed according to the type of pathology (p less than 0.003). Patients with acute myeloid leukaemia in blastic phase had a low level of calcitriol as compared with controls (p less than 0.05) and with patients with acute myeloid leukaemia in complete remission (p less than 0.001) whose calcitriol levels were never low. In contrast, there was no significant difference between controls and patients with myelodysplastic syndrome or acute lymphoid leukaemia in blastic phase. This study demonstrates the usefulness of plasma calcitriol assays in malignant blood diseases where low values in certain types of leukaemia would incite to include calcitriol in therapeutic regimens.

Acute Disease↗
PubMedDate not supplied

Treatment of subdiaphragmatic Hodgkin's disease: long-term results and side effects.

To evaluate the results, prognostic factors and especially side-effects of the treatment for subdiaphragmatic Hodgkin's disease (SHD) a retrospective study was conducted in the Haematology Departments and in the Cancer Centres of Nancy and Strasbourg between 1976 and 1990; 55 patients corresponding to the IA to IIB SHD stages were analysed. The median age was 45 years. In accordance with Ann Arbor classification, we observed 12 CS IA (21.3%), 2 CS IB (3.5%), 14 CS IIA (25.4%) and 27 CS IIB (49.7%). Twenty-five patients (45.4%) underwent laparotomy with spleen involvement in 10 cases. Fifteen patients (27.3%) had exclusive radiotherapy, 10 by inverted-Y field with or without splenic field, 5 by limited field to inguinal and homolateral iliac nodes. Forty patients had prior chemotherapy, 18 by MOPP protocol, 18 by hybrid MOPP/ABVD protocol and 4 by other schemes. The total dose delivered ranged from 26 to 45 Gy. With a median follow-up of 8 years, the overall and disease specific survival rates are respectively 61% and 83% at 10 years. Nine patients relapsed (16.4%), 4 among the 15 (26.6%) treated by exclusive irradiation and 5 among the 40 (12.5%) treated by combined therapy. We observed 8.3%, 21.4% and 18.5% of relapses respectively among the clinical stages IA, IIA and IIB. Eleven patients (20%) developed a second cancer. Twenty-six long-term complications were noted, nine of which concerned the digestive system. The only significant prognostic factor is age, with 10-year specific survival rates of 96% and 66% respectively for patients younger and older than 50 years (p=0.0003). Our data confirm that the most appropriate treatment for stage IA is exclusive radiotherapy and combined therapy for all other cases. With the use of CT-scan and eventually lymphography, the laparotomy is reserved only for cases with an uncertain diagnosis. Tobacco use is also clearly a risk factor in our series for late vascular complications and second cancers.

Adolescent↗
PubMedDate not supplied

[Treatment of aggressive primary lymphomas of the digestive system by intensive chemotherapy. Experience of the Study Group on Lymphomas in Adults with the LNH-84 protocol].

Ninety-one patients with primary gastrointestinal lymphoma included in the LNH-84 multicentric regimen were analyzed to determine the efficacy and the toxicity of intensive combination chemotherapy and of surgical debulking. All these patients had aggressive histological subtypes: 56 patients had localize disease, stage IE or IIE, and 35 patients had stage IV disease; 40 patients had bulky disease. Specific sites included stomach (43 cases), small bowel (35), ileo-cecum (13), colon (10), and rectum (6). Although 71 patients (78%) had an attempted surgical resection, only 28 (31%) had complete tumor excision. Patients were treated with 3 or 4 cycles of ACVB chemotherapy followed by sequential consolidation. Nine patients died during chemotherapy. With a median follow-up of 3 years, 10 patients have relapsed and predicted 4-year survival of the entire group is 62%. In stage IE or IIE patients, survival and disease-free survival are similar in patients who underwent complete resection or incomplete or no surgical resection prior to the administration of chemotherapy. Prognostic factors predicting for survival were similar to the entire group of patients treated with the LNH-84 regimen. Aggressive gastrointestinal lymphoma patients treated with intensive chemotherapy have outcome and prognostic factors comparable to those of other similarly staged aggressive lymphoma patients. Surgical resection prior to the administration of combination chemotherapy did not influence survival or disease-free survival in patients with localized disease.

Adolescent↗
PubMedDate not supplied

[Realization of an assisted system for medical decision and follow-up in hematologic diseases treated with sequential chemotherapy].

The follow-up of patients treated with sequential chemotherapy in internal medicine departments with special interest in haematology imposes a heavy burden on the entire treating staff. The chances of errors, notably in medical prescriptions and care, are not negligible, and these errors result in iatrogenic complications, readmissions and prolonged stays in hospitals. Designing a medical decision and therapeutic follow-up aid system should be time-saving for the staff and ensure good quality and safe prescriptions as well as reliable therapeutic evaluations and better hospital management. The system described here is developed on 4D Macintosh computer which handles a relational data-base. It includes the data-base, i.e. a knowledge-based system devised by the expert clinician containing "declarative" data and deduced rules which represent the expert's reasoning and determine the action to be taken, and the interface between them. The system easily accepts many parameters, thereby enabling medical knowledge and therapeutic attitudes to be updated.

Decision Making, Computer-Assisted↗