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Biomedical subjects

P Ostendorf

Publications and source records attributed to P Ostendorf.

At least 37 records · Page 2Linked to original sources
PubMed1985

Therapy for acute myeloid leukemia in 119 adults: a comparison of two treatment protocols.

Of 119 patients with acute myeloid leukemia, 69 were treated with Adriamycin, Vincristine and Cytosine Arabinoside (Therapy 1) and 50 with Daunorubicin, Cytosine Arabinoside and 6-Thioguanine (Therapy 2) as well as a consolidation therapy. The maintenance therapy with Cytosine Arabinoside and 6-Thioguanine was the same for both groups. The complete remission rate was 44% for Therapy 1 and 68% for Therapy 2 (p less than 0.05). - The median values for remission duration were 7 and 13 months respectively (p = 0.10); for survival time the median values were 18 and 19 months. These figures show in retrospect that high remission rates can be attained through intensive induction therapy and that longer remission duration is correlated with more aggressive induction therapy. A mild form of maintenance therapy seems to have little effect on the duration of complete remission.

Adolescent↗
PubMed1985

Mitoxantrone in the treatment of relapsed and refractory acute leukemia.

Twenty-four patients with acute leukemia and blast crisis of chronic myelocytic leukemia in relapse or refractory to standard chemotherapy were eligible for treatment with mitoxantrone. Mitoxantrone was administered in a dose of 8-13 mg/m2 on five consecutive days. 5 of 20 evaluable patients were induced into complete remission, 1 patient achieved a partial remission. Side effects included moderate to severe bone marrow suppression, moderate mucositis and hair loss. No cardiotoxicity was observed. We believe that mitoxantrone is an active agent in the treatment of acute leukemia and suggest further studies in combination chemotherapy.

Acute Disease↗
PubMed1985

Intravenous hyperimmune globulin prophylaxis against cytomegalovirus interstitial pneumonitis after allogenic bone marrow transplantation.

In an attempt to reduce the incidence of lethal cytomegalovirus (CMV) interstitial pneumonitis after allogenic bone marrow transplantation 49 patients were randomized in a multicenter controlled study to receive either CMV-hyperimmune globulin or a control immune globulin with low anticytomegalovirus titer. Immune globulin was administered intravenously 6 times with 20 days interval, starting on day 7 before transplantation. Patients receiving CMV hyperimmune globulin or control immune globulin were comparable with regard to age, diagnosis, pretransplant anti-CMV titer, incidence of graft-versus-host disease and transfusions. In each group, the incidence of histologically proven CMV interstitial pneumonitis during the first 110 days post BMT was recorded. Six of 23 patients in the control group versus 1 of 26 in the CMV hyperimmune globulin group died of CMV interstitial pneumonitis (p less than 0.05). No significant effect on idiopathic pneumonitis or survival was observed.

Bone Marrow Transplantation↗
PubMed1984

Bone marrow transplantation for acute leukemia in second or subsequent remission.

Twenty-one patients with acute leukemia in second to fifth remission were treated with bone marrow transplantation: 19 patients with transplants from HLA-matched siblings and two with transplants from identical twins. Twelve patients survived from 15 to 1,625 days after transplantation: six of 11 in the ALL group and six of 10 in the AML group. Recurrence of leukemia after marrow transplantation occurred in five patients. The cause of death in five patients was infection, in two patients combined with graft-versus-host disease. Long-term disease-free survival can probably be achieved in 30%-35% of all patients with acute leukemia who receive a marrow transplant in second or subsequent remission.

Adolescent↗
PubMed1984

Immunohistological skin alterations in allogeneic bone marrow transplantation.

Skin biopsies of 26 patients with leukemia and seven patients with aplastic anemia were investigated before and at different stages after allogeneic bone marrow transplantation (BMT) to establish the immunological criteria which distinguish skin alterations during normal reconstitution from dermal lesions mediated by graft-versus-host disease (GvHD). Of the 33 patients studied 27 presented with clinically diagnosed acute and/or chronic GvHD, one patient died of bone marrow rejection. Immunohistological analysis of the respective skin biopsies with selected monoclonal antibodies against human leukocyte antigens (HLA) and differentiation antigens of the lympho-hematopoietic cells revealed low dermal mononuclear cell counts with phenotypically normal constituents in five cases with uncomplicated reconstitution post-grafting. In contrast, increased dermal cellular infiltrates predominantly consisting of Lyt 3+, OKT 8+ T-lymphocytes, as well as of a large number of Ia-like (immune response associated = HLA-D) determinant + monocytes/macrophages were observed in all patients with active acute/chronic GvH reactivity. As sign of activation simultaneous expression of HLA-D region products was also found on a subset of the invading OKT8+ T-lymphocytes. Progression of GvHD was associated with additional surface staining of keratinocytes for Ia-like determinants. Loss of Ia-like determinant+, OKT6+ dentritic epithelial cells in all leukemic patients, as well as in patients with aplastic anemia with or without GvHD suggested damage of Langerhans cells due to the previous radiotherapy and/or specific immunological destruction. In patients with fatal outcome of GvHD prolonged reduction of these dentritic epithelial cells seemed to be indicative of impaired immune reconstitution or bone marrow dysfunction. Thus immunopathological features of skin GvHR may enable early recognition and prognostic evaluation of this disease possibly allowing more effective therapy.

Adolescent↗
PubMed1984

[Therapy of multiple myeloma. Results of sequential treatment with melphalan-prednisolone and the M2 protocol].

Melphalan and prednisolone were intermittently used for treatment of 101 patients with multiple myeloma. In case of progression, either initially or after remission or after a phase of stabilisation, treatment was changed to the M-2 protocol. By primary treatment, remission was obtained in 24 patients, a stable phase in 47 patients. The treatment of second choice which became necessary in a total of 46 patients led to remission in 5 patients (11%), 21 (46%) became stabilised and in 20 (43%) the disease progressed. The median survival time for all 101 patients was 40.5 months after commencement of treatment. In patients with remission it was clearly longer (67 months) than in those with stable disease (38.1 months) or in those with progression (16.8 months). The mean time of survival after commencement of treatment of second choice was 12.5 months. Compared to other studies the remission rates are slight, the time of survival, however, is very remarkable. The overall survival rates are equivalent to the results thus far obtained by more aggressive treatment schemes.

Adult↗
PubMed1983

CNS manifestations in non-Hodgkin lymphomas (NHL).

In a group of 241 patients with non-Hodgkin lymphoma investigated retrospectively, CNS manifestations occurred in 8%, mainly as meningeosis lymphoblastomatosa. Lymphoblastic and immunoblastic NHL showed the highest risk of CNS infiltration (40.7% and 12.5% respectively). Further risk factors were disseminated stage of the disease, prior involvement of the bone marrow and juvenile age. Characteristic symptoms were eye muscle paresis, paresthesias and pareses of peripheral muscles. The most fruitful diagnostic measure was lumbar puncture. More than 80% of the patients observed with CNS manifestations died within one year. The factor limiting life was less the CNS infiltration itself than the systemic progression. CNS prophylaxis should be incorporated in the treatment plan in patients with lymphoblastic and immunoblastic non-Hodgkin lymphoma at an early stage. In contrast CNS prophylaxis is not justified in uncontrollable systemic non-Hodgkin lymphoma spread.

Adult↗
PubMed1983

[Treatment of idiopathic thrombocytopenic purpura in adults with high-dosage immunoglobulins].

Four of five patients with idiopathic thrombocytopenic purpura (ITP) responded to high-dose immunoglobulin treatment with transitory rise in platelet count to normal values, while the fifth had only minimal improvement. In the individual case there was good correlation between serum-IgG concentration and platelet count, but an influence on platelet-associated IgG could not be demonstrated with certainty. Treatment with high-dose IgG is apparently particularly suitable for patients with ITP refractory to steroids or splenectomy, in whom bleeding complications or operative procedures make a transitory rise in platelet count desirable.

Adult↗
PubMed1983

[Combined chemo- and radiotherapy of small cell bronchial carcinoma with high dosages of radiation].

35 patients with small cell carcinoma of the lung were treated with adriamycin, cyclophosphamide and vincristine according to the ACO-protocol. Between the third and fourth course of chemotherapy the primary tumor region was irradiated with a dose of 50 to 60 Gy. In addition, the cranium and the parts of the mediastinum, which were not yet invaded by the tumor received irradiation with 30 Gy. The complete remission rate was 71% (10 out of 14 patients) in limited disease and 29% (6 out of 21 patients) in extensive disease. The median survival time was 13 months in LD and 7 in ED. The relapses occurred mainly outside the fields of the radiation. Only 3 of the 16 patients who achieved a complete remission relapsed in the irradiated field. In contrast to the results obtained with combined chemo- and radiotherapy with doses of only 30-40 Gy to the primary area, there was better local control of the tumor but without a better remission rate or survival time. The toxicity was not increased by the high dose irradiation.

Adult↗
PubMed1983

[Chemotherapy of nonseminomatous testicular tumors. The results of a pilot study with reduced cis-platin dosage].

23 patients with non-seminomatous germ cell tumors of the testis were treated with Cis-Platinum 50 mg/m2 body surface on day 1, Vinblastine 0,4 mg/kg body weight in two doses on days 1 and 2, and Bleomycin 30 mg daily as continuous infusion (days 2-5). 7 patients were treated adjuvant after retroperitoneal lymphadenectomy. One of these had a relapse, he again received the same therapy and now has a complete remission. All other adjuvant treated patients are free of tumor. Of the 16 patients with large retroperitoneal and/or lung metastases, 10 (62%) had a complete remission, 2 of them after resection of persistent metastases after chemotherapy. 4 of the 10 patients with complete remission relapsed. In two patients with relapse a new complete remission could be established by the same chemotherapy. The remission rates achieved with this therapy with a relatively low dose of Cis-Platinum are similar to those obtained with higher doses of this agent. It is possible that there are more relapses, but these respond well to further treatment. Thus, the survival times of the patients treated with this protocol are similar to those reported in the literature. It is concluded that this regimen is an effective treatment in non seminomatous germ cell tumors.

Bleomycin↗
PubMed1983

[Combination treatment of small cell bronchial carcinoma].

35 cases with micro-cellular bronchial carcinoma are described. The patients are treated with a combination of a modified ACO scheme and fractionated irradiations with 50 to 60 Gy to the primary tumor and 30 Gy to the encephalic skull. Among 14 patients with local disease, ten had a complete remission and three a partial remission. Among 21 patients with advanced disease, six had a complete remission and eight a partial remission. The side effects were not important, and they were not reinforced by the higher dose of the primary irradiation. The local recurrence rate was decreased, but the average survival times were not prolonged, because these are still dependent upon the hematogenic formation of metastases.

Adult↗
PubMed1982

[Bone marrow transplantation in patients with leukemia].

Between October 1979 and March 1982, bone marrow transplantations were performed by the Tübingen Group for BMT on 19 patients with acute leukemia in remission and on one patient with chronic myelocytic leukemia in chronic phase. The conditioning regimen consisted of 2 x 60 mg cyclophosphamide/kg and 10 Gy whole-body irradiation with the linear accelerator. The lung dose was limited by shielding to 8 Gy. In 15 patients, the bone marrow cell suspension of the donor was preincubated with antihuman T-cell globulin (AHTCG) for prophylaxis of graft-versus-host disease (GVHD). All patients showed prompt engraftment of donor cells with good hemopoietic function and complete chimerism. Under reverse isolation in sterile units, no severe bacterial or fungal infections were seen in the phase of bone marrow aplasia. Twelve in twenty patients survived between 25 and 900 days. A severe GVHD was seen only in two patients - one after preincubation with AHTCG. One patient died from relapse of his leukemia, another patient had a testicular relapse which was treated with local radiotherapy. Major problems were seen with chronic GVHD (six patients) and infectious complications, most importantly interstitial pneumonia, in the late post-transplant period.

Acute Disease↗
PubMed1981

[Unusual course in 2 patients with testicular teratoma during vinblastine-cyclophosphamide chemotherapy].

Two patients with metastatic embryonal testicular cancer achieved complete remission receiving a vinblastine-cyclophosphamide combination chemotherapy. After a previous treatment with vinblastine-bleomycin one patient had developed progressive disease, the other one had attained partial remission only. Because of our own experiences and because of the results in single agent chemotherapy this well tolerated vinblastine-cyclophosphamide combination is proposed as maintenance therapy for testicular teratoma. Other maintenance therapies according to the literature and the problem of maintenance therapy in general are discussed.

Adult↗