Treatment of intractable dyspnea: clinical and ethical issues.
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Alprazolam↗
Biomedical subjects
R G Wadleigh
Publications and source records attributed to R G Wadleigh.
H-ras-1 polymorphism in leukemia.
We have examined leukocyte DNAs obtained from 21 patients with various types of leukemia for the Sacl polymorphism of H-ras-1. The patients included ten with B-lineage leukemia, two with T-cell leukemia, and nine with acute myelogenous leukemia. Using a genomic probe for H-ras-1 in Southern hybridizations, we found that 78% of the DNA from leukemias of myeloid origin were heterozygous. In contrast, only three of ten B-cell-derived leukemias showed heterozygosity. This difference in the number of heterozygotes vs. homozygotes in the two patient samples studied is statistically significant (P = 0.04 by Fisher's exact test). These results suggest the possibility that the H-ras-1 allelic pattern that is associated with acute myelogenous leukemia is distinct from that found in B-cell-derived malignancies.
Genes, ras↗
Recent clinical experience with dronabinol.
Dronabinol, delta-9-tetrahydrocannabinol in sesame oil, has been used for several years as an antiemetic for patients receiving cancer chemotherapy. In combination studies with prochlorperazine, enhancement of efficacy, as measured by duration of episodes of nausea and vomiting and by severity of nausea, has been found. The incidence of psychotropic effects from dronabinol appears to be decreased by concomitant administration of prochlorperazine. In open pilot studies, dronabinol caused weight gain in seven of ten patients with symptomatic HIV infection. In both HIV and cancer patients, dronabinol improved appetite at a dose which was well tolerated for chronic administration.
Antineoplastic Agents↗
Simultaneous chemotherapy and radiotherapy for squamous cell lung cancer.
Simultaneous chemotherapy and radiotherapy was evaluated in 13 patients with inoperable, limited stage squamous cell lung cancer. The chemotherapeutic agents bleomycin, methotrexate, 5-fluorouracil, vinblastine, and cisplatin were administered on days 1 and 5 of two treatment cycles given 5 weeks apart. Radiation therapy was given in three 2-week cycles, the first two starting on the second day of each chemotherapy cycle and the third starting 3 weeks after the second course of radiation. The total dose was 5000-5500 rad (50-55 Gy) in 180 rad fractions. The objective response rate (complete response + partial response) was 85%, with 38% complete responders. Median survival was 7 months with two patients surviving 34 months, one with disease and one disease-free. Treatment toxicity was predominantly hematopoietic and renal. Two patients died with massive pulmonary hemorrhage while receiving treatment and a third patient died of acute respiratory failure 1 month after completing therapy. The severe toxicity and the failure to obtain long duration tumor control makes this regimen unsuitable for future use.
Aged↗