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Biomedical subjects

R Heinz

Publications and source records attributed to R Heinz.

At least 91 records · Page 5Linked to original sources
PubMed1984

Non-Hodgkin lymphoma following Hodgkin's disease. A case report.

A 40-year-old male developed 66 months after diagnosis of Hodgkin's disease a non-Hodgkin lymphoma of high grade malignancy. Initially he had been treated by irradiation because of Hodgkin's disease PS IIA. After 2 years of remission he had relapsed and had received MOPP and CCNU. After 2 years without any therapy he developed the secondary neoplasm. With increasing frequency of long term survivors late complications, either therapy related or caused by immunologic defects, are observed.

Adult↗
PubMed1983

[Alcohol and changes in the hematopoietic system; an epidemiological contribution to the problem of alcoholic anemia].

In the course of the "Vienna Health Study 1979" 1261 males and 1548 females divided into 3 age categories (25, 40 and 60 years), were investigated for serum iron level, RBC, leucocytes, haemoglobin, haematocrit, MCH, MVC, MCHC, GOT, GPT and AP. These parameters were evaluated in correlation to the drinking habits of each proband. Significant correlations were found between alcohol consumption and serum iron (elevation in most cases), RBC (decrease), MCV (elevation) and GOT (elevation).

Adult↗
PubMed1982

[Chemotherapy of non-Hodgkin's lymphomas].

Guidelines for the treatment of non-Hodgkin's lymphoma are laid down in this paper. Low-grade lymphomas diagnosed at an early stage be cured by adequate extended field radiotherapy, although this is a rare occurrence. Advanced stages are treated only on progression of the disease, whereby these measures can merely be regarded as palliative. Lymphomas of high-grade malignancy should be treated by massive chemotherapy from the very beginning, with additional supportive therapy for any complications which may arise, as necessary. After full remission has been achieved by means of chemotherapy, radiotherapy is applied to the previously worst-affected areas. This strategy aims at cure, as in the case of the acute leukaemias, although it is only very rarely successful. It is becoming increasingly possible to achieve remissions through applying various chemotherapeutic regimens, but the question of optimum maintenance therapy, both with regard to type and duration is still unsettled and urgently requires elucidation.

Age Factors↗
PubMed1981

Lymphoplasmacytic/lymphoplasmacytoid lymphoma: a clinical entity distinct from chronic lymphocytic leukaemia?

Clinical data of 116 patients with chronic lymphocytic leukaemia (CLL) and of 114 patients with lymphoplasmacytic/lymphoplasmacytoid lymphoma (synonym: LP immunocytoma, IC) as diagnosed according to the Kiel classification were compared. This interim evaluation of a prospective multicenter study of the Kiel Lymphoma Study Group characterizes IC the less favorable lymphoma entity as evidenced by a more rapid lymph node enlargement, by a higher incidence of constitutional symptoms and of marked anaemia, and by a higher percentage of patients requiring early treatment. In addition, in IC autoimmune haemolytic anaemia was detected in 11.2% of investigated patients as compared to none of the patients with CLL, and monoclonal gammopathy was disclosed in 34.2% of investigated patients as compared to only three patients with CLL who could be, however, unrecognized cases of IC. Actuarial survival data after a follow-up period of 40 months are in favor of an overall better prognosis of patients with CLL than of patients with IC.

Adult↗
PubMed1981

Clinical and prognostic heterogeneity of non-Hodgkin lymphomas of high-grade malignancy.

Comparison of clinical data of 64 patients with centroblastic lymphoma, 55 patients with immunoblastic lymphoma and 31 patients with lymphoblastic lymphoma not only confirmed the original assumption of high-grade malignancy as proposed by the concept of the Kiel classification but also demonstrated distinct clinical differences, particularly between lymphoblastic lymphoma and the two other entities. Rapid lymph node enlargement as well as steep fall of survival curves within the first year after diagnosis were common characteristics. Bimodal age distribution, predominance of males and early generalization of disease were typical features of lymphoblastic lymphoma; elderly patients and patients with the unclassified subtypes of lymphoblastic lymphoma exhibited the worst prognosis. Whereas patients with centroblastic and immunoblastic lymphomas showed similar distribution of age, sex and initial stage of disease, patients with immunoblastic lymphoma presented more frequently with a reduced performance status and showed a poorer response to radio- and chemotherapy resulting in a worse prognosis discernible after the first year of follow-up. Generalization during course of the disease was significantly more frequent in immunoblastic than in centroblastic lymphoma.

Adolescent↗
PubMed1981

[Hyperparathyreoidism and chronic lymphocytic leukemia (author's transl)].

A 55 year old patient with chronic lymphocytic leukemia is reported in whom hypercalcemia occurred associated with hypophosphatemia and elevated parathyroid hormone levels (C-terminal assay). Bone histology gave further evidence for hyperparathyroidism. During neck and mediastinal exploration numerous lymph nodes were exstirpated. Although pathologic parathyroid tissue could not be identified it is concluded from postoperative normalisation of calcium levels that hyperparathyroidism had been cured by surgery. The patient died the seventh postoperative day on bronchopulmonary infection. Early differential diagnostic evaluation of the rare symptom hypercalcemia in chronic lymphocytic leukemia is postulated.

Diagnosis, Differential↗
PubMed1980

[Methotrexate citrovorum factor therapy in advanced hypernephromas (author's transl)].

MTX-CF therapy was administered in 13 patients with advanced renal cell carcinoma. 2 patients were treated with MTX single agent therapy at a dosage of up to 750mg/m2 per cycle and a short CF rescue of 48 hours. They showed partial remissions along with severe toxicity including gastrointestinal symptoms and bone marrow depression. 11 patients were treated by combination of MTX/CF, vincristine, bleomycin and an alkylating agent (either peptichemio or cyclophosphamide). In this latter group, patients with a glomerular filtration rate of more than 70 ml/min received 150 to 400 mg/m2 per cycle MTX. Patients with decreased renal function (glomerular filtration rate less than 70 ml/min) received 35 to 100 mg/m2 per cycle MTX. Two out of 7 patients with decreased glomerular filtration rate achieved remissions of more than 50%, two achieved remissions of less than 50% and two patients achieved static disease. Only one patient in the group of 4 patients with normal renal function showed a remission of more than 50%. Median survival time of patients in partial remission or with static disease was 24 months, of patients showing progression was 5 months. This difference is highly significant (p < 0.001). These results seem to justify further investigations of MTX/CF therapy in hypernephromas, even in the presence of impaired renal function.

Adenocarcinoma↗
PubMed1980

[Clinical relevance of the Kiel classification of non-Hodgkin's lymphomas (author's transl)].

The Kiel classification of non-Hodgkin's lymphomas, based on morphological, cytochemical and functional criteria, differentiates between lymphomas of low-grade malignancy and high-grade malignancy, which are themselves subdivided into several distinct entities. The probability of survival, the symptomatology and some important laboratory parameters are described in 138 cases of malignant non-Hodgkin's lymphomas, classified according to the Kiel classification. The results show that this classification has not only prognostic and clinical relevance, but also explains some uncommon clinical courses of malignant lymphomas. It is to be hoped that this classification will also promote further progress in therapy.

Adolescent↗
PubMed1980

Methotrexate-citrovorum factor used alone and in combination chemotherapy for advanced hypernephromas.

Methotrexate-citrovorum factor (MTX-CF) therapy was administered to 20 patients with advanced renal cell carcinoma. Eight patients were treated with MTX-CF only. Two patients who received short-term rescue showed partial remissions along with severe toxicity including gastrointestinal symptoms and bone marrow depression. Twelve patients were treated with a combination of MTX-CF, vincristine, bleomycin, and an alkylating agent (either peptichemio or cyclophosphamide). In this latter group, patients with a glomerular filtration rate of greater than 70 ml/minute received 150-400 mg/m2/cycle of MTX. Patients with decreased renal function (less than 70 ml/minute) received 35-100 mg/m2/cycle of MTX. Two of seven patients with a decreased glomerular filtration rate showed partial remissions and four patients had static disease. One patient in the group of five with normal renal function showed static disease. None showed objective improvement. The median survival time was 25 months for patients with partial remission and static disease and 4.75 months for patients with progression. This difference is highly significant (P less than 0.0005). These results seem to justify further investigations of MTX-CF therapy in hypernephromas, even in the presence of impaired renal function.

Adenocarcinoma↗
PubMed1979

[A clinical study of the non-Hodgkin's lymphomas according to the Kiel classification (author's transl)].

A study of 138 patients with Non-Hodgkin's lymphomas was performed. The results were compared with retro- and prospective investigations of patients of the Kiel lymphoma study group. The aim of the study is to evaluate the value of the Kiel classification for the therapy and prognosis of malignant lymphomas. The malignant lymphomas of low- and high-grade malignancy differ significantly in their biological behaviour. Especially the clinical progress of the disease and the response to therapy are different. The lymphomas of low-grade malignancy may not need any treatment for long periods in some patients. In contrary, patients with lymphomas of high-grade malignancy need an active treatment immediately after the establishment of the diagnosis. In stages I and II radiotherapy is sufficient, in stages III and IV chemotherapeutic regimens are necessary. Each type of malignant lymphoma may be accompanied by leukemia. Most of the malignant lymphomas, particularly the immunocytomas, may produce monoclonal gammopathies, most of them being macroglobulinemias. Thus the macroglobulinemia Waldenström is just a clinical necessary to evaluate the significance of the subtypes of the Kiel classification for the planning of specific treatment.

Adolescent↗
PubMed1979

Adriamycin cardiotoxicity: a survey of 1273 patients.

Valuable information was collected on the medical history and clinical course of 1273 patients entered in clinical trials with Adriamycin (ADR) carried out in 12 European cancer centers. A coded patient form was used for the data collection carried out in each center by a qualified physician following a guideline which was discussed and accepted by all of the participants. The aim of the study was to define the incidence, characteristics, and possible co-factors of the cardiomyopathy (CMP) in patients treated with combination chemotherapy regimens including ADR. The mean total dose of ADR was 268 mg/m2 (range, 15--1251 mg/m2), and 5.1% of the patients received a total dose of greater than 550 mg/m2. A "definite" ADR-related CMP was observed in 1.7% of the cases; another 3% of the cases were reported as "possible" ADR-CMP since the role played by the drug could not be clearly defined. "Definite" ADR-CMP was fatal in eight patients (0.6%) while "possible" ADR-CMP was fatal in 13 patients (1.0%). Among the possible co-factors examined, the following ones were found to be significantly associated with the occurrence of a "definite" ADR-CMP: (a) total dose of ADR; (b) vincristine when given both before and concomitantly with ADR; (c) bleomycin when given before ADR; and (d) radiotherapy to the mediastinum when given concomitantly with ADR. Furthermore, none of 182 patients receiving ADR by slow infusion developed a "definite" ADR-CMP, while 2% of the patients treated by bolus injection did so. The occurrence of a "possible" ADR-CMP was found to be significantly associated with two pre-existing pathologic conditions (electrocardiogram [ECG] abnormalities and hypertension) but not with the treatment-related co-factors for the "definite" ADR-CMP mentioned above. Other variables examined, such as sex, age, cancer type, baseline liver function, and cyclophosphamide treatment, did not seem to influence the risk of ADR-CMP. Data on ECG changes occurring during ADR treatment were also reported and their incidence was found to be strictly related to the frequency of the ECG monitoring.

Adolescent↗
PubMed1979

[Accompanying hemolysis in lymphoproliferative diseases].

149 patients with non Hodgkin lymphomas (NHL) were observed at the III. Medical Department of the Hanusch Hospital during 1972--1978. 15 out of 106 patients with low malignant NHL had autoimmune hemolytic anemia (AHA). None of the patients with high malignant NHL showed evidence of hemolysis. In 10 cases AHA was diagnosed together with the lymphoproliferative disease. In 4 cases diagnosis of AHA and NHL was established at the same time and in only 1 patient diagnosis of AHA preceded the lymphatic disease. All patients had distinct signs of hemolysis with moderate to severe anemia. 4 patients with immunocytic lymphomas had IgM paraproteins and an elevation of gamma-globulins, all other patients had mild to severe hypogammaglobulinemia. Therapy in all cases consisted of corticosteroids and cytostatics (Chlorambucil, Cyclophosphamide). In none of our cases splenectomy was performed. AHA seems to be a bad prognostic factor in patients with chronic lymphocytic leukemia. Survival time in patients with chronic lymphocytic leukemia and AHA was 18 months shorter than in all other patients suffering from chronic lymphocytic leukemia.

Adult↗
PubMed1977

Treatment of acute non-lymphoid leukemias: comparison of two protocols.

The results of treatment of 57 patients suffering from acute non-lymphoid leukemia by two protocols are compared. The more aggressive Coap protocol rendered a higher remission rate (57.1%), than the mild Guyer protocol where the remission rate has been 25%. The best results have been achieved in the former group in the younger population; in the latter group there has been no age-effect relationship. Although the remission rate differed in both protocols there has been no statistically significant difference in survival.

Cyclophosphamide↗
PubMed1977

[Therapy of solid tumors using high-dose methotrexate and citrovorum factor].

Methotrexat (250-1100 mg/m2) was administered to 38 patients with malignant tumors by infusion of either 6 hours or of 75 minutes duration. MTX-infusion and continued at 3-6 hours interval for Citrovorum factor rescue was started 2 hours after 24 to 72 hours. 7 different MTX doses and rescue schedules were tested. It could be shown that MTX in the dose range used is effective in various tumors when CF-rescue is not higher than 7% of the administered MTX-dose, only occasionally therapeutic success was observed with higher doses. In the group of patients where CF-rescue was lower than 7% of the MTX dose on 9/14 patients objective tumor-regressions could be achieved. Conclusions drawn are discussed and the necessity of further investigations is emphasized.

Administration, Oral↗