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Biomedical subjects

R J Haas

Publications and source records attributed to R J Haas.

155 records · Page 9Linked to original sources
PubMedDate not supplied

[Results of the cooperative Malignant Testicular Tumors 82 Study of the German Society of Pediatric Oncology on the therapy of malignant germ cell tumors in childhood].

In the German Society of Pediatric Oncology (GPO) designed in 1982 a cooperative study to improve the outlook of patients with malignant testicular germ cell tumors. According to stage and histology of the tumor different surgical approaches to retroperitoneal lymphadenectomy are outlined. Local radiotherapy is not recommended. Adjuvant chemotherapy with Vinblastine, Bleomycin and CIS-Platinum is proposed. Up to 1987 27 YST, 3 MTI, 6 MTU, 1 MTT and 9 TD were treated. Only one patient with YST had a relapse; one patient died from candida septicemia. Alternative chemotherapy was given 3 times. Overall toxicity from treatment was mild. So far the combined modality therapy was found to be effective to increase the relapse free survival.

Adolescent↗
PubMedDate not supplied

[Progress in the therapy of children with congenital hemolytic anemias by transfusion of neocyte concentrations. Initial experiences in the separation and transfusion of young erythrocytes, obtained with the cell separator Fenwal CS-3000].

Transfusion-induced hemochromatosis remains a major therapeutic complication in the management of patients with chronic hemolytic anemias. Red cell units harvested with blood cell separators have an average estimated mean cell age of 30 days, compared to 60 days for unfractionated blood. Our initial experience with transfusion of neocytes indicates that the amount of transfused erythrocytes can be reduced on 60 per cent. Further studies must demonstrate the clinical benefit. When combined with modern iron chelator regimens, it may be possible to achieve consistently negative iron balance prior to the onset of hemochromatosis which would allow patients to probably lead a normal life-span.

Anemia, Hemolytic, Congenital↗
PubMedDate not supplied

[Anti-thymocyte globulin therapy in severe aplastic anemia: an alternative to bone marrow transplantation].

Eight patients with severe aplastic anemia (SAA) and two patients with congenital hypoplastic anemia (CHA) were treated with absorbed samples of rabbit anti-thymocyte globulin (ATG) at a total dose of 50-75 mg/kg body weight intravenously over 5 days. Duration of the disease was 1-14 years. Median age of the ten patients was 11 (4-15) years. Four of the eight patients with SAA were responders and transfusion independent for a follow up of 11 to 50 months. In two cases thrombocytopenia of about 100 000/mm3 is present. Four patients were non-responders three of them died in the meantime by the underlining disease. Two patients with CHA did not respond to ATG treatment. The CFU-C level of all eight patients with SAA before treatment was severely decreased. In co-culture studies with normal bone marrow no growth inhibition of normal bone marrow could be demonstrated. Also 20% patients serum did not inhibit normal bone marrow growth. The results are compared with data from literature and discussed in respect to alternative therapies.

Adolescent↗
PubMedDate not supplied

[The Munich study on the treatment of acute lymphoblastic leukemia in childhood (ALL 77-02)].

149 children with acute lymphocytic leukemia (ALL) were admitted to a prospective therapeutic regime. Remission induction was achieved by vincristine, daunorubicine, L-asparaginase and prednisone. During consolidation the patients received three intermediate dose methotrexate (MTX) infusions over 24 hours combined with intrathecal MTX, followed by L-asparaginase. High-risk patients were treated in addition with high dose cyclophosphamide and ARA-C over 3 weeks. Standard risk patients received cranial irradiation with 18 Gy, high-risk patients with 24 Gy. Maintenance therapy was performed with 6-mercaptopurine and MTX orally. Immunologic phaenotyping revealed: c-ALL 73%, pre-T or T-ALL 15%, c/T-ALL 4% and undifferentiated leukemia (AUL) 8%. Only 1 patient was nonresponder, 7 patients died during induction therapy, 5 patients during continuous complete remission (CCR). 18 relapses occurred, 12 of which were systemic, 8 CNS and 2 testicular relapses. In the total group the 54 months probability of CCR is 0,68 +/- 0,05 (life-table-analysis), for the reduced group 0,75 +/- 0,05. In the reduced group the probability of CCR at 54 months for standard risk patients is 0,86 +/- 0,06; for high-risk patients 0,60 +/- 0,09; for patients with c-ALL 0,73 +/- 0,08; for patients with c/T-ALL 1,0 +/- 0,0; for patients with pre-T or T-ALL 0,58 +/- 0,2 and for patients with AUL 0,45 +/- 0,25. For the reduced group the CCR probability at 54 months in relation to the leukocytes (WBC) at diagnosis is in patients with WBC less than 25 X 10(3)/mm3: 0,80 +/- 0,06; for patients with WBC greater than 25 X 10(3)/mm3: 0,63 +/- 0,11.

Antineoplastic Combined Chemotherapy Protocols↗
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[Active chickenpox vaccination of children with acute leukemia or other neoplastic diseases].

26 patients with acute leukemia and other malignancies susceptible to varicella were vaccinated during maintenance chemotherapy. Vaccination was done with OKA strain of live attenuated varicella vaccine developed by Takahashi 1974. All recipients showed no adverse clinical reactions. There was no spread of vaccine virus to others. Seroconversion was 94% in seronegative patients. In those having low antibody titers before vaccination in 56% booster effect was demonstrable. None of the seroconverted recipients contracted varicella in spite of documented contact exposure. Vaccine zoster was not observed. The results suggest that in immunocompromised children live varicella vaccination has a protective effect against varicella infection which has a described mortality rate up 7% in this patients.

Acute Disease↗
PubMedDate not supplied

[Malignant testicular tumors in children and adolescents: concept of the MAHO 82 cooperative therapeutic study of the Society for Pediatric Oncology].

The German Society of Pediatric Oncology (GPO) designed a cooperative study to improve the outlook of patients with malignant (testicular) germ cell tumors. According to stage and histology of the tumor different surgical approaches to retroperitoneal lymphadenectomy are suggested. Local radiotherapy is not recommended. Adjuvant chemotherapy with Vinblastine, Bleomycin and Cis-Platinum according to stage of disease, histologic classification and age of the patient is outlined. For non-responders or patients with only partial response an alternative aggressive chemotherapy with VP 16, Ifosfamide and Cis-Platinum is guidelined.

Adolescent↗
PubMedDate not supplied

[Treatment strategy in non-testicular malignant germ cell tumors in children and adolescents--concept of the MAKEI 83 cooperative therapeutic study of the Society for Pediatric Oncology].

In December 1982 the German Society of Pediatric Oncology (GPO) has initiated a cooperative study for non-testicular malignant germ cell tumors with initial vinblastine, bleomycin and cisplatinum chemotherapy depending on stage and histological grading, followed by ifosfamide, cisplatinum and VP 16 chemotherapy. Dysgerminoma patients with advanced disease are also treated with primary chemotherapy including vinblastine, bleomycin and cisplatinum; radiotherapy is limited to current disease. Patients with more differentiated teratomas receive combination chemotherapy with vinblastine, actinomycin D and cyclophosphamide.

Adolescent↗
PubMedDate not supplied

Testicular germ cell tumors, an update. Results of the German cooperative studies 1982-1997.

BACKGROUND: Oncologic treatment of childhood testicular germ cell tumors can be regarded as a model of curable neoplasm. Over 50% of the tumors are stage I A, produce alpha-fetoprotein and thus provide after semicastration a "wait and see" policy. PATIENTS: The MAHO 82, 88, 94 cooperative studies registered between 1982 and 1997 197 patients, 110 patients had yolk sac tumors (YST), 47 differentiated teratomas (TD), 38 malignant teratomas of either intermediate (MTI), undifferentiated (MTU), or trophoblastic type (MTT) and two seminomas. After semicastration only 65 patients received standard chemotherapy according to stage and histology consisting of four courses of vinblastine, bleomycin and cisplatin. If after two courses viable tumor was indicated, delayed laparotomy was performed (seven patients). Patients with incomplete tumor response after two courses received three courses of etoposide, ifosfamide and cisplatin (nine patients). RESULTS: 105 patients had YST stage I, five higher stages of disease. One of these died by tumor progression. Of 91 patients followed according to "wait and see" only 14 needed standard chemotherapy. The NED of 105 patients is 99%. 47 patients had TD stage I; the NED is 100%. 13 patients had malignant teratomas stage I. 13 patients had stage II and received chemotherapy; the NED for these 26 patients is 100%. 12 patients had stages III or IV, four died. CONCLUSION: In testicular germ cell tumors of childhood in alpha-fetoprotein producing tumors of stage I A a "wait and see" program is safe. X-irradiation or primary lymphadenectomy can be omitted since chemotherapy alone reveals excellent results.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

[Case example: malignant infantile osteopetrosis--pathogenesis and therapeutic options].

Malignant infantile osteopetrosis is a rare disease but can be clinically unequivocally diagnosed. Normal bone formation in the presence of decreased bone breakdown leads to the typical symptoms. The only proven curative approach, bone marrow transplantation, can reverse most of the symptoms and prevent progression to irreversible nerve damage when done early in infancy. Therefore, early diagnosis is decisive. We present a case report of an infant with osteopetrosis and discuss pathogenesis and therapeutical options.

Bone Marrow Transplantation↗
PubMedDate not supplied

Testicular germ cell tumors. Results of the GPO MAHO studies -82, -88, -92.

The MAHO studies 82, 88 and 92 were cooperative studies for the treatment of testicular germ cell tumors in childhood. Between 1992 and 1993 137 Patients were registered: 76 suffered from yolk sac tumors (YST), 30 from differentiated teratomas (TD), 29 from malignant teratomas of either intermediate (MTI), undifferentiated (MTU) or trophoblastic type (MTT) and 2 from seminoma. All patients received semicastratio. Chemotherapy was administered to 53 patients based on stage and histology. Standard therapy consisted of four courses of vinblastine, bleomycin and cisplatinum. However, if viable tumor was suspected after two courses delayed laparotomy was performed (7 patients). If there was then complete tumor regression, standard therapy was continued (4 pts). If there was incomplete tumor response, the patients received a salvage therapy with 3 courses of VP 16, ifosfamide and cisplatinum (3 pts). Results YST: 73 patients had stage I, 3 patients higher stages. 56 were followed according to "watch and wait" policy. 9 of these needed a delayed standard chemotherapy, one died. The disease free survival of all 76 patients is 98%. TD: 30 patients had stage I. The disease free survival is 100%. Malignant teratomas (MTI, MTU, MTT): 13 patients had stage I. 8 received adjuvant chemotherapy and 5 lymphadenectomy without chemotherapy. All patients survived disease free. 10 patients had stage II and received chemotherapy. All patients survived disease free. 6 patients had stage III. 3 died. Altogether 26 of 29 patients survived disease free. In summary, the probability of disease free survival of all 137 patients suffering from testicular germ cell tumors is 97% after a median observation time of 60 months.

Adolescent↗