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Biomedical subjects

S B Kahn

Publications and source records attributed to S B Kahn.

At least 37 records · Page 2Linked to original sources
PubMed1983

4'-(9-acridinylamino)methane-sulfon-m-anisidide (m-AMSA) and 5-azacytidine (AZA) in the treatment of relapsed adult acute leukemia.

Between March 1980 and December 1981, 22 patients were treated with 4'(9-acridinylamino)methanesulfon-m-anisidide (m-AMSA) and 5-azacytidine (AZA), each given by I.V. push in a dosage of 150 mg/m2 for 5 days. Seven of 12 prior-remitting, acute nonlymphoblastic leukemia (ANLL) patients achieved complete remission (58%). Six ANLL patients who failed to remit on standard daunorubicin-cytosine arabinoside programs also failed to remit on the m-AMSA-AZA combination. Two patients with relapsed acute lymphatic leukemia (ALL) also failed while two patients with chronic myelocytic leukemia (CML) in evolution were cytoreduced. The seven patients who achieved remission had additional relapse-free survival for a median of six months (range 1-23+ months). One patient obtained a second remission with m-AMSA-AZA after relapse which followed a 9-month period of nonmaintained remission. Most patients demonstrated mild to moderate nausea and vomiting. Hepatic toxicity was mild to infrequent. Only four patients showed cardiac toxicity which was not life-threatening. The most troublesome toxicity was mucositis and was seen in 11 patients; four whom required I.V. hyperalimentation. We conclude that this combination is an effective salvage program for relapsed prior-remitting ANLL. Future studies should be conducted in three areas. The first study might be a comparison of relapsed prior-remitting ANLL with single-agent m-AMSA. The second, in untreated ANLL, following induction with DAT, might use m-AMSA-AZA in consolidation and maintenance arms of future protocols. The final study should explore m-AMSA-AZA activity in evolved CML in a greater number of patients.

Acute Disease↗
PubMed1981

Induction therapy and intensive consolidation with daunorubicin, cytosine arabinoside, and 6-thioguanine in adult acute nonlymphoblastic leukemia.

Twenty-one patients with acute nonlymphocytic leukemia were treated with a regimen including daunorubicin, cytosine arabinoside, and 6-thioguanine and 15 patients (71%) achieved a complete remission. Thirteen of the 15 remissions occurred after a single course of therapy and two after two courses of treatment resulting in a rapid time to complete remission. The time from treatment initiation to complete remission was 21-82 days with a median of 29 days. Nine of the 15 patients who gained a complete remission were then treated with two cycles of consolidation therapy utilizing the three induction drugs in modified dosages to determine the toxicity of a consolidation program. With the doses used in consolidation, pancytopenia regularly occurred but only 5/15 courses were associated with complications of bleeding or infection that required hospitalization. No patient died as a result of consolidation therapy. This study confirms the rapid effectiveness of the induction program which provided equivalent complete remission rates for adults at any age (up to 66 years). The consolidation regimen is now being used in a randomized study to determine whether it contributes to the duration of complete remission.

Acute Disease↗
PubMed1979

Legionnaires' disease: ultrastructural appearance of the agent in a lung biopsy specimen.

During the Legionnaires' disease epidemic that occurred in Philadelphia in 1976, we performed a transbronchial lung biopsy on a patient who suffered from Legionnaires' disease that was confirmed by serology. The biopsy was performed in an attempt to detect a causal agent for the patient's pneumonia at a time when the cause of the epidemic was a mystery. We detected pleomorphic microbial structures that were both intracellular and extracellular in location. By electron microscopy, they ranged in size from 350 nm to 2.5 mu. Some displayed cell walls and fine cytoplasmic granules that resembled ribosomes. Our findings illustrate the appearance of the Legionnaires' disease agent in acutely infected, antibiotic-treated human lung obtained from biopsy specimens.

Biopsy↗
PubMed1976

Low dose bleomycin and methotrexate in cervical cancer.

Twenty patients with recurrent and disseminated carcinoma of the cervix were treated with Bleomycin, 10 mg/m2 weekly and Methotrexate, 10 mg/m2 every fourth day. Twelve of the 20 (60%) had a greater than 50% shrinking of measured tumor masses lasting a median remission time of 7.5 months. The data suggest that combination protracted chemotherapy with these drugs of metastatic cervical cancer might improve the outlook of patients with this condition.

Bleomycin↗
PubMed1976

Red blood cell metabolism in AKR mice in the prelymphomatous phase.

The purpose of this study was to evaluate erythrokinetics and in vitro red blood cell (RBC) glucose utilization, 2,3-diphosphoglycerate production, and adenosine triphosphate levels following incubation in AKR mice from early in life until the onset of AKR lymphoma. Normal BALB/c mice served as controls. While hemoglobin concentration and RBC survival remained constant and similar in both groups of mice, the half disappearance time of injected radioactive 59Fe was longer and the 48-hr reappearance of 59Fe was less in AKR mice, compared with those of BALB/c mice. In vitro RBC metabolic studies indicated increased glucose utilization and 2,3-diphosphoglycerate production and decreased adenosine triphosphate levels following incubation in AKR RBC, in contrast to those in BALB/c RBC. RBC metabolic studies were also done in a small group of low leukemic C3H mice, and were similar to BALB/c mice. These differences became most marked in RBC from mice aged 15 to 30 weeks. Overt lymphoma began to occur after age 40 weeks. Hence, these erythropoietic changes occurred prior to the onset of lymphoma. The data imply a direct effect of virus infection on RBC or their precursors. The results are similar to changes in RBC metabolism noted in Rauscher-infected BALB/c mice. The broader implication of these findings in reference to viral host interactions and human leukemogenesis is discussed.

Adenosine Triphosphate↗