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Biomedical subjects

S M Hubbard

Publications and source records attributed to S M Hubbard.

At least 55 records · Page 3Linked to original sources
PubMed1987

MOPP after two decades.

Explore the source record for details and available documents.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

The physician data query (PDQ) cancer information system.

PDQ is an online database that provides information about the prognosis and treatment of all major types of cancer. It represents a major effort by the NCI to communicate advances in cancer treatment using computer technology, and serves as a major component of the Institute's program to reduce cancer mortality nationwide. PDQ utilizes a modern large-scale computer to provide processing speed, a general purpose database management system to provide retrieval and display functions, and commercial telecommunication networks to provide online access to up-to-date information on cancer treatment. A series of user-friendly menus allow searching, browsing, and displaying without having to learn a specialized search language. PDQ is accessible through the National Library of Medicine's computer system via a computer terminal or personal computer and is available to the medical community at over 6,000 medical libraries and centers and through individual access codes. PDQ is also available as an online database under a special license agreement with NCI through two medical information systems produced by commercial database vendors: BRS/Saunders' COLLEAGUE Mead Data Central's MEDIS, and Telmed, a Swiss database.

Clinical Trials as Topic↗
PubMed1986

The effect of combined modality therapy on local control and survival.

The systemic component of combined modality therapeutic programs has influenced both the selection of the approach to local control and survival in a number of tumor types. The more effective systemic therapy is against metastatic cancer by itself, the greater the impact on local control and survival. This observation is consistent with the invariable inverse relationship between curability and tumor cell number. For some common cancers, local control is good, but survival remains poor because of the inability to deal effectively with micrometastases. Improved systemic treatment is likely to have an impact on survival may shift local control measures, in some cases, to radiation therapy or lesser surgery without radiation therapy. There remains a substantial number of tumor types where both local control and survival is poor. In these tumors, improvement in local control by itself is not likely to improve survival because of the presence of micrometastases, but such improvements must occur before we can have a true evaluation of the systemic treatment of micrometastases in these tumors. The recent understanding that the metastatic process is under genetic control and the cloning of metastases genes offers a substantial opportunity to control this process and influence both local control and survival.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

The Physician Data Query (PDQ) cancer information system.

PDQ is an online database that provides information about the prognosis and treatment of all major types of cancer. It represents a major effort by the NCI to communicate advances in cancer treatment using computer technology, and serves as a major component of the Institute's program to reduce cancer mortality nationwide. PDQ utilizes a modern large-scale computer to provide processing speed, a general purpose database management system to provide retrieval and display functions, and commercial telecommunication networks to provide online access to up-to-date information on cancer treatment. A series of user-friendly menus allow searching, browsing, and displaying without having to learn a specialized search language. PDQ is accessible through the National Library of Medicine's computer system via a computer terminal or personal computer and is available to the medical community at over 2000 medical libraries and centers and through individual access codes. PDQ is also available as an online database under a special license agreement with NCI through two medical information systems produced by commercial database vendors: BRS/Saunders' COLLEAGUE and Mead Data Central's MEDIS.

Drugs, Investigational↗
PubMed1986

The pathologic and clinical heterogeneity of lymphocyte-depleted Hodgkin's disease.

Patients with Hodgkin's disease of the lymphocyte-depleted subtype (LDHD) have been said to have a poor prognosis. However, reports of this subtype are complicated by the fact that the histologic diagnosis of LDHD is often not straightforward, and its distinction from aggressive non-Hodgkin's lymphomas (NHL) can be difficult. We have reviewed our patients with LDHD at the National Cancer Institute (NCI) in light of an additional decade of experience with neoplastic and non-neoplastic conditions mimicking Hodgkin's disease. Of 198 patients who received MOPP (mechlorethamine, vincristine, procarbazine, prednisone) treatment at the NCI for Hodgkin's disease between 1964 and 1976, 43 (22%) were originally classified as LDHD. The initial diagnostic biopsies from 39 of these patients were reviewed and revealed ten with NHL, nine with LDHD, and 13 with nodular sclerosing Hodgkin's disease of the lymphocyte-depleted subtype (NSLD). The other seven patients had Hodgkin's disease without a lymphocyte-depleted component. The NHL patients were further subclassified as diffuse, large-cell (two cases) and large-cell, immunoblastic (eight cases). The pathologic review was done without knowledge of clinical features which were examined after review in the three major subgroups. Of ten patients with NHL, only three had a complete remission (CR), and median survival was 7 months. Nine of the NHL patients presented with features that are unusual for patients with Hodgkin's disease, such as bulky abdominal disease, epitrochlear lymphade-nopathy, or hypercalcemia. CRs were attained by 67% and 85% of patients in the LDHD and NSLD groups, respectively: median survival had not been reached in either group with a median of 14 years of follow-up. Lymphocyte-depleted Hodgkin's disease, adequately treated, is in our limited group of patients no worse than other histopathologic subtypes of Hodgkin's disease. The erroneous inclusion of patients with high-grade NHLs into this subtype of Hodgkin's disease may be one reason for earlier literature reports of its more aggressive nature. The diagnosis of LDHD should be made cautiously, particularly in patients with clinical features that are unusual for Hodgkin's disease at presentation.

Adolescent↗
PubMed1986

Twenty years of MOPP therapy for Hodgkin's disease.

The results of treatment of 198 patients with MOPP (mechlorethamine, vincristine, procarbazine, and prednisone) for Hodgkin's disease were analyzed after a median of 14 years of follow-up. Throughout the period of follow-up, 103 patients have remained continuously free of disease. Review of biopsy specimens of 43 patients originally classified as Hodgkin's disease, lymphocyte-depleted type, revealed that ten of these patients actually had diffuse immunoblastic or large cell non-Hodgkin's lymphomas. Of the 188 patients with Hodgkin's disease, 157 achieved a complete response (CR) (84%), and 66% of them (101 patients) have remained disease-free more than 10 years from the end of treatment. Absence of B symptoms and receiving higher doses of vincristine were factors associated with a higher CR rate and longer survival. Patients entering complete remission in five cycles or less had significantly longer remissions than those requiring six or more cycles. Forty-eight percent of the Hodgkin's disease patients have survived between 9 and 21 years (median, 14 years) from the end of treatment. Nineteen percent of the CRs have died of intercurrent illnesses, free of Hodgkin's disease.

Adolescent↗
PubMed1986

Excess prevalence of Pneumocystis carinii pneumonia in patients treated for lymphoma with combination chemotherapy.

A significantly greater prevalence of interstitial pulmonary infiltrates and Pneumocystis carinii pneumonitis occurred on one arm of a randomized study comparing ProMACE-CytaBOM (prednisone, methotrexate with leucovorin, doxorubicin, cyclophosphamide, etoposide; cytarabine, bleomycin, vincristine, methotrexate with leucovorin) to ProMACE-MOPP (ProMACE, mechlorethamine, vincristine, prednisone, procarbazine) chemotherapy in patients with lymphoma. Of the 37 patients receiving ProMACE-CytaBOM, 13 (35.1%) developed an interstitial pulmonary infiltrate compared with 3 of 32 (9.4%) patients receiving ProMACE-MOPP (p2 = 0.02). Of the 13 patients receiving ProMACE-CytaBOM who had infiltrates, open lung biopsy in 7 showed P. carinii; 5 others had clinically suspected P. carinii pneumonia, and 1 had blastomycosis. No patient receiving ProMACE-MOPP had documented or suspected P. carinii pneumonia. Of patients with infiltrates, 3 of 13 on ProMACE-CytaBOM but 0 of 3 on ProMACE-MOPP died. Two other patients on ProMACE-CytaBOM who had P. carinii pneumonia died. Groups did not differ in predisposing risk factors or patient history. The exact cause for the increased prevalence of P. carinii infection in patients receiving ProMACE-CytaBOM was not ascertained. These data emphasize that new drug regimens may lead to unanticipated complications.

Adult↗
PubMed1984

Prolonged initial remission in patients with nodular mixed lymphoma.

Seventy-nine patients with nodular mixed lymphoma were treated at the National Cancer Institute between 1966 and 1978. Fifteen patients had stage I or II disease, and 64, stage III or IV disease. The overall complete response rate for the patients that received various primary treatment regimens was 76%, with 52% of complete responders remaining in their first remission at a median follow-up of 7 years. Median survival of complete responders is projected to be more than 13 years. Median survival of patients who do not achieve complete remission is less than 2 years. Patients with B symptoms, bone marrow involvement, or a lactate dehydrogenase level greater than 250 U/mL had significantly shorter survivals than did patients without these features. Patients with advanced-stage (III and IV) nodular mixed lymphoma had a 72% complete response rate, with the average remission lasting more than 6 years. Although relapses have been seen up to 8 years after diagnosis in patients with nodular mixed lymphoma given C-MOPP chemotherapy (cyclophosphamide, vincristine, procarbazine, prednisone), prolonged initial remissions can be achieved with this therapy.

Adult↗
PubMed1983

Diffuse aggressive lymphomas: increased survival after alternating flexible sequences of proMACE and MOPP chemotherapy.

A new treatment program was developed in an attempt to increase the complete remission rate and survival of previously untreated patients with advanced stages of diffuse aggressive lymphomas. A flexible number of cycles of ProMACE chemotherapy (prednisone, methotrexate, doxorubicin, cyclophosphamide, and epipodophyllotoxin VP-16) was alternated with a flexible number of cycles of MOPP chemotherapy (mechlorethamine, vincristine sulfate, procarbazine, and prednisone), and finally late intensification with ProMACE therapy was given. The duration of each phase of treatment was determined by the patient's rate of tumor response. Complete remissions were achieved in 55 of 74 patients (74%) with a median duration of follow-up exceeding 2 1/2 years. Only ten of the complete responders (18%) have had relapse. The dose-limiting toxicity is myelosuppression, and eight patients (10%) died from sepsis. Median survival for all patients has not been reached but is predicted to exceed 4 years with 65% of patients alive at 4 years. Previously we achieved a 46% complete remission rate with 38% of all patients alive at 4 years; relapse-free survival beyond 2 years was tantamount to cure. Therefore, ProMACE-MOPP chemotherapy represents a substantial improvement in treating patients with diffuse aggressive lymphomas.

Adolescent↗