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Biomedical subjects

T J Degnan

Publications and source records attributed to T J Degnan.

At least 19 recordsLinked to original sources
PubMed1988

Attempted prevention of blast crisis in chronic myeloid leukemia by the use of pulsed doses of cytosine arabinoside and cis-chloronitrosurea during the course of busulfan-maintained remission.

We performed this chemotherapeutic trial to try to delay the onset of the blast crisis of chronic myeloid leukemia (CML) by pulsing doses of drugs most likely to be effective against emerging "blast" cells characteristic of acute phase disease. A randomized trial in patients with CML comparing busulfan maintenance to busulfan maintenance plus pulsed doses of cytarabine and lomustine did not yield any differences in either time to blast crisis or death.

Adult↗
PubMed1986

A comparative assessment of home versus hospital comprehensive treatment for advanced cancer patients.

A prospective comparative analysis of home and hospital comprehensive treatment for advanced non-ambulatory cancer patients was conducted. Patients were assigned to hospital (group A) and home (group B) treatment groups based on geographic location. Home treatment was provided by the Don Monti Home Oncology Medical Extension (HOME) program. A multidisciplinary health team, including an oncologist, oncology nurse, social worker, dietitian, and medical technologist, was transported to the home in a medically equipped van. Services included physical examinations, pain control, psychosocial interventions, chemotherapy and blood transfusions, nutrition consultation, and bereavement counseling. One hundred seventy-four patients were treated at home and 44 in the hospital. Pretreatment characteristics were similar for both groups, with the exception that age under 50 years was more frequent in the hospital group, and home patients were more likely to have gastrointestinal (GI) cancer. Medical benefits for home treatment included decreased narcotic analgesic requirements, decreased hospitalization and length of stay, and improved measurements of fat stores for female patients. Improved survival for home patients was related to Karnofsky performance status, since there was no difference in survival for sicker patients with lower performance status whether they received home or hospital treatment. Patient and family acceptance of home treatment was excellent. Comprehensive home treatment provided by a multispecialty oncology team is an effective alternative to hospitalization for terminal cancer patients.

Analgesics↗
PubMed1986

Comparative cost analysis of home and hospital treatment.

A comparative study evaluating home and hospital treatment for terminal cancer patients is reported. Home care was provided by a comprehensive home care program, the Don Monti Home Oncology Medical Extension (H.O.M.E.). A multispecialty team including an oncologist, oncology nurse, social worker, dietitian and technologist is transported to the home in a medically-equipped van to render treatment. Services provided include physical assessments, pain control, chemotherapy and transfusion administration, psychosocial support, nutrition education and bereavement counseling. Two-hundred eighteen patients were entered of which 174 were treated at home and 44 in the hospital. Patients were comparable in age, diagnosis, sites of metastases, prior treatment and Karnofsky status. Both groups received similar supportive care either at home or in the hospital. Cost analysis of home and hospital care revealed a per diem cost benefit of $256.00 for home treatment. Comprehensive home treatment provided by a multi-specialty team can deliver effective care with medical and financial benefits to terminal cancer patients.

Cost Control↗
PubMed1983

Biclonal IgM gammopathy in a lymphoproliferative disorder.

An unusual case of an IgM producing lymphoproliferative disorder is presented. Using immunofluorescent techniques, this study shows that the heavy chain is associated with kappa light chain in some cells, and with lambda light chain in other cells. This indicates the presence of two distinct malignant cell populations in this patient.

Aged↗
PubMed1983

De novo disseminated intravascular coagulation in angioimmunoblastic lymphadenopathy (AILD).

An elderly woman with angioimmunoblastic lymphadenopathy with dysproteinemia (AILD) presented de novo with DIC in the absence of other etiologic causes for DIC. Complete reversal of the defibrination process occurred with vincristine, methyl-prednisolone, and heparin therapy. This case illustrates that defibrination can occur de novo in the presence of a clinically, although not pathologically, malignant process. AILD should be considered in the differential diagnosis of DIC.

Aged↗
PubMed1983

Phase II trial of mitomycin, vinblastine, and cisplatin (MVP) in non-small cell bronchogenic carcinoma.

A phase II trial of mitomycin, vinblastine, and cisplatin was undertaken in 26 patients with non-small cell carcinoma of the lung. A major response rate of 46% was seen in measurable and evaluable disease, with a complete response rate of 12%. Median duration of response is 6.5+ months (range, 2.5-19+). Toxic effects included moderate myelosuppression, mild neuropathy, mild azotemia, and severe nausea and vomiting. These results are similar to previously reported studies using vinca alkaloids and cisplatin alone.

Adult↗
PubMed1982

Cytogenetic findings in the dysmyelopoietic syndrome.

Cytogenetic studies of bone marrow specimens from 15 patients with dysmyelopoietic syndrome are presented. The group consists of nine patients with refractory anemia with excess of blasts (RAEB), three patients with chronic myelomonocytic leukemia (CMMoL), and three patients with acquired idiopathic sideroblastic anemia (AISA). None of these patients had a prior history of therapeutic or occupational exposure to potential carcinogenic agents, G(TG)-banding revealed clonal abnormalities in nine of the 15 patients. Five of these patients exhibited one or more of the following cytogenetic abnormalities: 5q deletion, -7, +8, or +21. The AISA group appeared to be unique as chromosome abnormalities were seen in two of the three patients and the clinical course in these patients had been prolonged without progression to acute leukemia. No other clinical correlation could be made in the blast RAEB and CMMoL groups, except for possible survival benefit in patients with normal karyotypes.

Aged↗
PubMed1982

Burkitt's leukemia: a re-evaluation.

Two patients who presented with acute leukemia of Burkitt's cell type are discussed. Although one patient died within four months of diagnosis, the other has maintained a one year clinical complete remission. The clinical and morphologic picture of Burkitt's leukemia is nonspecific and therefore requires complementary studies including cytochemistry, transmission electron microscopy, cell surface markers and cytogenetics studies to establish diagnosis. Serial bone marrow aspirations with marker analyses may detect relapse at an earlier stage than conventional cytology, allowing therapy to be modified prior to overt clinical relapse.

Adult↗
PubMed1982

Phase I trial of spirogermanium given by infusion in a multiple-dose schedule.

In a phase I study of spirogermanium, a new azaspiran-germanium compound, 28 patients were given a multiple-dose schedule. When infused over 1 hour, the maximum tolerated single dose of this agent was greater than 120 mg/m2 but significant chronic neurologic toxicity occurred after 1-2 weeks of treatment. Patients with a poor performance status (PS) were the most likely to manifest toxic reactions. Suggested phage II dose levels for infusion treatment with spirogermanium are 120 mg/m2 for patients with a PS of 0-2 and 80 mg/m2 for patients with a PS of 3.

Adult↗
PubMed1981

Tamoxifen in unresectable hypernephroma. A phase II trial and review of the literature.

Estrogen receptors have been demonstrated in human hypernephroma (renal cell carcinoma). Antiestrogens have been demonstrated to have antitumor activity in animal models of this disease. A prospective trial of tamoxifen therapy was undertaken in 10 consecutive patients with unresectable hypernephroma. No major responses to tamoxifen were observed. A review of the literature on antiestrogen therapy for this tumor reveals 148 published cases of hypernephroma treated with tamoxifen or nafoxidine. The overall response rate was 7.4%. Antiestrogens appear to have little clinical usefulness in the treatment of advanced hypernephroma.

Adenocarcinoma↗
PubMed1980

Meningeal involvement in IgD myeloma with cerebrospinal fluid paraprotein analysis.

Myelomatous meningitis is a rare occurrence in multiple myeloma. We report 2 cases of documented IgD myeloma with cytologic evidence of meningeal involvement in 1 and detailed paraprotein analysis in both. The occurrence of meningeal involvement in this rare form of plasma cell neoplasm may be more common than previously thought.

Aged↗
PubMed1980

Phase I evaluation of divided-dose vinblastine sulfate.

The known pharmacokinetics of vinblastine sulfate given by intermittent bolus dictate alternate dose schedules for prolonging the therapeutic levels. Herein, we have tested a divided dose schedule which shows out-patient feasibility, manageable toxicity, and encouraging responses.

Dose-Response Relationship, Drug↗