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Biomedical subjects

V Rodriguez

Publications and source records attributed to V Rodriguez.

At least 109 records · Page 6Linked to original sources

Combination 6-mercaptopurine-adriamycin in refractory adult acute leukemia.

Remission induction therapy with 6MP and adriamycin in combination was administered to 19 adult leukemic patients refractory to previous therapy. Eight patients also received vincristine and prednisone. Thirteen patients had acute myelogenous leukemia, 3 undifferentiated leukemia, and 3 blastic transformation of chronic myelogenous leukemia. Four patients achieved remission but in only 2 were the remissions complete. Eleven patients failed to respond. Ten of the 19 patients developed unexpected severe liver toxicity manifested by a clinical picture of cholestasis (in the majority) or ascending cholangitis (in 2 patients). In the postmortem examination of 8 patients there was cholestasis and mild to severe hepatocellular damage in all.

Acute Disease↗

Combinations of arabinosyl cytosine and 6-thioguanine for treatment of adults with acute leukemia.

The combination of arabinosyl cytosine and 6-thioguanine has been effective for the treatment of acute leukemia. Three schedules of this combination were studied to determine which was most effective, especially in patients who had prior exposure to either or both of these drugs. Sequential and simultaneous 5-day courses of the combination were ineffective. A regimen consisting of a 5-day course of arabinosyl cytosine followed by a 5-day course of 6-thioguanine and another 5-day course of arabinosyl cytosine produced responses in 36% of 25 patients. Seven of the nine patients who responded were refractory to prior therapy with arabinosyl cytosine and 5 were refractory tp prior therapy with 6-mercaptopurine. However, the median duration of response was only six weeks. Four patients developed central nervous system complications and three of these patients died while in complete remission. Major toxicity from all three regiments was myelosuppression. This regimen was about as effective as most other regimens used as secondary therapy in patients with acute myelogenous leukemia, but its toxicity was too great for routine usage.

Adolescent↗

Clinical and morphological correlations in acute promyelocytic leukemia.

Thirty adults with acute leukemia and greater than 20% bone marrow infiltrate by promyelocytes were studied. Eighteen patients had acute promyelocytic leukemia (APML) as defined by the presence of malignant promyelocytes, and the remaining 12 patients had acute myelocytic leukemia (AML) with an elevated percentage of normal promyelocytes. Malignant promyelocytes were characterized by abundant, abnormal, cytoplasmic granules, by Auer rods in meshwork pattern, and by splinter cytoplasmic granulations and dilatation of the cisternae of endoplasmic reticulum. Patients with APML had, in general, greater than 35% bone marrow infiltrate by promyelocytes. The degree of bone marrow infiltrate by these cells correlated with the clinical status of the patients. Diffuse intravascular coagulation with bleeding occurred in 61% of patients with APML, and the bone marrows of these patients had greater than 50% promyelocytes. No coagulation abnormalities were seen among patients with elevated bone marrow promyelocytes infiltrate and without APML. Coagulation abnormalities in patients with APML were only corrected by controlling the leukemia itself. When this occurred, patients with APML had an excellent rate of complete remission, and the duration of remission and survival were comparable to the results obtained in adults with AML.

Adult↗

Infections in cancer patients on a protected environment-prophylactic antibiotic program.

A total of 102 studies were conducted on 89 patients receiving cancer chemotherapy while on a protected environment-prophylactic antibiotic program. Major infections occurred during 22 studies. The majority of both minor and major infections originated during the first five weeks after the patients entered the protected environment units. The frequency of infectious complications was inversely related to the circulating neutrophil count. The majority of infections were cases of cellulitis, pharyngitis, pneumonia and septicemia. Most of the infections were caused by gram-negative bacilli. The majority of organisms causing infection had persisted in the patients after their entry into the protected environment units despite the use of prophylactic antibiotics.

Adolescent↗

Oral complications of cancer chemotherapy.

No part of the body reflects the complications of cancer chemotherapy as visibly and vividly as the mouth. The hemorrhagic, infectious, nutritional, cytotoxic, and neurologic signs of drug toxicity are registered in the mouth by changes in the color, character, and continuity of the mucosa. Although some of the complications are an inevitable part of the price of treatment, each constitutes a threat that must be kept within manageable limits.

Adult↗

Effects of cytotoxic and immunosuppressive agents on the immune system.

Most chemotherapeutic agents are myelosuppressive and immunosuppressive. Consequently their use greatly increases a patient's susceptibility to infection. Neutropenia creates greater risk than lymphopenia and is a particular problem in patients with acute leukemia who are treated with combination chemotherapy. Chemotherapy is less immunosuppressive if given in short intensive courses rather than continuously. Continuous therapy causes severe depression of antibody production and inhibition of delayed hypersensitivity reaction.

Anti-Bacterial Agents↗

Clinical pharmacology of sisomicin.

Studies were conducted in 30 patients with neoplastic diseases. Twelve patients received sisomicin intramuscularly at doses of 20 mg/m(2) and 40 mg/m(2). The mean peak serum concentration occurred at 1 h and was 2.5 mug/ml and 4.0 mug/ml, respectively. Ten patients received intravenous sisomicin at doses of 30 mg/m(2) during 30-min infusion. Mean peak serum level determined at 30 min was 5.1 mug/ml. The levels gradually decreased and at 6 h was 0.6 mug/ml. The serum half-life was 160 min. Serum levels determined in eight patients who received sisomicin by continuous infusion at doses of 30 mg/m(2) every 6 h were greater than 1.4 mug/ml during the 6-h period. The urinary excretion of sisomicin during the 6-h period after intramuscular administration of 20 mg/m(2) and 40 mg/m(2) was 49 and 61%, respectively. The pharmacology of sisomicin is similar to gentamicin.

Adolescent↗

Feasibility of administering aminoglycoside antibiotics by continuous intravenous infusion.

Eleven patients each received gentamicin sulfate, tobramycin, and sisomicin by continuous intravenous infusion after an initial loading dose. Subsequent doses of antibiotic were adjusted in an attempt to maintain constant serum concentrations. There was considerable variation in the serum concentration from patient to patient and in the same patient from day to day with each drug. Although the dosages of gentamicin sulfate and tobramycin were similar, the serum concentrations of the latter drug were consistently lower. Despite the daily administration of doses of at least 300 mg of gentamicin and tobramycin per m(2) and 160 mg of sisomicin per m(2), nephrotoxicity occurred in only three patients. This is a low frequency of nephrotoxicity, considering the dosages of drug administered. Although therapeutic efficacy was not an objective of this study, 8 of 11 documented infections were cured. This approach to the administration of aminoglycoside antibiotics deserves therapeutic trials.

Adolescent↗

Pharmacology of amikacin in humans.

Amikacin is a new aminoglycoside antibiotic which is active in vitro against most isolates of gram-negative bacilli. A dose of 300 mg/m(2) intramuscularly produced a highest mean serum concentration of 25.4 mug/ml with a mean serum concentration of 3.1 mug/ml at 8 h. The same dose intravenously produced a highest mean serum concentration of 52.4 mug/ml with a mean serum concentration of 2.1 mug/ml at 8 h. The mean urinary excretion during the first 6 h was 75 and 66%, respectively. When amikacin was administered at a dose of 150 mg/m(2) every 6 h, there was evidence of some drug accumulation. A loading dose of 150 mg/m(2) administered intravenously over 30 min followed by 200 mg/m(2) administered as a continuous infusion every 6 h maintained serum concentrations of 8 mug/ml. No major toxicity was observed with any of these drug regimens.

Amikacin↗