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Biomedical subjects

W Balwierz

Publications and source records attributed to W Balwierz.

At least 55 records · Page 3Linked to original sources

[Second cessation of therapy in children with acute lymphoblastic leukemia].

In the group of 63 children in whom a relapse of ALL after first suspension of treatment occurred, and in whom a repeated cessation of therapy had place, 46.2% of patients had probability of a prolonged symptomless survival. The children with an isolated extramedullary relapse had a greater chance for a DFS of 7 years, than those with a relapse in the bone marrow (p = 0.05). The patients with a relapse occurring after the first cessation of treatment of ALL should be treated as intensively as newly diagnosed cases, because they have a real possibility for a prolonged survival during remission phase of disease.

Antineoplastic Combined Chemotherapy Protocols↗

[The fate of children after discontinuation of treatment for acute lymphoblastic leukemia].

Among 1879 children with the diagnosis of acute lymphoblastic leukaemia made up to Dec 31 1987 in 863 cases (45.92%) treatment was discontinued. They were followed up till Dec 31 1989. The median follow-up was 3 years and 14 months. In 811 cases the treatment was discontinued during the first complete remission, in 56 cases after a relapse during initial treatment. In the time period when the programmes St. Jude and LSA2L2 were used the per cent of children with treatment withdrawal was 38.22%, but it rose to 53.01% when a more intensive programme BMF had been introduced. The probability of 7-year disease free survival after treatment discontinuation was 69.5% and 76.2% respectively. In 186 cases (21.6%) relapses developed., mostly in the first year after treatment discontinuation, but even after 7 years the risk of relapse was 2.46%. Ninety-six children (11.2%) died, 761 (88.8%) are alive, among them 671 in the first complete remission. Apart from therapy intensity, a statistically significant beneficial effect on disease free survival had discontinuation of treatment during the first complete remission, and sex--the prognosis was better in girls. In three cases secondary neoplasms were found.

Adolescent↗

[Proposed regimens for chemotherapy and radiotherapy to control preliminary failures of combined therapy in Hodgkin's disease].

Both regimens concern children who underwent--depending on the stage of the disease--three different therapeutical regimens: B-DOPA and/or MVPP combined with radiotherapy. Depending on the results of this treatment, each out of four saving regimens includes two types of chemotherapy: B-DOPA/CAD, MVPP/CAD, MOP-P/ABV/CAD, and MVPP/B-DOPA in case of delayed recurrence. Each cycle of chemotherapy should be introduced with high frequency. Doses of irradiation being additional method and indicated in some patients are given.

Antineoplastic Combined Chemotherapy Protocols↗

Long-term follow-up after relapses in children with Hodgkin's disease.

In the years 1969-1980, 68 children with Hodgkin's disease were subjected to a combined MVPP and radiotherapy. Remissions were obtained in 64 patients, and relapses occurred in 11 children. The treatment of relapse consisted in administration of B-DOPA alone or alternatively with MVPP combined with radiotherapy (in 7 out of 11 patients). The patients were recycled every 2-3 weeks which, with other modifications of chemotherapy, allowed for the completion of the six first cycles within the period of 4,5 to 7 months. A relapse caused death of one child, and two others demonstrated further relapses. At present eight children have been showing disease-free survival following a relapse for the period of 29+ to 152+ (median, 94.5 months). The authors concluded that in patients with relapses of Hodgkin's disease the decisive role rests upon aggressive chemotherapy (high frequency of cycles).

Adolescent↗

Is first salvage chemotherapy the last-line chemotherapy in children with Hodgkin's disease? A tentative answer based on long observation of two patients.

In 82 children affected with Hodgkin's disease, in whom a complete remission was obtained, the first relapses occurred in 13 patients, their outcome was a follows: one child died of relapse and in 12 others second complete remissions were achieved. They were durable in 10 children (median, 65.5 months). Two remaining children had further relapses, their treatment consisted of four successive salvage chemotherapies. Both patients are now in their fifth complete remission. The third-line chemotherapy was already introduced 78+ months and 39+ months ago respectively. We believe that it is not possible to determine exactly the end-stage of Hodgkin's disease in those children and adolescents who have failed the first-line salvage chemotherapy.

Adolescent↗

Children cured of acute lymphoid leukemia. Long-term follow-up studies, including progeny.

The subject of analysis is a group of 111 children with acute lymphoid leukemia (ALL) whose remission has lasted at least 4 years since stopping treatment. Patients were observed from 4 to 18 years after ALL therapy. No symptoms of disease were observed in 110 children; one child had leukemic infiltration of the testes during the fifth year after stopping treatment. In this group of children no changes in physical development have been recorded, but a growth deficiency is sometimes noted. No symptoms of intrinsic organ lesions have been ascertained in most of the patients. All of the patients, except one with schizophrenia, lead normal lives and either attend school or go to work. Seven patients have healthy children, who were born 6-24 years after the beginning of the disease and 3-16 years after cessation of therapy.

Adolescent↗