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Biomedical subjects

W M Gallmeier

Publications and source records attributed to W M Gallmeier.

At least 37 records · Page 2Linked to original sources

[Primary chemotherapy of advanced squamous epithelial carcinomas of the head and neck].

Advanced stage squamous cell carcinomas of the head and neck have a particularly poor prognosis despite surgical and irradiation treatment. Over the last few years attempts have been made to improve the local control rate using primary chemotherapy. 70 patients with advanced carcinomas were treated with methotrexate, cisplatin and bleomycin using double the dose of cisplatin as in the EORTC-study. The remission rate for patients undergoing two treatment courses was 83%. Toxicity was moderate to low with additional intensive anti-emetic treatment. The combination is well suited for chemotherapy of advanced tumours of the head and neck in combined treatment programmes.

Adult↗

Phase-I study of mafosfamide-cyclohexylamine (ASTA-Z-7557, NSC 345 842) and limited phase-I data on mafosfamide-lysine.

Mafosfamide-cyclohexylamine is a new oxazaphosphorine derivative. It was chosen for phase-I clinical testing because of an expected higher therapeutic index and lack of complete cross resistance in animal tumors compared to cyclophosphamide. The schedule consisted of a single iv dose repeated every three weeks. The compound was found to cause as it's dose limiting toxicity severe pain along the injected vein and acute irritation of mucous membranes. The maximal tolerated dose was around 1000 mg/m2 given as a slow infusion over 2-3 hours. Hematological toxicity was mild. A limited phase-I study with the lysine salt of mafosfamide showed an identical type of toxicity. Mafosfamide given iv in a high-dose intermittent schedule is of little interest for further clinical trials. It is probable, that the severe venous pain and the mucosal irritation are caused by the high local concentration of 4-hydroxy-cyclophosphamide or by a metabolite. An oxazaphosphorine derivative undergoing slower hydrolysis therefore leading to lower active drug concentrations within the injected vein may be more promising.

Adult↗

[Psycho-oncology].

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Adaptation, Psychological↗

Lack of response in nine patients with breast cancer treated with fibroblast interferon.

Nine patients with metastatic breast cancer were treated with a minimum of 6 X 10(6) U/day of beta-interferon (IFN-beta) for at least 6 weeks. In patients whose disease did not progress during this period treatment was continued to a maximum of 13 weeks, while in other patients doses were escalated. With daily treatments over 3 weeks the maximum tolerated dose was found to be around 60 X 10(6) U/day. Fever occurred regularly. The dose-limiting toxicities were granulocytopenia and increasing liver enzymes. No objective remissions were observed. One patient showed stable disease after her cancer en cuirasse had rapidly progressed under chemotherapy. One patient each with nasopharyngeal carcinoma and fibrous sarcoma were also treated without success. IFN-beta at this moderately toxic dose given over a period of 6-13 weeks is of no clinical value in the treatment of metastatic breast cancer in women.

Adult↗

Microangiopathic hemolytic anemia, a frequent complication of mitomycin therapy in cancer patients.

Microangiopathic hemolytic anemia (MAHA) has long been recognized as a rare complication in far-advanced malignant tumors. Recently several patients have been described in whom MAHA and renal insufficiency developed as a result of mitomycin therapy. We here describe another five such cases among 50 patients treated with mitomycin. All five cases were observed among the 14 patients who had received four or more doses of the drug. We conclude that MAHA is a frequent and potentially fatal complication of long-term mitomycin treatment. Careful monitoring for the early appearance of schistocytes is mandatory as the syndrome tends to be self-limited if this therapy is discontinued early.

Adenocarcinoma↗

[Hodgkin disease].

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Germany, West↗

A randomized study of combination chemotherapy (VAC-FMC) with or without immunostimulation by Corynebacterium parvum in metastatic breast cancer.

A total of 156 patients with metastatic breast cancer were entered into a prospective multi-center trial in September 1975. All patients were treated monthly with vincristine, adriamycin and cyclophosphamide (VAC) six times, followed by 5-fluorouracil, methotrexate and cyclophosphamide (FMC) until progression was documented. By random assignment, the patients received 5 mg/m2 Corynebacterium parvum (CP) subcutaneously on day 1, in addition to VAC/FMC. Of the 150 evaluable patients, 33 of 76 (45%) and 36 of 74 (49%) had complete or partial response to VAC/FMC plus CP, respectively. The Kaplan-Maier curves of duration of remission and survival were almost identical (medians 14.5 vs 12.1 months and 22.2 vs 21.1 months, respectively). The hematologic and gastrointestinal toxicity were also similar in the two study groups. However, 19 of 74 (26%) patients developed skin ulcers after repeated injections of CP. These patients showed prolonged survival (P = 0.002, log rank test). These results suggest that adding nonspecific immunostimulation with CP to currently available chemotherapy on day 1 is of no benefit to most patients with metastatic breast cancer, but may select an "immunoreactive subgroup with increased local toxicity and survival.

Adjuvants, Immunologic↗

[Microangiopathic haemolytic anaemia as a complication of mitomycin C treatment (author's transl)].

Microangiopathic haemolytic anaemia developed in 5 (out of 14) patients treated with mitomycin C combinations, having received 4 or more treatment cycles. This finding necessitates restricted use of broad and longterm use of mitomycin C, particularly in view of the occasionally fatal outcome of this toxic complication. Adjuvant treatment with mitomycin C does not appear acceptable any longer. Patients treated with mitomycin C should be monitored carefully for occurrence of schistocytosis and platelet deficiency as very early signs of microangiopathic haemolytic anaemia.

Adult↗