Preoperative chemotherapy in T2-T3, Nx, Mo bladder cancer: protocol modification and early experience

A prospective randomized study of preoperative chemotherapy for transitional cell bladder cancer was carried out. Patients were randomized either to preoperative chemotherapy then cystectomy [arm I], or cystectomy alone [arm II]. All patients in arm I received 2 cycles of the combination therapy of PMV: Paraplatin [300 mg/m2 IV, day 1, Methotrexate [50 mg/m2 IV, days 1 and 14] and Vinblastine [4 mg/m2 IV, days 1 and 14]. Until now, 35 patients were entered in arm I and 44 in arm II. From the preliminary results, it was concluded that preoperative chemotherapy protocol PMV is safe, well tolerated and effective. It can be given as outpatient treatment with minimal toxicity. The two years actuarial disease free survival is 70% for arm I and 46% for arm II with P value of 0.1. More patients and prolonged follow up were needed to detect the impact disease free and over all patients survival

Therapeutic drug-induced liver injury in liver biopsies

35 patients admitted to Mansoura University Hospital with the clinical picture of hepatitis were selected for the present investigation after being asked carefully for history of drug intake and examined clinically. Stool examinations were negative for Bilharzia and other parasites. Serological tests were negative for hepatitis surface antigen. Ture cut needle biopsy for liver was done for all of these patients and stained with various stains. These were one patient with history of halothain intake, 10 with history of intake of oral contraceptive, 2 with history of chlorpromazine and 20 with history of phenyl-butazone and 20 with history of isoniazid. Histologically a spectrum of lesions was recognized as a result of liver injury by these drugs. The produced lesions were categorized as follows: 1-lesion resembling viral hepatitis. 2-Cholestasis with inflammation and liver cell damage. 3-Pure cholestasis. The drugs causing each of these lesions and their differential diagnosis specially from viral hepatitis were discussed

Haemostatic changes in malignant lymphomas

This work involved the study of the hemostatic pattern in 30 patients with malignant lymphoma in comparison with a matched control group consisted of 15 normal persons. Study of primary hemostasis revealed prolongation of the bleeding time in cases with advanced clinical stages and thromocytopenia in cases with B symptoms. The only significant coagulation abnormality is a prolonged prothrombin time which is correlated with advanced disease activity. Bleeding if it occurs is usually due to the effect of several hemostatic parameters

Serum lipids in patients with lymphoma and leukemia

Serum lipid profile of 23 newly diagnosed patients was prospectively evaluated with non-Hodgkin's lymphoma and acute lymphatic leukemia divided into 2 separate groups. A similar pattern of abnormality was detected in both groups in the form of a rise in serum triglycerides and drop in serum high density lipoprotein-cholesterol. The serum lipid profile was found to be reversible in cases that developed complete remission. So, this abnormal serum lipid pattern may be considered as a chemical maker of malignancy in non-Hodgkin's lymphoma and acute lymphatic leukemia patients and the correction of this abnormal pattern may be utilized as a criterion of response to therapy in such patients

Serum gamma glutamyl transpeptidase as a tumour marker in patients with non Hodgkin's lymphoma

Levels of gamma glutamyl transpeptidase and lactic dehydrogenase were measured in the serum of 20 patients with advanced clinical stages of non-Hodkin's lymphoma before treatment and after four cycles of combination chemotherapy. Both were found to be significantly elevated in the active disease and they decrease significantly with the achievement of complete clinical remission. No correlations were detected between the serum levels of both enzymes indicating that the mechanisms of the rise of both enzymes may be different. So, serum gamma glutamyl transpeptidase can be used as a tumor marker in non- Hodkin's lymphoma

Burkitt's frequency among non Hodgkin's lymphomas in patients attending the Mansoura University Hospital

A series of 40 patients, with the diagnosis of non-Hodgkin's lymphoma [N.H.L.] presenting to Mansoura University Hospital in 1983, were studied. All cases were subjected to thorough clinical, histopathological, cytochemical, haematological and radiological examination. The cases were reviewed using the Rappaport and Kiel classifications. All cases except one were diffuse lymphomas, 6 cases were diagnosed as monomorphic small non-cleaved NHL having many pathological similarities with Burkitt's Lymphoma [B.L.]. Imprints with Giemsa stain and cytochemical study support the diagnosis. Abdominal masses were initially present in half B.L. cases, while the jaw was involved in the remainder, all except one case were under the age of 15 years, 4 females and 2 males all were of poor socioeconomic status, and all cases were characterised by short history of illness before presentation