Subject(s)
Adenocarcinoma/drug therapy , Antineoplastic Agents/therapeutic use , Aziridines/therapeutic use , Azirines/therapeutic use , Benzoquinones , Colonic Neoplasms/drug therapy , Adult , Aged , Antineoplastic Agents/toxicity , Aziridines/toxicity , Drug Evaluation , Female , Humans , Male , Middle Aged , Neoplasm Metastasis , Neutropenia/chemically induced , Thrombocytopenia/chemically inducedABSTRACT
A 42-year-old man with severe pancytopenia and myelofibrosis underwent splenectomy seven months after onset of his symptoms; the leukocyte, platelet, and hematocrit levels became normal. Myeloid metaplasia was identified in the liver and spleen. Progressive lymphocytosis started eight months after splenectomy, and after 66 months a florid hairy-cell leukemia was diagnosed; the circulating cells were B type with micro K surface markers. Anemia and thrombocytopenia reappeared and were controlled initially with daily prednisone; chlorambucil was later added. At that time, the peripheral blood had more than 150 megaloblastoid-appearing normoblasts per 100 leukocytes. The PAS stain was positive in 95% to 100% of these cells; the B-cell surface markers were no longer identified. Further treatment failed to control the lymphoproliferative and myeloproliferative syndromes; the patient died 99 months after splenectomy. On autopsy, infiltration by hairy-cell leukemia cells and erythroid precursors was observed in the bone marrow, liver, lymph nodes, and other organs.
Subject(s)
Leukemia, Hairy Cell/complications , Primary Myelofibrosis/complications , Adult , Humans , MaleABSTRACT
Nineteen patients with advanced refractory lymphoma and 12 patients with acute leukemia, including seven in blastic crisis of chronic myelogenous leukemia (CML), were treated with vindesine in combination with prednisone. Of 16 evaluable patients with lymphocytic or histiocytic lymphoma, one achieved complete remission (6%) and eight achieved partial remissions (50%). Median duration of response was 12 weeks (range, 4-72+). Four of six evaluable patients in blastic crisis of CML showed definite improvement in blood cell counts and symptoms. The major dose-limiting toxic effect was bone marrow suppression, while neurotoxicity was seldom cause for dose modification. The study shows vindesine and prednisone to be active in heavily pretreated patients with non-Hodgkin's lymphoma and blastic phase of CML.
Subject(s)
Antineoplastic Agents/administration & dosage , Leukemia/drug therapy , Lymphoma, Non-Hodgkin/drug therapy , Prednisone/administration & dosage , Vinblastine/analogs & derivatives , Acute Disease , Adult , Aged , Antineoplastic Agents/adverse effects , Drug Therapy, Combination , Female , Humans , Leukemia, Myeloid/drug therapy , Male , Middle Aged , Prednisone/adverse effects , Vinblastine/administration & dosage , Vinblastine/adverse effects , VindesineABSTRACT
Vindesine, a new vinca alkaloid, was administered to 20 patients with advanced refractory breast cancer in a phase II trial. The drug was given at a dose of 3 mg/m2 by iv bolus each week for 6 consecutive weeks, and responding patients were maintained on a dose of 4 mg/m2 every 2 weeks. Nineteen patients were evaluable for disease response; partial remissions were obtained in five patients, for a response rate of 26%. Leukopenia was the major dose-limiting toxic reaction, but most patients were able to tolerate this schedule without difficulty. Neurotoxicity was mild and did not require dose reduction.
Subject(s)
Breast Neoplasms/drug therapy , Vinblastine/analogs & derivatives , Aged , Anemia/chemically induced , Breast Neoplasms/pathology , Drug Administration Schedule , Drug Evaluation , Female , Humans , Leukopenia/chemically induced , Middle Aged , Peripheral Nervous System Diseases/chemically induced , Platelet Count/drug effects , Time Factors , Vinblastine/adverse effects , Vinblastine/therapeutic use , VindesineABSTRACT
We describe 3 patients with perinephric abscesses in whom the perinephric fluid collections were identified by ultrasonic examination. In 2 cases thin needle aspiration of these collections using sonographic guidance provided the preoperative diagnosis. Percutaneous tube drainage under ultrasound and fluoroscopy was used successfully in 1 patient whose medical condition precluded surgical drainage. We recommend that percutaneous drainage be considered in severely ill patients with perinephric abscesses.