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1.
J Allergy Clin Immunol ; 103(6): 1069-74, 1999 Jun.
Article in English | MEDLINE | ID: mdl-10359888

ABSTRACT

BACKGROUND: Home exposure to high levels of house dust mite allergen has been shown to aggravate airways reactivity and asthma. OBJECTIVE: The purpose of this study was to determine whether specific house dust mite control measures could reduce exposure levels and asthma severity. METHODS: This double-blinded, randomized trial compared asthma progression over 1 year in children whose homes received standard environmental control intervention with those whose homes received aggressive intervention for dust mite elimination. The primary end point was doubling in PD20 methacholine. RESULTS: Symptom scores and quality-of-life scores were similar for the standard and aggressive intervention groups. PD20 methacholine doubling occurred in 9 members of the aggressive intervention group vs 4 control patients (P <.05). Dust mite levels decreased in the aggressive intervention homes compared with the standard intervention homes (P <.05). CONCLUSION: Aggressive dust mite intervention decreased dust mite levels and improved bronchial hyperresponsiveness.


Subject(s)
Air Pollution, Indoor/prevention & control , Asthma/physiopathology , Bronchial Hyperreactivity/immunology , Environmental Pollutants/immunology , Mites/immunology , Adolescent , Allergens/analysis , Animals , Anti-Asthmatic Agents/administration & dosage , Anti-Asthmatic Agents/therapeutic use , Anti-Inflammatory Agents/administration & dosage , Anti-Inflammatory Agents/therapeutic use , Antigens/analysis , Asthma/drug therapy , Beclomethasone/administration & dosage , Child , Cromolyn Sodium/administration & dosage , Cromolyn Sodium/therapeutic use , Dust , Glycoproteins/analysis , Humans , Methacholine Chloride , Respiratory Function Tests , Socioeconomic Factors , Triamcinolone/administration & dosage , Triamcinolone/therapeutic use
2.
J Clin Oncol ; 11(9): 1691-702, 1993 Sep.
Article in English | MEDLINE | ID: mdl-8355036

ABSTRACT

PURPOSE: To determine the toxicity, response, and survival rate of orally administered combination chemotherapy in patients with AIDS-related intermediate- and high-grade non-Hodgkin's lymphoma. Secondary objectives included prospective quality-of-life assessment and quantitation of cell-associated p24 antigen (p24 Ag) by flow cytometry. PATIENTS AND METHODS: Eighteen patients with biopsy-proven lymphoma were treated with oral chemotherapy consisting of lomustine (CCNU) 100 mg/m2 on day 1, etoposide 200 mg/m2 on days 1 through 3; cyclophosphamide 100 mg/m2 on days 22 through 31, and procarbazine 100 mg/m2 on days 22 through 31 at 6-week intervals. A variety of clinical assessments were performed: prospective quality-of-life assessment using the Functional Living Index-Cancer (FLIC) and Brief Symptom Inventory (BSI) instruments; indirect immunofluorescence with flow cytometry to measure cell-associated p24 antigen; and price of the oral regimen compared with two other intravenous combination chemotherapy regimens. RESULTS: The overall objective response rate using Eastern Cooperative Oncology Group (ECOG) criteria was 61% (95% confidence interval, 39% to 84%), with seven complete remissions (39%) and four partial remissions (22%). The median survival duration was 7 months, with a range of 11 days to 36 months. The treatment-related mortality rate was 11%. One patient developed CNS progression. Myelosuppression was the most frequent and severe toxicity encountered. Predictor variables of performance status (PS), prior history of thrush, and CD4 lymphocyte count were found to be of prognostic value. In a separate analysis, scores on the three subscales of the BSI were also found to be predictive of complete response. The price of this regimen is several thousand dollars less than that of other intravenous combination chemotherapy regimens. CONCLUSION: This regimen is active in patients with AIDS-related non-Hodgkin's lymphoma. Because it is important to design systemic cytotoxic chemotherapy regimens that are cost-effective, considerate of quality-of-life issues, and efficacious in this patient population, this approach should be compared with standard intravenous combination chemotherapy regimens in randomized controlled clinical trials.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Lymphoma, AIDS-Related/drug therapy , Lymphoma, Non-Hodgkin/drug therapy , Adult , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Antineoplastic Combined Chemotherapy Protocols/economics , Cyclophosphamide/administration & dosage , Etoposide/administration & dosage , Female , Flow Cytometry , Humans , Lomustine/administration & dosage , Lymphoma, AIDS-Related/pathology , Lymphoma, Non-Hodgkin/pathology , Male , Middle Aged , Neoplasm Staging , Procarbazine/administration & dosage , Proportional Hazards Models , Quality of Life , Survival Analysis , Treatment Outcome
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