[The ambulatory cancer patient treated by chemotherapy]. / Le patient cancéreux ambulatoire traité par chimiothérapie.

The success of cancer chemotherapy in ambulatory patients depends on the perfect knowledge of the various side effects of the drugs and moreover on a close cooperation and comprehension between the medical staff, the family practitioner and the patient. Quality of life is one of the most important aims of the treatment in oncology, especially in an ambulatory setting.

[Hemoglobin C (alpha 2 beta 2 6Glu-->lys). Study of 19 heterozygote AC carriers and of 5 cases of double hemoglobinopathy SC]. / Hémoglobine C (alpha 2 beta 2 6Glu-->Lys). Etude de 19 porteurs hétérozygotes AC et de 5 cas de double hémoglobinopathie SC.

This paper describes clinical findings in subjects heterozygous for hemoglobin C and in compound heterozygotes SC. Most of our patients were coming from lands bordering the Guinea Gulf, on the inside of the loop made by the river Niger and from Haiti, which was populated by African slaves coming mainly from the Golden Coast (actually Ghana). Heterozygotes are asymptomatic and do not suffer from anemia. Age at diagnosis is higher than for SCA, although one of our cases was diagnosed at age one. Overwhelming infections or major anemia were not observed. Basal hemolysis remained moderate. HbF levels were not increased as they may be in sickle cell anemia. Splenomegaly was observed in 2/5 patients. Among severe complications we encountered, we must mention one case of foetal death, one tibial infarct, one case of pure red cell aplasia caused by parvovirus B19 infection, and one case of proliferative retinopathy.

Intraperitoneal chemotherapy with cisplatin and melphalan.

Cisplatin and melphalan given ip exert a synergistic therapeutic effect against ascitic P388 leukemia in mice and have different dose-limiting toxic effects as well as favorable pharmacokinetic characteristics in ip phase I studies. We gave a total of 98 courses of cisplatin (escalated from 40 to 120 mg/m2) and melphalan (escalated from 12 to 30 mg/m2) to 30 patients with ip tumors, most of whom had residual ovarian cancer following iv cisplatin-containing regimens. Treatment was delivered in 2 L of 0.9% NaCl through a Tenckhoff catheter with or without a Port-a-Cath system every 28 days for one to nine cycles. Myelosuppression was dose-related and leukopenia was dose-limiting. The maximum tolerated dose was 120 mg of cisplatin/m2 and 20 mg of melphalan/m2. With the exception of treatment-induced nausea and vomiting, nonhematologic toxic effects were mild and no (or very little) local toxicity occurred. Pharmacokinetic analyses showed that the areas under the peritoneal concentration versus time curve averaged 16-fold and 17-fold more than the area under the plasma curve for cisplatin and melphalan, respectively. Objective responses were documented by third-look laparotomy in ovarian cancer patients with minimal (less than 2 cm) residual disease.

Fifty cases of human immunodeficiency virus (HIV) infection: immunoultrastructural study of circulating lymphocytes.

The peripheral lymphocytes of 50 cases of human immunodeficiency virus (HIV) infection (13 of acquired immune deficiency syndrome (AIDS), 17 of AIDS related complex (ARC), and 20 healthy carriers) were studied immunoultrastructurally. The prevalence of "tubuloreticular structures" and "tubular confronting cisternae" increased with the progression of the disease. Numerous tubular confronting cisternae were noted in patients presenting with a high serum acid labile alpha-interferon values. The patients with depressed natural killer cell activity were characterised by circulating immature natural killer cells with abundant multivesicular bodies that were devoid of "parallel tubular arrays". With an immunogold staining technique the location of HIV antigen was detected ultrastructurally, both at the surface of "hand-mirror" natural killer cell lymphocytes and inside vacuolised cells, probably corresponding to infected T4 lymphocytes. These findings indicate the usefulness of electron microscopic techniques in evaluating the pathology and the pathogenetic outcome of AIDS.

[Benign hepatic tumours and oral contraception. Pathophysiology (author's transl)]. / Tumeurs hépatiques bénignes et contraceptifs oraux. Physiopathologie.

PIP: If the relation between OC (oral contraception) and hepatic tumors is well established, the pathogeny of such neoplasms is not well known. Estrogens exercise different metabolic actions on the liver, and progesogens contribute with a synergic action, especially on cholestasis. Other possible phenomena, however, are not yet explained, such as the role of acetylenic bindings, or the interference of OCs with other drugs, an interference which can become potentially toxic when metabolized in the liver.^ieng

The leucocyte alkaline phosphatase activity in mature neutrophils of different ages.

The marrow myeloid precursor cells of a haematologically normal patient were labelled by intravenous injection of tritiated thymidine. Young labelled segmented neutrophils were then released from the marrow into the blood by an injection of cortisol. These PMN had a significantly lower LAP activity than the older blood neutrophils. It is shown that within the morphologic boundaries of the segmented PMN, the cells are still in different stages of cytoplasmic maturation. In addition, labelled and unlabelled neutrophils showed a linear and parallel increase of LAP activity during the 24 h following cortisol injection. This observation suggests that the neutrophil prematurely released in the blood can mature into normal LAP=PMN and more generally that LAP activity of a blood neutrophil increases with time.