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B Walter,
I Schrettenbrunner,
M Vogelhuber,
J Grassinger,
K Bross,
J Wilke,
T Suedhoff,
A Berand,
W F Wieland,
S Rogenhofer,
R Andreesen, A Reichle
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ABSTRACT: We enrolled 45 patients with metastatic renal cell carcinoma (RCC) at a progressive disease between March 2003 and April 2008 to assess the impact of an anti-inflammatory treatment regime in combination with metronomic low-dose chemotherapy. 42% of the patients had been systemically pre-treated. Therapy consisted of etoricoxib 60 mg daily plus pioglitazone 60 mg daily, day 1+, low-dose interferon-α 4.5 MU sc three times a week, week 1+ and low-dose capecitabine 1 g/m(2) twice daily orally for 14 days, every 3 weeks, day 1+, until disease progression. Objective response was observed in 35% of the patients (PR 27, CR 9%), which was paralleled by strong CRP decline for all patients with initially elevated CRP levels (n = 32). CRP values decreased from mean 42.3 mg/L (range 9.1-236), to 11.1 mg/L, (range 1.1-35.6), P = 0.006. Median overall survival and progression-free survival for the total cohort were 26.9 and 7.2 months for patients with elevated CRP 24.4 and 11.3 months (95% CI, 22.8-31.0/5.7-16.9) and 13.8-2.6 months (95% CI, 6.5-21.1/0.4-4.8) for the non-elevated CRP group, respectively (P = 0.082/0.017). Median observation time: 26.1 months; Overall survival at 5 years: 18%. Toxicity>WHO grade 3 was reported: Hand-foot syndrome in 16 patients (36%), diarrhea in 4, and pneumonia in 2 patients. Our data allow us to conclude that the control of tumor-associated inflammation is an important therapeutic principle in patients with metastatic RCC.
Medical Oncology 05/2011; 29(2):799-805. · 2.14 Impact Factor
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ABSTRACT: Invasive fungal infections (IFI) are major causes of death in high-risk haematological patients receiving induction therapy for acute leukaemia or intensified immunosuppression due to acute or chronic graft-vs.-host disease (GvHD) following allogeneic stem cell transplantation (SCT). Recently, two randomised studies showed the efficacy of a posaconazole prophylaxis (PP) in these patients to prevent IFI. This prompted the strong recommendation for the use of PP in national and international guidelines. As we started PP in our leukaemia and transplantation unit in summer 2007, we retrospectively analysed the impact of PP on the incidence of possible, probable or proven IFI in this group of patients. Incidence of IFI according to the revised EORTC criteria, published in 2008, was reviewed retrospectively in a group of high-risk patients treated in our unit 1 year before the start of PP compared with the same group in the following year with PP. First analysis was performed on an intention-to-treat basis comparing patients during 1 year of PP with the same group of patients in the year before the start of PP. In a second, deeper analysis, patients were grouped for fluconazole or posaconazole irrespective of the time period the prophylaxis was given. In a first intent-to-treat analysis, 56 patients were analysed in the period without PP (noPP) compared with 34 patients in the period with PP. Overall IFI rates (possible, probable and proven IFI) were reduced from 47% (noPP group) to 35% (PP group). In a second analysis, only patients receiving either fluconazole or PP were analysed, resulting in 29 patients in the noPP group and 36 patients in the PP group. There was a reduction in overall IFI in the PP group especially in the acute myeloid leukaemia (AML) induction patients, but this does not reach statistical significance because of low patient numbers. However, initiation of antifungal therapy was significantly less frequent in AML induction patients in the PP group compared with the noPP group. Unfortunately, this does not result in reduced mortality rates, as mortality in the PP group is higher (15% vs. 7%) than in noPP patients because of double the number of patients with severe GvHD in the PP group. Both breakthrough infections were documented in this subgroup of patients. Our data, collected in every day clinical practice, add further evidence to the advantage of a PP strategy in this group of high-risk patients. However, more data are urgently needed to assess the impact of PP on the incidence and pattern of fungal infections and the strategies to be used in patients with persisting fever and pulmonary infiltrates receiving PP, especially in the setting of SCT and GvHD.
Mycoses 01/2011; 54 Suppl 1:12-6. · 2.25 Impact Factor
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ABSTRACT: The present multi-center phase II study was designed to support the hypothesis that networking agents, which bind to ubiquitous accessible targets in metastatic castration-refractory prostate cancer (CRPC) may counteract neoplasia-specific aberrant cellular functions, thereby mediating PSA response (primary endpoint).
Patients with metastatic CRPC received low-dose chemotherapy with capecitabine 1 g twice daily plus dexamethasone 1 mg daily for 14 days every 3 weeks, COX-2 blockade with rofecoxib 25 mg (or etoricoxib 60 mg) daily combined with pioglitazone 60 mg daily until disease progression.
Thirty-six consecutive patients with metastatic CRPC were enrolled, of whom n = 18 (50%) had been extensively pretreated with radio- or radionuclid therapy and n = 16 (44%) with chemotherapies; n = 8 patients (22%) were medically none-fit, having an ECOG-score of 0-2. Nine of 15 patients with PSA response >50% showed objective response. Median time to PSA response was 2.4 months (range 1.0-7.3 months). Two of 9 patients responding with PSA < 4 ng/ml showed complete resolution of skeletal lesions after 9 and 16 months; 13 patients had a stable course of disease, and 5 patients experienced progressive disease. Median progression-free survival (PFS) was 4.0 months (2.8-5.1 months) and median overall survival (OS) 14.4 months (10.7-17.2 months). Toxicities according to WHO grade II were noticed in 9 patients.
This new combined modular therapy approach is able to induce major responses including resolution of skeletal lesions in patients with CRPC. Furthermore, the study may clinically support the above-mentioned hypothesis.
World Journal of Urology 12/2010; 28(6):745-50. · 2.41 Impact Factor
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ABSTRACT: Combined treatment approaches targeting tumor as well as other cells contributing to tumor progression may control chemorefractory malignancies.
A phase II trial was initiated to analyze the activity of continuously administered pioglitazone and rofecoxib combined with low-dose chemotherapy (capecitabine or temozolomide) in patients with high-grade gliomas (glioblastoma or anaplastic glioma).
Fourteen patients were evaluable for response and toxicity. Major side effects were palmoplantar erythema, edema and motor neuropathy grade 3. Disease stabilizations lasting longer than 3 months were noted in 4 of 14 patients (29%). Clinical responses did not correspond to immunohistochemical staining for cyclooxygenase 2, peroxisome proliferator-activated receptor-gamma and CD31.
The study demonstrates that this novel regimen is moderately active and well tolerated in patients with high-grade gliomas. As a comparably small proportion of patients responded, the regimen might only be suitable for a subset of highly selected patients.
Oncology 02/2007; 73(1-2):21-5. · 2.27 Impact Factor
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British Journal of Haematology 04/2005; 128(5):730-2. · 4.94 Impact Factor
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ABSTRACT: To evaluate the usefulness of molecular markers in predicting histopathological and clinical response to preoperative high dose chemotherapy (HDCT) and survival of patients with advanced gastric cancer.
In a phase II trial, 25 patients with metastatic gastric cancer received preoperative tandem HDCT consisting of etoposide, cisplatin, and mitomycin, followed by autologous bone marrow transplantation to achieve surgical resectability. Samples before and after treatment, from normal and tumour tissue, were characterised histopathologically, and both p53 and BAX expression was analysed by immunohistochemistry. Pretreatment formalin fixed, paraffin wax embedded samples from normal and tumour tissue were microdissected, and the extracted DNA was preamplified using improved primer extension preamplification polymerase chain reaction. Detection of microsatellite instability (MSI) or loss of heterozygosity (LOH) was performed using markers for p53, BAX, BAT25, BAT26, D2S123, D17S250, and APC. Exons 5-9 of the p53 gene were sequenced directly on ABI 373.
Four parameters were significantly associated with response to chemotherapy and prolonged overall survival: positive p53 immunostaining, positive p53 mutation status before chemotherapy, strong histological regression induced by preoperative HDCT, and surgical treatment. Patients's sex or age, tumour location or stage, lymph node status, Lauren classification, MSI, or LOH did not influence duration of survival significantly in this high risk population.
Positive p53 immunostaining and p53 mutation status in pretreatment tumour biopsies might be useful molecular predictors of response and prognosis in patients with advanced gastric cancer treated by preoperative HDCT.
Molecular Pathology 11/2003; 56(5):286-92.
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ABSTRACT: High-dose chemotherapy with autologous peripheral blood stem cell transplantation (PBSCT) includes the risk of infectious complications due to neutropenia and therapy-induced immune deviation. In order to understand early immune recovery in this situation, we analyzed the distribution of cell subsets by flow cytometry and we measured cytokine production in a whole blood assay stimulated with lipopolysaccharide (LPS) in order to induce monocyte (MO) activation in 43 patients with solid tumors or lymphoma treated with two cycles of high-dose chemotherapy and PBSCT. Blood was collected at the following time points: before start of mobilization chemotherapy, before and after high-dose chemotherapy, and 10 and 30 days after PBSCT. In the lymphocyte compartment, we found a depletion of B cells and naive T cells and a transitory reduction of natural killer (NK) cells, whereas MO and neutrophils recovered rapidly. However, during early recovery, HLA-DR expression on MO and the percentage of CD16(+) MO was considerably reduced. Production of proinflammatory cytokines interleukin (IL)-1, IL-6, and tumor necrosis factor (TNF)-alpha upon LPS stimulation was severely impaired directly after chemotherapy and unexpectedly remained low during early recovery of myeloid cells, whereas production of IL-1RA was enhanced, indicating a shift of immune competent cells to an anti-inflammatory or anergic state early after PBSCT.
Annals of Hematology 11/2003; 82(10):628-36. · 2.62 Impact Factor
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ABSTRACT: The present multimodal treatment approach was designed to achieve prolonged tumor control in advanced gastric cancer. A total of 26 patients with stage IV gastric cancer (metastatic disease n=25), ECOG performance status 0-3 and laparoscopically evaluated peritoneal status received a modified EAP schedule to prove chemosensitivity and to mobilize autologous peripheral blood stem cells (aPBSC). Patients without progressive disease proceeded to tandem high-dose chemotherapy (HD-CT) and aPBSCT. Patients with >50% reduction of the target lesion received a second cycle of HD-CT. Responders were selected for local R0 resections (D2 resection) according clinical criteria. Of 26 patients, 20(77%) achieved partial remission after dose-intensive chemotherapy: local R0 resection was achieved in 12 out of 14 patients selected for surgery (46% of all patients). Eight of these R0-resected patients initially had peritoneal carcinomatosis. With a median follow-up of 3.2 years, four patients are still alive. The median overall survival was 8.4 months (CI 2.5-14.4 months), for histologic regression grade 3 (seven out of 25 patients, 28%) 29 months (CI 12-46 months). The combined treatment approach is tolerable and feasible in advanced disease and opens a therapeutic window for a significant proportion of patients, even in cases with histologically proven peritoneal carcinomatosis.
Bone Marrow Transplantation 10/2003; 32(7):665-71. · 3.75 Impact Factor
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ABSTRACT: Reduced post-transplant performance status because of infectious complications is still a problem following autologous peripheral blood stem cell transplantation (aPBSCT). In this study, a tandem transplantation scheme for 15 patients with breast cancer including etoposide (1500 mg/m(2)), ifosfamide (12 g/m(2)) and carboplatin (1500 mg/m(2)) as conditioning regimens, followed by aPBSCT, was used to evaluate the potential clinical benefit of the additional retransfusion of low numbers of ex vivo expanded committed myeloid postprogenitor cells (PPCs) (median 408 x 103 CFU-c/kg BW, range 0.93-1995) following the second transplantation. Following a 7+2 days expansion (using recombinant human SCF, IL-1beta, IL-3, IL-6 + G-CSF), CFU-c generated from CD34-positive cells from leukapheresis products could be expanded by a median factor of 153 (range 5-434). Flow cytometric analysis and morphology of CFUs have shown a nearly exclusive expansion and differentiation of committed myeloid progenitor cells and a significant reduction of CD34-positive cells. In an intra- and interindividual comparison it could be shown that the retransfusion of committed myeloid postprogenitor cells significantly accelerates myeloid recovery. Although retransfusion of PPCs fails to abrogate severe neutropenia following aPBSCT, it significantly ameliorates infectious complications and shortens the duration of hospital stay.
Bone Marrow Transplantation 09/2003; 32(3):299-305. · 3.75 Impact Factor
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ABSTRACT: Severe up to life-threatening neuropathy has been observed in patients with hereditary neuropathies receiving vincristine.
A 52-year-old female painter suffering from high-grade non-Hodgkin's lymphoma (stage IVB) was treated with a total of 4 mg of vincristine during two courses of CHOP chemotherapy (cyclophosphamide, vincristine, adriamycin, prednisone). At onset of treatment no neurological problems were reported. There was good lymphoma response to chemotherapy. At the same time, however, the patient gradually developed dysphagia, dysarthria, muscular weakness of both lower and upper extremities, areflexia, paraesthesia of the fingertips and bilateral sensory impairment of feet and lower legs. These symptoms continually worsened over a period of seven weeks until she was unable to walk or to perform her work. Electrophysiological studies showed peripheral axonal and demyelinative sensorimotor neuropathy in correlation to histological findings. Molecular analysis revealed 17p11.2 duplication typical for Charcot-Marie-Tooth disease IA. While continuing chemotherapy without the use of vincristine the patient's neurologic symptoms slowly recovered within six months.
Prior to administration of vincristine family and patient history as well as physical examination should be performed carefully to look for underlying hereditary neuropathy. For those patients with a clinical history or symptoms suggestive for CMT nerve conduction velocity studies and on an individual base even molecular genetic analysis are necessary to prevent serious neurologic complications. worsened significantly resulting in dependency on a wheelchair and inability to perform her work as a painter. Finally she consulted a neurologist and was admitted to hospital for further diagnostic studies and continuation of treatment for her lymphoma in March 1998 with a provisional diagnosis of severe vincristine-induced neuropathy. Medical history at time of admission included hyperthyroidism, that was currently treated with propylthiouracil, a MALT lymphoma 1983, that was treated surgically only, and a meningoencephalitis in 1968. No further medication was taken. In addition she had a history of Lyme disease since 1993 with positive IgM-titer until December 1997, when antibiotic therapy with doxycycline and ceftriaxone was administered successfully. Family history obtained on admission revealed that her mother had non-specific neuropathic symptoms as well as a poorly defined foot deformities of the mother's father. The patient's brother does not show any neurologic impairment and is in good physical health.
Annals of Oncology 07/2000; 11(6):743-7. · 6.43 Impact Factor
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Bone Marrow Transplantation 09/1999; 24(4):446-7. · 3.75 Impact Factor
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ABSTRACT: Dose escalation during consolidation therapy of de novo AML, including myeloablative chemotherapy supported with autologous peripheral blood stem cell transplantation (aPBSCT), continuously improved outcome. Therefore, quality control of transplants is getting increasing interest. We studied leukapheresis products (LPs), consecutively collected during postremission treatment of 20 patients with de novo AML for minimal residual disease (MRD) by 5-parametric flow cytometry and for myelodysplasia (MDS)-associated alterations by paired lineage-selected colony assays for colony-forming units-megakaryocytes (CFU-mega) and burst-granulocytes-monocytes colony-forming units (CFU) to evaluate the predictive value of these transplant-associated parameters on outcome. We defined the leukemia-associated immunophenotype at diagnosis and studied the impact of MRD detection in LPs collected after double induction with TAD (thioguanine, daunorubicin, cytarabine) and HAM (mitoxantrone, high-dose cytarabine, n=18 patients) and TAD consolidation treatment (n=20 patients) on outcome after aPBSCT. The level of MRD in the transplants correlated with the relapse-free survival (RFS) using a cut-off level of 1 x 10(-3) residual leukemic cells. The median RFS was 6 months for the group with > or = 1 x 10(-3) residual leukemic cells and has not been reached in the group with low MRD levels (< 1 x 10(-3)). By using the same cut-off level a weak correlation could also be demonstrated between MRD in the pregraft bone marrow and RFS (P = 0.04). Quantitatively abnormal megakaryocytic colony growth in the back-up LPs collected after double induction and in the transplant LPs was characterized by the ratio CFU-mega/CFU. In the group of relapsing patients the ratio CFU-mega/CFU was significantly lower than in the group of patients with CCR (P = 0.004), both in the back-ups and in the transplants. All patients with CFU-mega/CFU ratios < 0.12 relapsed, five of seven patients developed MDS before progressing to full leukemic relapse. Using the optimized cut-off level for the ratio CFU-mega/CFU (< vs > or = 0.12), seven of 10 relapsing patients (70%) could be identified to be at risk of relapse, whereas MRD in the transplants identified only 50% of the relapses and MRD in the pregraft bone marrow 25%. In conclusion, the study could identify two pretransplant risk factors predicting relapse in patients with AML receiving aPBSCT in first CR: MRD in transplants as well as MDS-like alterations within the transplants. These results may have multifold implications on the design of risk-adapted chemotherapy as well as on purging techniques and may contribute to a better understanding of leukemogenesis.
Leukemia 09/1999; 13(8):1227-34. · 9.56 Impact Factor
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ABSTRACT: Vincristine (VCR) accumulation in chronic lymphatic leukemia of B-cell origin (B-CLL) has recently been shown not to be inversely correlated to P-glycoprotein (PGP) levels. Therefore, we studied, in addition to PGP expression and accumulation of VCR, the cellular beta-tubulin content in quiescent and rhIL-2 activated B-CLL cells. VCR mediates cytotoxicity by binding to tubulin. Constitutive beta-tubulin levels in B-CLL cells varied considerably. Upon activation with rhIL-2, beta-tubulin expression increased significantly. Therefore, tubulin levels could be correlated over a wide range to VCR accumulation. When the PGP-mediated drug efflux was blocked by verapamil (VRP), tubulin levels correlated linearly to VCR accumulation. All B-CLL cases expressed PGP at different levels. There was no linear correlation between PGP expression and VCR accumulation. A modulation factor m was defined as a quotient of VCR accumulation in the presence and absence of VRP to define the extent by which VRP inhibited a steady-state accumulation of VCR. The factor allowed discrimination between B-CLLs expressing low versus high PGP, irrespective of the levels of tubulin. However, PGP and beta-tubulin levels together were predictive for VCR accumulation in steady state. There was no uniform-accumulation defect for VCR in B-cell CLL because beta-tubulin and PGP were expressed independently. Non PGP-mediated VCR transport seems to play a minor role in B-cell CLL. Leukemia-associated varying of cytoskeletal organization in B-cell CLL might be one reason for the diverse cellular responses to receptor-mediated signals.
Leukemia Research 12/1995; 19(11):823-9. · 2.92 Impact Factor
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ABSTRACT: Reduced drug accumulation may be one reason for intrinsic drug resistance in chronic lymphatic leukemia of the B-cell type (B-CLL). Immunophenotyped leukemic human B-cells from 38 cases of B-CLL were characterized for P-glycoprotein (PGP) content. In all, 30 cases of B-CLL were additionally analyzed for further parameters: accumulation of daunorubicin (DNR, n = 20) and rhodamine 123 (Rh123, n = 30) in both the presence and the absence of verapamil (VRP). Also, 16 cases of B-CLL were analyzed for vincristine (VCR) accumulation with or without VRP. Concerning the relative expression of PGP, these 16 cases of B-CLL were representative for the whole group of 30 cases. Spontaneous accumulation of Rh123 and VCR varied over a wide range: accumulation of Rh123, by a factor of 11.8; accumulation of VCR, by a factor of 9.7; and accumulation of DNR, by a factor of 3.6. VRP modulated the accumulation of RH123 in 16/30 cases (53%), that of VCR in 69% of cases, and that of DNR in 11% of cases. The maximal VRP-mediated increases in accumulation amounted to factors of 1.3 for DNR, 2.3 for Rh123, and 7.8 for VCR. Spontaneous drug accumulation did not correlate with the extent of chemomodulation. The amount of PGP in B-CLL cells (all cases studied were PGP-positive) did not correlate with drug accumulation or with the extent of VRP-mediated chemomodulation. Thus, high expression of PGP is only partially responsible for defective drug accumulation in B-CLL. Only the degree of chemomodulation by VRP is predictive for the extent of the PGP-related functional drug accumulation defect. Thus, in B-CLL, PGP-independent drug accumulation defects seem to be as important as those mediated by PGP. The extent of this drug accumulation defect varies for the different drugs in the following order VCR > Rh123 > DNR. The relevance of PGP-mediated and -independent drug accumulation defects in vivo may depend to a large extent on the drug being used and on the individual cell type. Both types of defect in drug accumulation are of high importance when regimens include VCR a drug commonly used in second-line chemotherapy of B-CLL. Both defects in drug accumulation may be responsible for intrinsic VCR resistance in B-CLL.
Cancer Chemotherapy and Pharmacology 02/1994; 34(4):307-16. · 2.83 Impact Factor
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ABSTRACT: Hydroxyurea is increasingly being used to control myeloproliferative disorders, in part because of its relative lack of side effects. We present a case of life-threatening alveolitis in a patient treated with hydroxyurea for myeloproliferative syndrome. Absence of exposure to other drugs and the clinical course suggest that the alveolitis was induced by hydroxyurea.
Annals of Hematology 10/1993; 67(3):133-4. · 2.62 Impact Factor
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DMW - Deutsche Medizinische Wochenschrift 03/1991; 116(5):186-91. · 0.53 Impact Factor
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ABSTRACT: Cells of a 21-year-old patient with acute lymphatic leukemia were analyzed for morphology and immunophenotype and for genotype consecutively during the course of disease. Initial therapy with the BMFT-ALL protocol (Bundesministerium für Forschung und Technologie) reduced leukemic cells only marginally. The following high-dose Ara-C, mitoxantrone (HAM) chemotherapy led to a cell reduction of 75% and to a drastic change in cell morphology from initially 90% blasts to mainly small lymphoid cells. Immunophenotype, which showed 90% CD7-positive cells in the beginning with a prevalence of helper (60%) over suppressor cells (15%) remained fairly constant until the onset of HAM chemotherapy, which led to a sharp fall and a subsequent slow increase in all T-cell markers. In contrast to pretherapeutic findings, CD7 was now only expressed on the small cells and not on blast cells. Southern blot analysis of the T-cell receptor configuration revealed an initially monoclonal population with rearranged T beta gene. A new band appearing during the clinically ineffective therapy was indicative for development of a second small population which did, however, not emerge in immunophenotype analysis. This second population was eliminated by the HAM chemotherapy, leaving back the initial clone responsible for the final fatal outcome. No activity of the multidrug resistance gene could be detected by Northern blotting.
Haematology and blood transfusion 02/1990; 33:159-65.
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ABSTRACT: A case of acquired pulmonic stenosis is described. The only symptoms reported by the patient, a seemingly healthy woman, were minor chest discomfort and mild dyspnea upon exertion for the last six month. Cardiac catheterization revealed stenoses of both the right and left pulmonary arteries. Magnetic resonance imaging revealed a mediastinal tumor mass that almost totally compressed the right main pulmonary artery and also encroached upon the left pulmonary artery. Histologically the tumor was a malignant teratoma. The subsequent course of treatment was complicated by cardiac tamponade. With regression of the tumor during therapy the signs of pulmonic stenosis disappeared. In cases with acquired pulmonic stenosis an underlying mediastinal tumor has to be considered.
Zeitschrift für Kardiologie 10/1988; 77(9):613-6. · 0.97 Impact Factor
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ABSTRACT: The value of serum deoxythymidine kinase (TK) for the staging and evaluation of disease activity of non-Hodgkin lymphoma (NHL) as compared with serum beta 2-microglobulin, serum lactate dehydrogenase, blood sedimentation rate, blood hemoglobin, white blood cell count, lymphocyte count and platelet count was investigated in 101 patients. In addition, the performance status was determined by the Karnofsky index. Patients with chronic lymphocytic leukemia (CLL; n = 43) and immunocytoma (IC; n = 19) were staged according to the Binet classification, and the other low (n = 28) and high grade NHL (n = 8) according to the Ann Arbor classification. The analysis of all CLL and IC patients revealed that TK values correlated better with Binet stages (p = 0.01; n = 58) than blood sedimentation rate (p = 0.05, n = 12), lactate dehydrogenase (p = 0.08; n = 50), beta 2-microglobulin (p = 0.29; n = 28), lymphocyte count (p = 0.70; n = 57), white blood cell count (p = 0.69, n = 59) and the Karnofsky index (p = 0.16, n = 50). Mean TK levels of these patients were for Binet stage A 6.2 +/- 0.8 U/l (mean +/- S.E.M., range 2.3-18.0), stage B 13.3 +/- 6.5 U/l (3.8-38.8) and stage C 19.6 +/- 4.4 U/l (1.9-79.0), and for 22 healthy controls 3.8 +/- 0.2 U/l (2.2-6.0). Patients with multiple courses of chemotherapy (n = 32) previous to the study had significantly (p = 0.01) higher TK levels (16.4 +/- 3.7 U/l; 2.3-79.0) than those with only up to one course (n = 66; TK: 8.6 +/- 1.4 U/l; 1.5-66.3). The follow-up of 16 patients with low grade NHL showed that serum TK levels paralleled well the clinical response. The results indicate that TK might be a worthful parameter to estimate progression and response to therapy of NHL.
Klinische Wochenschrift 09/1988; 66(16):718-23.
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