Bevacizumab plus Irinotecan,Fluorouracil,and Leucovorin for Metastatic Colorectal Cancer

Object. The extent of tumor resection that should be undertaken in patients with glioblastoma multiforme (GBM) remains controversial. The purpose of this study was to identify significant independent predictors of survival in these patients and to determine whether the extent of resection was associated with increased survival time. Methods. The authors retrospectively analyzed 416 consecutive patients with histologically proven GBM who underwent tumor resection at the authors' institution between June 1993 and June 1999. Volumetric data and other tumor characteristics identified on magnetic resonance (MR) imaging were collected prospectively. Conclusions. Five independent predictors of survival were identified: age, Karnofsky Performance Scale (KPS) score, extent of resection, and the degree of necrosis and enhancement on preoperative MR imaging studies. A significant survival advantage was associated with resection of 98% or more of the tumor volume (median survival 13 months, 95% confidence interval [C...

A multivariate analysis of 416 patients with glioblastoma multiforme: prognosis, extent of resection, and survival

Current status of platinum-based antitumor drugs.

The health-care facility environment is rarely implicated in disease transmission, except among patients who are immunocompromised. Nonetheless, inadvertent exposures to environmental pathogens (e.g., Aspergillus spp. and Legionella spp.) or airborne pathogens (e.g., Mycobacterium tuberculosis and varicella-zoster virus) can result in adverse patient outcomes and cause illness among health-care workers. Environmental infection-control strategies and engineering controls can effectively prevent these infections. The incidence of health-care--associated infections and pseudo-outbreaks can be minimized by 1) appropriate use of cleaners and disinfectants; 2) appropriate maintenance of medical equipment (e.g., automated endoscope reprocessors or hydrotherapy equipment); 3) adherence to water-quality standards for hemodialysis, and to ventilation standards for specialized care environments (e.g., airborne infection isolation rooms, protective environments, or operating rooms); and 4) prompt management of water intrusion into the facility. Routine environmental sampling is not usually advised, except for water quality determinations in hemodialysis settings and other situations where sampling is directed by epidemiologic principles, and results can be applied directly to infection-control decisions. This report reviews previous guidelines and strategies for preventing environment-associated infections in health-care facilities and offers recommendations. These include 1) evidence-based recommendations supported by studies; 2) requirements of federal agencies (e.g., Food and Drug Administration, U.S. Environmental Protection Agency, U.S. Department of Labor, Occupational Safety and Health Administration, and U.S. Department of Justice); 3) guidelines and standards from building and equipment professional organizations (e.g., American Institute of Architects, Association for the Advancement of Medical Instrumentation, and American Society of Heating, Refrigeration, and Air-Conditioning Engineers); 4) recommendations derived from scientific theory or rationale; and 5) experienced opinions based upon infection-control and engineering practices. The report also suggests a series of performance measurements as a means to evaluate infection-control efforts.

Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC)

Fifty patients with disseminated testicular cancer were treated with a three-drug combination consisting of cis-diamminedichloroplatinum, vinblastine, and bleomycin. Three patients were considered inevaluable due to early death. This chemotherapy regimen produced 74% complete and 26% partial remissions. Furthermore, five patients with partial remission became disease-free after surgical removal of residual disease, producing an overall 85% disease-free status. Toxicity, although significant during remission induction with cis-platinum, vinblastine, and bleomycin, was usually manageable, although there were two drug-related deaths during this period. Thirty-eight of these patients remain alive and 32 remain alive and disease-free at 6 + to 30 + months. We believe this regimen represents a major advance in the management of patients with disseminated testicular cancer.

Cis-Diamminedichloroplatinum, Vinblastine, and Bleomycin Combination Chemotherapy in Disseminated Testicular Cancer

Diaminodichloroplatinum was studied in a Phase I trial. Two dose schedules were explored. In Schedule I, a maximum dose of 100 mgJM2 given once was reached, and this proved too toxic for further use. The maximum dose in Schedule 11, 24 mg/M2 daily for 5 days, was also too toxic, so 20 mg/M2 per day for 5 days was the dose selected for further exploration. Responses were seen in 1 patient with anaplastic thyroid carcinoma, 1 with transitional cell carcinoma of the bladder, and 1 with breast cancer. In patients with testicular tumors, responses were seen in 9 of 11 patients. There were 3 complete regressions seen, 1 in seminoma, 1 in embryonal cell carcinoma, and 1 in male choriocarcinoma. Three partial regressions, and three cases of objective improvement were also seen in this series. These were also distributed over different tumor types. The possibility that diaminodichloroplatinum has a specific effect on tissues arising from the genitourinary anlage is suggested. Cancer 33:1219-1225, 1974. HE DISCHARGE OF AN ELECTRIC CURRENT T from a platinum electrode through a nutrient broth containing E. coli was found to be associated with the inhibition of bacterial replication by Rosenberg et al. The same investigators isolated several compounds containing platinum from the culture medium, and demonstrated that these agents were responsible for the alteration in the growth pattern of the organisms.8

https://acsjournals.onlinelibrary.wiley.com/doi/pdf/10.1002/1097-0142%28197405%2933%3A5%3C1219%3A%3AAID-CNCR2820330505%3E3.0.CO%3B2-U

Diaminodichloroplatinum: A phase I study showing responses in testicular and other tumors

To study the clinical efficacy of granulocytes obtained by filtration leukapheresis, patients with clinically evident infection and granulocyte counts of smaller than 500 per cubic millimeter were randomly assigned to receive conventional therapy alone or with a granulocyte transfusion obtained from a single donor each day for four days. Five of 19 control patients survived to day 20, and 15 of 17 in the transfused group survived. Comparison of the two populations for variables such as age, disease, and severity and type of infection revealed no other factor that could account for the difference in survival. Outcome was not demonstrated to be related to HL-A match, post-transfusion counts, or presence of leukocyte antibodies. Functional studies of granulocytes obtained by filtration leukapheresis showed only minor differences although appearance was altered. Granulocytes so obtained can be used safely and efficaciously as adjunctive therapy for infection associated with granulocytopenia.

https://www.nejm.org/doi/pdf/10.1056/NEJM197504102921501?listPDF=true

Filtration leukapheresis for granulocyte transfusion therapy. Clinical and laboratory studies.

The prophylactic treatment of thrombocytopenic leukemic patients with platelets: a double blind study

Treatment of acute nonlymphocytic leukemia: use of anthracycline- cytosine arabinoside induction therapy and comparison of two maintenance regimens

https://www.amjmed.com/article/0002-9343(82)90857-9/pdf

Donald J. Higby

Papers

Diaminodichloroplatinum: A phase I study showing responses in testicular and other tumors

Filtration leukapheresis for granulocyte transfusion therapy. Clinical and laboratory studies.

The prophylactic treatment of thrombocytopenic leukemic patients with platelets: a double blind study

Treatment of acute nonlymphocytic leukemia: use of anthracycline- cytosine arabinoside induction therapy and comparison of two maintenance regimens

Graft-versus-host reaction following blood product transfusion