Showing papers by "Maxine S. Jochelson published in 1986"

Identification of major prognostic subgroups of patients with large-cell lymphoma treated with m-BACOD or M-BACOD.

Abstract: One hundred twenty-one patients with diffuse large-cell lymphoma treated with m- or M-BACOD (methotrexate, bleomycin, doxorubicin, cyclophosphamide, vincristine, and dexamethasone) were evaluated for pretreatment characteristics predictive for response and survival. Two characteristics, poor performance status and massive bulky disease, were negatively associated with response rate in a multivariate analysis. These two characteristics were also negatively associated with survival in multivariate analysis, as was another factor, an increased number of extranodal sites of disease. These three pretreatment characteristics were used to construct a model containing 12 categories of patients at increasing risk for relapse and shortened survival. These categories divided naturally into three broad groups of patients with respective 5-year survival rates of 68%, 55%, and 24%.

CT evaluation of advanced seminoma treated with chemotherapy

Abstract: The serial CT characteristics of nodal metastases from pure seminoma treated with chemotherapy were evaluated in 18 patients. Fifty percent of masses at presentation contained areas of low attenuation; none had calcification. After chemotherapy, masses completely resolved in four patients, partially resolved in 12 patients, and remained unchanged in one patient. The remaining patient developed progressive liver metastases during therapy and died. Pathologic evaluation of residual masses in four patients demonstrated only fibrosis. Residual masses in nine other patients demonstrated further partial resolution or remained stable over the following year; two developed calcification. These patients exhibited no clinical evidence of disease for a median follow-up of 22 or more months. Persistent but stable or resolving masses are common after chemotherapy for advanced seminoma. Unlike their nonseminomatous counterparts, they most often represent fibrosis in patients with no other clinical evidence of disease and do not warrant surgical excision.

Unusual thoracic radiographic findings in children treated for Hodgkin's disease.

Abstract: Mantle irradiation is often part of the treatment for Hodgkin's disease. Localized pneumonitis and fibrosis are well-known sequelae of this treatment. We report nine patients with unusual thoracic radiographic findings following treatment for Hodgkin's disease. All nine had mediastinal widening. Seven of these patients received combined modality therapy in which prednisone was given with their MOPP. In these seven patients, an increase in mediastinal width developed at the same time as the radiographic changes of radiation pneumonitis. Two patients developed bilateral infiltrates extending beyond the field of radiation to the lung periphery. In one of these patients, a spontaneous pneumomediastinum developed. One patient underwent mediastinal biopsy that revealed inflammatory changes similar to those seen in radiation pneumonitis. All patients either responded to steroids or had spontaneous regression of radiographic abnormalities supporting the presumed diagnosis of treatment related changes. Recognition of these unusual sequelae of mantle irradiation will aid in differentiating them from infection or tumor and lead to prompt, appropriate treatment.