Showing papers by "Philippe Moreau published in 1997"
TL;DR: Delayed treatment is feasible in patients with follicular lymphoma and a low tumor burden and the long-term toxicity of alkylating agents can be reduced.
Abstract: PURPOSETo evaluate prospectively in patients with follicular lymphoma and a low tumor burden three therapeutic options: delay of any treatment until clinically meaningful progression, immediate treatment with an oral alkylating agent, or treatment with a biologic response modifier, interferon alfa-2bPATIENTS AND METHODSNewly diagnosed follicular lymphoma patients with a low tumor burden (n = 193) were randomly assigned to one of three arms: arm 1, no initial treatment (n = 66); arm 2, prednimustine 200 mg/m2/d for 5 days per month for 18 months (n = 64); or arm 3, interferon alfa 5 MU/d for 3 months then 5 MU three times per week for 15 months (n = 63) Clinical characteristics were similar in the three armsRESULTSOverall response rates with prednimustine and interferon alfa were 78% and 70%, respectively The overall response to therapy, when deferred, was similar at 70% With a median follow-up duration of 45 months after randomization, the median freedom-from-treatment (FFT) interval was 24 months in
528 citations
TL;DR: It is concluded that the combination cefepime/amikacin is at least as effective as the reference regimen of ceftazidime/AMIKacin in this setting.
Abstract: We conducted a randomized multicenter study to compare the efficacy and safety of two antibiotic regimens (cefepime [2 g b.i.d.] plus amikacin or ceftazidime [2 g t.i.d.] plus amikacin) as first-line therapy for fever in patients with hematologic malignancies and neutropenia. A total of 353 patients were randomized according to a 2:1 (cefepime:ceftazidime) ratio. Two hundred-twelve patients in the cefepime group and 107 in the ceftazidime group (90% of all patients) were evaluable for efficacy. The polymorphonuclear neutrophil count was <100/mm 3 on enrollment for 70% of the patients. The mean duration of neutropenia was 26 days. The efficacy in both study arms was comparable, although a trend in favor of cefepime was seen in terms of therapeutic success (response rate, 27% vs. 21% for the ceftazidime group). The overall response rate after glycopeptides were added to the regimens was 60% for the cefepime group and 51% for the ceftazidime group; the bacterial eradication rates were 81% vs. 76%, respectively, and the rates of new bacterial infections were 14% vs. 18%, respectively. We conclude that the combination cefepime/ amikacin is at least as effective as the reference regimen of ceftazidime/amikacin in this setting.
95 citations
TL;DR: GM-CSF after HDM without SCT is feasible and significantly shortens neutropenia with a trend toward reduction of hospitalization duration, but does not significantly reduce the morbidity and mortality of such therapy.
Abstract: PURPOSETo evaluate the impact of granulocyte-macrophage colony-stimulating factor (GM-CSF) or placebo on the durations of intravenous (IV) antibiotic use, hospitalization, neutropenia, and fever, as well as remission rates, after high-dose melphalan (HDM) without stem-cell transplantation (SCT) in patients with multiple myeloma (MM).PATIENTS AND METHODSOne hundred two patients with high-risk MM were randomized 2:1 in a prospective multicenter trial to receive 5 microg/kg/d GM-CSF (69 patients) or placebo (33 patients) starting the day after 140 mg/m2 IV melphalan for up to 21 days.RESULTSGM-CSF significantly reduced neutropenia after HDM (median, 23.5 v 29 days; P = .0468), with a trend to reduce the duration of hospitalization (median, 32 v 38 days; P = .0841). Nevertheless, GM-CSF did not significantly reduce infectious toxicity as regards the number of days with fever (median, 5 v 3; P = .359), the number of days with IV antibiotics (median, 22 v 27; P = .14), or early deaths, with an 11.5% treatment-r...
41 citations
TL;DR: The clinical use of 25–30 % of hydroxyethylstarch 6 % or dextran 40 with albumin 4 % was clinically well tolerated and associated with a 12 % decrease of the cost of substitution solutions.
Abstract: Objective: To compare the tolerance and the cost of three replacement fluids in plasmapheresis: albumin 4 % alone, albumin 4 % + dextran 40, or albumin 4 % + hydroxyethylstarch 6 %. Design: A one center randomized, cross-over, comparative study designed to explore the tolerance and the colloid oncotic pressure in patients undergoing plasmapheresis. Patients: 225 plasmapheresis procedures were performed in 27 patients. Measurements and results: Hemodynamic tolerance was good in the three treatment groups. Serum protein concentration after plasmapheresis was significantly lower in the albumin + hydroxyethylstarch group, followed by albumin + dextran 40, versus albumin alone. Colloid oncotic pressure before and after exchange was similar in the three groups. Conclusions: The clinical use of 25–30 % of hydroxyethylstarch 6 % or dextran 40 with albumin 4 % was clinically well tolerated and associated with a 12 % decrease of the cost of substitution solutions.
19 citations