Showing papers by "Tata Memorial Hospital published in 1985"

Anterior chemotherapy in esophageal cancer

Abstract: Front loading chemotherapy using methotrexate (200 mg/m2) alone or methotrexate (200 mg/m2) with cisplatin (20 mg/m2 daily for 5 days) was used in epidermoid carcinoma of esophagus. Evaluation after two courses showed objective response of 50% or greater in 48% of patients with metbotrexate alone. Response rate was increased to 76.2% with addition of cisplatin to methotrexate. Small lesions (less than 10 cm) showed better response as compared to advanced cases. Therapy was generally well tolerated and good palliation was obtained even after the first course. Postchemotherapy treatment either with surgery or radiotherapy was tolerated without any major complications. The data confirm the short-term usefulness of initial chemotherapy with methotrexate and cisplatin in esophageal cancer. Results of prolonged follow-up will help to evaluate the role of front loading chemotherapy on long-term survival. Cancer 56: 1502-1506, 1985.

Cell-mediated immune status in patients with squamous cell carcinoma of the oral cavity

Abstract: Sixteen untreated patients with squamous cell carcinoma of the oral cavity were tested for in vitro immune status in comparison with the normal healthy donors. The parameters investigated were total leukocyte and lymphocyte counts, percentages and absolute counts of T- and B-cells in circulation, subsets of T-cells identified by the Fc receptors, phytohemagglutinin (PHA), and mixed lymphocyte culture (MLC) responses, natural killer (NK) and antibody-dependent cellular cytotoxicity (ADCC) activities, and circulating immune complexes (CICs). Eight of these patients were retested 3 to 6 months after surgery. The results showed that there was an increase in leukocyte and lymphocyte counts, an increase in the percentage and absolute number of B-lymphocytes, an increase in the percentage of T-gamma cells, suboptimal PHA and MLC responses, normal NK and ADCC activities, and increased levels of CICs in untreated oral cancer patients. In the postoperative stage, except for a reduction in leukocyte and lymphocyte counts, other abnormalities remained unchanged. The CICs in treated patients correlated with the tumor load in that in three patients showing recurrence, the CIC level remained elevated, whereas in patients without evidence of the disease the CIC level was either low or comparable to the upper normal limits.

Studies on granulocyte functions in patients with chronic myeloid leukemia.

Abstract: Granulocyte functions, viz. endocytosis, NADPH oxidase activity and iodination by leukocytes, were studied in granulocytes isolated from 17 chronic myeloid leukemia (CML) patients at initial diagnosis (stage I), from 10 patients in relapse (stage II), and 10 patients in acute blastic crisis (stage III). The mean phagocytic index of granulocytes from CML patients was similar to the normal value. NADPH activity decreased as the disease progressed. Thus, the amount of formazan produced was lower in granulocytes from patients in stage II (P less than 0.05) and stage III (P less than 0.01) than that produced by normal granulocytes. H2O2-Myeloperoxidase-dependent iodination was found to be significantly reduced in granulocytes from all stages of the disease compared to that of normal, stage I (P less than 0.01), stage II (P less than 0.05) and stage III (P less than 0.01). It thus seems that granulocyte function becomes less efficient as the disease progresses towards acute blastic crisis. Immature cells from the same patients carried out these functions at a more reduced level than did their mature counterparts.

Acute leukaemia following malignant ependymoma: a case report.

Abstract: Though an increasing number of chemotherapy- and radiotherapy-related leukaemias are being reported, acute promyelocytic leukaemia developing as a therapy-related second malignancy is still uncommon. Here the authors report a case of acute promyelocytic leukemia, microgranular variant, developing in a case of intracranial malignant ependymoma, 1.5 years following treatment with craniospinal radiotherapy.

T-Cell Acute Lymphoblastic Leukemia: A Report of 60 Patients from India

Abstract: 60 patients studied at the Tata Memorial Hospital from January 1976 to December 1982 were diagnosed as having T-cell acute lymphoblastic leukemia (ALL) by nonimmune rosette formation with sheep red bl

Clinical significance of heat labile regan isoenzyme variant in Hodgkin's disease

Abstract: The activity of a heat labile variant of Regan type alkaline phosphatase (HLRI) was studied in the serum of 38 histologically proved patients with Hodgkin's disease. The activity was also studied in 40 normal healthy adults matched for age and sex as control. HLRI was significantly elevated in patients with Hodgkin's disease in comparison with normal controls (1.12 +/- 0.12 units/ml vs 0.09 +/- 0.01 units/ml; P less than 0.001). The mean values of the isoenzyme tended to increase progressively with increasing stages of disease, reflecting a significant linear trend (P less than 0.001). The serial measurement of this variant may serve as a useful parameter in assessing disease activity and response to chemotherapy.

Significance of histopathology in pulsed NMR studies on cancer.

Abstract: Characterization of tissue by pulsed nuclear magnetic resonance spectrometry opened a new area of research. The differences in the NMR parameters T1 and T2 of normal and malignant tissues constitute the basis for their distinction by pulsed NMR spectrometry and also by NMR imaging in vivo. The present studies were undertaken to correlate the role of constituent histological elements encountered in various malignancy-associated changes and T1 variations and are based on evaluation of samples taken from surgically resected specimens of carcinoma of the esophagus, comprising the uninvolved portions of the esophagus and the gastric end on gross examination. The uninvolved and involved regions showed low and high T1 values, respectively. High T1 values were also encountered in the zones of samples of uninvolved esophagus which histologically revealed areas with dysplasia. This feature, viz., dysplasia representing malignancy-associated changes, has been found to recur in many samples. Detailed histological studies provided further evidence confirming that areas with dysplasia contribute to an increase in T1 values whereas in zones at the gastric end metaplasia and hyperplasia are more common. The results are of value for demarcation of tumor area by in vivo NMR imaging.

The impact of combined therapeutic modalities in head, neck, and esophageal cancer.

Abstract: Nearly 50% of head and neck cancers and two-thirds of patients with esophageal cancer generally present late for initial treatment. UK patterns of failure are generally locoregional with around 10% showing distant dissemination. Surgery alone and in combination with pre-operadve radiation has not significantly increased salvage in these groups of cancer. The availability of increasingly effective drugs (Cisplatinum, MTX., Bleomycin), for head, neck and esophageal cancers have produced dramatic initial responses with excellent palliative relief of symptoms enabling adequate definitive radiotherapy or surgery for advanced T3, T3 lesions. Cisplatinum 20 mg/m2 daily × 5 - twice at the interval of 10 days with MTX 25 mg/m2 and Bleomycin 15 mg/m2 weekly × 2 have been used for T3 and T4 Head and Neck Cancers and Cisplatinum in the same dosage and MTX 200 mg twice in 10 days have been used for esophageal cancers. 88% responses in 35 patients have been noted in head and neck cancers and when the chemotherapy was followed by definitive radiotherapy, complete responses were achieved in 16 out of 25 patients (64%). This is a very significant response rate for T3, T4 cancers. Patients who were in a reasonably acceptable general condition after mis regimen were further considered for two more courses of consolidative chemotherapy. Response rates in esophageal cancer was 78% (26 of 34 evaluable patients) - 6 of the 26 showed a complete response and all are alive from 8 months to 26 months. Our failure to obtain increasing cures at 3 and 5 years may be due to our ignorance of the capacity of dormant cells to proliferate, tumor cell kinetics, more effective use of chemotherapy or the biology of the host. These areas need further investigation.

Evaluation of circulating immune complexes in lymphomas and leukemias using two different assays

Abstract: Circulating immune complexes (CICs) have been detected in the sera of patients with non-Hodgkin's lymphoma (NHL), Hodgkin's disease, chronic myeloid leukemia, and acute lymphoblastic leukemia by using C1q-binding and L1210-binding assays. Both assays gave broadly similar patterns of reactivity in terms of frequency and magnitude, though there are some differences. Significantly elevated CIC levels were observed in all pathologic groups. However, sera from NHL patients with an unfavorable prognosis consistently exhibited the highest frequency of positive values and mean CIC levels in both these assays. The two tests showed concordance in 66.6% of the NHL patients' sera and were significantly correlated. Of the sera from NHL patients 12.7% were positive in the C1q-binding assay only and 15.9% in the L1210-binding assay only. Both the assays gave positive results in some patients, and a degree of overlap indicates the presence of different types of CIC in cancer patients' sera. The combined use of two methods for detecting CICs may be useful for evaluation of the activity, the extent, and the prognosis of the malignant disease.

Ultrastructural localization of 5'nucleotidase in human normal and malignant lymphoid cells.

Abstract: 5'Nucleotidase (EC 3.1.3.5), a purine pathway enzyme, occurs as a cellular ectoenzyme. Widely differing 5'N activity has been reported in different types of lymphoid cells and appears to be related to lymphocyte function, differentiation and immunological subtype. This paper reports a study on the ultrastructural distribution of 5'N in in different types of lymphoid leukemias and non-Hodgkin's lymphomas. In lymphoid leukemias, only cALL cells showed strong 5'N staining. In CLL, PLL and HCL the intensity of staining was less than in normal cells. In the NHL group, the reaction pattern was mixed. Infiltrating neoplastic cells, specially the large lymphoid cells, consistently showed very mild activity of the enzyme, whereas follicular center cells and other mature lymphocytes were characterized by moderately strong to strong 5'N activity. These results support the view that 5'N is a marker of lymphocyte cell differentiation.

Cancer in young adults between the ages of 15 and 34 years in Greater Bombay.

Abstract: An attempt has been made in this study to examine the nature and magnitude of the cancer problem in young adults between the ages of 15 and 34 years living in Greater Bombay. The morbidity data utilised for this exercise were obtained from the Bombay Cancer Registry and the mortality analysis was made from the death records maintained by the Bombay Municipal Corporation. In Greater Bombay, the ratio of cancer incidence in this specific group as compared with the total incidence of the disease in the general population was very high in comparison with the Western incidence. The site most commonly affected by cancer in young adults seems to be the lymphatic and haematopoietic tissues in males and breast and cervix in females. The morbidity and mortality rates of the disease in the general population and in children reveal an overall male preponderance, but the situation is found to be totally reversed in young adults. Then again, the incidence as well as the mortality rates appear to decrease with advancing age in children, but in young adults the incidence increases with age. Leukaemia is the most commonly encountered malignancy in the young adult male, followed by cancers of the testes and bones, Hodgkin's disease, and cancers of the brain and connective tissues, in descending order of frequency. In females, breast cancer has the highest incidence followed by cancer of the cervix, leukaemia, and cancers of the ovary and thyroid. When the various registers are ranked according to age-adjusted incidence rates, the figures for Greater Bombay are seen to be at the lowest levels in both sexes.