Evaluation of amonafide in refractory and relapsing multiple myeloma: a Southwest Oncology Group study.

This study involved the administration of amonafide intravenously 300 mg/m2 daily times five days every three weeks to 16 refractory and relapsed myeloma patients. Doses were escalated to toxicity. These doses caused severe thrombocytopenia and granulocytopenia in seven patients. No responses were seen in this heavily pretreated group of patients.

Phase II trial of echinomycin in advanced soft tissue sarcomas. A Southwest Oncology Group study.

Thirty-four patients with advanced soft tissue sarcomas were entered in a phase II trial of echinomycin. Patients received 1.2 mg/m2 intravenously (i.v.) weekly times four followed by a two week rest period. There were no objective responses. Dose limiting toxicity was gastrointestinal. Echinomycin given on this weekly schedule is inactive in treating previously treated patients with advanced soft tissue sarcomas.

Massive ovarian mucinous cystadenoma of low malignant potential.

Operative removal of an 80.3-kg ovarian mucinous cystadenoma of low malignant potential is described. The 30-year-old woman from whom the tumor was removed had many medical problems spanning several medical fields, including psychiatry and plastic surgery, as well as gynecology. The team approach to these problems is summarized in this case report.

The psychological sequelae of abortion performed for a genetic indication.

Psychometric testing and psychiatric interviews were conducted on 13 families in which the women had undergone amniocentesis for the prenatal detection of a genetic defect in the fetus and, upon receiving positive results, elected to have a therapeutic abortion. The indication for amniocentesis was maternal age in two families, a previous child with Down's syndrome in one family, a previous child with a recessively inherited inborn error of metabolism in four families, and the mother being a carrier for an X-linked disease in six families. The incidence of depression following selective abortion may be as high as 92 per cent among the women and as high as 82 per cent among the men studied, and was greater than that usually associated with elective abortion for psychosocial indications or with delivery of a stillborn. Four families experienced separations during the pregnancy-abortion period. Despite the emotional trauma of the procedure, most of the families studied would repeat their course of action and consider selective abortion preferable to the alternative birth of a defective child. Several modifications in the amniocentesis and selective abortion procedure which might diminish the concomitant emotional trauma are suggested.

Therapeutic abortion follow-up study.

PIP: To determine the long-range psychological effects of therapeutic abortion, 50 women (aged from 13-44 years), who were granted abortions between 1967 and 1968 Because of possible impairment of mental and/or physical health, were analyzed by use of demographic questionnaires, psychological tests, and interviews. Testing revealed that 44 women had psychiatric problems at time of abortion. 43 patients were followed for 3-6 months. The follow-up interviews revealed that 29 patients reacted positively after abortion, 10 reported no significant change and 4 reacted negatively. 37 would definitely repeat the abortion. Women under 21 years of age felt substantially more ambivalent and guilty than older patients. A study of 36 paired pre- and post-abortion profiles showed that 15 initially abnormal tests had become normal. There was a significant increase in contraceptive use among the patients after the abortion, but 4 again became pregnant and 8 were apparently without consistent contraception. It is concluded that the abortions were therapeutic, but physicians are encouraged to be aware of psychological problems in abortion cases. Strong psychological and contraceptive counselling should be exercised.^ieng

Therapeutic abortion follow-up study.

PIP: From November 1967 to June 1968, a heterogeneous group of 55 pregnant women applied for abortion to the staff of the obstetrical services of the University of California/San Francisco because of possible impairment of mental and/or physical health. 43 of 50 were followed for 3 to 6 months. Ambivilance and guilt appeared more substantially in young women under 18 years of age. Three to 6 months afterward, 29 patients expressed a positive reaction toward abortion. 10 reported no significant change in their life situations and 4 responded negatively. Of the 41 patients remaining fertile, 4 had purposely become pregnant again. 8 others were apparently without consistent contraception. It was concluded that preabortion counseling should outline the necessary steps for Committee consideration, give reassurance as to physical safety and help the patient understand her motives and goals. Postabortion follow up should emphasize a clear contraceptive program.^ieng