Ewing's sarcoma: value of tumor necrosis as a predictive factor.

Forty cases of Ewing's sarcoma filed at the Uruguayan Committee for the Study of Bone Tumors, in the 1956-1979 period, were reviewed in order to determine the prognostic importance of several clinical and histological factors. Necrosis showed a strong association with survival (regression coefficient of -0.59). In fact, those cases with slight necrosis presented an actuarial survival of 48 per cent at a five-year period, contrasting with no survivors in the group with marked necrosis. Multivariate techniques (Multiple Linear Regression and Analysis of Variance) were employed to identify possible subsets of Ewing's sarcoma. In particular, the combination of longer delay (time between the appearance of the first symptom and histologic diagnosis) and slight necrosis as well as treatment with multidrug chemotherapy and slight necrosis resulted in rather prolonged survivals. This suggests interactions between necrosis and delay, and necrosis and treatment. The strong predictive value of tumor necrosis is probably related with rapidly growing Ewing's sarcoma.

A phase II trial of m-AMSA in the treatment of advanced gynecologic malignancies.

Thirty-two patients with advanced gynecologic malignancies were treated with m-AMSA, 120 mg/m2 intravenously every 3 weeks. Seventeen patients with advanced carcinoma of the cervix who were treated with m-AMSA had a median performance status (CALGB scale) of 2. There were two partial responses (PR) (14%) in 16 evaluable patients. The median duration of survival was 76 days following the initiation of m-AMSA treatment. In ovarian carcinoma, none of the nine evaluable patients who were treated responded. One PR occurred among four treated patients with endometrial adenocarcinoma. Toxicity was limited to myelosuppression (WBC greater than 2500/micrograms in 29/77 courses, WBC greater than 1500/micrograms in 16/77 courses, platelets greater than 100,000/micrograms in 10/77 courses, and drug-induced anemia in 7/77 courses) and mild to moderate nausea and vomiting (10/31 patients). Three patients required hospitalization for fever and granulocytopenia, and one patient died from drug-induced sepsis. Although toxicity was acceptable in this group of heavily pretreated patients, m-AMSA has limited activity in patients with advanced carcinoma of the cervix and no apparent activity in patients with advanced epithelial ovarian carcinomas. Continued trials are indicated in patients with adenocarcinoma of the endometrium.

Treatment of the blast crisis of chronic myelogenous leukemia with 5-azacitidine and VP-16-213.

Twenty-seven patients with chronic myelogenous leukemia in blast crisis were treated with a combination of 5-azacitidine (150 mg/m2/day iv in 3 divided doses x 5 days) and VP-16-213 (75 mg/m2/day x 5). No patient had lymphoid histology, and terminal transferase was not present in the 12 patients tested. One complete and 15 partial responses (58% response rate) were seen, with a median survival of 231 days for responders and 73 days for patients who failed to achieve a partial response (P = 0.008). The overall survival was 161 days (range, 20-316+). Moderately severe nausea and vomiting, muscle aches, and mucositis (two patients) were the major side effects, although toxic effects tended to decrease with subsequent courses and many patients could be treated on an outpatient basis. These results compare favorably with other results in this refractory disorders and suggest that 5-azacitidine and VP-16-213 be studied further, either in higher doses or in combination with other agents, in therapy for chronic myelogenous leukemia in blast crisis.

Enfermedad de Hodgkin: a forma mediastino-pulmonar. / Hodgkins disease: the mediastino-pulmonary form. Report of 2 cases

La enfermedad de Hodgkin primitiva de pulmon, originada en foliculos linfoides subpleurales, perivasculares o peribronquiales es una excepcion: se conocen aproximadamente 100 casos en la literatura. Por el contrario el compromiso mediastino-pulmonar en el curso de una enfermedad de Hodgkin diseminada tiene una frecuencia que se valora entre un 15 y un 40%, independientemente de la forma histologica Situacion especial son aquellos casos a comienzo mediastino-pulmonar, que no demuestran en estudios de estadificacion posterior participacion extraordinaria.Estos se caracterizan por afectar mujeres en edad media de la vida y por ser histologicamente formas esclero - nodulares.Precisamente hemos de comentar 2 casos recientes que se ajustan a estas condiciones clinico-patologicas

Metabolic changes in red blood cells in malignant lymphomas.

Serum copper levels (SCL) which are concomitantly related to red blood cell free copper are significantly increased in some malignant lymphomas in the phase of activity. This results in a profound inhibition of red cell key glycolytic enzymes, hexokinase (Hx) being the most sensitive. Fifteen patients (eight with Hodgkin's disease and seven with non-Hodgkin's lymphoma) were studied for serum and red cell copper concentrations and Hx activity. The mean red cell life span was determined using 51Cr labelled red cells. The resulting data shows that in active disease an increase in SCL was associated with a decrease in Hx activity and a shortened red cell survival. In these cases there was no evidence of autoimmune phenomena or of direct bone marrow involvement by the disease. It is suggested that the increase in copper levels results in a shortened red cell life span through a copper-induced inhibition of red cell Hx.

[A case of cerebral microglioma]. / A propósito de una observación de microglioma cerebral.

The authors present the first national observation of a microgliosarcoma. The patient, a woman of 57 years old, was admitted with the clinical and paraclinical diagnosis of an intracranial mass occupying lesion. Surgical excision was incomplete, and postoperative radiotherapy was undertaken. Posteriorly, lymphoma classification criteria was used to determine the extension of the process. Due to an abnormal retroperitoneal finding in the lymphangiogram the patient was submitted to a laparotomy following staging procedures and diagnosing tuberculous ganglia without lymphomatous lesions. Considerations are made on the identity of the origin of microglia and the reticuloendothelial system and the different nomenclature used to name this tumor. The necessity of a classification of the extension of lesion according to established norms for lymphomas is stressed and therapeutic procedures are proposed.