Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C1261473 (sarcoma)
 25,952 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two cases of primary intracerebral malignant lymphoma were reported. Case 1 was a 42-year-old man who had been suffering from headache and mental disturbances for about 3 months prior to admission. These complaints progressed insidiously. He was admitted to our hospital on March 31, 1973. On neurological examinations he was in somnolence state and had neck rigidity, positive of Kernig's sign, disorientation and dyscalculia. Lumbar puncture gave a C.S.F. pressure of 240 mmH2O and the fluid contained 180 mg/dl of protein. A left vertebral angiogram via brachial artery demonstrated thalamic and cerebellar mass lesions. For the development of symptoms of increased intracranial pressure, a ventriculoperitoneal shunt operation was performed on April 7. A right carotid angiogram after ventriculoperitoneal shunt operation disclosed a frontal mass lesion. On May 2, a right frontal craniotomy was carried out and the frontal lobe was removed together with the tumors. After the operation his consciousness remained stupor. Thereafter consciousness and clinical pictures gradually worsened, and he died on May 30. Autopsy was performed, and gross examinations revealed tumors in the bilateral frontal and temporal lobes, right parietal lobe, and left cerebellar hemisphere. On coronal sections, there were neoplastic proliferation extending from the right thalamus to the putamen and a tumor in the right midbrain. No evidence of neoplastic proliferation was found outside the central nervous system. Microscopic examinations showed a diffuse proliferation of tumor cells with mitosis and polymorphism. The tumor was consisted of small lymphoid cells. Reticulin fibers were not found in the tumor with Watanabe's silver method. It was also unable to impregnate the tumor cells with silver carbonate. This case may be classified the primary interacerebral lymphosarcoma. Case 2 was a 48-year-old man, who was admitted to the hospital complaining of occipitalgia, speech disturbances and diffculty in walking. On neurological examinations, he had a right spastic hemiparesis and dyscalculia. A right carotid angiogram showed the frontal mass lesion. On April 18, a left frontal craniotomy was performed and frontal lobe was removed with the tumor. He made a good recovery from the operation and remained well for about 1 month. However, it culminated in a gradual diminution in the level of consciousness. Unfortunately, he died on June 20. No autopsy was performed. Histologically, the tumor cells had round or ovoid nuclei, mitosis and polymorphism. The perivascular arrangement of the tumor tissue showed tendency to confluence. There were reticulin fibers in the tumor tissue, particularly around the blood vessels. Microglial cells were not impregated with silver carbonate. It is supposed that this case belongs to the primary intracerebral "reticulum cells sarcoma-microglioma" described by Rubinstein or reticulum cell sarcoma. Both the case 1 and the case 2 should be filed to be malignant lymphoma in the wide category.
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PMID:[Two cases of primary intracerebral malignant lymphoma (author's transl)]. 110 27

The dose-limiting toxicity in two separate phase I trials of the high-dose single agents ifosfamide and carboplatin was renal insufficiency at 18 g/m2 and hepatic and ototoxicity at 2,400 mg/m2, respectively. In this phase I study, 16 adults were treated with ifosfamide at 75% of the single-agent maximum-tolerated dose (MTD) (12 g/m2) and escalating doses of carboplatin (400 to 1,600 mg/m2) to determine the nonhematologic dose-limiting toxicity and the maximum-tolerated dose of the combination. Both drugs as well as mesna for uroprotection were given by continuous infusion over 4 days with an additional day of mesna (total dose per course, 15 g/m2). Autologous bone marrow support was stipulated for subsequent dose levels once granulocytes remained less than 500/microL for more than 14 days in two of three to five patients entered at a given dose level. Autologous bone marrow support was used at doses above the 400 mg/m2 carboplatin dose level. At the maximum-tolerated dose level of 1,600 mg/m2 of carboplatin, renal toxicity precluded further dose escalation. Of the five patients entered at this dose level, reversible creatinine elevation greater than 2 mg/dL (median peak, 2.6 mg/dL) was observed in three patients, and irreversible renal failure occurred in an additional patient (peak creatinine, 6.9 mg/dL. Transient gross hematuria appeared more common with the combination than with ifosfamide alone. Two patients developed severe somnolence and confusion associated with a rising creatinine. There were two complete (CRs) and four partial responses (PRs) in 14 heavily pretreated assessable patients (including four partial or complete responses in eight assessable patients with advanced refractory sarcoma, and one CR in two patients with germ cell carcinoma). Carboplatin and ifosfamide appear to have overlapping renal toxicity. Nevertheless, carboplatin and ifosfamide can be combined at 80% and 75% of the single-agent maximum-tolerated doses, respectively, with acceptable nonhematologic toxicity. Ifosfamide and carboplatin are an attractive core combination for further studies in the treatment of sarcoma, germ cell, ovarian, and lung carcinomas.
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PMID:A phase I study of high-dose ifosfamide and escalating doses of carboplatin with autologous bone marrow support. 184 7

Phase II trials of ifosfamide have been performed with standard doses of 5 to 8 g/m2/course. In this phase I study, 29 patients were treated with a 4-day continuous infusion ifosfamide to determine the maximum-tolerated dose and the nonhematologic dose-limiting toxicity. Autologous bone marrow support was to have been used for the subsequent dose level if granulocytes were more than 500/microL for more than 14 days in two of two to five patients at a given dose level. Doses were escalated from 8 to 18 g/m2 ifosfamide. Mesna was given at an equivalent dose by continuous infusion for 5 days. At the 18 g/m2 dose level, dose-limiting renal insufficiency and a median of 11 days (range, 8 to 18 days) of granulocytopenia (less than 500/microL) were observed. Thus, autologous bone marrow reinfusion ws not used. The duration of myelosuppression, the frequency and severity of mucositis, and renal tubular acidosis were all dose-dependent. Mild to moderate CNS toxicity also appeared to be related to dose; however, severe CNS toxicity (transient confusion, hallucinations, and somnolence) was observed sporadically at both low- and high-dose levels. Transient hematuria (greater than 50 red blood cells [RBCs]/high power field) occurred once but did not affect treatment. There were nine responses (two complete) in 27 heavily pretreated assessable patients including seven responses in 20 patients with advanced refractory sarcoma. Ifosfamide with mesna uroprotection can undergo considerable dose escalation over the usual prescribed doses before nonhematologic dose-limiting toxicity is encountered. Ifosfamide has broad cytotoxicity against solid tumors and may prove to be an important addition to high-dose combination chemotherapy regimens.
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PMID:High-dose ifosfamide with mesna uroprotection: a phase I study. 210 23

In two sequential trials, 154 patients were treated with dosages of ifosfamide, ranging between 8 and 18 g/m2 divided over 4 days, with mesna uroprotection. The first was a phase II efficacy trial in 125 advanced sarcoma patients (Antman et al: J Clin Oncol 7:126-131, 1989), while the second was a dose escalation trial involving 29 patients (Elias et al: J Clin Oncol 8:170-178, 1990). In the first trial, patients received 8 to 10 g/m2 ifosfamide either by bolus or continuous infusion. The response rate for the 64 patients receiving bolus administration was 23% compared with 12% for the 60 patients receiving a continuous infusion schedule (P = .09). Of the 154 patients, 144 had sarcoma and had failed at least one previous regimen. Of these 144, 4% responded completely and 23% had a complete or partial response. The maximum tolerated dose of ifosfamide was 16 g/m2 in the second trial. Dose-limiting renal toxicity was observed at 18 g/m2 ifosfamide (Elias et al: J Clin Oncol 8:170-178, 1990). The duration of myelosuppression and the frequency and severity of mucositis and renal tubular acidosis were dose-dependent. A median of 11 days (range, 8 to 18) of granulocytopenia (less than 500/microL) were observed. Thus, autologous bone marrow reinfusion was not required. Severe central nervous system toxicity (transient confusion, hallucinations, and somnolence) was observed sporadically at both low- and high-dose levels. The first four patients on the standard-dose study did not receive mesna because it was unavailable; three developed gross hematuria. In patients who received mesna, hematuria was uncommon. Hematuria in the group as a whole was significantly associated with a lack of uroprotection, but was not associated with prior cyclophosphamide, pelvic radiotherapy, age, or bolus versus a continuous infusion schedule. Patients receiving ifosfamide with mesna uroprotection can tolerate considerable dose escalation over the usual prescribed doses before nonhematologic toxicity becomes dose-limiting. Ifosfamide, with its broad activity in solid tumors, may prove to be an important addition to high-dose combination-chemotherapy regimens (Elias et al: J Clin Oncol 8:170-178, 1990).
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PMID:Ifosfamide and mesna: response and toxicity at standard- and high-dose schedules. 211 Mar 86

European and American investigators have reported response rates of 38% to 83% for ifosfamide alone in pretreated sarcomas. In a phase II trial of ifosfamide 2.0g/m2 days 1 to 4 with mesna uroprotection in 124 patients with previously failed sarcomas, four (3%) responded completely (95% exact confidence interval, 1% to 8%) and 26 (21%) had a complete or partial response (95% exact confidence interval, 14% to 29%). The median time to progression was 5 and 9 months for partial and complete responders, respectively. In the subset of soft tissue sarcomas, the response rate for the patients receiving bolus administration was 26%, compared with 9% for the patients receiving a continuous infusion schedule (P = .03). The response rates among patients with soft tissue and bony sarcomas with a performance score of 0-2 and 0-1 prior to chemotherapy administration were 20% and 40%, respectively. Somnolence or confusion developed in 19%. Neurotoxicity was significantly associated with poor performance status (P less than .01), elevated creatinine (P less than .01), and low bicarbonate levels (P = .05). A serum bicarbonate less than 20 developed in 31% of the patients and was significantly associated with older age (P = .01), elevated creatinine (P = .02), and female sex (P = .06). Hematuria was significantly associated with no uroprotection (the first four patients did not receive mesna because it was unavailable), but was not associated with prior cyclophosphamide, pelvic radiotherapy, age, or bolus v continuation infusion schedule. Thus, ifosfamide is active in failed sarcomas and warrants further study in previously untreated patients with sarcoma.
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PMID:Response to ifosfamide and mesna: 124 previously treated patients with metastatic or unresectable sarcoma. 249 83

One hundred and seventy-one patients with advanced soft tissue sarcoma entered a randomized crossover phase II study comparing cyclophosphamide (CYCLO) with a new analogue, ifosfamide (IFOS), both administered as 24 h i.v. infusions every 3 weeks. The doses used were CYCLO 1.5 g/m2 and IFOS 5 g/m2, with provision for dose escalation. All patients received mesna 400 mg/m2 as an i.v. bolus 4 hourly X 9 doses, commencing at the start of the oxazophosphorine infusion. Patients who had received previous chemotherapy were eligible provided this did not include a classical alkylating agent. There were 22 patients who were ineligible, and response could not be evaluated in 12 additional patients. IFOS produced two complete and ten partial remissions, for an overall response rate of 18%. CYCLO was significantly (P = 0.04) less active, producing one complete and five partial remissions, an overall response rate of 9%. Stabilization of disease was similar in both arms (27% and 24% respectively), but fewer patients showed progression on IFOS. The response rate was higher (20% vs 5%) for patients who had not received previous chemotherapy, and also for female compared with male patients (21% vs 5%). When only patients who had not received previous chemotherapy were considered, the respective response rates for IFOS and CYCLO were 24% and 15%. There were no responses in previously treated patients receiving CYCLO. There were four partial responses in 33 patients crossing from CYCLO to IFOS, but no responses in 18 patients receiving CYCLO after IFOS. Leucopenia was significantly more pronounced (P = 0.0004) with CYCLO, both after the first course and throughout treatment, although the incidence of severe infections, 6%, was the same in both arms. Nausea and vomiting were more severe with IFOS (P = 0.022), but other toxicities were mild. Grade 1 or 2 bladder (haematuria) or renal (rise in serum creatinine) toxicity was slightly more frequent with IFOS (7 vs 3 patients) and was a reason for stopping treatment for one patient in each arm. Three episodes of mild to moderate drowsiness after IFOS were reported, but no severe encephalopathy. A higher response rate with less myelosuppression suggests that IFOS may have advantages over CYCLO in combination with such active agents as adriamycin.
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PMID:Cyclophosphamide versus ifosfamide: preliminary report of a randomized phase II trial in adult soft tissue sarcomas. 310 89

A total of 64 courses of ifosfamide (IFM) treatments for sarcoma patients were evaluated for toxic effects. A dose of 100 ml of 1/2 diluted Maalox by normal saline was instilled into urinary bladder with clump of catheter for 15 min for uroprotection instead of Mesna that was not available in Japan at that time. Forty-six courses of ifosfamide treatment in 12-16 g/m2 doses with daily Maalox instillation resulted only one hemorrhagic cystitis, while 18 courses at a dose of 6-10 g/m2 of IFM without Maalox eventuated in 5 cases of hemorrhagic cystitis. Forty-six courses of ifosfamide treatment at a dose of 12-16 g/m2 (mean dose of 14.4 g/m2) for 5 to 6 day continuous infusion were evaluated also for myelosuppression, nephrotoxicity, neurotoxicity, and other toxicities. Myelosuppression was acceptable, although the absolute neutrophil count of the 80% course was below 500. No patient showed neurotoxicity characterized by confusion or somnolence. No course resulted in abnormal serum creatinine elevation, although two of 46 courses caused an abnormal decrease of creatinine clearance. One patient had arrhythmia that required medical treatment after 5 courses of IFM treatment.
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PMID:[Toxic effects of ifosfamide in the treatment of bone and soft tissue sarcomas]. 845 88

A 69 year old Japanese woman was hospitalized for emergency treatment of sudden onset of tetraplegia and somnolence. The patient had a long history of occipital pain without definite diagnosis. After admission, the patient progressively developed generalized palsy including respiratory paralysis, and died of bronchopneumonia. Autopsy revealed osteosarcoma of the cervical vertebrae with the features of Paget's disease involving the skull and the cervical vertebrae. Paget sarcoma is rare in Japan, where Paget's disease of the bone is an uncommon condition. A review of the world literature failed to reveal any reports describing Paget sarcoma of the cervical vertebrae. The present report indicates that the development of Paget sarcoma in the upper cervical vertebrae may cause life-threatening neurologic complications.
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PMID:Paget sarcoma of the cervical vertebrae: an autopsy case report and review of the literature. 858 Nov 54

A mass lesion in the subependymal region of the lateral ventricle in a 13-year-old neutered male mongrel cat with a complaint of somnolence, right circling movement and posture abnormality was examined. The magnetic resonance image examination revealed a relatively large T1-hypointense and T2-hyperintense mass lesion in the left interventricular foramen region, and there were no abnormalities in the chest and abdominal x-ray radiographic, funduscopic, and electric retinogram findings. The cat was died 43 days after the initial referral, and the post-mortem examinations revealed a poorly demarcated subependymal mass. Histologically, the brain lesion consisted of complex proliferation of highly pleomorphic cells resembling histiocytes with atypia and abundant mitotic figures. Moderate infiltrates of small reactive lymphocytes were admixed with the pleomorphic cell population. Gemistcytic astrocytes were also intermingled with the periphery of neoplastic foci. Immunohistochemically, most of the pleomorphic cells were positive for HLA-DR alpha-chain and ionized calcium binding adaptor molecule 1, and few were positive for lysozyme and alpha-1 antichymotrypsin. The atypical pleomorphic cells were negative for CD3, IgG (H and L), glial fibrillary acidic protein and neurofilament, suggesting monocytic/histiocytic-origin of the cells. The number of Ki-67-positive cell nuclei was extremely large, reflecting the high growth activity of these cells. Based on the findings, the lesion was considered as histiocytic sarcoma.
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PMID:Histiocytic sarcoma in the brain of a cat. 1991 32