melphalan and Abdominal-Neoplasms

Topics: Abdominal Neoplasms; Antineoplastic Agents; Cisplatin; Clinical Trials as Topic; Cytarabine; Doxorubicin; Evaluation Studies as Topic; Fluorouracil; Humans; Injections, Intraperitoneal; Liver; Mathematics; Melphalan; Methotrexate; Peritoneum

Topics: Abdominal Neoplasms; Alkylating Agents; Animals; Antimetabolites; Antineoplastic Agents; Carcinoma, Basal Cell; Choriocarcinoma; Cyclophosphamide; Dactinomycin; Dysgerminoma; Female; Fluorouracil; Head; Head and Neck Neoplasms; Hodgkin Disease; Humans; Injections, Intra-Arterial; Leg; Melanoma; Melphalan; Methotrexate; Neoplasm Metastasis; Neoplasm Recurrence, Local; Neoplasms; Nitrogen Mustard Compounds; Pregnancy; Sarcoma; Sarcoma, Ewing; Skin Neoplasms; Vinblastine; Wilms Tumor

To evaluate long-term survival of the first cohort of stage-4 neuroblastoma patients treated with the N7 induction chemotherapy, surgery of the primary tumor and high-dose chemotherapy (HDC) containing Busulfan-Melphalan (Bu-Mel) followed by autologous stem cell transplantation (ASCT).. From 1998 to 1999, 47 children were included in the NB97 trial and treated with induction chemotherapy according to the N7 protocol, followed by surgery of the primary tumor. HDC (Busulfan, 600 mg/m(2) Melphalan, 140 mg/m(2) ) was administered in patients with partial response of metastases with no more than 3 mIBG spots. Radiotherapy was delivered to the primary tumor site when tumors displayed MYCN amplification.. Thirty-nine patients received Bu-Mel (83%): 23 who had achieved complete response (CR) of metastases, 20 after induction treatment and 3 after second-line chemotherapy, and 16 in partial response (PR). The toxicity of the whole treatment was manageable. The main HDC related-toxicity was hepatic veno-occlusive disease grade > 2 occurring in 15% of the patients. The 8-year EFS of the whole cohort was 34% (95% CI, 22-48%). The 8-year EFS of the 39 patients who received Bu-Mel and ASCT was 41% (95% CI, 27-57%). Patients who achieved a CR of metastases at the end of induction chemotherapy had a significantly better outcome than the others (8-year EFS, 52% vs. 20%; P = 0.02).. The long-term results of this first prospective cohort of patients with metastatic disease treated with the N7 induction chemotherapy and HDC (Bu-Mel) confirm published data with stable survival curves but with a longer follow-up.

Topics: Abdominal Neoplasms; Antineoplastic Combined Chemotherapy Protocols; Busulfan; Child; Child, Preschool; Combined Modality Therapy; Consolidation Chemotherapy; Disease-Free Survival; Follow-Up Studies; Gene Amplification; Genes, myc; Hematopoietic Stem Cell Transplantation; Hepatic Veno-Occlusive Disease; Humans; Infant; Kaplan-Meier Estimate; Melphalan; Myeloablative Agonists; Neuroblastoma; Proportional Hazards Models; Remission Induction; Thoracic Neoplasms; Transplantation Conditioning; Transplantation, Autologous; Treatment Outcome

Topics: Abdominal Neoplasms; Antineoplastic Agents; Cisplatin; Clinical Trials as Topic; Cytarabine; Doxorubicin; Evaluation Studies as Topic; Fluorouracil; Humans; Injections, Intraperitoneal; Liver; Mathematics; Melphalan; Methotrexate; Peritoneum

Isolated limb perfusion (ILP) is an established and effective treatment for advanced melanoma and soft tissue sarcomas of the extremities with a high overall response rate. The aim of this study was to describe our experience of ILP for more rare types of tumours.. Patients with Merkel cell carcinoma (MCC) (n = 4), squamous cell carcinoma (SCC) (n = 2), B-cell lymphoma (n = 1), desmoid tumours (n = 3), pigmented villonodular synovitis (PVNS) (n = 1) and giant cell tumour (n = 1) were treated with ILP and analysed retrospectively.. The four patients with in-transit MCC had three complete responses (CR) and one partial response (PR); the two patients with SCC had one CR and one stable disease (SD); the patients with desmoid tumours had two PR and one SD. A CR was also observed for the patient with a giant cell tumour, but the patient with PVNS had a SD. The patient with cutaneous metastases of B-cell lymphoma showed a CR, however with rapid systemic progression. Local toxicity according to Wieberdink was grade II in 10 patients (83%) and grade III in two patients (17%).. These results show that ILP can be used as a treatment option also for more rare disease entities when other treatments have failed.

Topics: Abdominal Neoplasms; Adenomatous Polyposis Coli; Antineoplastic Agents, Alkylating; Carcinoma, Merkel Cell; Carcinoma, Squamous Cell; Chemotherapy, Cancer, Regional Perfusion; Extremities; Fibromatosis, Aggressive; Giant Cell Tumors; Humans; Hyperthermia, Induced; Lymphoma, B-Cell; Melphalan; Perfusion; Rare Diseases; Synovitis, Pigmented Villonodular; Tumor Necrosis Factor-alpha

Topotecan is an active drug in relapsed neuroblastoma. We investigated the efficacy and toxicity of a topotecan-based induction regimen in newly diagnosed neuroblastoma.. Patients older than 1 year with either metastatic or localised stage 2-3 MYCN-amplified neuroblastoma received 2 courses of high-dose topotecan (HD-TPT) 6mg/m(2) and high-dose cyclophosphamide (HD-CPM) 140 mg/kg, followed by 2 courses of ifosfamide, carboplatin and etoposide (ICE) every 28 days. After surgery on primary tumour, a fifth course with vincristine, doxorubicin and CPM was given, followed by high-dose chemotherapy with stem cell support. Response was assessed in accordance with the International Neuroblastoma Response Criteria.. Of 35 consecutive patients, 33 had metastatic disease. The median length of induction phase was 133 days (range 91-207) and time to high-dose chemotherapy was 208 days (range 156-285). The median tumour volume reduction was 55% after two HD-TPT/HD-CPM courses and 80% after four courses. Radical surgery was performed in 16/27 patients after chemotherapy. After the fifth course, 29/34 patients (85%) had achieved a partial remission (12) or a CR/very good partial remission (17). CR of metastases was achieved in 13/32 (41%) and bone marrow was in complete remission in 16/24 patients (67%). Grade 4 neutropenia and/or thrombocytopenia occurred in 100% of HD-TPT/HD-CPM and in 95% of ICE courses, while non-haematological toxicities were manageable.. These data indicate that our induction regimen is feasible and well tolerated. A major response rate of 85% with 41% complete metastatic response confirms this regimen as effective induction in high-risk neuroblastoma.

Topics: Abdominal Neoplasms; Adolescent; Antineoplastic Combined Chemotherapy Protocols; Carboplatin; Child; Child, Preschool; Etoposide; Female; Humans; Ifosfamide; Infant; Kaplan-Meier Estimate; Lomustine; Male; Melphalan; Mesna; Neuroblastoma; Pilot Projects; Risk Factors; Thoracic Neoplasms; Topotecan; Treatment Outcome

The local control of neuroblastoma is a very important treatment consideration. We describe a patient who received high-dose rate 60Co remote after loading system treatment for local control of recurrent neuroblastoma and discuss the efficacy of high-dose rate 60Co remote after loading system treatment.

Topics: Abdominal Neoplasms; Antineoplastic Combined Chemotherapy Protocols; Brachytherapy; Busulfan; Carboplatin; Cisplatin; Cobalt Radioisotopes; Combined Modality Therapy; Cord Blood Stem Cell Transplantation; Cyclophosphamide; Cytarabine; Doxorubicin; Etoposide; Humans; Ifosfamide; Infant; Male; Melphalan; Neoadjuvant Therapy; Neoplasm Recurrence, Local; Neuroblastoma; Peripheral Blood Stem Cell Transplantation; Radiotherapy Dosage; Radiotherapy, Adjuvant; Remission Induction; Vidarabine; Vincristine

Addition of tumour necrosis factor-alpha (TNF) to hypoxic abdominal perfusion (HAP) and hypoxic pelvic perfusion (HPP) with chemotherapeutic agents for treatment of un-resectable malignancies may lead to similar enhanced anti-tumour effects as are observed when TNF is added to isolated limb perfusions (ILP) with Melphalan. Here, we validate the methodology of HAP and HPP using balloon catheter techniques, and investigate the distribution of TNF, Melphalan and Mitomycin C (MMC) over the regional and systemic blood compartments when applying these techniques.. Twelve pigs underwent HAP or HPP with TNF, Melphalan and MMC for 20 min. Throughout and after the procedures blood samples were obtained from hepatic, portal and systemic blood compartments and plasma concentrations of perfused agents were determined.. We demonstrated that HAP and HPP result in temporary loco-regional concentration advantages of all perfused agents, although from start of perfusion significant systemic leakage occurred.. On basis of these results it seems that the advantage in terms of regional plasma concentration of TNF may be insufficient for TNF-mediated effects to occur, making future addition of this cytokine to these procedures in the clinical setting questionable. The observed regional concentration advantages of MMC and Melphalan, however, warrant further studies on clinical application of these agents in both settings.

Topics: Abdominal Neoplasms; Animals; Antineoplastic Agents; Balloon Occlusion; Chemotherapy, Cancer, Regional Perfusion; Hypoxia; Melphalan; Mitomycin; Models, Animal; Pelvic Neoplasms; Swine; Tumor Necrosis Factor-alpha

Solitary plasmacytomas include extramedullary plasmacytomas and those found in the bone. Seventy percent of patients are male and the median age is 50-55 years, younger than that for plasma cell myeloma. Most solitary plasmacytomas of bone eventually evolve to plasma cell myeloma within 2-10 years, while the extramedullary ones do so infrequently. We present an unusual case of intra-abdominal plasmacytoma in a young woman which was misdiagnosed and treated as T cell lymphoma initially. Typical manifestations of plasma cell myeloma appeared one year later. High dose chemotherapy followed by allogeneic peripheral stem cell blood transplantation (allo-PBSCT) was given. Relapse in skin occurred one year after allo-PBSCT, and was treated with wide excision and local irradiation. The patient was well and alive without evidence of disease 4 years after wide excision of the recurrence of chest wall solitary plasmacytoma and local radiotherapy.

Topics: Abdominal Neoplasms; Adult; Combined Modality Therapy; Female; Hematopoietic Stem Cell Transplantation; Humans; Melphalan; Multiple Myeloma; Plasmacytoma; Prednisolone; Transplantation, Homologous

Topics: Abdominal Neoplasms; Antineoplastic Combined Chemotherapy Protocols; Ascites; Cell Division; Cisplatin; Combined Modality Therapy; Female; Fluorouracil; Humans; Hyperthermia, Induced; Infusions, Parenteral; Male; Melphalan; Middle Aged; Mitomycin; Perfusion; Survival Rate

Topics: Abdominal Neoplasms; Antineoplastic Combined Chemotherapy Protocols; Breast Neoplasms; Chemotherapy, Cancer, Regional Perfusion; Cisplatin; Doxorubicin; Female; Fluorouracil; Humans; Hypoxia; Melphalan; Mitomycin

We initiated in February 1982 a pilot study of high dose melphalan (HDM) and ABMT as consolidation treatment for ovarian carcinoma. Eleven patients entered into this study; 6 patients received HDM and ABMT (group 1), 5 patients received HDM in combination with flash abdominal radiotherapy followed by ABMT (group 2). Two of 6 group 1 patients and 3 of 5 group 2 patients are still alive with NED more than 3 years after ABMT (58+, 72+, 37+, 39+, 43+) and are hopefully cured. Main toxicity was haematological, we have not observed any death related to therapy. HDM and ABMT compared favorably with other consolidation treatments (abdominopelvic radiotherapy or IP chemotherapy) and merits a larger evaluation.

Topics: Abdominal Neoplasms; Adult; Bone Marrow Diseases; Bone Marrow Transplantation; Combined Modality Therapy; Cystadenocarcinoma; Female; Humans; Melphalan; Middle Aged; Ovarian Neoplasms; Ovariectomy; Prognosis; Remission Induction; Transplantation, Autologous

Among 62 children over 1 year of age at diagnosis, who were treated for stage IV neuroblastoma, 33 entered complete remission (CR) or good partial remission (GPR) after conventional therapy and received high-dose chemotherapy (HDC) with in vitro purged autologous bone marrow transplantation (ABMT) as consolidation therapy. The HDC was a combination of carmustine (BCNU), teniposide (VM-26), and melphalan. Thirty-three patients received one course of this regimen, and 18 received two courses. At present, 16 of the 33 grafted patients are alive in continuous CR, with a median follow-up of 28 months. Toxicity of this regimen was tolerable, principally marked by bone marrow depression and gastrointestinal (GI) tract complications. Four complication-related deaths were observed. Relapse post-ABMT occurred most often in the bone marrow. Under this treatment, actuarial disease-free survival is improved compared with that observed under conventional therapy.

Topics: Abdominal Neoplasms; Adolescent; Antineoplastic Combined Chemotherapy Protocols; Bone Marrow Diseases; Bone Marrow Transplantation; Carmustine; Child; Child, Preschool; Cisplatin; Combined Modality Therapy; Cyclophosphamide; Doxorubicin; Etoposide; Gastrointestinal Diseases; Humans; Infant; Infections; Melphalan; Neuroblastoma; Teniposide; Thoracic Neoplasms; Transplantation, Autologous; Vincristine

A patient with ovarian carcinoma who subsequently developed the paraneoplastic syndrome of cerebellar degeneration is presented. The literature is reviewed and possible explanations of the phenomenon are discussed.

Topics: Abdominal Neoplasms; Adenocarcinoma, Papillary; Autopsy; Cerebellar Diseases; Combined Modality Therapy; Female; Humans; Melphalan; Middle Aged; Neurologic Examination; Ovarian Neoplasms; Paraneoplastic Syndromes; Physical Therapy Modalities; Thiamine

Neuroblastoma and Ewing's sarcoma are examples of pediatric cancers in which disseminated disease is often present at diagnosis or develops later in spite of combination therapy. The demonstration that marrow-ablative doses of chemotherapy can increase tumor cell kill, and that autologous bone marrow can be cryopreserved and reinfused into the patient to reverse such marrow ablation, has stimulated interest in this approach to refractory childhood cancers. We present results of treating eighteen patients with recurrent neuroblastoma and Ewing's sarcoma resistant to conventional therapy. We used supralethal doses of melphalan, supported by reinfusion of previously cryopreserved autologous bone marrow. Seven of 10 neuroblastoma and six of eight Ewing's sarcoma patients had complete or partial responses, lasting for a median of 6 months (neuroblastoma) and 3 months (Ewing's sarcoma). Prolonged hospitalization, pancytopenia complicated by sepsis, and reversible gastrointestinal toxicity were the major side effects. These results suggest this approach should be tested in therapeutic trials at an earlier disease stage in children who have cancers with a predictably bad prognosis.

Topics: Abdominal Neoplasms; Adolescent; Adult; Bone Marrow Transplantation; Bone Neoplasms; Child; Child, Preschool; Combined Modality Therapy; Gastrointestinal Diseases; Humans; Melphalan; Neoplasm Recurrence, Local; Neuroblastoma; Pancytopenia; Sarcoma, Ewing; Transplantation, Autologous

Topics: Abdominal Neoplasms; Adenocarcinoma, Papillary; Aged; Alkylating Agents; Ascitic Fluid; Chromosomes; Female; Humans; Hydroxyprogesterones; Karyotyping; Melphalan; Methods; Neoplasm Metastasis; Neoplastic Cells, Circulating; Ovarian Neoplasms

Topics: Abdominal Neoplasms; Angiography; Breast Neoplasms; Geriatrics; Gold; Humans; Injections; Iodine Isotopes; Leukemia; Lymphatic Metastasis; Lymphatic System; Lymphography; Lymphoma; Lymphoma, Non-Hodgkin; Melanoma; Melphalan; Methotrexate; Neoplasms; Radioisotopes; Radionuclide Imaging; Retroperitoneal Neoplasms; Scandium; Thiotepa; Yttrium