mercaptopurine and Testicular-Neoplasms

Topics: Adolescent; Adult; Asparaginase; B-Lymphocytes; Bacterial Infections; Child; Child, Preschool; Chromosome Aberrations; Chromosome Disorders; Diagnosis, Differential; Drug Therapy, Combination; Female; Humans; Infant; Leukemia; Leukemia, Lymphoid; Leukocyte Count; Male; Meningeal Neoplasms; Mercaptopurine; Methotrexate; Prednisolone; T-Lymphocytes; Testicular Neoplasms; Vincristine

Topics: Alkanesulfonates; Amidines; Bone Marrow Examination; Chickenpox; Child; Child, Preschool; Cyclophosphamide; Drug Therapy, Combination; gamma-Globulins; Humans; Leukemia, Lymphoid; Male; Mercaptopurine; Methotrexate; Nervous System Diseases; Phenyl Ethers; Physician-Patient Relations; Pneumonia, Pneumocystis; Prednisone; Pseudomonas Infections; Recurrence; Testicular Neoplasms; Vincristine

Topics: Asparaginase; Child; Cyclophosphamide; Cytarabine; Daunorubicin; Doxorubicin; Humans; Leukemia, Lymphoid; Male; Meninges; Mercaptopurine; Methotrexate; Neoplasm Metastasis; Prednisolone; Remission, Spontaneous; Testicular Neoplasms; Time Factors; Vincristine

Topics: Asparaginase; Bacterial Infections; Central Nervous System Diseases; Child; Child, Preschool; Cyclophosphamide; Cytarabine; Daunorubicin; Drug Synergism; Hemorrhage; Humans; Immunotherapy; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Methotrexate; Mitosis; Neoplasms, Nerve Tissue; Prednisone; Remission, Spontaneous; Testicular Neoplasms; Uric Acid; Vincristine

Topics: Alkylating Agents; Aminopterin; Chlorambucil; Choriocarcinoma; Chorionic Gonadotropin; Dactinomycin; Diet; Female; Hormones, Ectopic; Humans; Hydatidiform Mole; Hydatidiform Mole, Invasive; Isoantigens; Male; Mercaptopurine; Methotrexate; Neoplasm Metastasis; Pregnancy; Socioeconomic Factors; Testicular Neoplasms; Transplantation Immunology; Trophoblastic Neoplasms; Uterine Neoplasms; Vincristine

On study CCG-161 of the Childrens Cancer Study Group (CCSG), 631 children with acute lymphoblastic leukemia (ALL) at low risk for relapse were randomized to receive monthly pulses of vincristine-prednisone (VCR-PDN ) during maintenance therapy in addition to standard therapy with mercaptopurine (6MP) and methotrexate (MTX), and either cranial irradiation during consolidation or intrathecal (IT) MTX every 3 months during maintenance. All patients received six doses of IT MTX during induction and consolidation. With a minimum follow-up time of 4.25 years, 76.7% receiving VCR-PDN were in continuous complete remission at 5 years, in contrast to 63.9% receiving GMP-MTX alone (P = .002). The difference in relapse-free survival was due primarily to bone marrow relapse (P = .0008), and in boys also to testicular relapse (P = .003). Among the nonirradiated patients, the 5-year disease-free survival (DFS) was 79.4% for patients randomized to the VCR-PDN pulses, in contrast to 61.2% for the patients randomized to receive 6MP-MTX alone (P = .0002). Among the irradiated patients, the DFS was not significantly different. Of the four combinations of maintenance and CNS therapy studied, the highest DFS was achieved with VCR-PDN pulses and maintenance IT MTX.

Topics: Antineoplastic Combined Chemotherapy Protocols; Bone Marrow Diseases; Brain Neoplasms; Child, Preschool; Combined Modality Therapy; Drug Administration Schedule; Female; Follow-Up Studies; Humans; Injections, Spinal; Male; Mercaptopurine; Methotrexate; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Prednisone; Random Allocation; Recurrence; Remission Induction; Survival Rate; Testicular Neoplasms; Vincristine

Between 1972-1977, 92 patients with acute lymphoblastic leukemia, between 0 and 14 years of age, were treated with C2-72 and D-74 protocols. Induction treatment consisted of prednisolone (PRED)-vincristine (VCR) with the addition of daunorubicin (prot. C2-72) or asparaginase (prot. D-74). In both protocols, preventive therapy on the CNS consisted of cranial irradiation (24 Gy) and 5 doses of methotrexate i.t. (MTX). For the maintenance phase in protocol C2-72, three combinations: mercaptopurine (MP)-MTX, MP-Ara.C and MTX-cyclophosphamide, were sequentially administered for 3 years, with reinductions of PRED-VCR every three months. In protocol D-74, only MP-MTX was used for 3 years; the random half of the patients also received "reinductions". In protocol C2-72, BCG was administered by scarifications for 2 years to patients in remission after 36 months; in D-74, the random-half patients received BCG and irradiated allogeneic blasts for one year. The other half of the patients received no other treatment. The overall disease-free survival rate is 45.6% with a duration of between 84 and 156 months. Only one death occurred after 7 years. In protocol C2-72, 9 of 26 initial patients (34.6%) and in protocol D-74, 33 of 66 initial patients (50%) are still alive, off treatment and with no sign of disease. Ten patients (10.8%) died in continuous remission of infection (8) or toxic encephalopathy (2); five deaths were caused by "Pn. carinii". The incidence of meningeal relapse was 11% and isolated testicular relapse in males 15.7%; moreover, in 6 of the 22 boys in remission, programmed testicular biopsy showed interstitial leukemic infiltrates. Analysis of initial risk factors permitted the establishment of a risk index (r.i.): in cases with a r.i. below 3 (76% of cases) the survival rate was 53%; in the group with a higher r.i. (24%), it was 22%. Further conclusions of this study were: the lack of effectivity of "reinductions" and immunotherapy and proof of a higher rate of relapses in males mainly owing to isolated testicular relapse.

Topics: Adolescent; Antineoplastic Combined Chemotherapy Protocols; Asparaginase; BCG Vaccine; Child; Child, Preschool; Clinical Trials as Topic; Combined Modality Therapy; Cyclophosphamide; Cytarabine; Daunorubicin; Female; Humans; Immunotherapy; Infant; Infant, Newborn; Leukemia, Lymphoid; Male; Meningeal Neoplasms; Mercaptopurine; Methotrexate; Prednisolone; Random Allocation; Testicular Neoplasms; Vincristine

108 children with standard-risk acute lymphocytic leukaemia (ALL) were randomised to a post-induction treatment protocol including 15 doses of intermediate-dose methotrexate (1000 mg/m2) in addition to conventional oral therapy of mercaptopurine and low-dose methotrexate. After median follow-up of 26 months, 22 patients have had relapses. Among the 108 patients, rates of methotrexate systemic clearance ranged from 44.7 to 132 ml/min/m2. When the group was divided into three subgroups according to the patients' rates of methotrexate clearance, statistical analysis of the Kaplan-Meier curves estimating the probability of complete remission showed significant differences (p = 0.016) among the subgroups, patients with faster clearance having higher probability of relapse. Multivariate Cox's regression analysis incorporating other potential prognostic variables identified three significant variables influencing the risk of relapse--methotrexate clearance and white-blood-cell count and haemoglobin level at diagnosis (p = 0.0015). This study has demonstrated the potential clinical importance of the rate of drug clearance in children with ALL.

Topics: Bone Marrow Examination; Central Nervous System Diseases; Child; Clinical Trials as Topic; Drug Therapy, Combination; Female; Humans; Kinetics; Leukemia, Lymphoid; Male; Mercaptopurine; Methotrexate; Probability; Random Allocation; Recurrence; Testicular Neoplasms

Topics: Age Factors; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Asparaginase; Bone Marrow; Brain Neoplasms; Central Nervous System Diseases; Child; Child, Preschool; Clinical Trials as Topic; Drug Therapy, Combination; Female; Humans; Infant; Leukemia, Lymphoid; Leukocyte Count; Male; Mercaptopurine; Methotrexate; Prednisone; Probability; Prognosis; Random Allocation; Testicular Neoplasms; Vincristine

In a comparison of treatments for standard-risk acute lymphoblastic leukaemia in children (UKALL III), there were no differences in remission lengths between regimens with or without second-line drugs (cytosine arabinoside and asparaginase) and with continuous or discontinuous mercaptopurine. The number of infections was significantly lower when maintenance followed the less immunosuppressive modified induction period and when there were 1-week gaps each month in the administration of mercaptopurine. As in the previous trial, a higher rate of relapse in boys was found to be due partly to testicular and partly to bone marrow relapse. Cell-typing by the FAB system showed that the proportion of patients still in their first remission at 5 years was very much higher in L1 than in L2 cases.

Topics: Adolescent; Antineoplastic Agents; Asparaginase; Bone Marrow Diseases; Child; Child, Preschool; Clinical Trials as Topic; Cytarabine; Drug Administration Schedule; Drug Therapy, Combination; Female; Humans; Infant; Leukemia, Lymphoid; Male; Mercaptopurine; Neoplasm Recurrence, Local; Prognosis; Sex Factors; Testicular Neoplasms; Time Factors

Since 01.07.1993 to 30.09.2002, 640 children (48.2% girls and 51.8% boys) with ALL-SR were diagnosed and treated according to the modified ALL-BFM 90 protocol. In 29 children the treatment was intensified because of poor corticosteroid response. Subject to statistical analysis (Kaplan-Meier method) were thus 611 children with ALL-SR. Among them, 89 patients failed to respond to therapy: 10 (1.6%) early deaths, 15 (2.5%) deaths during I complete remission, 64 (10.5%) relapses. Relapses occurred: 45 (7.4%) in bone marrow, 11 (1.8%) in central nervous system, 4 (0.7%) in testicular and in 4 (0.7%) children combined relapses were observed. Probability rates for 9-year event free survival (EFS) and relapse free survival (RFS) for all patients were 0.77 (0.02) and 0.79 (0.02), respectively. Application of high dose of methotrexate is effective in prevention of relapses, especially meningeal and testicular involvement.

Topics: Adolescent; Antineoplastic Combined Chemotherapy Protocols; Asparaginase; Bone Marrow; Bone Neoplasms; Central Nervous System Neoplasms; Child; Child, Preschool; Cyclophosphamide; Cytarabine; Daunorubicin; Female; Humans; Infant; Infant, Newborn; Male; Mercaptopurine; Methotrexate; Poland; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Prednisone; Prognosis; Remission Induction; Retrospective Studies; Risk Factors; Secondary Prevention; Survival Analysis; Testicular Neoplasms; Time Factors; Treatment Outcome; Vincristine

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Histocytochemistry; Humans; Leukemia, Myeloid; Leukemia, Promyelocytic, Acute; Male; Mercaptopurine; Methotrexate; Testicular Neoplasms; Tretinoin

Topics: Antineoplastic Combined Chemotherapy Protocols; Child; Combined Modality Therapy; Cranial Irradiation; Cytarabine; Daunorubicin; Doxorubicin; Humans; Hydrocortisone; Leukemia, Monocytic, Acute; Male; Meningeal Neoplasms; Mercaptopurine; Methotrexate; Prednisone; Remission Induction; Testicular Neoplasms; Thioguanine

Between 1964 and 1982, 862 patients with acute leukemia who were collected from medical institutions throughout the country had a survival of 5 years or longer. Their remission has been achieved mainly with a combination therapy of vincristine and prednisone in childhood acute leukemia and daunomycin, cytosine arabinoside, 6-mercaptopurine, prednisone (DCMP) regimen in adult acute leukemia. Among 320 relapsed patients, 88 (38.8%) of 227 children had a primary relapse in the marrow, 85 in the central nervous system (CNS), 37 in the testis/ovary, and 13 in a combined site. The large majority of adult relapsed patients relapsed in the marrow. Ninety-three patients who experienced only one relapse had a much longer prolongation of survival, not yet reaching a median over 14 years after diagnosis, compared to those experiencing two or more relapses. Survival curves in five groups of patients divided by length of maintained remission were investigated by the life table method. In children as well as adults, survival duration in patients on 5 or more years maintained remission was significantly longer than that in the other maintained groups. With respect to relation between frequency of CNS relapse and type of CNS prophylaxis, there was no statistically significant difference between patients who received CNS prophylaxis and patients who did not. However, a better survival was observed in patients who received CNS prophylaxis with cranial radiation plus intrathecal methotrexate. Thus, long-term clinical follow-up might provide important information for the therapeutic strategy against acute leukemia.

Topics: Actuarial Analysis; Acute Disease; Adolescent; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Bone Marrow Diseases; Child; Child, Preschool; Cytarabine; Daunorubicin; Female; Health Surveys; Humans; Infant; Japan; Leukemia; Leukemia, Lymphoid; Male; Mercaptopurine; Middle Aged; Nervous System Neoplasms; Prednisolone; Recurrence; Testicular Neoplasms

The incidence of testicular infiltrates in 68 boys with acute lymphoblastic leukemia in first remission (1974-81), was prospectively investigated through careful clinical exams and routine bilateral biopsies at 2-3 years of remission. All boys were under 14 years of age and they were treated with protocols D.74 and pethema 7/78. Seven patients (10.3%) presented an isolated testicular relapse (ITR) during the chemotherapy period. In 13 out of the 43 testicular biopsies (31%) leukemic infiltrates were found and in other 2 findings were controversial. Three boys, two of them whose previous biopsy was negative, had an ITR, 6 to 18 months after stopping therapy. Finally, other 3 had simultaneous relapses in testes and bone-marrow: one during chemotherapy and two after suppression. In total, 23 patients (33.8%) in first remission had overt or occult ITR. Overall incidence of testes leukemia, is calculated to be 40% in all the group. Incidence of early and occult ITR was higher in boys with initial WBC counts over 20 X 10 9/l. Therapy in ITR generally consisted in local radiotherapy (20-25 Gy), a new induction treatment followed by 2 year maintenance treatment; in 3 patients with early ITR, orchidectomy was also performed and six were given a new preventive SNC treatment. Clinical course in the 7 patients with early ITR was unfavourable in 5 with subsequent hematological relapses and death; one had a long-term disease-free survival (78 + months) and the other was a recent case. 10 out of the 13 patients with occult infiltrates followed in remission and four were of treatment with a follow-up over 64 months. The 3 patients with late ITR were in second remission at 8-14 months after a new cessation of therapy. It may be concluded from this study that prognosis in ITR is related to the phase of presentation: It is unfavourable in cases of early ITR but in cases of occult infiltrates detected by routine biopsies and in late ITR the combined therapy is effective in most cases.

Topics: Adolescent; Antineoplastic Combined Chemotherapy Protocols; Asparaginase; Bone Marrow; Child; Child, Preschool; Combined Modality Therapy; Humans; Infant; Leukemia, Lymphoid; Male; Mercaptopurine; Methotrexate; Prednisone; Spain; Testicular Neoplasms; Testis; Time Factors; Vincristine

A 65-year-old male visited the Sawara Hospital with the chief complaint of right intrascrotal mass. The mass without tenderness, in which right testis and spermatic cord appeared to be involved, reached the right inguinal region. Right high orchiectomy was performed under the diagnosis of a testicular tumor. Histological diagnosis was malignant lymphoma. Intravenous pyelogram revealed right hydronephrosis and 67Ga-scintigram showed an abnormal accumulation of radioisotopes in the pelvic and paraaortic region. Chemotherapy with vincristine, cyclophosphamide, 6-mercaptopurine and prednisolone was performed under the diagnosis of stage IV lymphoma. Two months after chemotherapy, right hydronephrosis disappeared and no abnormal accumulation in 67Ga-scintigram was found. He has been doing well three months after treatment.

Topics: Aged; Castration; Cyclophosphamide; Gallium Radioisotopes; Humans; Lymphoma; Male; Mercaptopurine; Prednisolone; Testicular Neoplasms; Vincristine

This is a review of the progress achieved in the treatment of acute lymphoblastic leukaemia, based on a series of 1580 children treated in Prof. Jean Bernard's unit, Paris, from 1956 to 1976. The children are retrospectively divided into three prognostic classes and five therapeutic categories. The benefits obtained from successive additions to the therapeutic armentarium during that period are conspicuous in all classes and categories and particularly striking in children with poor initial prognosis. The role of each component of the therapeutic measures applied is discussed.

Topics: Adolescent; Child; Child, Preschool; Cyclophosphamide; Daunorubicin; Humans; Infant; Leukemia, Lymphoid; Male; Meningeal Neoplasms; Mercaptopurine; Methotrexate; Prednisone; Testicular Neoplasms; Vincristine

Report on a case of acute childhood leukemia, who presents with the following exceptional features: During complete remission early bilateral leukemic infiltrations of the testes, followed--after an intervall of several months--by a serve, general relapse with ascites. New induction therapy resulted in a second complete remission, persisting for the next 8 years with 6MP as well as after cessation of therapy until up to more than 17 years. Comparable courses are not as yet on record.

Topics: Acute Disease; Adolescent; Adult; Blood Transfusion; Child; Child, Preschool; Humans; Leukemia; Male; Mercaptopurine; Methotrexate; Prednisone; Remission, Spontaneous; Splenomegaly; Testicular Neoplasms

Topics: Adolescent; Adult; Antineoplastic Agents; Choriocarcinoma; Cyclophosphamide; Dactinomycin; Female; Follow-Up Studies; Head and Neck Neoplasms; Hemangiosarcoma; Humans; Infant; Lung Neoplasms; Male; Mechlorethamine; Mercaptopurine; Methotrexate; Middle Aged; Neoplasm Metastasis; Pregnancy; Prostatic Neoplasms; Sarcoma; Teratoma; Testicular Neoplasms; Thoracic Neoplasms; Thyroid Neoplasms; Triaziquone; Uterine Neoplasms; Vinblastine

Topics: Breast Neoplasms; Cobalt Isotopes; Cyclophosphamide; Dactinomycin; DNA, Neoplasm; Female; Humans; Male; Mercaptopurine; Methotrexate; Neoplasm Metastasis; Neoplasms; Prednisone; Radiotherapy Dosage; RNA, Messenger; Testicular Neoplasms

Topics: Antineoplastic Agents; Busulfan; Carcinoma, Squamous Cell; Child; Chlorambucil; Choriocarcinoma; Dactinomycin; Female; Fluorouracil; Gonadal Steroid Hormones; Hodgkin Disease; Humans; Hydrazines; Leukemia; Lymphoma, Large B-Cell, Diffuse; Lymphoma, Non-Hodgkin; Male; Mercaptopurine; Mesenchymoma; Methotrexate; Multiple Myeloma; Nitrogen Mustard Compounds; Ovarian Neoplasms; Pregnancy; Prostatic Neoplasms; Steroids; Testicular Neoplasms; Urethane; Vinblastine; Vincristine; Wilms Tumor

Topics: Adult; Choriocarcinoma; Chorionic Gonadotropin; Humans; Male; Mercaptopurine; Methotrexate; Neoplasm Metastasis; Teratoma; Testicular Neoplasms

Topics: Adult; Antibiotics, Antineoplastic; Antimetabolites; Chlorambucil; Choriocarcinoma; Dactinomycin; Dysgerminoma; Humans; Male; Mercaptopurine; Methotrexate; Middle Aged; Neoplasm Metastasis; Teratoma; Testicular Neoplasms