Adjuvant treatment of high-risk breast cancer using multicycle high-dose chemotherapy and filgrastim-mobilized peripheral blood progenitor cells

Women with primary breast cancer associated with extensive axillary node involvement or large primary tumors have a very poor prognosis despite treatment with standard-dose adjuvant chemotherapy. In an attempt to improve the outlook of these patients, we investigated the safety and feasibility of delivering three cycles of high-dose epirubicin and cyclophosphamide supported with filgrastim-mobilized peripheral blood progenitor cells (PBPC). Fifteen previously untreated women, median age 50 (range, 30-58) years, with poor prognosis early stage breast cancer received filgrastim (12 microgram/kg daily for 6 days) prior to chemotherapy to mobilize progenitor cells. Patients were then given three cycles of epirubicin (200 mg/m2) and cyclophosphamide (4 g/m2) at planned 28-day intervals, each followed by infusion of one third of the PBPC collected and daily administration of filgrastim (5 microgram/kg s.c.). Three leukaphereses collected a median of 114.9 (range, 22.7-273.5) x 10(4) granulocyte-macrophage-colony-forming cells/kg body weight. Hemopoietic recovery was rapid after each cycle, and there was no correlation between the rate of recovery and the number of granulocyte-macrophage-colony-forming cells infused. There was a small but significant progressive delay in recovery from hematological and nonhematological toxicities across the three cycles. Left ventricular ejection fraction fell to below 50% in eight (53%) patients, but none developed congestive cardiac failure. Two patients did not complete three cycles because of insufficient PBPC for a third cycle (n = 1) and 2-mercaptoethane sodium sulfonate- related drug reaction during the second cycle (n = 1). There were no deaths during the study or during the follow-up period (median, 70 weeks; range, 50-85 weeks), and no late toxicities occurred. Therefore, we concluded that the delivery of multiple cycles of nonmyeloablative, dose-intensive chemotherapy supported by PBPC and filgrastim is safe, and may be widely applicable to a variety of common chemosensitive cancers with a poor prognosis. The efficacy of three cycles of high-dose epirubicin and cyclophosphamide is to be compared with standard-dose chemotherapy in a randomized trial in patients with high-risk, operable stage II and III breast cancer.     

Kinetics of humoral response in children with acute lymphoblastic leukemia immunized with influenza vaccine in 1993 in Poland

Songbirds exhibit seasonal changes in the volumes of song control nuclei. Birds on long, spring-like days have larger nuclei than do birds on short, winter-like days. The mechanisms mediating volumetric changes have not been determined unequivocally, but testosterone (T) is probably involved. This study examined whether testicular factors are uniquely responsible for seasonal changes in the song system, or whether photoperiod has testis-independent effects. Male American tree sparrows were exposed to one of three photoperiodic conditions: (1) Photosensitive birds were retained on short days (8L:16D). Plasma T is rarely detected in such birds. (2) Photosensitive birds were moved from short days to long days (20L:4D) and photostimulated for three weeks. Photostimulation elevates circulating T in photosensitive birds. (3) Photorefractory birds were held at least four months on 20L:4D. Such birds seldom have detectable levels of T, even though they are on long days. In each condition, there were both intact and castrated birds. Castration typically removes circulating T in tree sparrows. The volumes of the high vocal center (HVC), nucleus robustus archistriatalis (RA), and area X were measured. Song nuclei were largest in intact photostimulated birds. Other long-day birds (i.e. castrated photostimulated, and intact and castrated photorefractory groups) had larger song nuclei than did short-day intact or castrated photosensitive birds and did not differ from each other. These data indicate that photoperiod has both testis-dependent and -independent effects on the volumes of song control nuclei.     

联产二氯乙酸和巯基乙酸的研究

以氯乙酸母液为原料 ,采用硫代硫酸钠法将其转化为二氯乙酸和巯基乙酸 ,在反应温度 70℃ ,母液中一氯乙酸与硫代硫酸钠物质的量比为 1∶1,反应时间 4.5h ,还原用锌粉量为 8g,最佳反应条件下 ,可得到质量分数为 98.6 %的二氯乙酸 ,收率达 93% ;同时获得收率为 88%的巯基乙酸