Harold R. Silberman

Allopurinol in the Treatment of Gout

Excerpt Allopurinol, 4-hydroxypyrazolo (3,4-d) pyrimidine (4-HPP),*recently introduced as a new type of agent useful in the treatment of gout, developed from studies undertaken to increase the ther...

Treatment of acute myelogenous leukemia: influence of three induction regimens and maintenance with chemotherapy or BCG immunotherapy.

The effect of a synchronizing‐recruiting drug schedule vs. myelotoxic therapy on remission rate and of Bacillus Calmette‐Guerin on remission duration and survival of adults with acute myelogenous leukemia were studied in a prospective cooperative trial. After randomized remission induction with Arabinosyl Cytosine + vincristine + methotrexate + leucovorin (AVML), thioguanine + Ara‐C + Daunorubin (TAD), or Daunorubicin + Ara‐C (DA), complete remissions (CR) were consolidated with TAD or AVML, CRs were maintained with BCG vaccination (Tice strain) by the tine technique, or BCNU plus Ara‐C (B/A), or no further therapy (NFT). Of 209 evaluable TAD patients, 105 (50%) achieved CR; of 187 DA, 97 (52%) achieved CR. AVML yielded only 15 CR among 59 patients (25%). The time to remission was significantly shorter with DA compared with TAD. Ninety‐seven patients were randomized to maintenance therapy (35 B/A, 30 BCG, 32 NFT). There were no differences in remission duration (7, 8, 6 months) or survival (16, 22, 16 months, respectively). Manipulation of the cell cycle, as employed in this study, was not helpful. There may be a marginal effect of BCG, but our data fail to show a statistically significant benefit.

Phase III study of BCOP v CHOP in unfavorable categories of malignant lymphoma: a Southeastern Cancer Study Group trial.

A total of 296 evaluable patients with unfavorable categories of malignant lymphoma were randomly assigned treatment with cyclophosphamide, vincristine, and prednisone plus BCNU (BCOP) or doxorubicin (CHOP). In diffuse histiocytic (DH) lymphoma, CHOP produced superior complete (54% v 34%) and total (70% v 46%) response rates. Among the responders to either therapy, no differences were seen in duration of response or survival times. Median duration of response has not been reached with follow-up in excess of 50 months. In categories of lymphoma other than DH (including small-cell, mixed, and nodular histiocytic lymphomas), complete (27% v 29%) and total (48% v 54%) responses were similar for BCOP and CHOP, as were durations of response and survival. These data suggest that BCOP and CHOP are equivalent regimens for other categories of malignant lymphomas. CHOP appears preferable for diffuse large-cell categories, since it resulted in greater overall survival in patients with DH lymphoma; this was due to a significantly greater response rate, since patients with DH lymphoma who did respond to BCOP maintained their response and survived as long as did the CHOP responders.

Effects of Xanthine Oxidase Inhibitor on Clinical Manifestations and Purine Metabolism in Gout.

Excerpt A series of pyrazolopyrimidines synthesized some years ago as potential purine antagonists were found to be active in suppressing the growth of bacteria, fungi, tumor cells in culture, and ...