John J. Costanzi

The nephrotic syndrome associated with neoplasia: An unusual paraneoplastic syndrome: Report of a case and review of the literature

The nephrotic syndrome complicating malignancy in the absence of renal vein thrombosis, amyloid or neoplastic infiltration of the kidney is an unusual occurrence. A case of diffuse, well differentiated, lymphocytic lymphoma and lipoid nephrosis documented by light microscopy, electron microscopy and immunofluorescent studies is reported. A review of the literature revealed 76 case reports in which the nephrotic syndrome was associated with neoplasia. The most frequently associated neoplasms are Hodgkins disease, various carcinomas, nonHodgkins lymphoma and leukemia in descending order. The most frequent renal lesion in patients with the nephrotic syndrome associated with various carcinomas is membranous glomerulonephritis (81 per cent) as opposed to patients with lymphomas or leukemias who have predominantly lipoid nephrosis (60 per cent). The evidence is reviewed suggesting that the lesions in membranous nephropathy are immunologically mediated by tumor or viral antigen-antibody complexes and in lipoid nephrosis perhaps by a defect in t-lymphocyte function.

Cis-Diamminedichloroplatinum in the Treatment of Advanced Epidermoid Carcinoma of the Penis: A Southwest Oncology Group Study

A total of 26 patients with biopsy proved epidermoid carcinoma of the penis (Jackson stage III or IV) with measurable disease, no prior chemotherapy and adequate renal function received 50 mg. per M.2 cis-diamminedichloroplatinum intravenously on days 1 and 8 of 28-day cycles. There were 4 partial responses (15.4 per cent), with a response duration of 1 to 3 months. The median survival was 4.7 months. This agent cannot be recommended as treatment for advanced epidermoid carcinoma of the penis using this particular dose and schedule.

Adjuvant chemotherapy with cyclophosphamide, methotrexate, and 5-fluorouracil, vincristine, and prednisone compared with single-agent L-phenylalanine mustard for patients with operable breast carcinoma and positive axillary lymph nodes: 20-year results of a southwest oncology group study

Adjuvant combination chemotherapy with cyclophosphamide, methotrexate, and 5‐fluorouracil plus vincristine and prednisone (CMFVP) was compared with single‐agent L‐phenylalanine mustard (L‐PAM) for the treatment of patients with axillary lymph node positive primary breast carcinoma over 20‐years of follow‐up.

Rubidazone in combination with Ara-C, vincristine and prednisone (ROAP) in the treatment of adult acute leukemia. A Southwest Oncology Group Study

IN AN 18-MONTH PERIOD, 340 consecutive adult patients with acute leukemia were treated using a 7-day continuous infusion of Ara-C in combination with rubidazone, vincristine and prednisone (ROAP). Of 334 (96%) evaluable cases, 77% were 50 years of age or older. The complete remission (CR) rate was 51% with a standard error of 3%. After adjustment for known prognostic factors this overall CR rate is 10% higher than the predicted CR rate when compared to the last completed SWOG study which used adriamycin in combination with a similar regimen of Ara-C, vincristine, and prednisone. The CR rate in patients over 50 years of age was particularly noteworthy. Using rubidazone, the CR rate was 46.1% (116/256) compared to 37.4% (91/243) for the adriamycin study in this poorly responding age group. The median survival time achieved was 27 weeks. However, in the age groups 40–49 years and 50–59 years the median survival was 70 and 44 weeks, respectively.