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Dive into the research topics where Mariana Eppinger-Helft is active.

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Featured researches published by Mariana Eppinger-Helft.


Cancer | 1974

Evaluation of induction of remission, intensification, and central nervous system prophylactic treatment in acute lymphoblastic leukemia†

Federico Sackmann Muriel; Santiago Pavlovsky; Jorge Peñalver; Guillermo Hidalgo; Angela Cebrian Bonesana; Mariana Eppinger-Helft; Graciela H. de Macchi; Alfredo Pavlovsky

A total of 146 previously untreated acute lymphoblastic leukemia patients—126 children and 20 adults—has been studied prospectively in order to evaluate the relative efficacy and toxicity of: A) two induction of remission treatments (Group A: Daunorubicin‐vincristine‐prednisone vs. Group B: Adriamycin‐vincristine‐prednisone) and the use of the same drugs as reinforcement courses every 90 days during the 1st year of complete remission and every 180 days thereafter; B) the use of a short course of L‐asparaginase early in remission as intensification treatment (to half of Group A only (Group Aa); Groups Ab and B did not receive this treatment); and C) the use of 2400 rads cobalt‐60 irradiation to cranium coupled with five doses of intrathecal methotrexate as prophylactic CNS treatment. Complete remission was achieved in 85.7% of 112 cases of Group A and in 79.4% of 34 cases of Group B. The median duration of hematologic remission was 23, 21, and 22 months for Groups Aa, Ab, and B respectively. Toxicity was about the same for all regimens. The median duration of complete remission was 24 months, and of hematologic remission 27 months in the CNS prophylactically treated group, against 9 and 18 months, respectively, for the non‐treated group. We have concluded that: A) Adriamycin did not seem to be any better than Daunorubicin in inducing or prolonging complete remission when used in combination with vincristine and prednisone, either as induction treatment or in reinforcement courses; B) we did not demonstrate any significant difference in duration of remission, incidence, or site of relapse between L‐asparaginase‐treated and non‐treated patients; and C) the CNS prophylactic treatment employed in this trial is very effective in preventing CNS relapse, although it does not seem to prevent hematologic relapse.


Cancer | 1973

Induction and maintenance of remission in acute leukemia

Santiago Pavlovsky; Jorge Peñalver; Mariana Eppinger-Helft; Federico Sackmann Muriel; Luis J. Bergna; Argimiro Suárez; Guillermo Vilaseca; Alberto Andino Pavlovsky; Alfredo Pavlovsky

A total of 227 patients—124 with acute lymphoblastic leukemia (ALL) and 103 with acute myeloblastic leukemia (AML)—have been studied in order to evaluate the therapeutic effectiveness of vincristine, daunorubicin, and prednisone for induction followed by consolidation courses every 6 months with these drugs and either 6‐mercaptopurine and methotrexate (plan A) or methotrexate alone (plan B) for maintenance of remission. In ALL, complete remission (CR) was achieved in 90.2% of untreated and 71.6% of previously treated patients. In AML, 34.8% untreated and 23.5% previously treated patients obtained CR. There was no statistically significant difference between the two maintenance regimens. Median duration of hematologic remission in ALL was 16 months and that of complete remission terminating in either meningeal, visceral, or bone marrow relapse was 9 months. Median survival was 18.2 months. In AML, the median survival was 11.8% months for those that achieved CR, 4.2 months for the partial remission (PR) group, and 0.9 months for nonresponders.


Cancer | 1978

Evaluation of intensification and maintenance programs in the treatment of acute lymphoblastic leukemia.

Federico Sackmann-Muriel; Eva Svarch; Mariana Eppinger-Helft; Jorge Braier; Santiago Pavlovsky; Liliana Guman; Berta Vergara; Carlos Ponzinibbio; Renato Failace; Guy Garay; Enrique Bugnard; Félix G. Ojeda; Roberto de Bellis; Susana R. de Sijvarger; Jorge Saslavsky

This cooperative prospective study was designed to answer the following questions in cases with acute lymphoblastic leukemia induced to achieve complete remission with the combination of vincristine and prednisone (if by day 29 the bone marrow was not M1, daunorubicin was added to the former regimen) and who received preventive CNS therapy with 2400 rad of cobalt‐60 to cranio‐cervical region and simultaneously intrathecal methotrexate and dexamethasone: 1) Is a short intensification with cytosine‐arabinoside and cyclophosphamide immediately after complete remission useful? 2) Does the use of weekly doses of 6‐mercaptopurine and methotrexate have the same maintenance effect as daily 6‐mercaptopurine and twice weekly methotrexate? and 3) Do further 3 month‐doses of intrathecal methotrexate and dexamethasone help to decrease still more the incidence of meningeal leukemia? From October 1972 to December 1975, 473 previously untreated patients entered this study and 465 (390 children and 75 adults) are evaluated in this paper. Of them, 373 (80%) achieved complete remission (children 84% and adults 61%). Out of 109 “high risk”children (one or more of the following characteristics at diagnosis: marked organomegaly, mediastinal widening, leukocytosis above 50000/ mm3 and CNS involvement) 83 (76%) and out of 281 “standard risk”children (all the others) 244 (87%) achieved complete remission. The median duration of complete remission according to different prognostic factors was as follows: “high risk”children 10 months, adults 24 months and “standard risk”children 25 months. Duration of complete remission of the “standard risk”children in relation to with or without intensification, daily or weekly maintenance and additional intrathecal therapy or none, showed no significant difference; however, those who received intensification, daily maintenance and further intrathecal therapy behaved slightly better. Median survival for all the cases of this study was as follows: adults 10 months, “high risk”children 12 months and “standard risk”children 26. months. At 36 months, 13% of “high risk”children, 25% of adults and 39% of “standard risk”children are still alive. We conclude that the variables studied in this protocol did not show significant extension of complete remission, however the sum of them seems to offer some advantage. Moreover, what appears clear is the importance of prognostic factors which must be taken into account in future studies. Cancer 42:1730–1740, 1978.


Cancer | 1981

Chemoimmunotherapy with levamisole in acute lymphoblastic leukemia

Santiago Pavlovsky; Federico Sackmann Muriel; Guy Garay; Eva Svarch; Jorge Braier; Marcia Lagarde; Cristina Scaglione; Mariana Eppinger-Helft; Renato Failace; Eduardo Dibar

Patients with acute lymphoblastic leukemia (ALL) who were in two consecutive protocols and in complete remission (CR) with maintenance therapy, were randomized to receive or not receive levamisole. A total of 15 of 55 low‐risk patients of protocol 10‐LLA‐72 with levamisole had relapses, compared with 25 of 54 not receiving levamisole; 67 and 49%, respectively, remain in CR at 48 months (P < 0.025). In protocol 1‐LLA‐76, 14 of 91 low‐risk patients on levamisole and 25 of 93 patients not receiving levamisole had relapses; 78 and 61%, respectively, remain in CR at 36 months (P < 0.05). Seventeen of 39 high‐risk patients (children with a leukocyte count higher than 50,000 and adults) receiving levamisole had relapses compared with 37 of 61 not on levamisole. The DNCB skin test shows at 18 and 24 months a 74 and 85% positivity in the levamisole group vs. a 38 and 35% positivity in the control group (P< 0.025). We conclude that levamisole prolongs the duration of CR and survival in low‐risk patients with ALL.


Cancer | 1975

Sequential therapy for induction and maintenance of remission in acute myeloblastic leukemia

Mariana Eppinger-Helft; Santiago Pavlovsky; Argimiro Suárez; Federico Sackmann Muriel; Guillermo Hidalgo; Alfredo Pavlovsky; Guillermo Vilaseca

A total of 114 previously untreated patients with myeloblastic leukemia was included in a sequential therapy protocol. Daunorubicin, vincristine, and prednisone were employed for the first 3 weeks, followed by two or more 5‐day courses of cytosine arabinoside and 6‐mercaptopurine; there was a 5‐day rest between courses. Maintenance therapy was as follows: the continuing 6‐mercaptopurine and methotrexate treatment was interrupted every 30 days for sequential reinforcement courses consisting of one dose of daunorubicin and vincristine and 7 days of prednisone, or by a 5‐day course of cytosine arabinoside plus 6‐mercaptopurine. Of the 114 patients, 48 obtained complete remission, 14 had partial remission, 16 failed to respond, and 36 died during the course of treatment. The remission rate in children (under 16) was 57%; in adults (16–45) 54%; and in those over 45, 19%. The difference in the incidence of complete remission in patients under 45 and those over 45 was statistically significant (p < 0.01). The median duration of complete remission was 8 months: 12 months in children and 5 months in adults. The over‐all survival rate was 4 months: 13 months for patients with complete remission, 4 months for those with partial remission, and 1 month for patients who did not respond to therapy. The difference in survival of those with complete remission and all the others was significant (p < 0.01).


British Journal of Haematology | 1976

Remission Maintenance Therapy for Meningeal Leukaemia: Intrathecal Methotrexate and Dexamethasone versus Intrathecal Craniospinal Irradiation with a Radiocolloid

F. Sackmann Muriel; D. Schere; A. Barengols; Mariana Eppinger-Helft; Jorge Braier; Santiago Pavlovsky; G. H. Macchi; L. Guman

SUMMARY. Thirty‐two patients with meningeal leukaemia who achieved meningeal remission with intrathecal methotrexate (MTX) plus dexamethasone (DMT) were entered in a randomized study of two maintenance treatments: (a) 16 patients received intermittent intrathecal doses of MTX plus DMT, and (b) 16 patients received intermittent intrathecal doses of radioactive chromic phosphate (CROP). The population and clinical characteristics of the cases assigned to each maintenance regimen were similar. The duration of meningeal remission was 55–600+ d (median 550 d) for the MTX and DMT group and 56–555 d (median 360 d) for the CROP group. There was no statistical difference (P0.05) between the curves of the two groups. Intrathecal CROP seems to be as effective as intrathecal MTX plus DMT as maintenance treatment for intrathecal MTX plus DMT induced meningeal remission. Further uses of this compound should be explored but it seems to be dangerous to administer it by lumbar puncture.


Cancer | 1980

Chemoimmunotherapy with corynebacterium parvum in acute myelocytic leukemia

Mariana Eppinger-Helft; Santiago Pavlovsky; Guillermo Hidalgo; Federico Sackmann Muriel; Argimiro Suárez; Guy Garay; Carlos Russo; Maria José Santos; Alfredo Macchi; José M. Lein

The purpose of this study is to see if immunotherapy with C. parvum and prevention of central nervous system relapse with intrathecal methotrexate can prolong duration of complete remission and survival as well as avoid central nervous system relapse. For induction, three weekly I.V. injections of vincristine and Daunorubicin were given with daily prednisone orally, followed by 5‐day courses of Cytosine Arabinoside and 6‐mercaptopurine. The patients were randomized to chemotherapy or chemoimmunotherapy. Maintenance consisted of vincristine, Daunorubicin, and prednisone one week every odd month, and a 5‐day course of Cytosine Arabinoside and 6‐mercaptopurine every even month. Every week, the chemoimmunotherapy group also received, without chemotherapy, one injection of C. parvum 4 mg, subcutaneously. All patients received five weekly injections of intrathecal methotrexate 13 mg/m2 right after complete remission was achieved. Out of 181 evaluable cases, 80 (44%) achieved complete remission, 45 were randomized to chemotherapy, and 35 to chemoimmunotherapy. In the chemoimmunotherapy group 32/35 relapsed, and in the chemotherapy group 36/45. Median duration of complete remission and survival were: for group chemotherapy, 8 and 15 months; for group chemoimmunotherapy, 5 and 10 months. This difference is not significant. Intrathecal methotrexate was given to all patients. Six patients (7%) had central nervous system leukemia at the time of the first injection. None had central nervous system relapse after prevention with intrathecal methotrexate. This method seems useful in preventing central nervous system relapse in patients with acute myeloblastic leukemia, but does not seem to prolong complete remission.


Cancer Chemotherapy and Pharmacology | 1983

Vindesine, prednisone, and daunomycin in acute lymphoblastic leukemia in relapse

Guy Garay; Jörge Milone; Eduardo Dibar; Santiago Pavlovsky; Rita Kvicala; Federico Sackmann Muriel; Dolores Montres Varela; Mariana Eppinger-Helft

SummaryPatients with resistant or recurrent acute lymphoblastic leukemia were treated with vindesine 3 mg/m2/IV weekly x 4, daunomycin 25 mg/m2/IV weekly x 4, and prednisone 40 mg/m2/PO daily x 28.Seventeen (44%) of 38 evaluable patients achieved complete remission. Fifty-one percent of 31 patients in first relapse achieved complete remission, while only one of five in second or third relapse and neither of two resistant to first induction achieved complete remission. The major toxicity was hematologic. The median duration of complete remission was only 6 weeks and median survival from start of the study, 3 months, with 22% patients remaining alive at 10 months.We conclude that the vindesine, prednisone, and daunomycin combination is no more effective than vincristine, prednisone, and daunomycin in achieving remission of relapsed acute lymphoblastic leukemia patients, and is more toxic than the latter regimen.


Blood | 1973

Factors That Influence the Appearance of Central Nervous System Leukemia

Santiago Pavlovsky; Mariana Eppinger-Helft; Federico Sackmann Muriel


Blood | 1983

Comparison of Central Nervous System Prophylaxis With Cranial Radiation and Intrathecal Methotrexate Versus Intrathecal Methotrexate Alone in Acute Lymphoblastic Leukemia

Federico Sackmann Muriel; Eva Svarch; Santiago Pavlovsky; Mariana Eppinger-Helft; Jorge Braier; Berta Vergara; Guy Garay; Rita Kvicala; Jorge M. Divito; Renato Failace; Eduardo Dibar; Elias Jimenez

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Santiago Pavlovsky

Academia Nacional de Medicina

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Santiago Pavlovsky

Academia Nacional de Medicina

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