Nasser Movassaghi

Experimental use of cytosine arabinoside in congenital cytomegalovirus infection

Two infants with congenital cytomegalovirus infection were treated with cytosine arabinoside in an attempt to eradicate the virus and thereby possibly prevent further neurologic deterioration. Although in one case there appears to have been some modification of virus excretion during and after therapy, complete cessation of virus excretion was not achieved. The second patient apparently stopped excreting cytomegalovirus just prior to therapy but continued to harbor virus in white blood cells after therapy. Toxicities were vomiting, neutropenia, and thrombocytopenia.

In-111 pentetreotide scintigraphy in patients with neuroblastoma : Comparison with I-131 MIBG, N-Myc oncogene amplification, and patient outcome

OBJECTIVE 1. To evaluate the relative efficacy of In-111 pentetreotide and 1-131 radioiodinated meta-idobenzyl guanidine (MIBG) for detection of primary and metastatic neuroblastoma. 2. To assess the prognostic value of In-111 pentetreotide uptake. METHODS AND MATERIALS Seven In-111 pentetreotide and seven I-131 MIBG scans were obtained in six patients with stage IV neuroblastoma and 1 with stage III ganglioneuroblastoma. Three scans were obtained at initial staging and four were obtained during therapy. Correlation was made with concomitant computed tomography scans, bone scans, N-myc oncogene amplification, and clinical outcome. RESULTS Primary tumor was present in six patients and had been resected in 1. In-111 pentetreotide uptake was seen in two of six primary tumors, I-131 MIBG scan was positive in five of six. In-111 pentetreotide scan was positive in two of four patients with bone metastases, I-131 MIBG scan was positive in three of four. Both showed liver metastases in one patient and did not show bone marrow metastases in another. Overall sensitivity for primary or metastatic disease was 57% (four of seven) for In-111 pentetreotide and 86% (six of seven) for MIBG. Correlation between N-myc oncogene and In-111 pentetreotide uptake was seen in four of seven patients. In-111 pentetreotide uptake correlated with the clinical outcome in six patients with more than 1 year follow-up. Two patients with negative In-111 pentetreotide scans had unfavorable outcome. One patient died, and the other had local recurrence 15 months after diagnosis. Four patients with a positive scan are alive without disease on follow-up at 13-31 months after diagnosis. CONCLUSION In-111 pentetreotide scintigraphy is less sensitive than I-131 MIBG for detecting active neuroblastoma. In-111 pentetreotide uptake on scintigraphy may correlate with the prognosis. However, a larger series of patients is needed for further evaluation.

Comparison of exchange transfusion and deferoxamine in the treatment of acute iron poisoning

The efficacy of iron removal by deferoxamine, exchange transfusion, and a combination of deferoxamine and exchange transfusion was studied in 3 groups of dogs with severe iron intoxication. The amount of iron excreted in the urine of dogs treated with deferoxamine was minimal. The mean amount of iron removed in the group receiving exchange transfusion alone was 30 times greater than the amount obtained by urinary excretion in the group treated with deferoxamine. Chelation with deferoxamine followed by exchange transfusion did not increase the amount of iron removed by exchange transfusion.

The Prevention and Treatment of Varicella- Zoster Infection in Patients at High Risk

Disseminated herpes zoster or varicella can be life-threatening to patients with malignancy or immune deficiency and those receiving immunosuppres sive or cytotoxic drugs. For prevention of the infection, convalescent zoster plasma or Zoster Immune Globulin (ZIG) should be given within 72 hours after exposure to herpes zoster or varicella. For such patients already ill with herpes zoster infection or varicella, cytosine arabinoside should be infused continuously for several days until the infection is under control.

Prognosis in black children with neuroblastoma

Thirty white and 15 black children with neuroblastoma were compared with respect to survival. Patient age and tumor stage at diagnosis were similar in the two groups, as was duration of symptoms prior to diagnosis. There was no significant difference between the white and black children in regard to median duration of survival or percentage of long‐term survivors. The results of this study indicate that race is not a factor in the prognosis of this tumor.