Vincristine, BCNU, doxorubicin, and prednisone (VBAP) combination in the treatment of relapsing or resistant multiple myeloma: a Southwest Oncology Group study

A total of 151 patients with myeloma who had relapsed with or were resistant to melphalan and/or cyclophosphamide (Cytoxan) with prednisone received vincristine, carmustine (BCNU), doxorubicin (Adriamycin), and prednisone (VBAP) at 21-day intervals; 39 patients (25%) responded. Of the 123 patients with relapsing myeloma, 37 (30%) responded. Only two (7%) of the 28 patients with resistant myeloma responded. The regimen was well-tolerated in patients who had not had prior extensive irradiation. Thrombocytopenia was the most frequent form of toxicity. Survival was significantly longer in those patients responding to VBAP (median, 78 weeks) than in those not responding (median, 33 weeks) (P = 0.002). VBAP is a safe, effective regimen for patients with myeloma who relapse with alkylating agents.

Combination chemotherapy plus BCG in the treatment of disseminated malignant melanoma: a Southwest Oncology Group Study

The Southwest Oncology Group performed a randomized study comparing combination chemotherapy alone versus combination chemotherapy plus BCG versus DTIC plus BCG in the treatment of disseminated malignant melanoma. A 31% response rate was noted with combination chemotherapy alone, a 27% response rate with combination chemotherapy plus BCG, and an 18% response rate with DTIC plus BCG. Survival was not influenced by type of therapy, but the responders had significantly longer survival than the nonresponders. There appeared to be some significant differences in response as related to age wherein those patients between the ages of 30 and 60 years had a higher response rate to combination chemotherapy as compared to DTIC plus BCG. Those patients older than 60 years of age had a higher response rate in the BCG groups. Furthermore, in those patients older than 60 years of age who responded, their duration of response was longer if they received BCG than those who did not receive BCG. It should be emphasized that those differences noted in various age groups could occur by chance alone. These differences should be studied in the future, by appropriate pretreatment stratifications. Patients with higher peripheral lymphocyte counts had significantly better response rates and those patients with higher numbers of positive delayed hypersensitivity skin tests had significantly greater survival. A significant improvement in survival was noted in patients whose PPD converted from negative to positive during therapy.

Treatment of recurrent lymphomas with vincristine, BCNU, doxorubicin, and prednisone (VBAP): a Southwest Oncology Group Study

Chemotherapy with vincristine, BCNU, doxorubicin, and prednisone (VBAP) was administered to 75 patients with malignant lymphoma, including both Hodgkin's disease and non-Hodgkin's lymphoma. All patients had prior chemotherapy with or without radiation therapy. Remissions were achieved in 41% of all patients, with only minor toxicity. The median duration of remission for Hodgkin's disease and non-Hodgkin's lymphoma was 51 and 22 weeks, respectively. The median survival for all patients was 34 weeks. The VBAP program is effective palliative chemotherapy for advanced malignant lymphoma.

Study of tamoxifen in metastatic renal cell carcinoma and the influence of certain prognostic factors: a Southwest Oncology Group Study

A prospective study of tamoxifen therapy in doses of 10 mg twice daily was carried out in 79 patients with advanced renal cell cancer. The objective response rate (complete response plus partial response) was 6.3% (five of 79 patients), while 34.1% (27 of 79 patients) had stable disease. Survival of this group of patients (complete response plus partial response plus stable disease) was significantly longer than that of patients with progressive disease (P less than 0.04). Also, among patients with a good performance status at the beginning of the study, survival was longer than among those with a poor performance status (P less than 0.001). No statistical significance was found in the survival of these patients according to sex (P = 0.55) or whether or not they had received previous systemic therapy (P = 0.97). Toxicity was low and acceptable. We concluded that stratification according to performance status may be used in future randomized systemic therapy protocols for patients with metastatic renal cell cancer. Also, in spite of the low response rate to hormonal therapy including tamoxifen, the use of these agents with combination chemotherapy may enhance the overall response rate without increasing side effects.

Chemoimmunotherapy for multiple myeloma

The effect of chemoimmunotherapy consolidation treatment using alternating courses of alkylating agents and BCG was studied in 105 responding patients with multiple myeloma. The survival time of these patients was similar to that of responding patients treated on previous maintenance programs, indicating no apparent value from BCG for myeloma. The duration of unmaintained remission was longest in those with low numbers of residual plasma cells, and relapse usually developed within one year in patients with persistent serum myeloma peaks. Disease recontrol was achieved in 50% of relapsing patients whose median survival from retreatment was 20 months. Patient follow-up without chemotherapy until relapse was justified mainly for those responding patients with disappearance of myeloma proteins.

Predicint lifting capacity

As science and technology become more sophisticated and with the rapid computation capabilities of the modern computer available, it becomes both possible and economically feasible to scientifically study man and his interaction with his working environment. It is now possible for a person seeking employment to expect and obtain a position which will not be unnecessarily hazardous to his immediate health or have detrimental effects over the long run. Manual materials handling is the contributor of over 400,000 back injuries suffered in the U.S. each year. This research is directed at determining the appropriate operator variables to measure for predicting the permissible weight of lift for three ranges of lift: floor to knuckle height, knuckle height to shoulder height, and shoulder height to reach height. A modified psychophysical procedure was used during which the subjects were instructed to adjust the weight in a tote box to the maximum weight they could lift repetitively without excessive strain or fatique. The task consisted of lifting loads under different conditions of task variables, namely, height of lift, frequency of lift, and load size. Industrial workers as well as students of both sexes were used as subjects. Based on the data obtained, the lifting capacity of the worker was determined for the different ranges of lift. In addition, predictive models were developed based on the operator variables and the task variables investigated.

Comparison of the in vitro antifungal activities of miconazole and a new imidazole, R41,400

R41,400 is a recently synthesized, water-soluble imidazole. Its antifungal properties were compared in vitro with those of miconazole using an agar dilution procedure and 175 isolates of human fungal pathogens. The filamentous forms of Histoplasma capsulatum and Blastomyces dermatitidis were inhibited by less than or equal to 2 microgram of either drug/ml; Coccidioides immitis was inhibited by less than or equal to 0.5 microgram of R41,400/ml. Among the yeasts tested, Cryptococcus neoformans and Candida parapsilosis were the most susceptibel to the two drugs, whereas Candida albicans and Candida tropicalis were the least susceptible; 0.5 microgram of either drug/ml was inhibitory for 90%-100% of tested isolates of C. neoformans but for only less than or equal to 20% of isolates of C. albicans, C. tropicalis, and Torulopsis glabrata. Both drugs were inhibitory for most isolates of Trichophyton and Microsporum species at concentrations of less than or equal to 4 microgram/ml; Epidermophyton floccosum was uniquely susceptible to both drugs.

Training disadvantaged preschoolers on various fantasy activities: effects on cognitive functioning and impulse control

Preschool children were trained in 1 of 3 different types of fantasy activities over a school year. The effects of this training were evaluated over a variety of tasks measuring cognitive development and impulse control. The same basic experiment was replicated over 3 different years. Results indicated that physical enactment of fantasy experiences (viz., acting fairy tales or enacting previous experiences) had a sizable effect on many of these variables; while simply listening and discussing was often no more effective than the control condition that merely cut, pasted, etc. Evidence suggested that fantasy play remoter from reality was more facilitative for development than more realistically oriented fantasy play.