Combined CT venography with dual-slice scanning is an accurate method to diagnose deep venous thrombosis that may reveal additional imaging findings in some patients with possible pulmonary embolism.

Our study shows that the PET-FDG imaging strength lies in its very high negative predictive value and increased sensitivity. In this study, the overall accuracy of PET-FDG scan (82%) was lower than previously reported. Combined with chest CT-scan preoperatively, it may alleviate the need for surgical staging when PET-FDG studies of the mediastinum are negative. However, with a positive PET-FDG scan result, further diagnostic procedures should be pursued in order to avoid overstaging and allow better surgical patient selection.

Helical scanning can improve CT depiction of bronchiectasis but with an increase in radiation exposure to the patient. It should be used in patients considered for surgery or for thin-section CT scans that are difficult to interpret.

No abstract

Because of their substantial in vitro synergy, we conducted a dose-escalation study of cyclophosphamide (CP) added to 2-chloro-2′-deoxyadenosine (CdA) in patients with previously treated chronic lymphocytic leukemia and non-Hodgkin's lymphoma. CdA was given at a fixed dose (5.6 mg/m 2 /day) as a 2-h intravenous (i.v.) infusion, immediately followed by a 1-h i.v. infusion of CP, for 3 days. The initial daily CP dose was 200 mg/m 2 , and was escalated by 100 mg/m 2 increments in successive cohorts of three to six patients to determine the maximum-tolerated dose (MTD). Additional patients were included at the MTD to extend toxicity and response analysis. Twenty-six patients received 68 cycles of chemotherapy. The MTD of CP after CdA 5.6 mg/m 2 , was 300 mg/m 2 . Acute neutropenia was the dose-limiting toxicity of this regimen, which was otherwise well tolerated. Delivery of repeated cycles was not feasible in eight patients (31%) because of prolonged thrombocytopenia. Severe infections were seen in three of 68 cycles (4%). The overall response rate was 58% (15 of 26; 95% CI, 36-76%), with 15% complete responses and 42% partial responses. These data show the feasibility of the association of CdA with CP. Given the response rate observed, further studies of this regimen are warranted in untreated patients, in particular with chronic lymphocytic leukemia and with Waldenströ m macroglobulinemia. Leukemia (2000) 14, 1136-1142. Keywords: 2-chloro-2′-deoxyadenosine; cladribine; cyclophosphamide; chronic lymphocytic leukemia; non-Hodgkin's lymphomaThe purine nucleoside analogs 2-chloro-2′-deoxyadenosine (CdA) and fludarabine have established activity in the treatment of B cell chronic lymphocytic leukemia (CLL) and indolent non-Hodgkin's lymphoma (NHL). The hallmark of these compounds is their ability to kill both non-dividing and dividing cells via an apoptotic pathway. This may explain why they are effective in indolent lymphoproliferative disorders that usually have a low growth fraction rate and acquired resistance to apoptosis, together with the potential to accumulate active phosphorylated derivatives of purine analogs. 1In B-CLL, purine analogs yield an unprecedented rate of complete remissions (CR) compared to alkylating agents at standard dose.2,3 CdA and fludarabine are also active in follicular lymphoma (FL), Waldenströ m macroglobulinemia (WM), mantle-cell lymphoma (MCL), and lymphoplasmacytic lymphoma. [4][5][6][7][8] To date however, these drugs have not been shown to confer a survival advantage over standard therapy. 9-11In an attempt to increase the rate of CRs -as a step towards prolonged survival -one approach is to incorporate purine analogs into regimens that include agents such as chlorambuCorrespondence: E Van Den Neste, Hematology, Cliniques Universitaires Saint-Luc, 10, Av. Hippocrate, 1200 Brussels, Belgium; Fax: 32 2 764 8959 Received 17 November 1999; accepted 25 January 2000 cil (CLB) or cyclophosphamide (CP). This strategy relies on a variety of rationales including the individual activity of ...