Response to Drs. Pritchard and Pinkerton

✍ Scribed by Willoughby, M. L. N.

• Publisher: John Wiley and Sons
• Year: 1989
• Tongue: English
• Weight: 71 KB
• Volume: 17
• Category: Article
• ISSN: 0098-1532
• DOI: 10.1002/mpo.2950170402

✦ Synopsis

We have read the comments of Drs. Pritchard and Pinkerton from Great Ormond St. (GOS), London, United Kingdom [ 11. The major amendment to our original presentation is that our patient is now close to 5-years from diagnosis (July 21st 1983) and has a plasma creatinine level of 40 umol/L. ''CR EDTA GFR was normal throughout therapy but transiently fell to 46 ml/Min/l .73M2 following the last course of therapy, and is currently 75 ml/Min/l .73M2.

The GOS queries 1 and 2 are answered by rereading our presentation commencing with Dr. Fiona Cameron's comment (P.259). Therapy was started 2 days before we had either AFP or histological diagnosis, at which time lymphoma remained a possibility. Her clinical condition, with dyspnoea at presentation, was desperate. Radiotherapy was given because, as stated: 'This was certainly a malignant tumor, and because Some response could be expected in all possible pediatric tumors that could occur in this site. . . "

Five years ago it was not commonplace for AFP results to be available within 24 hrs in either Australia or U.K.

Obviously their reference 1 (1986, from Dr. Pritchard, quoted twice) and reference 4 (1987) were not available to us when we were treating our patient in July, 1983. Their reference 2 (in a book published by Oxford University in 1983) is still not in our library and is unknown to us.