(Brock et al., 1988;Koliouskas et al., 1985), there is little evidence that either renal function or hearing loss shows meaningful improvement with time.Substitution for cisplatin by a less toxic analogue such as carboplatin has been shown to be effective in ovarian cancer (Calvert et al., 1982;Wiltshaw et al., 1985) and this drug has clear activity in adult Phase II studies with MGCT (Horwich et al., 1988). There is, however, little or no evidence that significant non-cross resistance exists in cisplatin-resistant tumours and its use in the JEB regimen is primarily to avoid toxicity. In this regimen, carboplatin is given at a dose based on renal function calculated from the Calvert formula (Calvert et al., 1989). This is predicted to produce an area under the drug concentration curve (AUC) which may lead to significant but manageable myelosuppression but possibly maximum therapeutic effect. Early studies in adults show clearly that inferior results are achieved with carboplatin unless the dose is pushed to myelosuppressive levels .Etoposide and bleomycin are used as in the standard BEP regimen (Peckham et al., 1983). There is some controversy about the necessity of weekly rather than 3-weekly bleomycin. In this study, if it was possible to monitor lung function, children were given this drug weekly. Infants, whose lung function could not be tested, received bleomycin 3-weekly after the first two cycles of chemotherapy. Patients and methodsTwenty-one children aged 1 to 16 years (median 11 years) received the JEB regimen. Nineteen were previously untreated and two had received single courses of PVB and BEP chemotherapy respectively. Clinical details are shown in Table I. Serum markers (a-fetoprotein and P-HCG) were estimated in all patients by immunoassay. Staging investigations included PA and lateral chest X-ray, CT chest scan, isotope bone scan and abdominal ultrasound or CT scan. Lymphography was not performed.Indications for chemotherapy were the presence of metastatic disease in lung (6), lymph nodes (6), or peritoneum (1); bulky, unresectable primary tumour (5), peritoneal spill at surgery (3), or an intracranial primary (2). The testis was the primary site in 6 patients, ovary in 8 and sacrococcygeal area in 4. A one-year-old infant with a large vaginal tumour was treated electively with chemotherapy alone to avoid mutilating surgery. One boy with a pineal germinoma received JEB after complete resection and before irradiation. A second patient with a pineal tumour had undergone surgery but developed rapidly progressive disease within a month of this. a-FP was elevated in 19 patients, P-HCG in 8. In no patient was both x-FP and P-HCG normal. The chemotherapy is outlined in Figure 1. Bleomycin (15 mg m-2) was given weekly as a slow intravenous infusion. Etoposide (120 mg m2) was administered daily x 3 as a 1 to 3 hour infusion and carboplatin infused over one hour. The formula for calculating the dose of carboplatin was based on the uncorrected "Cr-EDTA clearance. In four children the GFR was not measured ...

High concentrations of the dopaminergic drug levodopa (L-dopa, L-3,4-dihydroxphenylalanine) administered to mice in their diet affected fertility to a moderate degree and prolonged the mean life-span by a maximum of 50 percent.

al., 1985). Whilst factors predictive of relapse in both adults (Kennedy et al., 1985) and children (Mauch et al., 1983;Robinson et al., 1984;Russell et al., 1984)