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  • 1
    Electronic Resource
    Electronic Resource
    Chronic systemic candidiasis in acute leukemia (1992)
    Springer
    Annals of hematology 64 (1992), S. 240-244 
    Details
    ISSN: 1432-0584
    Keywords: Chronic systemic candidiasis ; Acute leukemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In the past few years a new syndrome of invasiveCandida infection, the so-called hepatosplenic or chronic systemic candidiasis (CSC), has been recognized with increasing frequency in neutropenic patients. From January 1985 to December 1990, ten of 305 acute leukemia (AL) patients treated at our institution were diagnosed as having CSC. In contrast, during the same period this type ofCandida infection was not observed in any patient with hematological diseases other than AL treated in our center, including 277 patients who underwent bone marrow transplantation. All patients with CSC had fever and hepatomegaly, and five complained of abdominal pain. Seven patients had neutrophilic leukocytosis and six an increased serum alkaline phosphatase activity. Abdominal computed tomography and ultrasound study showed typical lesions in eight and seven patients, respectively. In four patients a laparoscopy-guided needle liver biopsy displayed yellowish nodules on the liver surface, and the histologic study revealed large granulomas with yeasts and pseudohyphae. All patients were given amphotericin B (mean: 4.6 g, range: 1–12.5 g) and 5-fluorocytosine, and five received fluoconazole. No patient died as a direct consequence of CSC and in six the infection resolved. Finally, once controlled, the infectious complication did not preclude subsequent intensive antileukemic therapy, including bone marrow transplantation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01738303
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  • 2
    Electronic Resource
    Electronic Resource
    Iron stores in essential thrombocythaemia (1989)
    Springer
    Annals of hematology 58 (1989), S. 291-294 
    Details
    ISSN: 1432-0584
    Keywords: Essential thrombocythaemia ; Iron stores ; Serum ferritin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The iron status of 26 patients with essential thrombocythaemia (ET) was evaluated at diagnosis by means of bone marrow iron and blood studies, including serum ferritin determination. Nine patients were males, 17 females, and the mean age was 53 years (range 7–81). A decreased or absent iron level by semiquantitative estimation on bone marrow smears was observed in 77% of patients, and 81% had a low sideroblast score. Such a marrow pattern of iron depletion was equally distributed between both sexes. Contrasting with this, normal Hb, MCV, serum iron and serum ferritin were registered in the majority of cases. According to these results, absent or decreased marrow iron would be a common feature in ET, generally not reflecting true iron deficiency, as it occurs in the remaining chronic myeloproliferative disorders. Thus, in patients in whom ET is suspected, the diagnostic criterion of ruling out iron deficiency would be better served by serum ferritin measurement than by bone marrow iron estimation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00320169
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  • 3
    Electronic Resource
    Electronic Resource
    Molecular response assessed by PCR is the most important factor predicting failure-free survival in indolent follicular lymphoma: Update of the MDACC series (2000)
    Springer
    Annals of oncology 11 (2000), S. 137-140 
    Details
    ISSN: 1569-8041
    Keywords: BCL-2 ; follicular lymphoma ; minimal residual disease ; PCR ; prognostic factors
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:We have observed that molecular response, as definedby a PCR-negative status during the first year of therapy, along withβ2–microglobulin (β2M), was the most important variable associatedwith failure-free survival (FFS) in follicular lymphoma (FL). Herein, wepresent an update of the previously published MDACC series. Patients and methods:A total of 116 patients (male : female ratio64 : 52; median age: 52 years) with indolent FL andBCL-2rearrangement (at MBRor mcrbreakpoints) assessablein peripheral blood (pb) by PCR prior to treatment, and with two or more PCRdeterminations during the first year, were selected for the present study. Results:Of the 116 patients, 4 who presented with progression and1 who died of unrelated causes during the first year were excluded from thelandmark analysis. One hundred patients (86%) achieved clinical CR and80 (69%) achieved a negative PCR status within first year. Median FFSwas 6.4 years. Five-year FFS was 73% and 28% for molecularresponders and nonresponders, respectively (P = 0.001). In spite ofthis strikingly higher FFS favoring molecular responders, no clear-cutplateauwas evident in this group. Molecular response assessed in pb(P = 0.001) and serum β2M (P 〈 0.001) were the mostimportant factors to predict FFS in the multivariate analysis. In the subsetof patients with normal β2M and molecular CR, there was a trend for aplateau in the FFS curve. No significant difference between the groups hasbeen observed so far in terms of survival. Conclusions:Molecular response assessed in pb using a PCRtechnique is, along with β2M, the most important factor to predict FFS inFL.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008369623425
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  • 4
    Electronic Resource
    Electronic Resource
    Peripheral T-cell lymphomas: Initial features, natural history, and prognostic factors in a series of 174 patients diagnosed according to the R.E.A.L. Classification (1998)
    Springer
    Annals of oncology 9 (1998), S. 849-855 
    Details
    ISSN: 1569-8041
    Keywords: peripheral T-cell lymphomas ; prognosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Peripheral T-cell lymphomas (PTCL) account for about 10% of all lymphomas in Western countries. The aim of the present study is to analyze the initial characteristics and prognostic factors in a large series of PTCL patients. Patients and methods: 174 patients (105 male/69 female; median age 61 years) were diagnosed with PTCL according to the R.E.A.L. Classification in nine Spanish institutions between 1985 and 1996. Cutaneous lymphomas and T-cell chronic lymphocytic/prolymphocytic leukemia were excluded from the study. Univariate and multivariate analyses were used to assess the prognostic value of the main initial variables. Results: The distribution according to histology subgroup was: PTCL unspecified, 95 cases (54.4%); anaplastic large-cell Ki-1-positive (ALCL), 30 cases (17%); angioimmunoblastic T cell, 22 cases (13%); angiocentric, 14 cases (8%); intestinal T cell, 12 cases (7%), and hepatosplenic γδ T cell, one case (0.6%). As compared to the other types, ALCL presented more frequently in ambulatory performance status, without extranodal involvement, in early stage, normal serum β2-microglobulin (B2M) level and low-risk international prognostic index (IPI). Most patients were treated with adriamycin-containing regimens. The overall CR rate was 49% (69% for ALCL vs. 45% for other PTCL; P 〈 0.02). The risk of relapse was 48% at four years. Median survival of the series was 22 months (65 months for ALCL vs. 20 months for other PTCL; P = 0.03), with a four-year probability of survival of 38% (95% confidence intervals (95% CI): 28–48). In the univariate analysis, in addition to the histology, older age, poor performance status, presence of B-symptoms, extranodal involvement, bone marrow infiltration, advanced Ann Arbor stage, high serum LDH, high serum B2M, and intermediate- or high-risk IPI were related to poor survival. In the multivariate analysis the histologic subgroup (ALCL vs. other PTCL) (P = 0.02; response rate (RR): 4.3), the presence of B-symptoms (P = 0.02, RR: 2.2), and the IPI (low vs. high) (P = 0.04, RR: 2) maintained independent predictive value. When the analysis was restricted to the unspecified subtype, only IPI had independent prognostic value (P = 0.003; RR: 3.5). Conclusions: PTCL have adverse prognostic features at diagnosis, respond poorly to therapy and have short survival, with no sustained remission. ALCL constitutes a subgroup which responds better to therapy and has a longer survival.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008418727472
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  • 5
    Electronic Resource
    Electronic Resource
    Hematopoietic stem cell transplantation in chronic lymphocytic leukemia: A report of 12 patients from a single institution (1998)
    Springer
    Annals of oncology 9 (1998), S. 167-172 
    Details
    ISSN: 1569-8041
    Keywords: chronic lymphocytic leukemia ; hematopoietic stem cell transplantation ; minimal residual disease ; molecular remissions
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Stem-cell transplantation is a reasonable therapeutic approach for younger patients with high-risk CLL. Patients and methods: Twelve patients (seven males; median age 47 years, range 29–51) with high-risk CLL underwent transplantation (allo, n = 7; auto, n = 5). The conditioning regimen consisted of cyclophosphamide and total body irradiation in 11 patients, and BEAC in the remaining one. Minimal residual disease (MRD) was assessed by cytofluorometry and PCR. Results: All 11 evaluable patients engrafted. Of the seven allografted patients, two died of treatment-related causes; three patients developed acute GVHD. No transplant-related mortality was observed in autografted patients. After transplantation, 10 of 11 patients evaluable for response achieved CR (91%; 95% CI 59%–100%) which was molecular in nine patients (82%; 95% CI 48%–98%). One patient in CR but MRD+ relapsed nine months after transplantation and died. Seven patients remain in molecular CR for a median of 16 months (range 1–58). Estimated actuarial survival and disease-free survival at two years is 81% (95% CI 43%–100%) and 71% (95% CI 43%–99%), respectively. Relapse risk at two years is 12.5% (95% CI 0%–35.5%). Conclusions: Patients with high-risk CLL can achieve long-lasting molecular CR after SCT. The role of transplants in CLL management deserves investigation in controlled trials.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008266505896
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  • 6
    Electronic Resource
    Electronic Resource
    Primary central nervous system lymphoma of T-cell origin: description of two cases and review of the literature (1997)
    Springer
    Journal of neuro-oncology 34 (1997), S. 157-161 
    Details
    ISSN: 1573-7373
    Keywords: primary T-cell lymphoma ; central nervous system
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Primary lymphomas of the central nervous system (PLCNS)of T-cell lineage are unusual. It has beensuggested that T-cell PLCNS, compared to those ofB-cell origin, present some differences in relation toage of presentation, gender, location of the tumorand survival. We describe two cases with T-cellPLCNS and review 22 parenchymatous T-cell PLCNS reportedin the English literature. Age, gender and survivalof the whole series of 24 T-cell PLCNSdid not differ from that reported in largeseries of PLCNS where the great majority wereof B-cell origin. In contrast, a location inthe posterior fossa was found in 54% ofT-cell PLCNS, whereas this location ranged from 12go 29% in series of, mostly B-cell, PLCNS.T-cell PLCNS had a higher frequency (33%) ofthe histologic low grade small lymphocytic lymphoma thanB-cell PLCNS (5%). Analysis of six T-cell PLCNSlong-term survivors showed that half of them hadlow grade lymphomas. We conclude that T-cell PLCNSdo not differ from those of B-cell originin age of presentation or gender, but theyhave a preference to develop in the posteriorfossa and a higher frequency of low gradehistology which would probably explain the longer survivalin some patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1005754212792
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