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  • 1
    Electronic Resource
    Electronic Resource
    Mantle cell lymphoma, in leukaemic phase with prominent splenomegaly. A report of eight cases with similar clinical presentation and aggressive outcome (2000)
    Springer
    Virchows Archiv 437 (2000), S. 591-598 
    Details
    ISSN: 1432-2307
    Keywords: Mantle cell lymphoma B-CLL Leukaemia Splenomegaly Prolymphocytic leukaemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Mantle cell lymphoma (MCL) is a well-defined peripheral B-cell lymphoma usually diagnosed upon peripheral lymph node biopsy. We report eight cases of peripheral B-cell leukaemia that demonstrate presumptive evidence of mantle cell characteristics. The patients had a median age of 68.5 years, and five were male. All presented with an enlarged spleen without any peripheral lymphadenopathies, and they were leukaemic at presentation (median lymphocytosis, 38×109/l). Morphological diagnosis of MCL was very difficult in five cases but easier in three because we were able to analyse either pre- or post-mortem lymph nodes and spleen. The immunophenotype of blood lymphocytosis using flow cytometry, the presence of a t(11;14)(q13;q32) and a cyclin D1 expression by leukaemic cells all fit with the diagnosis of MCL. All patients progressed and died with a median overall survival of 8 months. Multifocal areas of transformation in blastoid or large cell variants were observed in the three autopsied patients. In summary, one should consider the diagnosis of MCL at presentation in leukaemic phase even in the absence of peripheral adenopathies.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004280000284
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  • 2
    Electronic Resource
    Electronic Resource
    Critères histologiques de l'anémie sidéroblastique idiopathique acquise (1969)
    Springer
    Virchows Archiv 347 (1969), S. 105-114 
    Details
    ISSN: 1432-2307
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Douze cas d'anémies sidéroblastiques idiopathiques acquises (A.S.I.A) ont été étudiés histologiquement, dont six après autopsie. Les constatations majeures intéressent la moelle osseuse: hyperplasie cellulaire intense, portant surtout sur la lignée érythroblastique, mais sans modification des travées osseuses, trame réticulinique normale ou très discrètement épaissie autour des vaisseaux, mais sans myélofibrose, présence d'assez nombreuses cellules jeunes, peu différenciées, souvent groupées en îlots ou en nappes, surtout dans les régions centrales des lacunes médullaires. Il n'existe pas de foyers d'hématopoïèse extra-médullaire. Certaines de ces constatations plaident en faveur de l'hypothèse selon laquelle l'A.S.I.A. constitue un syndrome myélo-prolifératif primitif, chronique et autonome, mais sans certitude absolue. D'autre part, une hémosidérose est habituellement retrouvée, réalisant à l'autopsie une hémochromatose diffuse (foie et glandes endocrines, etc.), avec développement de fibrose. L'étude histologique précise du foie et de la moelle osseuse parait indispensable non seulement pour affirmer le diagnostic même d'A.S.I.A., mais encore pour apprécier le pronostic sur l'intensité de l'infiltration ferrique du foie et pour dépister une éventuelle évolution leucosique.
    Notes: Zusammenfassung Anhand der Untersuchung von 12 Fällen (davon 6 Obduktionen) von idiopathischer sideroachrestischer Anämie wurde festgestellt, daß die wesentlichen Veränderungen das Knochenmark betreffen. Es wird die These vertreten, daß es sich um eine primärchronische Proliferation der roten Zellreihe ohne Desintegration der Knochenbälkchen und ohne wesentliche Myelofibrose handelt. Daneben wird eine starke Siderose der Leber und der Drüsen mit innerer Sekretion gefunden. Diese imponiert wie eine Hämochromatose. Die Stärke der Eisenablagerung ist ein Gradmesser für die Beurteilung einer möglichen Prognose. Diagnostische Leberpunktate beim Lebenden sind daher auch prognostisch bedeutsam. Sie helfen ferner mit bei der unbedingt erforderlichen Abgrenzung gegenüber einer Leukämie.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00544112
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  • 3
    Electronic Resource
    Electronic Resource
    High incidence of infectious gastrointestinal complications observed in patients with acute myeloid leukemia receiving intensive chemotherapy for first induction of remission (1996)
    Springer
    Supportive care in cancer 4 (1996), S. 294-297 
    Details
    ISSN: 1433-7339
    Keywords: Leukemia ; Chemotherapy ; Diarrhea ; Ileothyphlitis ; Candida
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract An increased incidence of severe infections, in particular gastrointestinal complications, was observed in our institution among 35 consecutive patients with acute myelogenous leukemia submitted to their first intensive pilot protocol for induction of remission containing idarubicin, etoposide and cytosine arabinoside. Ten patients presented fever and severe diarrhea (4 or more loose stools/day for at least 4 consecutive days); 3 of these developed ileothyphlitis, which proved fatal in 2 cases, 7 needed amphotericin B addition to antibacterial treatment and, in 6 cases, a fungal infection was documented. We have compared these 10 patients with the other 25 submitted to the same chemotherapeutic protocol and the incidence of candidemias (5/10 compared to 0/25), the early use of systemic fluconazole from the onset of fever (0/10 compared to 9/25) and the pre-emptive use of total parenteral nutrition (0/10 compared to 8/25) differed in the two groups. We conclude that during this chemotherapeutic protocol the incidence of severe gastrointestinal infectious complications was particularly high (28.5%) and, even though only a small number of patients were studied, our results suggest an important role forCandida spp. in the pathogenesis of this disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01358883
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  • 4
    Electronic Resource
    Electronic Resource
    Piperacillin/tazobactam plus tobramycin versus ceftazidime plus tobramycin as empiric therapy for fever in severely neutropenic patients (1999)
    Springer
    Supportive care in cancer 7 (1999), S. 89-94 
    Details
    ISSN: 1433-7339
    Keywords: Key words Empiric antibiotic therapy ; Febrile neutropenic patients ; Acute leukemia ; Randomized trial
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The objective of this trial was to evaluate the potential advantages of the combination of piperacillin and tazobactam in the control of fever in neutropenic patients. In this single-center study, patients who experienced a total of 247 febrile episodes were prospectively randomized to receive either our standard regimen, ceftazidime 3 g/day (1 g t.i.d.) plus tobramycin 3 mg/kg per day (1.5 mg/kg b.i.d.), or piperacillin 12 g/day plus tazobactam 1.5 g/day (4 g+0.5 g t.i.d.) plus tobramycin 3 mg/kg per day (1.5 mg/kg b.i.d.). Vancomycin was added in all cases of persistent fever in the ceftazidime arm, but only when there was microbiologically documented resistance in the piperacillin/tazobactam arm. All 247 episodes were evaluable by "intent-to-treat" analysis. The two populations were well matched in terms of age, gender, underlying disease, chemotherapy received, oral decontamination, clinical and bacterial documentation, and severity and duration of neutropenia. Initial antibacterial therapy was successful (apyrexia at 72 h, without antibiotic change) more frequently (P=0.008) with the regimen containing piperacillin/tazobactam (54.4%) than with the one including ceftazidime (37.6%). Fewer (P=0.02) major infectious events (infectious death or delay in treatment of underlying disease due to infection) were observed during piperacillin/ tazobactam treatment (2.6%) than with the ceftazidime regimen (11.3%), despite a lower frequency of glycopeptide addition when piperacillin/tazobactam was used (54.4% versus 77.4%) according to the rules adopted. This trial confirmed the efficacy of the piperacillin/tazobactam combination for empirical treatment of febrile neutropenic patients. This antibiotic combination permitted a dramatic decrease in empiric glycopeptide antibiotic administration in such patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s005200050233
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  • 5
    Electronic Resource
    Electronic Resource
    Foreword (1993)
    Springer
    Quality of life research 2 (1993), S. 48-48 
    Details
    ISSN: 1573-2649
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00642888
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