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  • 1
    Electronic Resource
    Electronic Resource
    Disseminated Mucormycosis Caused by Absidia corymbifera Leading to Cerebral Vasculitis (2000)
    Springer
    Infection 28 (2000), S. 246-250 
    Details
    ISSN: 1439-0973
    Keywords: Key WordsAbsidia corymbifera ; Mucormycosis ; Acute myeloid leukemia ; Neutropenia ; Vasculitis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary An 18-year-old woman was admitted to hospital because of subcutaneous hematoma and fever of unknown origin. Acute myeloid leukemia was diagnosed and empirical antimicrobial treatment and induction chemotherapy were started. After initial defervescence, fever relapsed 21 days after the onset of neutropenia. The CT scan of the lung was consistent with an invasive fungal infection. Treatment with amphotericin B was started and antimicrobial treatment was continued with liposomal amphotericin B because of an increase in creatinine later. The fever persisted and the patient suddenly developed progressive neurological symptoms. CT scan of the head suggested cerebral infarction and angiography of the extra- and intracranial arteries showed signs of vasculitis. Six days after the onset of neurological symptoms cerebral death was diagnosed. Autopsy revealed non-septate, irregularly branched hyphae in various histologic sections including brain. Absidia corymbifera could be isolated from lung tissue confirming the diagnosis of disseminated mucormycosis. In this case, angiographic findings suggested severe cerebral vasculitis which was in fact caused by thromboembolic dissemination of fungal hyphae. This case underlines the fact that cerebral symptoms in febrile neutropenic patients are highly indicative for fungal infections of the brain.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s150100070047
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  • 2
    Electronic Resource
    Electronic Resource
    Patients with malignant lymphomas experience a higher rate of documented infections than patients with breast cancer after high-dose chemotherapy with autologous peripheral stem cell transplantation (2000)
    Springer
    Annals of hematology 79 (2000), S. 627-630 
    Details
    ISSN: 1432-0584
    Keywords: Key words Infection ; Febrile neutropenia ; High-dose chemotherapy ; Peripheral blood stem cell transplantation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The influence of underlying disease on documented infections has rarely been addressed in patients treated with high-dose chemotherapy (HDCT) and subsequent autologous peripheral blood stem cell transplantation (PBSCT). Because autografting has been used most frequently for malignant lymphomas and breast cancer, we analyzed in a retrospective study the data of 100 consecutive adult patients with either malignant lymphomas (group A, n=50) or breast cancer (group B, n=50) treated with HDCT at a single institution. The number of autografted CD34+ cells was not statistically different in either group. In this paper, we show for the first time that there is a significant difference in clinically or microbiologically documented infections in these groups of patients: documented infections occurred in 30% of malignant lymphoma patients but only in 4% of breast cancer patients (P=0.001). Of all isolated microorganisms, 78% were gram-positive. Because most of the documented infections were due to staphylococci, further studies should prospectively evaluate preventive measures to reduce the high incidence of these infections. This is especially important for lymphoma patients, who can be regarded as a high-risk group concerning gram-positive bacteremia.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002770000218
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  • 3
    Electronic Resource
    Electronic Resource
    Bone marrow microvessel density is a prognostic factor for survival in patients with multiple myeloma (2000)
    Springer
    Annals of hematology 79 (2000), S. 574-577 
    Details
    ISSN: 1432-0584
    Keywords: Key words Multiple myeloma ; Angiogenesis ; Bone marrow ; Microvessel density
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The importance of neoangiogenesis for the progressive growth and viability of solid tumors is well established. Recently, there has been growing evidence that angiogenesis might also be important in hematological malignancies, but only few data are available. In this report, we have studied the impact of bone marrow microvessel density and survival in patients with multiple myeloma (MM). Immunohistochemical CD34 stained paraffin-embedded bone marrow biopsies of 44 patients with newly diagnosed MM were studied. Microvessels were counted in 400× magnification and the mean number of vessels per area in each sample was noted as the microvessel density (MVD). The median MVD was 48 vessels/mm2, the range was 0–125 vessels/mm2. Using a cut-off value of the median MVD in the Kaplan-Meier analysis, the median survival was 22.2 months in the group with the higher MVD and was not reached in the group with the lower MVD (P〈0.01). In a multivariate Cox regression analysis, using previously identified prognostic factors β2-microglobulin, C-reactive protein (CRP), and age, MVD remained significant as a prognostic factor (P〈0.03).
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002770000236
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  • 4
    Electronic Resource
    Electronic Resource
    New therapeutic approaches in primary systemic AL amyloidosis (2000)
    Springer
    Annals of hematology 79 (2000), S. 1-6 
    Details
    ISSN: 1432-0584
    Keywords: Amyloidosis ; High-dose chemotherapy ; Peripheral blood stem cell transplantation ; Nephrotic syndrome
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002770050001
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  • 5
    Electronic Resource
    Electronic Resource
    Coincidence of Gaucher's disease due to a 1226G/1448C mutation and of an immunoglobulin G lambda multiple myeloma with Bence-Jones proteinuria (2000)
    Springer
    Annals of hematology 79 (2000), S. 640-643 
    Details
    ISSN: 1432-0584
    Keywords: Key words Gaucher disease ; Plasmacytoma ; Monoclonal gammopathy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  We report about a 58-year-old female with coexisting type-I Gaucher's disease (GD) and multiple myeloma (MM). The diagnosis of GD was made in early childhood by means of bone marrow biopsy and was recently confirmed by analysis of the patient's genomic DNA for the underlying glucocerebrosidase mutations and the identification of the 1226G/1448C genotype. At the age of 24 years, the patient developed massive splenomegaly. Therefore, a splenectomy was performed. No further therapy was necessary for the next 34 years until 1999 when progressive anemia and thrombocytopenia occurred. Additional laboratory analysis revealed high serum protein and immunoglobulin (Ig) G levels and evidence of monoclonal gammopathy and lambda light-chain proteinuria, indicating plasma cell dyscrasia. This diagnosis was confirmed by the detection of osteolytic lesions in skeletal X-rays and a bone marrow biopsy showing an extensive infiltration with Gaucher cells and an increase of plasma cells, which expressed lambda light chains. When examined by means of electron microscopy, typical Gaucher cells, i.e., histiocytes containing tubular-structured cytoplasmatic material and spots of plasma cells with an increase of the endoplasmic reticulum, were found. GD associated with acquired MM has been described 13 times in the literature from 1968 to 1997. Only three of the patients were suffering from IgG myeloma. This distribution of the monoclonal component is in contrast to that of patients suffering from MM alone.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002770000202
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