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  • 1
    ISSN: 1365-2559
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Allogeneic haematopoietic stem cell transplantation (i.e. bone marrow or peripheral blood stem cell transplantation) is a common procedure in the treatment of various haematological disorders such as aplastic anaemia, (pre)leukaemias, some malignant lymphomas, multiple myeloma and immunodeficiency states. Many of these patients develop erythematous skin lesions following transplantation. Although graft- versus-host disease is the major differential diagnosis in these situations, many other causes of erythema are encountered. The large number of transplant patients means that more and more pathologists are confronted with the challenging problem of making a correct diagnosis in these situations. In this review article we therefore describe the different causes of erythema and their differential diagnoses. In most cases the clinical presentation is related to the microscopical features. Besides acute and chronic graft-versus-host disease, we discuss the (common) drug reactions and non-specific features such as Sweet's syndrome, erythema nodosum and eosinophilic folliculitis. In addition, we deal with the recurrence of original diseases and infections. With this knowledge every pathologist should feel comfortable when looking at skin biopsies of patients after haematological stem cell transplantation.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1365-3083
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Plasmacellular hyperplasia in lymphoid tissue was found in 4 out of 9 patients 1-6 months after allogeneic bone marrow transplantation as treatment for leukaemia. In the plasma cell populations. 13-85% expressed a single immunoglobulin light and heavy chain isotype (monotypic Ig expression). DNA analysis, using a DNA probe specific for heavy chain JH gene segments and for light chains, did not reveal the presence of clonally restricted B lymphocytes. The patients' sera lacked homogeneous immunoglobulins. We conclude that plasmacellular hyperplasia found after allogeneic bone marrow transplantation represents a polyclonal B-cell expansion-with a restriction in Ig isotype.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-0584
    Keywords: IL-3 ; Lymphoma ; Interleukin-3 ; Inter-leukin-6
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The objective of this phase-I study was to establish the maximum tolerable dose of recombinant human interleukin-3 (rhIL-3) after salvage chemotherapy in patients with malignant lymphoma. Twenty-one patients with relapsed Hodgkin's disease or intermediate/high-grade non-Hodgkin's lymphoma received rhIL-3 after the second cycle of DHAP chemotherapy (cisplatin, cytosine-arabinoside, dexamethasone). Cycles 1 and 3 were given without rhIL-3. The rhIL-3 was administered as a continuous intravenous infusion for 10 days starting 48 h after chemotherapy in cycle 2. Five different dose levels of rhIL-3 (0.25, 1.0, 2.5, 5.0, and 10.0μg/kg/day) were sequentially tested. At the three lowest dose levels one double-blinded placebo was included for every four patients per dose level. Low-grade fever occurred in 15/21 patients, unrelated to the dose of rhIL-3. Nausea and vomiting (grade 1–2) occurred in seven patients. Headache was dose related, with 3/4 patients at a dose of 10μg/kg/day experiencing troublesome grade-2 headache precluding further dose escalation. Facial flushing developed in 3/8 patients at the highest dose levels of rhIL-3. There was a significant increase in eosinophil count during rhIL-3 (p=0.03 cycle 2 vs cycle 1 andp=0.002 cycle 2 vs cycle 3) without accompanying clinical signs or symptoms. No increase in basophil count was observed. There were no increased plasma levels of interleukin-6 or macrophage colony-stimulating factor (M-CSF) during rhIL-3. We conclude that rhIL-3 can be safely administered as a continuous intravenous infusion for 10 days after DHAP chemotherapy. Dose-limiting side effects, especially headache, occur at a dose of 10μg/kg/day.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-0584
    Keywords: Bone marrow transplantation ; Graft-versus-host-disease ; Herpes viruses
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The effects of pretransplant herpes virus serology on the occurrence of grades II–IV acute graft-versus-host disease (GVHD) were studied in 262 recipients and their HLA-identical family donors. In 131 recipients on standard GVHD prophylaxis (either methotrexate or cyclosporin A) significant effects were observed for donor HSV serology (seropositivity associated with increased risk for GVHD) and donor EBV serology (seronegativity associated with increased risk). However, these effects were nonsignificant in the other 131 recipients on intensified GVHD prophylaxis (i.e., methotrexate combined with cyclosporin A, in vivo anti-T-cell monoclonal antibodies, or various procedures to reduce the T-cell numbers in the transplants).
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-0584
    Keywords: Adult ALL ; Immunophenotyping ; Clinical features ; Diagnosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In 91 of 106 adult patients with acute lymphoblastic leukemia (ALL) enrolled in the treatment protocol ALL HOVON-5 between May 1988 and October 1991, the immunophenotype of the leukemia was determined and correlated with clinical characteristics at presentation. The immunological marker analysis was performed in ten laboratories, all members of the Dutch Study Group on Immunophenotyping of Leukemias and Lymphomas (SIHON). Undifferentiated blasts were found in four patients, 67 had B-lineage ALL, 18 had T-lineage ALL, and two had biphenotypic ALL. The age of T-lineage ALL patients was lower (mean 29.3) than that of B-lineage ALL patients (mean 35.5). Tumor mass, as expressed by leukocyte count, organomegaly, and LDH, was more pronounced in T-lineage ALL. Hemoglobin and platelet count was similar in all (sub)types. CD34 was expressed in 58% of the leukemias, but most frequently in the common B-ALL (70%). Thirteen percent of the leukemias expressed one or more markers not associated with their lineage. In this prospective study immunological data were not evaluable for 15 patients. On four of them data were not available because of dry tap, for six patients the typing was technically insufficient, and for four patients the results were unclassifiable; with one patient the marker analysis was not performed.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1432-0428
    Keywords: Lactic acidosis ; plasma buformin concentration ; tissue buformin concentration ; biguanides
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A fatal case of lactic acidosis in a 84 year old diabetic woman taking buformin is reported. Buformin concentrations in serum, other body fluids and tissues were measured by gas chromatography. Serum buformin concentration at admission was 5.5 mg/l. Postmortem concentrations were: in serum 3.2 mg/l; in lung 2.8 mg/kg wet weight; in heart 3.0 mg/kg; in pericardial fluid 3.5 mg/l; in liver 5.2 mg/kg; in bile 6.3 mg/l; and in kidney 98 mg/kg.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1432-0428
    Keywords: Lactic acidosis ; plasma buformin concentration ; tissue buformin concentration ; biguanides
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A fatal case of lactic acidosis in a 84 year old diabetic woman taking buformin is reported. Buformin concentrations in serum, other body fluids and tissues were measured by gas chromatography. Serum buformin concentration at admission was 5.5 mg/1. Postmortem concentrations were: in serum 3.2mg/l; in lung 2.8mg/kg wet weight; in heart 3.0mg/kg; in pericardial fluid 3.5 mg/1; in liver 5.2 mg/kg; in bile 6.3 mg/1; and in kidney 98 mg/kg.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1569-8041
    Keywords: central nervous system disease ; non-Hodgkin's lymphoma ; prophylactic treatment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Purpose: Data of a multicenter study in non-Hodgkin's lymphoma (NHL) by the Dutch Hovon Group were reanalyzed to assess the risk of relapse in the central nervous system (CNS) related to the international risk index for NHL. In addition we assessed the risk for CNS disease in relation to the presence of bone marrow localisation at presentation. Design: We focused our analysis on those patients reaching a complete remission (CR). Two hundred eighty-six patients (histological subtypes D–H Working Formulation) and with stages II–IV were analyzed. One hundred ninety-three (67%) patients reached a CR. Results: Relapse occurred in 78 patients of whom 10 patients with concomitant or isolated CNS disease. According to the international risk index the following observations were made: low risk (n = 38) nine out of 34 CR relapsed, none had CNS involvement; low-intermediate risk (n = 115) 27 out of 83 CR relapsed, three had CNS involvement; high-intermediate risk (n = 110) 37 out of 68 CR relapsed, six had CNS involvement; high risk (n = 22) four out of seven CR relapsed, one had CNS involvement. Two out of 10 developed isolated CNS disease and eight out of 10 patients developed CNS disease with systemic relapse. Conclusion: Our data show that the number of CNS relapses after CR is relatively low (10 out of 193 = 5%), with an increasing incidence in the high-risk groups according to the international risk index. The occurrence of CNS relapse seems to be related to the risk of systemic relapse after CR. No subgroup could be discriminated in which prophylactic treatment would be of substantial benefit.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1434-9949
    Keywords: Ischemic Necrosis of Bone ; Osteonecrosis ; Amyloidosis ; Corticosteroids ; Magnetic Resonance Imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A 36-year-old white male suffering from auto-immune granulocytopenia with recurrent infections and subsequent systemic AA-amyloidosis developed ischemic necrosis of bone (INB) in several joints following long-term corticosteroid treatment. Early signs of INB in one joint were detected by Magnetic Resonance Imaging and joint damage could be prevented by core decompression. The importance of early detection of INB Magnetic Resonance Imaging is stressed. According to the present theory regarding the pathogenesis of INB, amyloidosis might contribute to intraas well as extra-osseous factors. However, no relation was found between amyloidosis and INB.
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    European journal of clinical microbiology & infectious diseases 17 (1998), S. 591-592 
    ISSN: 1435-4373
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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