[Does multiple myeloma response induction therapy depending on plasma cell il6 receptor gene expression]

Interleukine 6 [IL-6] is the most important cytokine involved in malignant plasma cells growth and survival. To analyse bone marrow plasma cells IL6 receptor gene expression in both multiple myeloma patients at diagnosis and healthy bone marrow donors. Clinical and biological patients' features and responses to Dexamethasone-Thalidomide induction therapy were gathered. 47 patients and 16 case controls were analyzed: Bone marrow plasma cells were isolated; and IL6 receptor gene expression was quantified using Taqman quantitative PCr technology and 2-DELTA CT formula. Quantitative and qualitative IL6 receptor gene expression were negatively correlated with the degree of response to therapy [p= 0.02]. In this study, plasma cells IL6 receptor gene expression seems to be decisive in predicting the response to treatment. Understanding the mechanisms involved in plasma cells IL6 receptor gene expression may offer a better appreciation of the physiopathologic and anti-oncogenic ways of drug resistance in multiple myeloma and consequently the discovery of new specific drugs

[Adult lymphocytosis classification by flow cytometry]

Positive and differential diagnosis of chronic lymphocytic leukemia [CLL] is based on immunophenotyping analysis. CLL is searched whenever a persistent lymphocytosis is found. To evaluate the performance of flow cytometry in etiologic diagnosis of lymphocytosis. Could it allow us to distinguish CLL from other causes of lymphocytosis? Blood samples from 104 adult patients having a rate of lymphocytes> 5000 ele/mm[3] persisting more than three months were analyzed using a large panel of monoclonal antibodies in three colors and Cell Quest software. Lymphoproliferative B disorder was retained in 83 cases, including 50 cases of typical CLL with Matutes score >/= 4 and 12 cases of atypical CLL with Matutes score = 3. Diagnosis of hairy cell leukemia and follicular lymphoma were guided by the respective specific antigen expression CD103 and CD10. Large granular T lymphoma [LGL-T] was the most common etiology of lymphoid T proliferation. Unusual cases of Natural Killer [NK] and NK/T proliferations were found. The Flow cytometry is a powerful tool to establish lymphocytosis etiological diagnosis; it avoids invasive investigations in a large number of cases

[Prevalence and causal factors of anemia in children in Tunisia]

Anemia continue to be prevalent among children under five years despite the improvement of socioeconomic and sanitary indicators. The purpose of the present cross-sectorial study is to assess the etiologic factors responsible for anemia. Knowledge of the relative importance of the different causes should form a basis for intervention strategies to prevent and control anemia. The survey covered 955 children under the age of five years, native of two regions with the highest prevalence of anemia, the Southwest and the District of Tunis. The results showed that 29% of children suffered from anemia. About 70% of them were iron deficient. The fractions of the deficiency in vitamin B 12 and in folates were insignificant Only 3% of children had chronic inflammation associated with [and possibly responsible for] their anemia A little fraction of anemia [=5%] was due to thalassemia or drepanocytosis. Picawasan important causal factor of iron deficiency anemia. The parasites identified in stool could not cause anemia

[Indications and complications of central venous catheters in oncohematology: a report of 81 cases]

From February 1998 to July 1999, 81 central venous catheters were placed in 41 patients 28 years old [5 to 51 years]. We used the subclavicular anatomic way [Aubaniac] in all cases. The total duration of catheter placement was 2905 days [median of 31 days, range 1 to 165 days]. We observed 1 pneumothorax [1,2%], 3 venous thrombosis [3,7%] and 1 arterial puncture [1,2%]. Catheter-related infections were seen in 8 catheters [2,7 per 1000 catheter-days]. Candida was encountered in 4 cases [50%], Gram-positive cocci in 2 cases [25%], and Gram-negative bacilli in 2 cases [25%]. The improvment of preventive ways, diagnosis techniques [simultaneous quantitative cultures, differential positivity time], and therapeutic methods [treatment without removal of the catheter, antibiotic lock technique, catheter exchange by guidewire] should allow a better treatment of catheter-related infections

[Long term survival and prognostic factors in multiple myeloma treated with conventional chemotherapy. About 109 cases]

Our study is retrospective. We report the results of conventional chemotherapy in previosly untreated patients with myeloma. Survival and progonstic factors were analysed in 109 patients diagnosed from 1983 to 1992. The median age was 65 years, 87 patients [80%] were including in the stage III according the Durie Salmon staging system. The median survival time was 27 months and 10 years survival rate is 3,66%. In the univariate analysis, two prognostic variables were retained namely the hemoglobin and creatinine level. The study suggest that conventional therapy is agood treatment for old patients. However, patients younger than 55 years, must benefit from intensive chemotherapy supported by autologus bone marrow, pheripherol blood stem cells, or allogenic bone marrow transplantation. A considerable encrace in duration of remission and survival is possible