Independent value of DNA ploidy as a prognostic indicator in patients with nonmetastatic renal cell carcinoma

Several studies performed on tumours from different organs have shown that DNA ploidy is art additional predictor for survival. However the significance of DNA ploidy as an independant prognostic for patients with renal cell carcinoma [RCC] is less clear. Therefore purpose of this study is to assess if DNA flow cytometry data in RCC valuable prognostic information. One hundred sixty-eight consecutive patients were selected from 226 patients with RCC who underwent nephrectomy at our institution between 1983 and 1995. All patients were free of metastatic or locally irresectable disease preoperatively. DNA content was analysed by flow-try. DNA ploidy of the tumour tissue was compared with tumour pathologic stage [TNM 1997], grade, histological subtypes and disease related survival rates. Different prognostic factors were studied us-both univariate and multivariate analyses. Of the 168 tumours analysed, 92 [54.8%] displayed diploid and 76 [45.2%] had aneuploid pattern. Statistical correlations were between DNA ploidy pattern and each of tumour size, stage and grade. Significant high incidence of tumour recurrence was observed among patients with aneuploid tumours [46%] when compared with that diploid population [17, 4%] [P<0.001]. According to univariate analysis, tumour size, stage, grade and DNA ploidy had significant impact on patients outcome. On rnultivariate analysis, DNA ploidy in addition to tumour stage and grade were sign4ftcant independent prognostic factors. DNA ploidy is a reliable prognostic factor for RCC and yields considerable information for patient management and predicting clinical outcome

Mansoura ATG and steroid resistant rejection

ATG is one of the most effective therapeutic agents in the treatment of acute renal allogrqft rejection, especially when the episode is resistant to steroids. Anti thymocyte globulin [ATG] is a hyperirnmune serum produced in rabbits against purified human thymus cells. Fifteen patches of ATG were prepared locally in our lab. Antibody production was done by injection of purified human thymus cells into about 10-12 rabbits/patch. Adsorption, fractionation and purification of rabbit serum, antibody assays, and quality control tests were done. Our ATG was utilized in 20 patients suffering from sterioid resistant rejection [SRR]. Monitoring of the drug by T cell subsets analysis and Anti ATG antibodies revealed depletion of the total T lymphocytes especially in the early doses beside absence of anti ATG antibodies without any side effects of the preparation on the other haematologic series. Regarding the clinical efficacy of our ATG in reversing SRR, 80% of cases respond completely while partial response was noted in 10% and another 10% showed failure. In conclusion our ATG is as effective as other ATG in saving renal transplantation otherwise the graft will be lost