ABSTRACT
Abstract Background l-Asparaginase is essential in the treatment of childhood acute lymphoblastic leukemia. If immunoglobulin G anti-l-asparaginase antibodies develop, they can lead to faster plasma clearance and reduced efficiency as well as to hypersensitivity reactions, in which immunoglobulin E can also participate. This study investigated the presence of immunoglobulin G and immunoglobulin E anti-l-asparaginase antibodies and their clinical associations. Methods Under 16-year-old patients at diagnosis of B-cell acute lymphoblastic leukemia confirmed by flow cytometry and treated with a uniform l-asparaginase and chemotherapy protocol were studied. Immunoglobulin G anti-l-asparaginase antibodies were measured using an enzyme-linked immunosorbent assay. Intradermal and prick skin testing was performed to establish the presence of specific immunoglobulin E anti-l-asparaginase antibodies in vivo. Statistical analysis was used to investigate associations of these antibodies with relevant clinical events and outcomes. Results Fifty-one children were studied with 42 (82.35%) having anti-l-asparaginase antibodies. In this group immunoglobulin G antibodies alone were documented in 10 (23.8%) compared to immunoglobulin E alone in 18 (42.8%) patients. Immunoglobulin G together with immunoglobulin E were simultaneously present in 14 patients. Children who produced exclusively immunoglobulin G or no antibodies had a lower event-free survival (p-value = 0.024). Eighteen children (35.3%) relapsed with five of nine of this group who had negative skin tests suffering additional relapses (range: 2-4), compared to none of the nine children who relapsed who had positive skin tests (p-value < 0.001). Conclusion Children with acute lymphoblastic leukemia and isolated immunoglobulin G anti-l-asparaginase antibodies had a higher relapse rate, whereas no additional relapses developed in children with immunoglobulin E anti-l-asparaginase antibodies after the first relapse.
Subject(s)
Asparaginase , Immunoglobulin E , Immunoglobulin G , Escherichia coli , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Antibodies, Neutralizing , HypersensitivityABSTRACT
La rinosinusitis crónica afecta al 5 por ciento de la población que sufre infecciones de las vías respiratorias. El objetivo del presente estudio es conocer los sintomas predominantes en la población menor de 14 años con diagnóstico de rinosinusitis crónica, conocer su distribución etaria, por sexo y tiempo de evolución. Se incluyeron 100 pacientes con este diagnóstico a quienes se les realizaron: historia clínica, examen físico, citología nasal, pruebas cutáneas y serie de senos paranasales. Los sintomas predominantes fueron: tos, halitosis, descarga retronasal purulenta, fiebre, cefalea, odinofagia, dolor facial, y edema periorbitario, de predominio en el sexo masculino y con un tiempo promedio de evolución de 1-2 años
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Adolescent , Clinical Diagnosis , Hypersensitivity/prevention & control , Hypersensitivity/therapy , Paranasal Sinuses , Rhinitis/prevention & control , Rhinitis/therapy , Signs and Symptoms, RespiratoryABSTRACT
En el presente estudio se trata de demostrar si hay correlación entre elevación de IgE, eosinofilia y parasitosis, ya que la cuantificación de la IgE es difícil y costosa, mientras que el estudio de eosinófilos es simple y económico. Los resultados muestran en forma estadística, moderada correlación entre los valores de IgE y eosinófilos. Además se encontró que en la población económicamente baja la IgE y los eosinófilos son más elevados que los de la población de estrato medio, esto pudiera explicarse por la presencia de parasitosis intestinal