Trasplante autólogo de progenitores hematopoyéticos en el Linfoma de Hodgkin / Autologous hematopoietic stem cell transplantation in Hodgkin's Lymphoma

Introducción: El trasplante autólogo de progenitores hematopoyéticos es una terapéutica aplicable en determinadas situaciones a pacientes con Linfoma de Hodgkin. Objetivo: Evaluar la respuesta al trasplante autólogo de progenitores hematopoyéticos en los pacientes con Linfoma de Hodgkin. Métodos: Se realizó un estudio de 60 pacientes con Linfoma de Hodgkin trasplantados en el Hospital Clínico Quirúrgico Hermanos Ameijeiras, entre 1991 y 2018. Se estimó el porcentaje de respuesta a los tres meses, la supervivencia global y la supervivencia libre de enfermedad a los cinco años. Resultados: La tasa de respuesta a los tres meses fue de 82,7 por ciento. La supervivencia global y libre de enfermedad a los cinco años fue de 94,7 por ciento y 51,7 por ciento, respectivamente. La mortalidad temprana relacionada con el trasplante fue de 5 por ciento. Conclusiones: La aplicación del trasplante autólogo de progenitores hematopoyéticos constituyó una alternativa terapéutica válida. La baja mortalidad temprana evidenció una realización del procedimiento con un perfil de seguridad satisfactorio(AU)

Introduction: Autologous hematopoietic stem cell transplantation is an applicable therapy in certain situations to patients with Hodgkin's Lymphoma. Objective: To evaluate the response to autologous hematopoietic stem cell transplantation in patients with Hodgkin's Lymphoma. Methods: A study of 60 patients with Hodgkin lymphoma transplanted at Hermanos Ameijeiras Clinical and Surgical Hospital was carried out from 1991 to 2018. The percentage of response at three months, overall survival and disease-free survival period were estimated at five years. Results: The response rate at three months was 82.7 percent. Overall and disease-free survival at five years was 94.7 percent and 51.7 percent, respectively. Early transplant-related mortality was 5 percent. Conclusions: The use of autologous hematopoietic stem cell transplantation was a valid therapeutic alternative. The low early mortality evidenced that the procedure was performed with a satisfactory safety profile(AU)

Autologous Transplantation of Bone Marrow Adult Stem Cells for the Treatment of Idiopathic Dilated Cardiomyopathy / Transplante Autólogo de Células-Tronco Adultas para Tratamento da Cardiomiopatia Dilatada Idiopática

Background: Morbimortality in patients with dilated idiopathic cardiomyopathy is high, even under optimal medical treatment. Autologous infusion of bone marrow adult stem cells has shown promising preliminary results in these patients. Objective: Determine the effectiveness of autologous transplantation of bone marrow adult stem cells on systolic and diastolic left ventricular function, and on the degree of mitral regurgitation in patients with dilated idiopathic cardiomyopathy in functional classes NYHA II and III. Methods: We administered 4,54 x 108 ± 0,89 x 108 bone marrow adult stem cells into the coronary arteries of 24 patients with dilated idiopathic cardiomyopathy in functional classes NYHA II and III. Changes in functional class, systolic and diastolic left ventricular function and degree of mitral regurgitation were assessed after 3 months, 6 months and 1 year. Results: During follow-up, six patients (25%) improved functional class and eight (33.3%) kept stable. Left ventricular ejection fraction improved 8.9%, 9.7% e 13.6%, after 3, 6 and 12 months (p = 0.024; 0.017 and 0.018), respectively. There were no significant changes neither in diastolic left ventricular function nor in mitral regurgitation degree. A combined cardiac resynchronization and implantable cardioversion defibrillation was implanted in two patients (8.3%). Four patients (16.6%) had sudden death and four patients died due to terminal cardiac failure. Average survival of these eight patients was 2.6 years. Conclusion: Intracoronary infusion of bone marrow adult stem cells was associated with an improvement or stabilization of functional class and an improvement in left ventricular ejection fraction, suggesting the efficacy of this intervention. There were no significant changes neither in left ventricular diastolic function nor in the degree of mitral regurgitation. .

Fundamento: Pacientes portadores de cardiomiopatia dilatada idiopática apresentam alta morbimortalidade, mesmo em tratamento clínico otimizado. A infusão autóloga de células-tronco adultas da medula óssea mostrou resultados clínicos preliminares promissores nesses pacientes. Objetivo: Determinar a eficácia do transplante autólogo de células-tronco adultas da medula óssea sobre as funções sistólica e diastólica, e o grau de insuficiência mitral em pacientes portadores de cardiomiopatia dilatada idiopática em classes funcionais NYHA II e III. Métodos: Infundiram-se 4,54 x 108 ± 0,89 x 108 células-tronco adultas da medula óssea nas artérias coronárias de 24 pacientes com cardiomiopatia dilatada idiopática em classes funcionais NYHA II e III. Após 3 meses, 6 meses e 1 ano, avaliaram-se as mudanças de classe funcional, das funções ventricular esquerda sistólica e diastólica, e do grau da insuficiência mitral. Resultados: No seguimento, seis (25%) pacientes melhoraram sua classe funcional e oito (33,3%) mantiveram sua classe funcional inicial. A fração de ejeção ventricular esquerda aumentou 8,9%, 9,7% e 13,6%, após 3 e 6 meses e 1 ano (p = 0,024; p = 0,017 e p = 0,018), respectivamente. A função diastólica ventricular esquerda e o grau de insuficiência mitral não demonstraram mudanças significativas. Dois pacientes (8,3%) receberam cardioversor e ressincronizador implantável. Ocorreram quatro (16,6%) mortes súbitas e quatro (16,6%) mortes por insuficiência cardíaca terminal. A sobrevida média desses oitos pacientes foi de 2,6 anos. Conclusão: A infusão intracoronariana de células-tronco adultas da medula óssea em pacientes com cardiomiopatia dilatada idiopática promoveu melhora ...

Transplante pulmonar experimental / Unilateral lung transplant experimental

Se realizaron 21 transplantes pulmonares unilaterales en perros, divididos en tres grupos: 1) autotransplante sin sobrevida, 2) autotransplante y 3) homotransplante. Se anastomosaron la arteria pulmonar, una porción de pared de aurícula izquierda con las venas pulmonares y el bronquio, cuya sutura fue cubierta con epiplón en 4 animales, con grasa pericárdica en 2 y no fue cubierta en 3. Los hallasgos post-operatorios se corresponden en general con los mencionados en la literatura. No se observó relación entre la cicatrización de la sutura bronquial y el uso o tipo de cobertura utilizada para la misma