Tumor del estroma gastrointestinal gástrico epitelioide en el curso de una leucemia de linfocitos grandes granulares T / Gastrointestinal stromal tumour coexisting with a T cell large granular lympholcytic leukemia

Los tumores del estroma gastrointestinal (GIST) representan las neoplasias mesenquimales más comunes del tracto gastrointestinal. Estos tumores generalmente muestran expresión inmunohistoquímica de c-KIT y/o DOG-1 y presentan mutaciones en los genes KIT o PDGFRα. La coexistencia de GIST con otras neoplasias ha sido ampliamente documentada en la literatura. Los tumores más comúnmente asociados a GIST son los carcinomas y las patologías hematológicas, sobre todo las leucemias mieloides. Describimos un caso de coexistencia de GIST con leucemia de linfocitos grandes granulares, algo previamente no descrito en la literatura. Se describen las características clinicopatológicas de ambos tumores y se revisa la literatura actualizada sobre el tema (AU)

Gastrointestinal stromal tumours (GISTs) are the most common mesenchymal tumours of the gastrointestinal tract. GISTs usually have c-KIT and/or DOG-1 immunoexpression and are related to mutational activation of KIT or PDGFRα. The coexistence of GISTs with other neoplasms has been frequently reported, the most common secondary neoplasms being carcinomas and hematologic neoplasms, mainly myeloid leukaemia. We describe, to our knowledge for the first time, the coexistence of GIST and T-large granular lymphocytic leukemia (T-LGL). The clinicopathological features of both tumours are discussed and the recent literature is reviewed (AU)

Evaluation of bleeding risk and measurement methods in dental patients

Objective: The present study explores bleeding manifestations in routine dental surgical procedures, evaluates the influence of antithrombotic drugs upon bleeding risk, and validates the efficiency of a clinical method for the measurement of bleeding.Material and method: A prospective observational study was made involving a cohort of 99 patients in the setting of normal clinical practice, with the added conduction of prior hematological tests including baseline hemostasis and platelet function, based on a new method (Multiplate System(R). For evaluation of the bleeding manifestations,a clinical method was selected that evaluates bleeding on the basis of its duration and the hemostatic measures needed to resolve the problem.Results: Almost one-third of the patients (27.3%) were receiving treatment with oral antiplatelet drugs, while 19.2% received oral anticoagulants and 9% received combined therapy with acetylsalicylic acid plus clopidogrel. In turn, an 8% incidence of moderate bleeding episodes was detected correlated to the ASPI platelet function testand to advanced patient age.Conclusion: The incorporation of platelet function tests increases the safety of oral surgery in elderly patients subjected to antiplatelet treatment, particularly with acetylsalicylic acid and clopidogrel (AU)

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Evaluation of bleeding risk and measurement methods in dental patients.

OBJECTIVE: The present study explores bleeding manifestations in routine dental surgical procedures, evaluates the influence of antithrombotic drugs upon bleeding risk, and validates the efficiency of a clinical method for the measurement of bleeding. MATERIAL AND METHOD: A prospective observational study was made involving a cohort of 99 patients in the setting of normal clinical practice, with the added conduction of prior hematological tests including baseline hemostasis and platelet function, based on a new method (Multiplate System®). For evaluation of the bleeding manifestations, a clinical method was selected that evaluates bleeding on the basis of its duration and the hemostatic measures needed to resolve the problem. RESULTS: Almost one-third of the patients (27.3%) were receiving treatment with oral antiplatelet drugs, while 19.2% received oral anticoagulants and 9% received combined therapy with acetylsalicylic acid plus clopidogrel. In turn, an 8% incidence of moderate bleeding episodes was detected correlated to the ASPI platelet function test and to advanced patient age. CONCLUSION: The incorporation of platelet function tests increases the safety of oral surgery in elderly patients subjected to antiplatelet treatment, particularly with acetylsalicylic acid and clopidogrel.

Prolonged survival of patients with angioimmunoblastic T-cell lymphoma after high-dose chemotherapy and autologous stem cell transplantation: the GELTAMO experience.

OBJECTIVES: Angioimmunoblastic T-cell lymphoma (AIL) is a rare lymphoma with a poor prognosis and no standard treatment. Here, we report our experiences with 19 patients treated with high-dose chemotherapy and autologous stem cell transplantation (HDC/ASCT) within the GELTAMO co-operative group between 1992 and 2004. METHODS: The median age at transplantation was 46 yr. Fifteen patients underwent the procedure as front-line therapy and four patients as salvage therapy. Most patients received peripheral stem cells (90%) coupled with BEAM or BEAC as conditioning regimen (79%). RESULTS: A 79% of patients achieved complete response, 5% partial response and 16% failed the procedure. After a median follow-up of 25 months, eight patients died (seven of progressive disease and secondary neoplasia), while actuarial overall survival and progression-free survival at 3 yr was 60% and 55%. Prognostic factors associated with a poor outcome included bone marrow involvement, transplantation in refractory disease state, attributing more than one factor of the age-adjusted-International Prognostic Index, Pretransplant peripheral T-cell lymphoma (PTCL) Score or Prognostic Index for PTCL. CONCLUSIONS: More than half of the patients with AIL that display unfavourable prognostic factors at diagnosis or relapse would be expected to be alive and disease-free after 3 yr when treated with HDC/ASCT. Patients who are transplanted in a refractory disease state do not benefit from this procedure.