Subject(s)
Central Nervous System Neoplasms/drug therapy , Cladribine/administration & dosage , Lymphoproliferative Disorders/pathology , Neoplasms, Second Primary/drug therapy , Disease-Free Survival , Female , Humans , Leukemia, Hairy Cell/drug therapy , Leukemia, Hairy Cell/pathology , Lymphoma, Non-Hodgkin/drug therapy , Lymphoma, Non-Hodgkin/pathology , Lymphoproliferative Disorders/drug therapy , Male , Middle Aged , Treatment Outcome , Waldenstrom Macroglobulinemia/drug therapy , Waldenstrom Macroglobulinemia/pathologyABSTRACT
Pseudotumour of the ilium is a rare but severe complication in haemophiliacs. Excision is often complicated by infections, fistulation and extensive pelvic bone destruction. In 1978, the first author carried out excision of the pseudotumour with transposition of the omentum in the dead cavity to avoid recurrence. This type of surgery has been carried out in three additional patients. The long follow-up of these four patients suggests that this procedure is feasible and curative; local bleeding, infection and fistulation did not recur and the patients remained ambulant with the aid of appropriate devices.
Subject(s)
Bone Diseases/etiology , Bone Diseases/surgery , Granuloma, Plasma Cell/etiology , Granuloma, Plasma Cell/surgery , Hemophilia A/complications , Hemophilia A/surgery , Ilium/surgery , Adult , Humans , Middle Aged , Surgical Procedures, OperativeSubject(s)
Antineoplastic Agents/therapeutic use , Brain Neoplasms/drug therapy , Cladribine/therapeutic use , Lymphoma, Non-Hodgkin/drug therapy , Brain Neoplasms/diagnostic imaging , Brain Neoplasms/secondary , Cause of Death , Fatal Outcome , Female , Humans , Lymphoma, Non-Hodgkin/diagnostic imaging , Middle Aged , Remission Induction , Tomography, X-Ray ComputedABSTRACT
Severe intraoperative bleeding is one of the main problems during liver transplantation. Acquired hemostatic defects, namely primary or secondary hyperfibrinolysis, are considered significant pathogenetic events. Antithrombin III (ATIII), the main physiological serine protease inhibitor, has a critical role in the regulation of hemostasis. 29 patients with post necrotic cirrhosis undergoing liver transplantation were randomized to receive or not ATIII replacement therapy before the induction of anaesthesia and thereafter throughout surgery. Activation of both coagulation and fibrinolysis (increase of thrombin-antithrombin complexes, fibrin and fibrinogen degradation products) were demonstrated in both groups. Blood loss and transfusion requirements were not affected by ATIII administration.
Subject(s)
Antithrombin III/administration & dosage , Hemorrhage/prevention & control , Liver Cirrhosis/surgery , Liver Transplantation , Adult , Antithrombins/analysis , Blood Coagulation/drug effects , Female , Fibrin Fibrinogen Degradation Products/analysis , Humans , Infant , Male , Middle Aged , Multienzyme Complexes/analysis , Thrombin/analysisABSTRACT
Thromboembolic complications during pregnancy are frequent in patients with congenital antithrombin III deficiency. We report on a 29-year-old patient with congenital antithrombin III deficiency and severe pulmonary embolism treated with recombinant tissue plasminogen activator. The diagnosis of antithrombin deficiency is retrospective. This case indicates that the risk of thrombolytic therapy in this clinical setting might have been overemphasized.
Subject(s)
Antithrombin III Deficiency , Pregnancy Complications, Cardiovascular/drug therapy , Pulmonary Embolism/drug therapy , Tissue Plasminogen Activator/administration & dosage , Adult , Emergencies , Female , Humans , Infant, Newborn , Infusions, Intravenous , Male , PregnancyABSTRACT
Pentostatin was used to treat 26 patients with advanced B-cell chronic lymphocytic leukemia resistant to conventional treatment. Twenty patients had progressive disease on previous regimens and six had had partial remission and then relapsed 3-34 months after previous chemotherapy. Eleven patients had previously been treated with three different regimens. 10 had been treated with two regimens, and five had been treated with one regimen. Pentostatin was administered at a dosage of 4 mg/m2 weekly for 3 weeks, then 4 mg/m2 every other week for 6 weeks and once a month for 6 months. Seven of 26 assessable patients (27%) achieved partial remission and five (19%) achieved clinical improvement. The median duration of partial remission until relapse or death was 210 days. Myelosuppression was minor and transient in responsive patients, indicating some degree of selective effect on lymphocytes. Except for one patient who died of cerebral hemorrhage during the first 6 weeks of treatment, no drug-related deaths were registered. Major toxic effects included nausea in 17 patients (mainly grade 1), infections in 15, and liver enzyme elevations in five. Thus, pentostatin is active, even in patients with advanced B-cell chronic lymphocytic leukemia that is refractory to multiple chemotherapy regimens. Response can be achieved with mild myelosuppression.
Subject(s)
Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy , Pentostatin/therapeutic use , Adult , Aged , Drug Evaluation , Female , Humans , Male , Middle Aged , Pentostatin/adverse effectsABSTRACT
The patient is a 23 y.o. man with acute nephritis and bleeding at presentation. Laboratory data consistent with the diagnosis of systemic lupus erythematosus. A lupus anticoagulant was found: tissue thromboplastin inhibition test (TTIT) ratio 3.4; diluted Russell viper venom (DRVV) ratio 2.6. Hypoprothrombinemia (FII:C less than 1%; FIIR:Ag 5%) was present; prothrombin survival time (FII concentrate infusion 60 U/kg): t1/2 approximately to 9 hours. A prothrombin antibody was identified: it is not neutralizing but forms an immunecomplex with prothrombin. The antibody was characterized as IgG2, IgA, k, lambda. The prothrombin survival time indicates that the hypoprothrombinemia is due to the clearance of the prothrombin-antiprothrombin complex in vivo.
