Use of selected CD34+ cells in the treatment of relapsed/progressive HD: experiences from a single center.

BACKGROUND: Treatment of HD using positively selected stem cells can achieve a durable CR in almost 80% patients, with a median follow-up of 24 months. We have found the use of positive selected CD34+ cells in the treatment of relapsed/progressive HD after high-dose chemotherapy to be a safe procedure with promising results. METHODS: Positively selected (CD34+) stem cells were employed for autografting in the patients with HD after high-dose chemotherapy. RESULTS: Between April 1996 and February 2001, 28 patients with relapsed/progressive HD were autografted with positively selected CD34+ cells at our Institute. All patients are alive and we did not observe any deaths as a result of toxicity. From this group, 22 (78.6%) patients are in durable CR, with a median follow-up of 24 months (range 7-65 months). Six (21.4%) patients relapsed but are now in CR after radiotherapy and mini-allogeneic transplantation (one patient) or radiotherapy (five patients). DISCUSSION: Autologous transplantation with positively selected CD34+ cells in relapsed HD is a safe and effective procedure in the treatment of this disease.

A multicenter study of recombinant human erythropoietin (epoetin alpha) in the management of anemia in cancer patients receiving chemotherapy.

Current evidence suggests that epoetin alpha administration is well tolerated and effective in the management of anemia of cancer and cancer chemotherapy. An open-label, multinational, non-comparative study was conducted in 215 cancer patients with anemia secondary to chemotherapy with platinum- or non-platinum-based combinations. Epoetin alpha was administered s.c. (150 IU/kg three times/week) for a planned period of 16 weeks. The response rate of epoetin alpha, defined as an increase in hemoglobin level of 2 g/dl or more from baseline, was 67%. The rate of response was not related to the chemotherapy regimen administered (platinum or non-platinum based). The percentage of patients transfused and the transfusion rate during epoetin alpha treatment were reduced. Transfusional need was eliminated in 64 (75%) of the 85 patients transfused before the study start, after 1 month of therapy. Quality of life, assessed using a visual analog scale, improved markedly in patients who experienced a hematological response. These patients also experienced a statistically significant (p < 0.0001) improvement in mean WHO performance score. These findings indicate that epoetin alpha is a well tolerated and effective agent which increases hemoglobin concentration and reduces transfusion requirements in anemic cancer patients receiving chemotherapy.

Ciprofloxacin plus vancomycin versus ceftazidime plus gentamicin in the treatment of pneumonia in granulocytopenic patients with or without venous catheters. Short communication.

58 granulocytopenic patients with confirmed bronchopneumonia were divided retrospectively into two groups for this pilot study: group 1 included neutropenic patients with venous catheters who were treated with ciprofloxacin (CIP; 200-300 mg, i.v. b.i.d.) + vancomycin (VAN; 0.5-1 g, i.v. b.i.d.), and group 2, which included patients without venous catheters treated with ceftazidime (2 g, i.v. t.i.d.) + gentamicin (1 mg/kg, i.v. t.i.d.). Pneumonia was diagnosed clinically and radiologically in all patients; 92.3% in group 1 and 46.8% in group 2 were also microbially confirmed. Mixed infections were present in most patients. 3 of 26 patients (11.5%) in group 1 and 9 of 32 (20.1%) in group 2 did not recover while 88.5% in group 1 and 71.9% in group 2 recovered. CIP + VAN seems to be more effective in treating pneumonia in neutropenic patients, with only 1 patient in the group suffering an adverse effect compared with 5 in group 2.

[Determination of B and T lymphocytes in bronchoalveolar lavage and peripheral blood of patients with active sarcoidosis]. / Odredivanje B i T limfocita u bronhioalveolarnom ispirku i perfirnoj krvi kod bolesnika sa aktivnom sarkoidozom.

The total number of cells, alveolar lymphocytes as well as T lymphocytes is increased in BAL in patients with active sarcoidosis (acute phase and relapse) with disturbed relation T4-T8 subpopulation. T lymphocytes are significantly decreased in peripheral blood of patients with active sarcoidosis, while B lymphocytes are also decreased but without evident significance in relation to normal values.