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1.
Cytotherapy ; 9(4): 348-55, 2007.
Article in English | MEDLINE | ID: mdl-17573610

ABSTRACT

BACKGROUND: Adverse events (AE) represent a significant clinical problem after infusion of cryopreserved HPC. However, the factors playing a role in the pathogenesis have not yet been fully established. METHODS: We prospectively collected data on AE that occurred with 179 HPC infusions performed on patients affected with hematologic neoplasm after high-dose chemotherapy. The stem cell source was hemopoietic progenitor cells aphaeresis (HPC-A) in 157 cases and hemopoietic progenitor cell BM (HPC-BM) in 22 cases. In all cases, an endotoxin-free DMSO was used. RESULTS: One or more AE were registered in 51/179 infusions (28.6%). The frequency of AE was higher after HPC-A than after HPC-BM (31.3% vs. 4.5%; chi(2) test, P =0.008). With univariate logistic regression, other factors found important for AE were age (P =0.028), number of total nucleated cells infused per kilogram (P =0.002), volume per kilogram infused (P =0.057), volume of packed RBC (P =0.019), a content of non-mononuclear cells >0.5 x 10(8)/kg (

0.5 x 10(8)/kg (P =0.0003) remained significant. A significant correlation existed between reduction of cardiac frequency both with volume per kilogram infused (r =0.221, P =0.02) and actual time of infusion (r =0.269, P =0.005). DISCUSSION: Cardiovascular changes are influenced by volume per kilogram infused and by actual time of infusion, while non-cardiovascular AE are dependent on patient age and contamination by non-mononuclear cells in apheretic harvests.


Subject(s)
Aging/physiology , Cryopreservation , Hematopoietic Stem Cell Transplantation/adverse effects , Adolescent , Adult , Aged , Blood Component Removal , Blood Pressure , Bone Marrow Cells/cytology , Cardiovascular System , Child , Female , Heart Rate , Hematocrit , Humans , Infusions, Intravenous , L-Lactate Dehydrogenase/blood , Leukocytes, Mononuclear , Male , Middle Aged
2.
Ann Oncol ; 18(2): 351-6, 2007 Feb.
Article in English | MEDLINE | ID: mdl-17065587

ABSTRACT

BACKGROUND: Endoscopic ultrasound (EUS) is considered the best technique for locoregional staging at diagnosis but its role in the follow-up of patients with gastric lymphoma after organ-conserving strategies has not been established. DESIGN AND METHODS: We retrospectively evaluated 23 patients with primary gastric lymphoma treated with a stomach-conservative approach. Sixteen of them were affected by MALT lymphoma and seven by diffuse large-B-cell lymphoma (DLBCL). Five patients were treated with Helicobacter pylori (HP) eradication therapy alone (omeprazole + amoxicillin + clarithromycin); eight patients received a treatment including HP eradication and chemotherapy and the remaining 10 patients were treated with chemotherapy alone. RESULTS: At the end of treatment, a complete remission was documented in 21 (91%) patients by endoscopy with biopsy (E-Bx) but in only seven (30%) patients by EUS. A total of 99 evaluations with both EUS and E-Bx were evaluated and we found concordance between the two methods in 33 occasions (33%) only. No significant difference on the percentage of concordance was recorded between MALT and DLBCL. After a median follow-up of 36.5 months we have not observed any relapse in 12 patients (six DLBCL and six MALT) with a persistent positive EUS but negative E-Bx. CONCLUSIONS: Although the length of follow-up cannot exclude late relapse, we think that in restaging and follow-up of gastric lymphoma, EUS seems not to be a reliable tool if it is abnormal and E-Bx still remains the gold standard. Therefore, after conventional conservative treatment, persistence of EUS abnormality with a negative histology should not be considered as a clinically relevant persistence of disease and should not be a reason for further treatment.


Subject(s)
Endosonography , Helicobacter Infections/drug therapy , Helicobacter pylori , Lymphoma, B-Cell, Marginal Zone/diagnostic imaging , Lymphoma, Large B-Cell, Diffuse/diagnostic imaging , Stomach Neoplasms/diagnostic imaging , Adult , Aged , Anti-Bacterial Agents/therapeutic use , Antineoplastic Agents/therapeutic use , Drug Therapy, Combination , Female , Helicobacter Infections/complications , Humans , Lymphoma, B-Cell, Marginal Zone/complications , Lymphoma, B-Cell, Marginal Zone/drug therapy , Lymphoma, Large B-Cell, Diffuse/complications , Lymphoma, Large B-Cell, Diffuse/drug therapy , Male , Middle Aged , Retrospective Studies , Stomach Neoplasms/complications , Stomach Neoplasms/drug therapy
4.
Leukemia ; 17(6): 1085-90, 2003 Jun.
Article in English | MEDLINE | ID: mdl-12764372

ABSTRACT

In all, 134 elderly patients (median age 66 years, range 60-75 years) with newly diagnosed acute promyelocytic leukemia (APL) were enrolled in two successive protocols of the Italian multicenter group GIMEMA. All patients received an identical induction with all-trans retinoic acid and idarubicin; 116 (86%) entered complete remission (CR), two (2%) were resistant and 16 (12%) died during induction. After CR, 106 patients received further therapy whereas 10 did not, because of refusal (n=5) or toxicity (n=5). Consolidation consisted of three chemotherapy courses in the AIDA protocol (AIDA, 67 patients) or, since 1997, of an amended protocol including only the first cycle (amended AIDA, aAIDA, 39 patients). In the AIDA group, 43 patients (64%) completed consolidation, while seven (11%) and 17 (25%) patients were withdrawn after first and second courses, respectively; nine patients (13%) died in CR and 12 (18%) relapsed. In the aAIDA group, all patients received the assigned treatment; two patients (5%) died in CR and six (15%) relapsed. In the AIDA and aAIDA series, the 3-year overall and discase-free survival rates were 81 and 83% (P=NS), 73 and 72% (P=NS), respectively. We highlight here the frequency and severity of complications linked to intensive chemotherapy in this clinical setting and suggest that, in APL of the elderly, less intensive postremission therapy allows significant reduction of severe treatment-related toxicity and may be equally effective.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Idarubicin/therapeutic use , Leukemia, Promyelocytic, Acute/drug therapy , Tretinoin/therapeutic use , Aged , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Female , Humans , Idarubicin/adverse effects , Leukemia, Promyelocytic, Acute/genetics , Male , Middle Aged , Neoplasm Proteins/genetics , Neoplasm Proteins/metabolism , Oncogene Proteins, Fusion/genetics , Oncogene Proteins, Fusion/metabolism , RNA, Messenger/metabolism , RNA, Neoplasm/genetics , RNA, Neoplasm/metabolism , Remission Induction , Reverse Transcriptase Polymerase Chain Reaction , Survival Rate , Treatment Outcome , Tretinoin/adverse effects
5.
Bone Marrow Transplant ; 31(9): 747-54, 2003 May.
Article in English | MEDLINE | ID: mdl-12732880

ABSTRACT

We performed a randomized study to compare 'G-CSF alone' (administered at dose of 10 mcg/kg/day) and 'cyclophosphamide plus G-CSF' (cyclophosphamide at dose of 4 g/m(2) and G-CSF at dose of 10 microg/kg/day), as PBPC mobilization schedules in 52 patients with NHL or HD. Randomization was stratified according to the amount of previous chemotherapy (< or =2 and >2 lines of previous chemotherapy). Mean CD34+ cell peak in P.B., mean 'Total CD34+ cells' harvested and percentage of patients successfully mobilized, in the group mobilized with 'G-CSF alone' vs the group mobilized with 'cyclophosphamide plus G-CSF', were: 35.3 x 10(6) vs 45.8 x 10(6)/l (P=0.3), 5.4 x 10(6) vs 6.8 x 10(6)/kg (P>0.9) and 50 vs 61% (P=0.4). No differences were observed in the stratum of less pretreated patients. However, in the stratum of patients who had previously received more than two lines of chemotherapy, CD34+cell peak (P=0.05) and percentage of successful mobilization (P=0.01) were higher when 'cyclophosphamide plus G-CSF' was used. Using logistic regression, both age and mobilization with 'G-CSF alone' were significantly associated with a low CD34+ cell peak in P.B. However, in the stratum of less pretreated patients, only age was significantly associated with this risk.


Subject(s)
Cyclophosphamide/administration & dosage , Granulocyte Colony-Stimulating Factor/administration & dosage , Hematopoietic Stem Cell Mobilization/methods , Lymphoma/therapy , Adult , Age Factors , Antigens, CD34 , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Cell Count , Female , Hematopoietic Stem Cells/drug effects , Humans , Male , Middle Aged , Premedication , Retreatment
6.
Ann Oncol ; 12(5): 621-5, 2001 May.
Article in English | MEDLINE | ID: mdl-11432619

ABSTRACT

BACKGROUND: Previous studies have shown that the serum thymidine kinase (TK) level can be used to determine prognosis in patients with lymphoproliferative diseases, but mainly those with multiple myeloma and non-Hodgkin's lymphoma. In patients with chronic lymphocytic leukemia (CLL), TK levels may provide prognostic information independent of stage and other prognostic factors, but it is still unclear whether they can be used to predict the response to treatment and length of survival. PATIENTS AND METHODS: To determine whether TK levels can be used to predict response and survival, we retrospectively examined the serum TK level in 188 previously treated and untreated patients with active or advanced CLL who were then treated with fludarabine alone or in combination with prednisone. The correlation of the TK level with other prognostic features and with outcome was then assessed. RESULTS: Serum TK levels were elevated in 92% of the patients, and the levels proved to associate with previous treatment, stage of disease, and other tumor-burden related features (i.e., white blood cell counts, absolute lymphocyte count, bone marrow cellularity). The levels were also directly associated with indicators of tumor cell turnover (i.e., beta2-microglobulin and lactate dehydrogenase levels). Of particular importance, we found that the TK level was a significant prognostic indicator of both response to treatment and survival. Specifically, 83% of patients with a TK level of < 10 U/L responded (complete and partial response) to treatment with fludarabine, whereas only 45% of patients with a TK level of > or = 10 U/l responded to treatment (P < 0.01). This difference was maintained when we separately analyzed untreated and previously treated patients, and in patients divided according to the Binet stage. The TK level also added prognostic information about response to a predictive model based on the hemoglobin and, albumin levels and the extent of prior treatment. Of further importance, the median survival rate in patients with a TK level of < 10 U/l was 65%, as opposed to a rate of 22% in patients with a TK level of > or = 10 U/l (P = 0.000). CONCLUSIONS: The serum TK level in CLL patients provides useful prognostic information regarding both response to therapy and length of survival and should be used in planning appropriate therapy. In particular, patients with a TK level of > or = 10 U/l have a poor prognosis and should be considered for aggressive treatment.


Subject(s)
Antineoplastic Agents, Hormonal/therapeutic use , Antineoplastic Agents/therapeutic use , Biomarkers, Tumor/analysis , Leukemia, Lymphocytic, Chronic, B-Cell/enzymology , Leukemia, Lymphocytic, Chronic, B-Cell/pathology , Thymidine Kinase/analysis , Vidarabine/analogs & derivatives , Vidarabine/therapeutic use , Aged , Female , Humans , Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy , Male , Middle Aged , Prednisolone/therapeutic use , Prognosis , Retrospective Studies , Survival Analysis , Thymidine Kinase/metabolism , Treatment Outcome
8.
Leukemia ; 15(6): 976-80, 2001 Jun.
Article in English | MEDLINE | ID: mdl-11417486

ABSTRACT

An increase of angiogenesis has been shown in idiopathic myelofibrosis with myeloid metaplasia (MMM) by microvessel density count method but evaluation of circulating angiogenic factors is still incomplete. In 31 patients affected by MMM and in 12 healthy subjects we evaluated the serum levels of VEGF (vascular endothelial growth factor) and correlated VEGF with clinical and laboratory features of disease. We found that MMM patients had circulating VEGF concentrations much higher than controls (Median 1208 ng/ml vs 138 ng/ml, P < 0.0001). No correlation was found between VEGF and Hb, WBC, PLT, LDH, creatinine, bone marrow cellularity, fibrosis, splenomegaly, hepatomegaly, and therapy. However, in the subgroup of patients with a normal or low VEGF concentration, a direct correlation between VEGF and platelet count (r = 0.90, P = 0.002) was detected. Moreover, patients with a platelet count < 300 x 10(9)/l had VEGF serum levels lower than patients with a higher PLT count (median VEGF 864 vs 1557 pg/ml, P = 0.001). In six patients and in eight controls we also had the opportunity to measure VEGF in the plasma and we calculated that VEGF concentration was much higher in platelet-rich than in platelet-poor plasma and that platetets of MMM patients contained four times more VEGF than those of healthy controls. These results indicate that VEGF is overproduced in MMM, thus confirming an increased angiogenic activity. Platelets are probably a major source of VEGF in MMM but not the only one.


Subject(s)
Endothelial Growth Factors/blood , Lymphokines/blood , Primary Myelofibrosis/blood , Adult , Aged , Aged, 80 and over , Bone Marrow/pathology , Cohort Studies , Enzyme-Linked Immunosorbent Assay , Female , Humans , Male , Middle Aged , Neovascularization, Pathologic/blood , Neovascularization, Pathologic/etiology , Plasma/chemistry , Platelet Count , Primary Myelofibrosis/complications , Spleen/pathology , Vascular Endothelial Growth Factor A , Vascular Endothelial Growth Factors
11.
Acta Haematol ; 106(4): 177-83, 2001.
Article in English | MEDLINE | ID: mdl-11815715

ABSTRACT

Increased angiogenic activity has been demonstrated in myelofibrosis with myeloid metaplasia (MMM), chronic myeloid leukemia (CML), and essential thrombocythemia (ET) by both bone marrow microvessel density evaluation and measurement of circulating angiogenic factors. MMM is probably the disease with the more pronounced angiogenesis among myeloproliferative disorders but the significance of this finding remains speculative since the angiogenic activity is not correlated with any of the clinical and laboratory features of the disease. Circulating serum levels of angiogenic factors such as vascular endothelial growth factor (VEGF) and hepatocyte growth factor (HGF) were found increased in MMM, CML and ET but the frequent thrombocytosis that accompanies these diseases could limit the interpretation of these data since platelets and megakaryocytes may be considered a major source at least for VEGF. However, CML patients treated with interferon were found to have lower VEGF and HGF levels than untreated or hydroxyurea-treated patients, thus suggesting a possible antiangiogenic mechanism of this drug. In addition, preliminary experiences with the antiangiogenic drug thalidomide have shown therapeutic activity in some myeloproliferative disorders.


Subject(s)
Myeloproliferative Disorders/pathology , Neovascularization, Pathologic , Bone Marrow/blood supply , Bone Marrow/pathology , Chronic Disease , Growth Substances/metabolism , Growth Substances/physiology , Humans , Myeloproliferative Disorders/metabolism , Primary Myelofibrosis/metabolism , Primary Myelofibrosis/pathology
12.
Haematologica ; 85(8): 800-5, 2000 Aug.
Article in English | MEDLINE | ID: mdl-10942925

ABSTRACT

BACKGROUND AND OBJECTIVES: To study the role of some soluble factors in the process of angiogenesis that accompanies multiple myeloma (MM). DESIGN AND METHODS: The concentrations of three well-known angiogenic peptides, vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), and hepatocyte growth factor (HGF) were evaluated by an ELISA method. All of these factors were measured in the plasma obtained from peripheral blood (PB) and bone marrow (BM) aspirates of 34 patients affected by plasma cell disorders. This series included one patient with a solitary extramedullary plasmacytoma, 17 patients with MM at diagnosis, and 16 with previously treated MM. RESULTS: In all the patients, the concentration of each angiogenic factor was higher in bone marrow than in peripheral blood. Mean values of the three angiogenic factors in BM or in PB were lower in stage I than stage II-III. One patient with extramedullary solitary myeloma had high levels of VEGF and bFGF but this increase was not found in the other 6 patients with extramedullary disease when compared with patients without extramedullary disease. VEGF and bFGF did not correlate with each other while HGF showed a weak correlation with VEGF and a stronger one with bFGF. Moreover, VEGF correlated with features of disease activity, such as C-reactive protein, and 2-microglobulin, while both bFGF and HGF showed an inverse correlation with albumin level. No correlation was found between VEGF, bFGF and HGF levels and age, M protein level, osteolytic lesions, or percentage of BM plasma cells. Since angiogenic factors may be released by normal cells in response to hypoxia, we also evaluated erythropoietin (EPO) levels (which correlate with the hypoxic stimulus) both in PB and BM plasma of these patients but none of the measured angiogenic factors correlated with EPO levels. Interpretation and Conclusions. Several soluble factors may play a role in the angiogenic activity described in MM but their contribution to the progression of disease may be different. The finding of higher levels of these factors in BM than in PB might indicate that the bone marrow environment is their major source. Concentrations of angiogenic factors parallel the activity of disease and are independent of the hypoxic stimulus.


Subject(s)
Bone Marrow/chemistry , Endothelial Growth Factors/analysis , Fibroblast Growth Factor 2/analysis , Hepatocyte Growth Factor/analysis , Lymphokines/analysis , Multiple Myeloma/physiopathology , Neoplasm Proteins/analysis , Neovascularization, Pathologic/metabolism , Adrenal Cortex Hormones/therapeutic use , Adult , Aged , Aged, 80 and over , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Biomarkers , Bone Marrow/pathology , Cell Count , Endothelial Growth Factors/blood , Enzyme-Linked Immunosorbent Assay , Erythropoietin/analysis , Female , Fibroblast Growth Factor 2/blood , Hepatocyte Growth Factor/blood , Humans , Interferon-alpha/therapeutic use , Lymphokines/blood , Male , Middle Aged , Multiple Myeloma/drug therapy , Multiple Myeloma/metabolism , Neoplasm Proteins/blood , Neoplasm Staging , Neoplastic Stem Cells/pathology , Plasma Cells/pathology , Plasmacytoma/metabolism , Plasmacytoma/physiopathology , Vascular Endothelial Growth Factor A , Vascular Endothelial Growth Factors
14.
Acta Haematol ; 104(2-3): 57-64, 2000.
Article in English | MEDLINE | ID: mdl-11154976

ABSTRACT

Chronic myeloid leukemia (CML) is a hematological malignancy resulting from clonal expansion and massive accumulation of leukemic myeloid cells that retain differentiation and maturation capacity. Since CML cell accumulation has been related to apoptosis inhibition by the product of the BCR-ABL gene, attempts to eradicate leukemic cells would require therapeutic drugs able to overcome this inherent resistance. Here, we investigated in vitro the apoptotic effect of all-trans retinoic acid (ATRA) and cytosine arabinoside (ARA-C), employed alone, in combination or in sequence, on freshly isolated cells from 10 patients with chronic-phase CML. Our cell cultures showed that both ATRA and ARA-C were able to induce apoptosis in CML cells, even if ARA-C resulted more effective than ATRA. The combined use of ATRA and ARA-C seemed to have only an additive effect while the sequential use did not show any advantage. These in vitro observations indicate that ATRA and ARA-C may be effective in reducing CML cells through apoptosis induction, suggesting that it could be worthwhile to examine ATRA and ARA-C combinations in the therapy of CML.


Subject(s)
Apoptosis/drug effects , Cytarabine/pharmacology , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/blood , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology , Tretinoin/pharmacology , Antigens, CD/biosynthesis , Antigens, Differentiation, Myelomonocytic/biosynthesis , Antimetabolites, Antineoplastic/pharmacology , Antineoplastic Combined Chemotherapy Protocols/pharmacology , Biomarkers, Tumor/blood , Biomarkers, Tumor/immunology , Cell Differentiation/drug effects , Cell Separation , DNA Fragmentation/drug effects , Electrophoresis, Agar Gel , Female , Granulocytes/drug effects , Granulocytes/pathology , Humans , Immunophenotyping , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/immunology , Leukemia, Myeloid, Chronic-Phase/blood , Leukemia, Myeloid, Chronic-Phase/immunology , Leukemia, Myeloid, Chronic-Phase/pathology , Macrophage-1 Antigen/biosynthesis , Male , Middle Aged , Sialic Acid Binding Ig-like Lectin 3 , Tumor Cells, Cultured
15.
Int Surg ; 85(3): 252-6, 2000.
Article in English | MEDLINE | ID: mdl-11325006

ABSTRACT

A total of 26 surgical patients with chronic idiopathic thrombocytopenic purpura (ITP) were reviewed and results of splenectomy were statistically related to age and sex, length of and response to pre-operative corticosteroid therapy, pre-operative platelet count and time interval between diagnosis and surgery. Median age was 37 years (range, 17-81 years) and the male:female ratio was 1.16. Pre-operative platelet count ranged from 2-70 x 10(9)/l. The length of pre-surgical corticosteroid therapy (prednisone 1-2 mg/kg/day) varied from 2 weeks to 3 years. Steroid therapy was unsuccessful in 15 patients and only achieved temporary remission in the remaining 11 cases. The time interval between diagnosis and splenectomy ranged from 4-60 months. There were 21 responders (80.4%) and 5 non-responders (19.6%) to splenectomy. Using the chi-square test, differences in age, length and response to pre-operative steroid therapy and diagnosis-to-splenectomy interval did not achieve statistical significance when responder and non-responder groups to splenectomy were compared. Conversely, a significant difference was found comparing male to female groups, since 92.9% of males and only 66.7% of females were successfully treated by surgery (P approximately 0.01). In addition, patients with a pre-operative platelet count less than 30 x 10(9)/l responded at an higher rate (100% versus 70.6%; P approximately 0.05) to splenectomy.


Subject(s)
Purpura, Thrombocytopenic, Idiopathic/surgery , Splenectomy , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Platelet Count , Prednisone/administration & dosage , Sex Factors , Treatment Outcome
16.
Acta Haematol ; 102(2): 61-5, 1999.
Article in English | MEDLINE | ID: mdl-10529507

ABSTRACT

Reduced or absent neutrophil alkaline phosphatase (NAP) activity is a common feature of neutrophilic granulocytes from patients with chronic myeloid leukemia (CML). In this study we examined whether NAP activity could be restored in vitro by stimulating CML cells with different promoters such as all-trans-retinoic acid (ATRA), granulocyte-macrophage colony-stimulating factor (GM-CSF) and granulocyte colony-stimulating factor (G-CSF). The results obtained indicated that ATRA and G-CSF, either alone or in combination, were effective in inducing NAP activity in CML cells, whereas GM-CSF was not. Further, NAP restoration in ATRA- and G-CSF-treated cultures was accompanied by increased morphologic differentiation of the CML clone. It might be concluded that the CML clone could be driven in vitro by ATRA and G-CSF both to achieve granulocytic maturation and to correct functional NAP-related defects.


Subject(s)
Alkaline Phosphatase/drug effects , Growth Substances/pharmacology , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy , Neutrophils/enzymology , Tretinoin/pharmacology , Alkaline Phosphatase/biosynthesis , Cell Separation , Enzyme Induction , Female , Humans , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/metabolism , Male , Middle Aged , Tumor Cells, Cultured
20.
Am J Hum Genet ; 64(4): 949-62, 1999 Apr.
Article in English | MEDLINE | ID: mdl-10090880

ABSTRACT

Familial Mediterranean fever (FMF) is a recessive disorder characterized by episodes of fever with serositis or synovitis. The FMF gene (MEFV) was cloned recently, and four missense mutations were identified. Here we present data from non-Ashkenazi Jewish and Arab patients in whom we had not originally found mutations and from a new, more ethnically diverse panel. Among 90 symptomatic mutation-positive individuals, 11 mutations accounted for 79% of carrier chromosomes. Of the two mutations that are novel, one alters the same residue (680) as a previously known mutation, and the other (P369S) is located in exon 3. Consistent with another recent report, the E148Q mutation was observed in patients of several ethnicities and on multiple microsatellite haplotypes, but haplotype data indicate an ancestral relationships between non-Jewish Italian and Ashkenazi Jewish patients with FMF and other affected populations. Among approximately 200 anonymous Ashkenazi Jewish DNA samples, the MEFV carrier frequency was 21%, with E148Q the most common mutation. Several lines of evidence indicate reduced penetrance among Ashkenazi Jews, especially for E148Q, P369S, and K695R. Nevertheless, E148Q helps account for recessive inheritance in an Ashkenazi family previously reported as an unusual case of dominantly inherited FMF. The presence of three frequent MEFV mutations in multiple Mediterranean populations strongly suggests a heterozygote advantage in this geographic region.


Subject(s)
Familial Mediterranean Fever/genetics , Haplotypes/genetics , Heterozygote , Jews/genetics , Mutation/genetics , Penetrance , Amino Acid Substitution/genetics , Arabs/genetics , Armenia/ethnology , Base Sequence , Chromosomes, Human/genetics , Cytoskeletal Proteins , Exons/genetics , Familial Mediterranean Fever/epidemiology , Female , Gene Frequency , Genes, Recessive/genetics , Humans , Israel , Italy , Male , Microsatellite Repeats/genetics , Molecular Sequence Data , Pedigree , Proteins/genetics , Pyrin , Turkey/ethnology
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