Poor mobilization of peripheral blood stem cells is a risk factor for worse outcome in lymphoma patients undergoing autologous stem cell transplantation.

The effect of poor blood stem cells mobilization on the outcome of autologous stem cell transplantation (ASCT) has not been well studied. Our aim is to evaluate poor mobilization as a prognostic factor in lymphoma patients undergoing ASCT. We analyzed 90 consecutive patients with Hodgkin's (HD) and non-Hodgkin's lymphoma (NHL) who underwent ASCT. Poor mobilization was defined as the inability to obtain > or = 1 x 10(6) CD34+ cells/kg ideal body weight with two large volume aphereses. Patients were divided into 2 groups: group 1 = poor mobilizers, and group 2 = good mobilizers. The poor mobilizers received lower median transplant CD34+ cell dose (2 x 10(6) vs. 4.5 x 10(6)/kg for good mobilizers, P = 0.001), were more heavily pretreated (P = 0.01), and required higher number of aphereses for PBSC collection (P = 0.0006). The median progression-free survival (PFS) in groups 1 and 2 was 10 and 41 months (P = 0.04), while the median overall survival (OS) was 38 months and not reached (P = 0.02), respectively. Univariate analysis showed that > or = 3 pre-transplant treatments, CD34+ cell dose < or = 2 x 10(6), elevated LDH before transplant, and poor mobilization were significant prognostic factors for poor PFS, while only the first three were significant for worse OS. Multivariate analysis using these same four factors revealed that number of pre-transplant treatments (HR = 6.03, P = 0.001), CD34+ cell dose (HR = 0.1, P = 0.0007) were the only independent predictive factors for worse overall outcome. In conclusion, our data show that poor mobilization could indicate poor outcome in lymphoma patients undergoing ASCT, however, it is more likely to be a reflection of the heavy pre-transplant therapy and lower CD34+ cell dose re-infused in this group of patients.

Correlation of early lymphocyte recovery and progression-free survival after autologous stem-cell transplant in patients with Hodgkin's and non-Hodgkin's Lymphoma.

The importance of the association between early lymphocyte recovery and outcome has not been well studied in autologous stem cell transplantation (ASCT). In this retrospective study, we analyzed 90 consecutive patients with non-Hodgkin's and Hodgkin's lymphoma who underwent ASCT. Patients were divided into two groups: group 1 with absolute lymphocyte count (ALC) on day +15 below the median of 667/mm(3), and group 2 with ALC >or=667/mm(3). The median progression-free survival (PFS), but not overall survival (OS), was significantly longer in group 2 when compared to group 1 (16 months vs not reached P=0.02). Group 2 patients also had significantly shorter hospital stay, received higher CD34(+) cell dose, and had shorter time to neutrophil recovery. Multivariate analysis demonstrated day +15 ALC to be an independent prognostic indicator for PFS, but not OS, while CD34(+) cell dose and the number of pretransplant treatments were better predictors for both PFS and OS. We conclude that higher day +15 ALC may independently predict better PFS after ASCT for lymphoma patients; however, whether this merely reflects faster overall recovery caused by higher infused CD34(+) cell dose and less pretransplant therapy needs further investigation.

[Accuracy of the oscillometric method to measure blood pressure in children] / A acurácia do método oscilométrico na determinação da pressão arterial em crianças.

OBJECTIVE: The aim of this study is to analyze the substitution of the standard auscultatory method by the oscillometric blood pressure monitor, independently of the validity of the intraarterial blood pressure measurement. The accuracy of the automatic oscillometric monitor was compared to the auscultatory mercury manometer blood pressure measurement in apparently healthy school age children. METHODS: A device able to perform 3 simultaneous readings are used: one reading by the monitor and the others by two "blind" observers. We studied 72 school age children with the following characteristics: mean age 9.5 (6.1-16.1) and 39 males (54.2%). RESULTS: The difference for the systolic and diastolic blood pressure obtained by the monitor was in average + 6.2 mmHg and + 10.0 mmHg, respectively, when compared to the observer's readings. There was neither a good correlation nor a good agreement between the two observers and the monitor in the blood pressure determination. CONCLUSIONS: We concluded that the substitution of the standard auscultatory method for the non-invasive oscillometric method to measure blood pressure in school age children can not be generally recommended.

[Cardiac arrhythmia with oral oxamniquine use in the schistosomiasis mansoni treatment]. / Arritmia cardíaca com uso de oxamniquine oral no tratamento de esquistossomose mansônica.

The authors report a case of a patient with schistosomiasis (S. mansoni) treated with one single dose (15 mg/kg/BWT) of oral oxamniquine who presented Mobitz type I second-degree AV block and sinus arrest with ventricular escape as a side-effect. They conclude that in spite of the safety and good activity of oxamniquine it may be a determinant of cardiotoxicity.