ABSTRACT
Valproic acid (VPA), an inhibitor of histone deacetylases, inhibits the growth of leukemia cells and induces their differentiation in vitro. In the present study, VPA in combination with two differentiating agents, 13-cis retinoic acid and 1,25-dihydroxyvitamin D3, was given to 19 previously untreated patients with MDS or CMML. Eight patients had to discontinue treatment before week 16 due to toxicity. According to international working group criteria, three patients (16%) responded to treatment. No correlation between VPA serum level, histone acetylation or clinical response was observed.
Subject(s)
Calcitriol/therapeutic use , Isotretinoin/therapeutic use , Myelodysplastic Syndromes/drug therapy , Valproic Acid/therapeutic use , Acetylation/drug effects , Aged , Aged, 80 and over , Calcitriol/administration & dosage , Calcitriol/adverse effects , Cheilitis/chemically induced , Chemical and Drug Induced Liver Injury/etiology , Drug Therapy, Combination , Fatigue/chemically induced , Histones/metabolism , Humans , Isotretinoin/administration & dosage , Isotretinoin/adverse effects , Middle Aged , Pneumonia/chemically induced , Protein Processing, Post-Translational/drug effects , Treatment Outcome , Valproic Acid/administration & dosage , Valproic Acid/adverse effectsABSTRACT
Although glomerulonephritis and renal failure have been observed after allogenic stem cell transplantation, only a few such reports were published about patients undergoing autologous stem cell transplantation. We report a case of mesangial proliferative glomerulonephritis developing 4 months after autologous stem cell transplantation for chronic lymphatic leukemia. Serological test results, together with histological, immunohistochemical, and electronic microscopic findings of a kidney biopsy specimen, confirmed the diagnosis of mesangial proliferative glomerulonephritis in our patient. Complement and immunoglobulin A were not present in the kidney biopsy specimen. An abnormal clone, not previously reported, with the translocation t(5;11)(q31;q13) in blood and bone marrow was observed. The reason for and whether progenitor cells in stem cell transplantations could contribute to the development of glomerulonephritis remain open questions. Kidney biopsy should be performed in patients with microscopic hematuria and/or proteinuria after autologous stem cell transplantation.
Subject(s)
Glomerulonephritis/etiology , Stem Cell Transplantation/adverse effects , Biopsy , Female , Humans , Leukemia, Lymphocytic, Chronic, B-Cell/therapy , Mesangial Cells , Middle Aged , Time Factors , Transplantation, AutologousABSTRACT
In this study, the course of 40 pregnancies in 16 women with essential thrombocythaemia (ET) was analysed retrospectively. Of the pregnancies, 45% were complicated, 55% uncomplicated, and 62% resulted in live birth. The most common complication was spontaneous abortion during the first trimester seen in 33% of all pregnancies and comprising 72% of all complications. Two intrauterine foetal deaths occurred at weeks 22 and 28. Three pregnancies were complicated by eclampsia or pre-eclampsia. Nine of 16 women with 29 pregnancies had at least one complicated pregnancy. In seven of 16 women, all 11 pregnancies were uneventful. The non-pregnancy-related symptoms of ET or the platelet count before conception or during pregnancy did not correlate with the risk of pregnancy complications. Treatment with low-dose acetylsalicylic acid (ASA) alone during pregnancy or platelet-lowering drugs before or during pregnancy reduced the risk of complications.
