ABSTRACT
A major outbreak of West Nile virus (WNV) infections took place in 2010 in Greece. Apart from the neuroinvasive cases, many additional cases without involvement of the nervous system were observed, characterized by high fever, myalgia, rash, leukopenia, and long-lasting recovery. West Nile non-neuroinvasive disease is a distinct clinical syndrome, and is not always mild.
Subject(s)
Disease Outbreaks , West Nile Fever/epidemiology , West Nile Fever/virology , West Nile virus/isolation & purification , West Nile virus/pathogenicity , Adult , Aged , Aged, 80 and over , Animals , Female , Greece/epidemiology , Humans , Male , Middle Aged , Nervous System Diseases/epidemiology , Nervous System Diseases/virology , West Nile Fever/complications , West Nile Fever/pathologyABSTRACT
The responsiveness of bone marrow erythroid progenitors (CFU-E and BFU-E) to various concentrations of recombinant human erythropoietin (rh-Epo) (2,5,20,40,100,200 and 500 U/ml) was investigated in vitro in 18 patients with B-chronic lymphocytic leukemia to assess the clinical usefulness of rh-Epo in this disease. Bone marrow mononuclear cells were cultured by methylcellulose methods for CFU-E and BFU-E assays. The B-chronic lymphocytic leukemia patients were divided into two groups according to the percentage of lymphocytes in the bone marrow (under 70% and over 70%). Among the patients with few lymphocytes, more than one third demonstrated some degree of response to rh-Epo. Among the patients with a high percentage of lymphocytes in the bone marrow, some revealed no response to rh-Epo, but there were patients who showed a good response to rh-Epo. Because erythroid progenitors from B-chronic lymphocytic leukemia appeared sensitive to rh-Epo in vitro, we propose that high doses of this drug may be clinically effective in some patients with this disease, regardless of the degree of lymphocytic inflitration of the bone marrow.
Subject(s)
Bone Marrow Cells , Bone Marrow/drug effects , Erythroid Precursor Cells/drug effects , Erythropoietin/pharmacology , Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy , Leukemia, Lymphocytic, Chronic, B-Cell/pathology , Aged , Dose-Response Relationship, Drug , Erythropoietin/blood , Female , Humans , Leukemia, Lymphocytic, Chronic, B-Cell/blood , Male , Middle Aged , Recombinant Proteins/pharmacologyABSTRACT
We assayed granulocyte-macrophage committed progenitor cells (CFU-GM) in the peripheral blood of 34 patients with chronic lymphocytic leukemia (CLL) and 12 normal individuals. The patients were divided into separate groups on the basis of previous therapy (i.e. analysis performed at diagnosis, during and after chemotherapy) and clinical features of the disease (i.e. disease stage, pattern of bone marrow infiltration, peripheral blood lymphocytosis). The mean CFU-GM colony count of the patients was 30 times higher than that of the controls (206.4 +/- 197.8 (SD) CFU-GM per 5 x 10(5) cells plated versus 6.5 +/- 3.6). There was no statistical difference in the numbers of circulating CFU-GM between the patients studied at diagnosis (257 +/- 215.4 CFU-GM/5 x 10(5) cells) and those studied during (117.6 +/- 169.2 CFU-GM/5 x 10(5) cells) or after chemotherapy (207.5 +/- 105.9 CFU-GM/5 x 10(5) cells), although a trend towards a higher recovery of myeloid progenitors was observed as a function of time elapsing from the last treatment. In addition, we found no significant difference in the in vitro CFU-GM growth of patients grouped according to their disease stage, pattern of bone marrow infiltration and degree of peripheral blood lymphocytosis. In conclusion, our data indicate that intensification with peripheral blood stem cell support may be feasible in CLL, since progenitor cells of myeloid-monocytic series are markedly increased in the peripheral blood of these patients. Moreover, it is possible to extend this kind of therapy to patients who have undergone previous extensive chemotherapy and who might have persisting bone marrow infiltration.
