[Fungal infections in leukemic patients: our experience during 5 years]. / Infecciones por hongos en enfermos leucémicos: nuestra experiencia a lo largo de 5 años.

The use of high-dose chemotherapy and the subsequent prolonged neutropenia in patients with haematological diseases have resulted in an increased incidence of fungal infections. These infections are associated with a high mortality rate. There are several predisposing factors including broad-spectrum antibiotic, central venous access. Diagnosis remains difficult. Characteristic clinical manifestations are not constant and they appear only after neutrophil recovery. Responsible organisms are infrequently isolated. The use of invasive procedures is far from being justified in patients who suffering usual severe thrombocytopenia. The unique drug with proven efficiency in the treatment of fungal infections is amphotericin B or liposomal amphotericin B. A favourable outcome strongly correlated with complete leukemia remission. We describe our findings in seven leukemic patients with fungal infections.

[Changes in bone marrow among HIV-positive and HIV-negative parenteral drug addicts]. / Alteraciones de la médula ósea en adictos a drogas por vía parenteral seropositivos y seronegativos para el virus de la inmunodeficiencia humana.

BACKGROUND: The aim of the present was to study the cytohistology of the bone marrow in intravenous drug addicts (IVDA) and to analyze the possible differences according to the period of drug addiction. METHODS: A prospective study was performed in 60 IVDA patients previously untreated and distributed into three groups: 20 seronegative for the human immunodeficiency virus (HIV), 20 patients in a phase of generalized adenopathic infection (GAI) and 20 patients with AIDS. RESULTS: Cytohistologic examination of the bone marrow aspirates showed plasmocytosis and eosinophilia in all the groups. Selective changes were seen in the red series in 20% of the HIV negative patients and in 25% of the GAI group. The prevalence of cytologic changes was greater in those with AIDS, with hypocellular bone marrow being observed in 65% of the patients with coexistent dismyelopoietic changes in 15%. Pathologic structure showed granulomatous lesions of tuberculous etiology in 30% of the patients with AIDS while in the HIV negative and GAI groups these were found in 10% and 5%, respectively. A greater presence of fibrosis and bone marrow hypoplasia was also found in the group with AIDS, than in the other two groups. CONCLUSIONS: An increased number of bone marrow changes and progressive bone marrow hypocellularity may be observed on advancement of the clinical stages in intravenous drug addict patients. The incidence of tuberculous granulomas is higher in the AIDS group.

[Complete remission without marrow aplasia phase in a patient with acute promyelocytic leukosis treated with aggressive chemotherapy]. / Remisión completa sin fase de aplasia medular en un paciente con leucosis aguda promielocítica tratado con quimioterapia agresiva.

A patient diagnose of acute promyelocytic leukemia treated with chemotherapy schedule type VAPA. 2 weeks after the administration, there was no response this being the reason to administer a new induction course. 2 weeks after this, a new bone marrow aspiration was performed showing leukemic infiltration with 78% promyelocytes. The clinical situation of the patient did not recommend the addition of more chemotherapy. 10 days later complete remission in bone marrow and blood were demonstrated. The importance of this finding is discussed, complete remission without aplasia, as well as the diagnosis and therapeutic remarks of the case.