Hairy cell leukemia is infrequent in México and has a geographic distribution.

Considering that the prevalence of some hematologic malignancies may have a geographic distribution that could be related with its etiology, a group of 2,387 patients with acute leukemia (1,968 adults and 419 children) was studied along a 5-year period in six different locations within México. Twenty-seven patients (16 males and 11 females) with hairy cell leukemia (HCL) were identified. The adjusted overall proportion of HCL, after excluding data from centers reporting only adults, was 1.12% of all leukemia cases; this figure is lower than that reported in the United States or England. The proportion of adult leukemic patients with HCL was significantly higher in the northern region of the country-where there are more people devoted to farming and agricultural activities-as compared with the central or southeastern regions (3.07 vs. 1.03% vs. 0%; P < 0.05); possible explanations for these differences are briefly discussed.

Outpatient supportive therapy after induction to remission therapy in adult acute myelogenous leukaemia (AML) is feasible: a multicentre study.

Twenty-four adult patients with AML were treated with standard "7 + 3" chemotherapy. After administering the myeloablative drugs in the hospital, patients were instructed to continue their supportive treatment on an outpatient basis; they received ciprofloxacin, cotrimoxasole and itraconazole vo until the absolute granulocyte count rose above 1 x 10(9)/l. Platelet concentrates were given every other day until the platelet count rose above 20 x 10(9)/l. Complete remission (CR) was obtained in 87%. Fever developed in 29% and 2 cases were complicated by indwelling-catheter-related Pseudomona aeruginosa septicaemia, 1 Entamoeba hystolytica enteritis and 1 Pneumocystis carinii pneumonia; these patients were hospitalized to treat these infections specifically. In no case was the infection fatal. The median disease free-survival (DFS) was 17 months, 12-month DFS was 66%, and 30-month DFS was 17%. Our calculations have shown that 1700 USD/patient were saved by avoiding prolonged hospitalization; this may provide not only economical, but also psychological advantages to patients.

Survival of patients with advanced HIV infection treated with 300 mg/d of zidovudine: a prospective study.

In this prospective study we analyze the long-term survival using 300 mg/day zidovudine (AZT) in patients with advanced forms of human immunodeficiency virus infection. The study is in a private-practice setting, over a 5-year period, and includes 72 patients with advanced human immunodeficiency virus infection (categories C1, 2 or 3). The median survival (SV) is above 60 months (24-months SV 65% and 60-month SV 54%). According to the number of CD4 cells at diagnosis it was found that patients with above or below 200 CD4 T cells had a median SV of above 60 and 18 months (p < 0.001) and a 24-month SV 88 and 45% (p < 0.001); for patients with CD4 cells below 20 at diagnosis, the median survival was even lower (three months) and the 12-month survival less than 18%. It is concluded that the results of treating HIV-infected patients with AZT 300 mg/day are similar to those reported by others using higher doses of AZT. A low dosage is also more easily available to a larger number of HIV-infected individuals.

[Sequential dideoxycytidine and zidovudine in advanced HIV-1 infection. Phase II study]. / Didesoxicitdina y zidovudina secuenciales en infección avanzada por virus VIH-1. Estudio fase II.

Seventeen HIV-1-infected individuals were given AZT (100 mg tid) and ddC (0.375 mg tid) for consecutive periods of four weeks each and for total periods ranging from 8 to 32 weeks (median 17). Thirteen patients were offered AZT/ddC after having received other anti-retroviral combinations containing AZT, whereas in four it was used as front therapy. Before and after AZT/ddC, the median CD4 cell count changed from 184 to 164/uL (p NS), and the median body weight from 60 to 61 kg (p NS). Increases in hematological parameters were observed in patients previously exposed to AZT. In eight patients the side effects of AZT (gastrointestinal intolerance, cephalalgia and fever) disappeared when switched to ddC, whereas in one a reversible peripheral neuropathy ensued. The dosages of AZT/ddC used in this trial were well tolerated.