Mitoxantrone alone or in combination chemotherapy (VeMP) as second-line treatment in relapsed or refractory poor-prognosis non-Hodgkin's lymphoma. A report of the Non-Hodgkin's Lymphoma Co-operative Study Group (NHLCSG).

BACKGROUND AND METHODS: From October, 1986 to July 1989, 35 consecutive patients with high- and intermediate-grade non-Hodgkin's lymphoma, relapsed or refractory to first-line-anthracycline-containing regimens, were treated with mitoxantrone alone or in combination chemotherapy (VeMP: Ve = VP-16, M = Mitoxantrone, P = Prednisolone). RESULTS: In the first 15 patients, treated with Mitoxantrone alone, complete response (CR) and partial response (PR) each occurred in 4 patients, for a total response rate of 54%. In the following 20 patients, treated with the VeMP regimen, CR occurred in 10 patients (50%), PR in 1. The overall three-year survival was 27% in the first group and 40% in the second. Acute toxicity was generally mild. No patient developed cardiac symptoms or other toxicities requiring discontinuation of therapy. Myelosuppression was the most important side effect, being more remarkable for patients treated with VeMP regimen. CONCLUSION: Mitoxantrone, alone or in combination chemotherapy, appears to be a drug with significant activity in aggressive non-Hodgkin's lymphomas.

Successful treatment of a steroid-resistant form of idiopathic thrombocytopenic purpura in pregnancy with high doses of intravenous immunoglobulins.

Idiopathic thrombocytopenic purpura (ITP) during pregnancy may cause serious bleeding in the mother and fetus. Therapy with high-dose intravenous immunoglobulins has caused an immediate and predictable rise in platelet count in both adults and children with chronic or acute ITP. We report our experience in managing a woman near term in pregnancy. The patient demonstrated a rapid increase in platelet count, delivered without excessive bleeding and had a normal child with normal platelet count. Intravenous immunoglobulins may offer a new and safe way to control maternal and fetal platelet counts during pregnancy, delivery and neonatal period.

Emergency splenectomy in hairy cell leukemia.

The role of splenectomy in the treatment of hairy cell leukemia (HCL) is now well established. There are however some particular situations which indicate splenectomy as a possible emergency therapy in markedly cytopenic cases with severe antibiotic-resistant infections. The aim of the emergency splenectomy in such conditions is to temporarily increase neutrophils and to permit the improvement of the infectious disease. We describe 2 cases of HCL with severe infectious disease, successfully splenectomized.

Analysis of physical parameters of discrete cell populations. (Double data control by combining specific density and sedimentation velocity cell separation techniques).

Physical cell separations are employed in a number of investigations in cell biology, immunology, haematology, etc., when the study of homogeneous cell populations is required. Differences in physical characters are reflected in the various functions and differentiation stages of the individual cell lines, which can be concentrated and separated into discrete cell classes by these methods. The correct utilization of the separation techniques mainly depends on the knowledge of the physical laws on which they are based. This paper discusses the theoretical background and a practical application of a combined separation procedure which uses velocity sedimentation and linear density gradient and also gives a double check of the physical data obtained in the different experiments. As an example of this analysis, cells from the lymph nodes of Hodgkin's patients were separated, and the physical parameters as well as some sources of 'error' in the experimental results obtained with these 'Hodgkin's cells' are reported and discussed.