[Usefulness of prothrombin fragment 1 + 2 and fibrin dimer in the detection of hypercoagulation in obstetrical patients with thrombosis risk factors]. / Utilidad del fragmento 1 + 2 de protrombina y del dímero de fibrina en la detección de hipercoagulabilidad en pacientes obstétricas con factores de riesgo de trombosis.

We measured prothrombin 1 + 2 fragment (f1 + 2p) and dimer D (dD) in plasma from 100 pregnant women at high risk for thromboembolic disease (TED) and in 23 non-pregnant control. Measures of f1 + 2p were made by immunoassay analysis in 75 patients and dD by semiquantitative analysis of plate agglutination in 97 cases. F1 + 2p was significantly elevated in 85% of cases, but its levels was not predictive value for TED. Dimer D was not found in 40 cases, in 33 patients its values were between 500 and 1000 ng/ml. and in the other 24 cases were higher than 2000 ng/ml. Values higher than 1000 ng/ml. were founded in 78% of patients with history of TED, in 60% of cesarean section patients, in 37% of hypertensive patients and in the 23% of diabetic patients. Dimer D, that was higher than 500 ng/ml. in 59% of pregnant and puerperal patients, have predictive value for TED, because 25% of 24 patients that had dD higher than 2000 ng/ml. developed TED and/or coagulation anomalies suggestive of thrombotic activity. These findings were not found in the rest of patients (n 73) which had negative dD or less than 1000 ng/ml.

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.

Hematological and biochemical studies in children with Down syndrome.

Eighty-three children with Down syndrome were submitted to hematological and biochemical studies; 69 normal children were included as controls. The variables analyzed were: HbF, HbA2, serum B12 vitamin (B12), folates, total iron and iron binding capacity, hematic cytology, and the red blood cell enzymes adenosine deaminase (ADA), glucose-6-phosphate dehydrogenase (G6PD) and superoxide dismutase (SOD). The most relevant results were: macrocytosis, normal leucocytes, HbF, B12 and folates, as well as high levels of the enzymes ADA and G6PD. An indirect association between macrocytosis, ADA and G6PD is discussed.

[Polychemotherapy in multiple myeloma. The COMPA protocol]. / Poliquimioterapia en mieloma múltiple. Esquema C.O.M.P.A.

Ninety three patients with multiple myeloma (MM) were treated with cyclophosphamide, vincristine, melphalan, prednisone and adriamycin (C.O.M.P.A.). Their median age was 60.9 years and sixty five were males. Seven patients were in stage I-A; 25 in II-A; 33 in III-A and 28 in III-B. Complete remission (CR) was achieved in 61 (65.6%), partial remission (PR) in 18 (19.3%) and no response in 14 (15%). At present, the mean survival of the CR group, is 32.3 months (10 to 78), and of the PR 11.2 months (6 to 18). The actuarial survival of the CR group is 37.9 months. A hemoglobin level lower than 8.5 g/dL, serum creatinine higher than 2.0 mg/dL, and stage III disease were factors that together negatively influenced in both response to treatment and survival. Proteinuria did not affect response, but it was a negative factor for survival. Thirty percent of deaths were due to infection, and 24.5% to myeloma activity associated with infection. We conclude that this five drug combination (C.O.M.P.A.) achieves a high percentage of complete remissions, but does not differ significantly from other reported schemes in the mean survival obtained for multiple myeloma.

Low doses of high-potency antithymocyte globulin (ATG) in severe aplastic anemia: experience with the Mexican ATG.

Twenty patients with severe aplastic anemia (SAA) were treated with low doses (1-5 mg/kg/day) of a high-potency antithymocyte globulin (ATG) produced in Mexico, shown to have at least a 10-fold potency as compared with other globulins of commercial sources. Patients received ATG within a 10-day period, every other day (5 doses) at a dose of 1 mg/kg/day (4 courses), 2 mg/kg/day (12 courses) or 5 mg/kg/day (8 courses). Four patients received 2 consecutive courses of different doses of ATG. A response rate of 42% was recorded in the group, assessed by means of increases in reticulocytes, granulocytes or platelets. One patient showed a complete remission. The 570-day survival of the group was 51%. It is concluded that the domestically produced ATG is useful in the treatment of some patients with SAA in Mexico.