ABSTRACT
We have treated 28 patients (pts) with malignant hematological diseases with allogenic bone marrow transplantation (BMT). 18 pts had acute lymphoblastic (ALL) and non lymphoblastic leukemia (ANLL), 5 chronic myeloid leukemia (CML), 2 severe aplastic anemia (SAA), 1 myelodisplasia, 1 Fanconi's anemia and 1 advanced Non Hodgkin's lymphoma. All but three received the graft from HLA identical sibling donors. We used conditioning with total body irradiation and chemotherapy (cyclophosphamide, cytarabine and etoposide) in 17 pts and chemotherapy alone in 11.24 pts had a full hematological recovery 18 to 25 days post BMT. 15 pts died after BMT as a consequence of toxicity or early infection (4), graft failure (2), graft vesus host disease (4) or relapse (5). Actuarial event free survival for the group with favorable prognosis (SAA, ALL and ANLL in first or second remission and CML in chronic phase) is 57 percent at 36 months. Allogeneic BMT is an effective and feasing therapeutic procedure for selected patients with hematological malignancies
Subject(s)
Humans , Male , Female , Child, Preschool , Adolescent , Adult , Bone Marrow Transplantation , Hematologic Diseases/surgery , Patient Isolation , Postoperative Complications/drug therapy , Transplantation, Homologous , Transplantation, Homologous/mortality , Leukemia/therapy , Neural Tube Defects/therapy , Anemia, Aplastic/therapy , Premedication/methods , Host vs Graft Reaction/immunology , Hematopoietic System/physiopathology , Blood Transfusion/methodsABSTRACT
Objetivos: probar si la adición de vancomicina en microdosis (25 mcg/ml) a la solución de heparinización de catéteres venosos centrales permanentes (CVP) previene la ocurrencia de bacteremias por gérmenes vancomicina sensibles en pacientes oncológicos. Métodos: 39 pacientes con patología oncológica portadores de CVP externo (Hickman-Broviac) participaron en un estudio prospectivo, randomizado de doble ciego y fueron asignados a recibir una solución de heparina sola (Hep) o de heparina-vancomicina (HepVan). Todos los episodios febriles fueron registrados, realizándose hemograma y hemocultivo central y periférico. Los episodios febriles fueron tratados con antibióticos según normas establecidas. Resultados: se observaron en 14 meses 6.519 días catéter. Hubo 70 episodios febriles y 16 episodios de bacteremia, de los cuales 9 fueron por gérmenes sensibles a la vancomicina, 6 en el grupo Hep y 3 en el grupo HepVan (p = 0,31). En los episodios no neutropénicos (recuento absoluto de neutrófilos > 500/cm3) hubo 4 bacteremias en el grupo Hep y 0 en el grupo HepVan (p = 0,057). Conclusiones: la adición de vancomicina a la solución de heparinización de CVP no previene bacteremia asociada a CVP. La menor incidencia de bacteremias por gérmenes sensibles a la vancomicina en pacientes no neutropénicos versus neutropénicos en el grupo HepVan apoya la hipótesis de que la colonización intraluminal del CVP es un factor importante en las bacteremias en pacientes no neutropénicos
Subject(s)
Humans , Bacteremia , Catheters, Indwelling/microbiology , Heparin , Vancomycin , Catheterization, Central Venous , Drug Combinations , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapyABSTRACT
During the sixties, investigational efforts around automated cytology, biophysics, computer processing, flurochrome chemistry and monoclonal antibody technology created the new field of flow cytometry, giving thus the ability for scientists and clinicians to make biological measurements in viable cells and fixed tissues. The initial applications of this new technology to the problems of cellular biology, pathology, immunology and hematology was mainly done in research laboratories due to the high cost and sophisticatin of the first instruments in use. The recent development of smaller, more compatible systems for the clinical laboratory have made the flow cytomater a very valuable tool for up-to-date pathological diagnosis. Flow cytometry can be used to identify and rapidly count different kinds of cells in the heterogeneous structure of a tissue sample. The ability to characterize a particular subset of cells depends on labeling them with fluorescent markers that identify specific cellular components like DNA, RNA, mitochondria and a whole repertoire of intracellular components like DNA, RNA, mitochondria and a whole repertoire of intracellular and membrane proteins
Subject(s)
Humans , Male , Female , Flow Cytometry/methods , Leukemia/diagnosis , Genital Neoplasms, Female/diagnosis , Lymphoma/diagnosisABSTRACT
Se estudia el suero de 500 pacientes de hepatitis aguda probablemente viral a fin de identificar el virus responsable; se investigan los marcadores inmunológicos correspondientes (antígenos y anticuerpos). El virus A sigue siendo la causa más frecuente de la hepatitis viral, seguido por los virus nA nB. El virus está más bien circuscrito a un grupo con características epidemiológicas particulares
