ABSTRACT
AIM: To define optimal time for transplantation of bone marrow (TBM) in children with hematological malignancies. MATERIALS AND METHODS: 20 allogenic TBMs were performed in children with acute myeloblastic leukemia (6 patients, 2 of them in recurrence), acute lymphoblastic leukemia (7 patients, 4 of them in recurrence), chronic myeloid leukemia (CML) in a chronic stage (3 patients), severe aplastic anemia (3 patients), generalized neuroblastoma (1 patient). Pretransplantation preparation included cyclophosphamide and busulphane or cyclophosphamide, busulphane and vepezide. The graft-versus-host reaction (GVHR) was prevented with cyclosporin A plus methotrexate or cyclosporin A plus urbazone. Engrafting was recognized by change of karyotype and blood group. RESULTS: From 13 children with acute leukemia subjected to TBM in a complete remission 4(33%) are alive, 5 died within 100 days after TBM (TBM was made in recurrence in 4 children), 3 patients died of recurrence 12 months after TBM. One patient with CML and one with severe aplastic anemia remain in remission. The main complications and causes of death in early posttransplantation period were hemorrhagic syndrome, infectious complications, GVHR. According to a one-year follow-up, the recurrent disease caused death most frequently. CONCLUSION: Positive result of TBM is related to the disease stage at transplantation.
Subject(s)
Bone Marrow Transplantation , Hematologic Neoplasms/therapy , Adolescent , Bone Marrow Transplantation/adverse effects , Bone Marrow Transplantation/statistics & numerical data , Child , Child, Preschool , Hematologic Neoplasms/complications , Hematologic Neoplasms/mortality , Humans , Transplantation Conditioning , Transplantation, HomologousABSTRACT
The investigation deals with a simplified modification or molecular-genetic detection of translocation t(9;22) using a combination of reverse transcription and polymerase chain reactions (RT-PCR). Unlike the available protocols, analysis is carried out using one enzyme--TET-Z polymerase--(instead of two) which has both revertase and DNA-polymerase activities. The present modification is highly sensitive, less time-consuming and cheaper. The method has proved useful for both diagnosing t(9;22) translocation and diagnosing and monitoring minimal residual disease remaining after marrow transplantation.
Subject(s)
Chromosomes, Human, Pair 22/genetics , Chromosomes, Human, Pair 9/genetics , Neoplasm, Residual/diagnosis , Neoplasm, Residual/genetics , Polymerase Chain Reaction , Translocation, Genetic , Humans , Polymerase Chain Reaction/methods , RNA-Directed DNA PolymeraseABSTRACT
Cytomegalovirus (CMV) infection often causes death after organ transplantation. Therefore, adequate prevention, diagnosis and treatment of this complication are of critical importance. The experience of establishing routine PCR-detection of CMV is presented. A widely accepted PCR protocol was used for clinical purposes. The strategy included 3 steps: 1) PCR amplification of CMV-sequences from leukocytes of patients; 2) visualization of PCR-product in polyacrylamide gel; 3) verification of the identity of PCR product by its hybridization to a membrane-bound specific probe. This approach allowed to detect CMV infection in 10 out of 28 bone marrow and in 4 out of 32 kidney recipients. The administration of specific antiviral treatment led to the elimination of CMV sequences from the blood.
