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1.
J Intern Med ; 266(5): 484-91, 2009 Nov.
Article in English | MEDLINE | ID: mdl-19549092

ABSTRACT

OBJECTIVES: For better characterizing the effect of anti-CD20 therapy, we analysed the use of rituximab in Belgian patients experiencing auto-immune haemolytic anaemia (AIHA) and immune thrombocytopenic purpura (ITP). DESIGN: We performed a retrospective multicentric analysis of patients with AIHA and ITP treated with rituximab in Belgium. SETTING: Haematological departments were invited to fill in a questionnaire about patient and disease characteristics. SUBJECTS: All patients with AIHA and ITP, both primary and secondary to other diseases, who received one or more courses of rituximab during their disease course were included. Sixty-eight courses of rituximab in 53 patients with AIHA and 43 courses in 40 patients with ITP were analyzed. INTERVENTION: Response rates, duration of response and factors predictive for response were assessed. RESULTS: All patients were given rituximab after failing at least one previous line of treatment, including splenectomy in 19% and 72.5% of AIHA-patients and ITP-patients respectively. Overall response rates were 79.2% in AIHA and 70% in ITP, with a median follow-up since first rituximab administration of 15 months (range 0.5-62) in AIHA and 11 months (range 0-74) in ITP. Progression free survival at 1 and 2 years were 72% and 56% in AIHA and 70% and 44% in ITP. In this retrospective analysis we were not able to identify pretreatment characteristics predictive for response to rituximab. Nine patients with AIHA and three patients with ITP were given one or more additional courses of rituximab. Most of these patients, who had responded to a previous course, experienced a new response comparable to the previous one, both in terms of quality and of duration of response. Finally, the outcome of patients who failed to respond to rituximab therapy was poor both in terms of response to subsequent therapy and in terms of survival. CONCLUSIONS: This study confirms that rituximab induces responses in a majority of previously treated patients with AIHA and ITP. Response duration generally exceeds 1 year. Retreatment with rituximab in responding patients is most often successful. The outcome of patients who fail on rituximab is poor. We were not able to identify pretreatment patient characteristics predicting for response.


Subject(s)
Anemia, Hemolytic, Autoimmune/drug therapy , Antibodies, Monoclonal/therapeutic use , Immunologic Factors/therapeutic use , Purpura, Thrombocytopenic, Idiopathic/drug therapy , Adolescent , Adult , Aged , Aged, 80 and over , Antibodies, Monoclonal, Murine-Derived , Belgium , Child , Child, Preschool , Disease-Free Survival , Female , Humans , Infant , Male , Middle Aged , Retrospective Studies , Rituximab , Treatment Outcome , Young Adult
3.
Tijdschr Psychiatr ; 51(1): 21-30, 2009.
Article in Dutch | MEDLINE | ID: mdl-19194843

ABSTRACT

BACKGROUND: The relatively recent adoption of modern statistical analysis methods, such as latent growth modelling (lgm), makes it possible to study differences in the individual trajectories of development over time. AIM: To examine prospectively the developmental trajectories of anxiety disorder symptoms in a large sample of adolescents (N = 1,318) from the general population over a period of five years. METHOD: The adolescents were divided into two cohorts: early adolescents (average age 12 at the first measurement) and middle adolescents (average age 16 at the first measurement). Age and gender differences in the developmental trajectories of adolescent anxiety disorder symptoms over time were examined by means of lgm. results Over the course of five years there was a slight decrease in panic disorder, school anxiety and separation anxiety disorder symptoms for all adolescents, with the exception of social phobia symptoms, which remained fairly stable over time. Adolescent girls showed a slight increase in generalised anxiety disorder symptoms over time, whereas these symptoms decreased among adolescent boys. CONCLUSION: The use of individual trajectory-based analyses, enabled us to study advance our understanding of age and gender differences in the development of adolescent anxiety symptoms.


Subject(s)
Adolescent Psychiatry , Anxiety Disorders/epidemiology , Anxiety, Separation/epidemiology , Panic Disorder/epidemiology , Phobic Disorders/epidemiology , Adolescent , Anxiety Disorders/diagnosis , Anxiety Disorders/psychology , Anxiety, Separation/diagnosis , Anxiety, Separation/psychology , Child , Female , Health Surveys , Humans , Longitudinal Studies , Male , Netherlands/epidemiology , Panic Disorder/diagnosis , Panic Disorder/psychology , Phobic Disorders/diagnosis , Phobic Disorders/psychology , Prospective Studies
4.
Ann Hematol ; 87(4): 277-83, 2008 Apr.
Article in English | MEDLINE | ID: mdl-17952688

ABSTRACT

The treatment of diffuse large B-cell lymphoma with chemotherapy was retrospectively evaluated in 348 patients who had received at least three cycles of CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone)-like, ACVBP (doxorubicin, cyclophosphamide, vindesine, bleomycin, and prednisone)-like or CHVmP-BV (cyclophosphamide, hydroxorubicin, Vm-26, prednisone, vincristine and bleomycin) treatment in Belgium between 1995 and 2000. In our sample, the proportion who received each of the three regimens was 78.4, 16.4, and 5.2%, respectively. Of those prescribed CHOP-like regimens, 15% received <80% average relative dose intensity (ARDI). In 210 patients treated with CHOP-21 (77% of the CHOP-like group), median survival was 7.08 years in those who received >90% of the ARDI, significantly longer than in those who received < or = 90% of the ARDI (p = 0.002). Dose reductions and/or delays, mainly due to hematological toxicities, resulted in a reduction in treatment intensity. These data indicate that patient outcome is improved when the intensity of chemotherapy treatment is optimal.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Lymphoma, Large B-Cell, Diffuse/drug therapy , Adult , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/pharmacokinetics , Bleomycin/administration & dosage , Bleomycin/pharmacokinetics , Combined Modality Therapy , Cyclophosphamide/administration & dosage , Cyclophosphamide/pharmacokinetics , Dose-Response Relationship, Drug , Doxorubicin/administration & dosage , Doxorubicin/pharmacokinetics , Follow-Up Studies , Granulocyte Colony-Stimulating Factor/therapeutic use , Humans , Lymphoma/classification , Lymphoma/drug therapy , Lymphoma/mortality , Lymphoma/radiotherapy , Lymphoma, Large B-Cell, Diffuse/mortality , Patient Selection , Prednisone/administration & dosage , Prednisone/pharmacokinetics , Retrospective Studies , Survival Analysis , Time Factors , Vindesine/administration & dosage , Vindesine/pharmacokinetics
5.
JBR-BTR ; 90(2): 128-31, 2007.
Article in English | MEDLINE | ID: mdl-17555075

ABSTRACT

We report a case of splenic hamartoma that was occasionally detected. Ultrasonography performed as a screening examination revealed a hypoechoic splenic lesion. A computed tomography and magnetic resonance examination were performed in order to characterize the lesion but failed to make a final diagnosis. An elective laparoscopic splenectomy with consecutive histologic examination revealed a splenic hamartoma. Splenectomy may be required for definite characterization of this type of splenic lesion.


Subject(s)
Hamartoma/diagnosis , Splenic Diseases/diagnosis , Adult , Contrast Media , Diagnosis, Differential , Humans , Magnetic Resonance Imaging , Male , Tomography, X-Ray Computed , Ultrasonography, Doppler
6.
J Clin Oncol ; 23(18): 4117-26, 2005 Jun 20.
Article in English | MEDLINE | ID: mdl-15867204

ABSTRACT

PURPOSE: To analyze the long-term outcome of patients included in the Lymphome Non Hodgkinien study 98-5 (LNH98-5) comparing cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) to rituximab plus CHOP (R-CHOP) in elderly patients with diffuse large B-cell lymphoma. PATIENTS AND METHODS: LNH98-5 was a randomized study that included 399 previously untreated patients, age 60 to 80 years, with diffuse large B-cell lymphoma. Patients received eight cycles of classical CHOP (cyclophosphamide 750 mg/m(2), doxorubicin 50 mg/m(2), vincristine 1.4 mg/m(2), and prednisone 40 mg/m(2) for 5 days) every 3 weeks. In R-CHOP, rituximab 375 mg/m(2) was administered the same day as CHOP. Survivals were analyzed using the intent-to-treat principle. RESULTS: Median follow-up is 5 years at present. Event-free survival, progression-free survival, disease-free survival, and overall survival remain statistically significant in favor of the combination of R-CHOP (P = .00002, P < .00001, P < .00031, and P < .0073, respectively, in the log-rank test). Patients with low-risk or high-risk lymphoma according to the age-adjusted International Prognostic Index have longer survivals if treated with the combination. No long-term toxicity appeared to be associated with the R-CHOP combination. CONCLUSION: Using the combination of R-CHOP leads to significant improvement of the outcome of elderly patients with diffuse large B-cell lymphoma, with significant survival benefit maintained during a 5-year follow-up. This combination should become the standard for treating these patients.


Subject(s)
Antibodies, Monoclonal/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Cyclophosphamide/therapeutic use , Doxorubicin/therapeutic use , Lymphoma, Large B-Cell, Diffuse/drug therapy , Prednisone/therapeutic use , Vincristine/therapeutic use , Aged , Aged, 80 and over , Antibodies, Monoclonal, Murine-Derived , Disease Progression , Female , Humans , Male , Middle Aged , Rituximab , Salvage Therapy , Survival Analysis , Treatment Outcome
7.
Leukemia ; 19(1): 77-82, 2005 Jan.
Article in English | MEDLINE | ID: mdl-15510210

ABSTRACT

Although reciprocal chromosomal translocations are not typical for B-cell chronic lymphocytic leukemia (B-CLL), we identified the novel t(1;6)(p35.3;p25.2) in eight patients with this disorder. Interestingly, all cases showed lack of somatically mutated IgV(H). Clinical, morphological, immunologic, and genetic features of these patients are described. Briefly, the age ranged from 33 to 81 years (median: 62.5 years) and the sex ratio was 6M:2F. Most of the patients (6/8) presented with advanced clinical stage. Therapy was required in seven cases. After a median follow-up of 28 months, five patients are alive and three died from disease evolution. Three cases developed transformation into diffuse large B-cell lymphoma. Translocation t(1;6) was found as the primary karyotypic abnormality in three patients. Additional chromosomal aberrations included changes frequently found in unmutated B-CLL, that is, del(11)(q), trisomy 12 and 17p aberrations. Fluorescence in situ hybridization analysis performed in seven cases allowed us to map the t(1;6) breakpoints to the 1p35.3 and 6p25.2 chromosomal bands, respectively. The latter breakpoint was located in the genomic region coding for MUM1/IRF4, one of the key regulators of lymphocyte development and proliferation, suggesting involvement of this gene in the t(1;6). Molecular characterization of the t(1;6)(p35.3;p25.2), exclusively found in unmutated subtype of B-CLL, is in progress.


Subject(s)
Chromosomes, Human, Pair 1 , Chromosomes, Human, Pair 6 , Leukemia, Lymphocytic, Chronic, B-Cell/genetics , Translocation, Genetic , Humans , In Situ Hybridization, Fluorescence , Karyotyping
8.
J Clin Oncol ; 22(7): 1260-7, 2004 Apr 01.
Article in English | MEDLINE | ID: mdl-15051774

ABSTRACT

PURPOSE: A prospective, multicenter, open-label, phase II clinical trial to assess oral fludarabine phosphate treatment in terms of safety, efficacy, and quality of life. Reference to a historical group of patients treated with the intravenous (IV) formulation allowed the two formulations to be compared. PATIENTS AND METHODS: Patients with previously untreated B-cell chronic lymphocytic leukemia received 10-mg tablets of fludarabine phosphate to a dose of 40 mg/m(2)/d for 5 days, repeated every 4 weeks, for a total of six to eight cycles. Efficacy was assessed using International Workshop on Chronic Lymphocytic Leukemia and National Cancer Institute criteria for response. Safety monitoring included WHO toxicity grading for adverse events. Quality of life was also assessed. RESULTS: Eighty-one patients received treatment. According to International Workshop on Chronic Lymphocytic Leukemia criteria, the overall response rate was 71.6% (complete remission, 37.0%; partial remission, 34.6%). The response rate using National Cancer Institute criteria was 80.2% (complete remission, 12.3%; partial remission, 67.9%). Median time to progression was 841 days (range, 28 to 1,146 days). The most frequently reported grade 3/4 toxicity was myelosuppression. WHO grade 3/4 hematological toxicities included granulocytopenia (32.1%), anemia (9.9%), and thrombocytopenia (4.9%). Gastrointestinal toxicity was more common with the oral formulation than with IV fludarabine phosphate, but was generally mild to moderate and did not require treatment. Statistically significant improvements in mean emotional and insomnia quality-of-life scores were seen after treatment. CONCLUSION: This study demonstrates that oral fludarabine phosphate is clinically effective and generally well tolerated by patients with previously untreated B-cell chronic lymphocytic leukemia. Oral fludarabine phosphate has a similar clinical efficacy and safety profile to the IV formulation. Oral fludarabine phosphate does not adversely affect quality of life and may improve emotional and insomnia scores.


Subject(s)
Antimetabolites, Antineoplastic/therapeutic use , Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy , Vidarabine Phosphate/analogs & derivatives , Vidarabine Phosphate/therapeutic use , Administration, Oral , Adult , Aged , Female , Humans , Male , Middle Aged , Prospective Studies , Quality of Life , Remission Induction , Retrospective Studies , Safety , Survival Rate , Treatment Outcome
9.
Leukemia ; 18(4): 734-42, 2004 Apr.
Article in English | MEDLINE | ID: mdl-14973504

ABSTRACT

Detection of the FIP1L1-PDGFRA fusion gene or the corresponding cryptic 4q12 deletion supports the diagnosis of chronic eosinophilic leukemia (CEL) in patients with chronic hypereosinophilia. We retrospectively characterized 17 patients fulfilling WHO criteria for idiopathic hypereosinophilic syndrome (IHES) or CEL, using nested RT-PCR and interphase fluorescence in situ hybridization (FISH). Eight had FIP1L1-PDGFRA (+) CEL, three had FIP1L1-PDGFRA (-) CEL and six had IHES. FIP1L1-PDGFRA (+) CEL responded poorly to steroids, hydroxyurea or interferon-alpha, and had a high probability of eosinophilic endomyocarditis (n=4) and disease-related death (n=4). In FIP1L1-PDGFRA (+) CEL, palpable splenomegaly was present in 5/8 cases, serum vitamin B(12) was always markedly increased, and marrow biopsies revealed a distinctively myeloproliferative aspect. Imatinib induced rapid complete hematological responses in 4/4 treated FIP1L1-PDGFRA (+) cases, including one female, and complete molecular remission in 2/3 evaluable cases. In the female patient, 1 log reduction of FIP1L1-PDGFRA copy number was reached as by real-time quantitative PCR (RQ-PCR). Thus, correlating IHES/CEL genotype with phenotype, FIP1L1-PDGFRA (+) CEL emerges as a homogeneous clinicobiological entity, where imatinib can induce molecular remission. While RT-PCR and interphase FISH are equally valid diagnostic tools, the role of marrow biopsy in diagnosis and of RQ-PCR in disease and therapy monitoring needs further evaluation.


Subject(s)
Hypereosinophilic Syndrome/diagnosis , Hypereosinophilic Syndrome/genetics , Receptor, Platelet-Derived Growth Factor alpha/genetics , mRNA Cleavage and Polyadenylation Factors/genetics , Adult , Benzamides , Chromosomes, Human, Pair 4 , Clone Cells/pathology , Female , Humans , Hypereosinophilic Syndrome/complications , Hypereosinophilic Syndrome/drug therapy , Imatinib Mesylate , In Situ Hybridization, Fluorescence , Male , Middle Aged , Oncogene Proteins, Fusion , Phenotype , Piperazines/therapeutic use , Pyrimidines/therapeutic use , RNA, Messenger/analysis , Receptor, Platelet-Derived Growth Factor alpha/analysis , Retrospective Studies , Reverse Transcriptase Polymerase Chain Reaction , Survival Rate , mRNA Cleavage and Polyadenylation Factors/analysis
10.
J Clin Oncol ; 19(22): 4252-8, 2001 Nov 15.
Article in English | MEDLINE | ID: mdl-11709569

ABSTRACT

PURPOSE: A prospective, multicenter, open-label phase II clinical trial was conducted to assess the efficacy and safety of oral fludarabine phosphate. Reference to an historical group of patients treated with the intravenous (IV) formulation allowed the investigators to compare the two formulations. PATIENTS AND METHODS: Efficacy was assessed using the International Workshop on Chronic Lymphocytic Leukemia (IWCLL) and National Cancer Institute (NCI) criteria for complete remission (CR), partial remission (PR), stable disease, or disease progression. Safety monitoring included World Health Organization (WHO) toxicity grading for all adverse events. RESULTS: Seventy-eight (96.3%) of 81 recruited patients with previously treated B-cell chronic lymphocytic leukemia (CLL) received 10-mg tablets of fludarabine phosphate to a dose of 40 mg/m(2)/d for 5 days, repeated every 4 weeks, for a total of six to eight cycles. According to IWCLL criteria, the overall remission rate was 46.2% (CR, 20.5%; PR, 25.6%). The comparative figures using NCI criteria were 51.3% (CR, 17.9%; PR, 33.3%). Overall, 30 incidents of severe adverse events were reported for 22 patients. WHO grade 3 or grade 4 hematologic toxicities included granulocytopenia (53.8%), leukocytopenia (28.2%), thrombocytopenia (25.6%), and anemia (24.4%). Gastrointestinal adverse events were more common with the oral formulation than previously reported with IV fludarabine phosphate. However, these events were generally mild to moderate. CONCLUSION: This study demonstrates that oral fludarabine phosphate has similar clinical efficacy to the IV formulation and a safety profile that is both predictable and essentially similar to that of the IV formulation.


Subject(s)
Antimetabolites, Antineoplastic/therapeutic use , Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy , Vidarabine Phosphate/analogs & derivatives , Vidarabine Phosphate/therapeutic use , Administration, Oral , Adult , Aged , Antimetabolites, Antineoplastic/administration & dosage , Disease Progression , Disease-Free Survival , Drug Evaluation , Female , Humans , Infusions, Intravenous , Male , Middle Aged , Prospective Studies , Treatment Outcome , Vidarabine Phosphate/administration & dosage
11.
Blood ; 98(1): 85-92, 2001 Jul 01.
Article in English | MEDLINE | ID: mdl-11418466

ABSTRACT

A new mutation is described in the X-linked gene GATA1, resulting in macrothrombocytopenia and mild dyserythropoietic features but no marked anemia in a 4-generation family. The molecular basis for the observed phenotype is a substitution of glycine for aspartate in the strictly conserved codon 218 (D218G) of the amino-terminal zinc finger loop of the transcription factor GATA1. Zinc finger interaction studies demonstrated that this mutation results in a weak loss of affinity of GATA1 for its essential cofactor FOG1, whereas direct D218G-GATA1 binding to DNA was normal. The phenotypic effects of this mutation in the patients' platelets have been studied. Semiquantitative RNA analysis, normalized for beta-actin messenger RNA, showed extremely low transcription of the GATA1 target genes GPIbbeta and GPIX but also a significantly lower expression of the nondirectly GATA1-regulated Gsalpha gene, suggestive of incomplete megakaryocyte maturation. In contrast, GPIIIa expression was close to normal in agreement with its early appearance during megakaryocyte differentiation. Flow cytometric analysis of patient platelets confirmed the existence of a platelet population with abnormal size distribution and reduced GPIb complex levels but with normal GPIIIa expression. It also showed the presence of very immature platelets lacking almost all membrane glycoproteins studied (GPIbalpha, GPIbbeta, GPIIIa, GPIX, and GPV). Patients' platelets showed weak ristocetin-induced agglutination, compatible with the disturbed GPIb complex. Accordingly, electron microscopy of the patients' platelets revealed giant platelets with cytoplasmic clusters consisting of smooth endoplasmic reticulum and abnormal membrane complexes. In conclusion, GATA1 mutations can lead to isolated X-linked macrothrombocytopenia without anemia.


Subject(s)
Blood Platelets/pathology , DNA-Binding Proteins/genetics , Thrombocytopenia/genetics , Transcription Factors/genetics , X Chromosome , Adult , Blood Platelets/drug effects , Carrier Proteins/drug effects , DNA Mutational Analysis , DNA-Binding Proteins/drug effects , DNA-Binding Proteins/pharmacology , Erythrocytes/pathology , Erythroid-Specific DNA-Binding Factors , Family Health , Female , GATA1 Transcription Factor , Genetic Linkage , Haplotypes , Humans , Male , Mutation , Nuclear Proteins/drug effects , Pedigree , Platelet Aggregation/drug effects , Platelet Membrane Glycoproteins/drug effects , Platelet Membrane Glycoproteins/metabolism , Transcription Factors/pharmacology , Zinc Fingers/genetics
12.
J Antimicrob Chemother ; 48(1): 97-103, 2001 Jul.
Article in English | MEDLINE | ID: mdl-11418517

ABSTRACT

The efficacy and safety of itraconazole oral solution and a combination of amphotericin B capsules plus nystatin oral suspension were compared in the prophylaxis of fungal infections in neutropenic patients. In an open, randomized, multicentre trial, 144 patients received itraconazole oral solution 100 mg bd, and 133 patients received amphotericin B 500 mg tds plus nystatin 2 MU qds. Overall, 65% of itraconazole-treated patients were considered to have had successful prophylaxis, compared with 53% in the polyene group. Proven deep fungal infections occurred in 5% of patients in each group. Fewer patients receiving itraconazole than amphotericin plus nystatin had superficial infections (3 versus 8%; P = 0.066). This trend in favour of itraconazole was seen in patients with profound neutropenia (neutrophil count <0.1 x 10(9) cells/L at least once) or prolonged neutropenia (neutrophil count <1.0 x 10(9) cells/L for >14 days). The median time to prophylactic failure was longer in the itraconazole group (37 days) than in the polyene group (34 days). The number of patients with fungal colonization (nose, sputum, stool) changed more favourably from baseline to endpoint in the itraconazole group than in the polyene group. Both treatments were safe and well tolerated; however, patients receiving amphotericin plus nystatin had a higher incidence of nausea and rash. In conclusion, itraconazole oral solution at doses of 100 mg bd and oral amphotericin B plus nystatin have similar prophylactic efficacy against fungal infections in neutropenic patients. On the basis of reduced incidence of superficial fungal infections, fungal colonization and specific adverse events, itraconazole may be the preferred treatment.


Subject(s)
Amphotericin B/administration & dosage , Antifungal Agents/therapeutic use , Itraconazole/therapeutic use , Mycoses/prevention & control , Neoplasms/complications , Neutropenia/complications , Nystatin/administration & dosage , Adult , Aged , Amphotericin B/adverse effects , Female , Humans , Itraconazole/adverse effects , Itraconazole/blood , Male , Middle Aged
13.
Antimicrob Agents Chemother ; 45(3): 981-5, 2001 Mar.
Article in English | MEDLINE | ID: mdl-11181397

ABSTRACT

The pharmacokinetics and safety of an intravenous hydroxypropyl-beta-cyclodextrin solution of itraconazole administered for 7 days followed by itraconazole oral solution administered at 200 mg once or twice daily for 14 days were assessed in 17 patients with hematologic malignancies. Steady-state plasma itraconazole concentrations were reached by 48 h after the start of intravenous treatment. The mean trough plasma itraconazole concentration at the end of the intravenous treatment was 0.54 +/- 0.20 microg/ml. This concentration was not maintained during once-daily oral treatment but increased further in the twice-daily treatment group, with a trough itraconazole concentration of 1.12 +/- 0.73 microg/ml at the end of oral treatment. As expected in the patient population studied, all patients experienced some adverse events (mainly gastrointestinal). Biochemical and hematologic abnormalities were frequent, but no consistent changes occurred. In conclusion, 7 days of intravenous treatment followed by 14 days of twice-daily oral treatment with itraconazole solution enables plasma itraconazole concentrations of at least 0.5 microg/ml to be reached rapidly and to be maintained. The regimen is well tolerated and has a good safety profile.


Subject(s)
Hematologic Neoplasms/metabolism , Itraconazole/pharmacokinetics , Administration, Oral , Adult , Antifungal Agents/administration & dosage , Antifungal Agents/adverse effects , Antifungal Agents/pharmacokinetics , Drug Administration Schedule , Female , Humans , Infusions, Intravenous , Itraconazole/administration & dosage , Itraconazole/adverse effects , Male , Middle Aged
14.
Carbohydr Res ; 329(2): 341-9, 2000 Nov 03.
Article in English | MEDLINE | ID: mdl-11117317

ABSTRACT

Amylose was methylated with CH3I in alkaline aqueous suspension, yielding methylated amylose (MeAl) with a degree of substitution of 1.44 (s < 0.01). Determination of the monomer composition showed that HO-6 and HO-2 were highly substituted in contrast to HO-3 (7:2:5.5, HO-2:HO-3:HO-6). By using partial acid hydrolysis, oligomers were prepared that varied both in degree of polymerisation and in methyl-content. Studies on the distribution of substituents in trimers showed large deviations from random distributions. By using CID tandem mass spectrometry, the substituent distribution in these trimers was determined in more detail. Various sets of trimers with equal amounts of methyl-groups but differing in substituted positions were quantified. From the monomer composition of MeAl, the probability of each trimer was calculated and compared to the outcome of the measured distributions. It was concluded that trimers with terminal tri- or non-substituted glucose monomers at the non-reducing end were formed preferentially during partial hydrolysis and that partial hydrolysis of MeAl yielded oligomers in a non-random way. This is the first study that describes the partial hydrolysis of MeAl in such detail.


Subject(s)
Amylose/chemistry , Mass Spectrometry/methods , Trisaccharides/chemistry , Carbohydrate Sequence , Chromatography, Gas , Hydrocarbons, Iodinated/chemistry , Hydrolysis , Methylation , Molecular Sequence Data , Molecular Structure , Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization , Structure-Activity Relationship
15.
Mol Cell Biol ; 20(21): 8230-43, 2000 Nov.
Article in English | MEDLINE | ID: mdl-11027292

ABSTRACT

One of two general pathways of mRNA decay in the yeast Saccharomyces cerevisiae occurs by deadenylation followed by 3'-to-5' degradation of the mRNA body. Previous results have shown that this degradation requires components of the exosome and the Ski2p, Ski3p, and Ski8p proteins, which were originally identified due to their superkiller phenotype. In this work, we demonstrate that deletion of the SKI7 gene, which encodes a putative GTPase, also causes a defect in 3'-to-5' degradation of mRNA. Deletion of SKI7, like deletion of SKI2, SKI3, or SKI8, does not affect various RNA-processing reactions of the exosome. In addition, we show that a mutation in the SKI4 gene also causes a defect in 3'-to-5' mRNA degradation. We show that the SKI4 gene is identical to the CSL4 gene, which encodes a core component of the exosome. Interestingly, the ski4-1 allele contains a point mutation resulting in a mutation in the putative RNA binding domain of the Csl4p protein. This point mutation strongly affects mRNA degradation without affecting exosome function in rRNA or snRNA processing, 5' externally transcribed spacer (ETS) degradation, or viability. In contrast, the csl4-1 allele of the same gene affects rRNA processing but not 3'-to-5' mRNA degradation. We identify csl4-1 as resulting from a partial-loss-of-function mutation in the promoter of the CSL4 gene. These data indicate that the distinct functions of the exosome can be separated genetically and suggest that the RNA binding domain of Csl4p may have a specific function in mRNA degradation.


Subject(s)
Fungal Proteins/physiology , GTP-Binding Proteins , Nuclear Proteins/physiology , RNA, Messenger/metabolism , Saccharomyces cerevisiae Proteins , Adaptor Proteins, Signal Transducing , Alleles , Amino Acid Sequence , Binding Sites , Cell Nucleus/metabolism , Cytoplasm/metabolism , Fungal Proteins/biosynthesis , Fungal Proteins/genetics , GTP Phosphohydrolases/metabolism , Galactose/metabolism , Genotype , Glucose/metabolism , Green Fluorescent Proteins , Lac Operon , Luminescent Proteins/metabolism , Models, Genetic , Molecular Sequence Data , Nuclear Proteins/biosynthesis , Nuclear Proteins/genetics , Phenotype , Plasmids/metabolism , Point Mutation , Promoter Regions, Genetic , Protein Structure, Tertiary , RNA, Ribosomal/metabolism , RNA, Ribosomal, 5.8S/metabolism , RNA, Small Nuclear/metabolism , Recombinant Fusion Proteins/metabolism , Saccharomyces cerevisiae/genetics , Saccharomyces cerevisiae/physiology , Sequence Homology, Amino Acid , Sucrose/metabolism , Temperature , Time Factors , Transcription, Genetic
16.
Carbohydr Res ; 325(3): 183-91, 2000 Apr 20.
Article in English | MEDLINE | ID: mdl-10795809

ABSTRACT

Granular potato starches were methylated in aqueous suspension with dimethyl sulfate to molar substitution (MS) values up to 0.29. Fractions containing mainly amylose or amylopectin were obtained after aqueous leaching of the derivatised starch granules. Amylopectin in these fractions was precipitated with Concanavalin A to separate it from amylose. Amylose remained in solution and was enzymatically converted into D-glucose for quantification, thereby taking into account the decreased digestibility due to the presence of methyl substituents. It was found that the MS of amylose was 1.6-1.9 times higher than that of amylopectin in methylated starch granules. The distributions of methyl substituents in trimers and tetramers, prepared from amylose- or amylopectin-enriched fractions, were determined by FAB mass spectrometry and compared with the outcome of a statistically random distribution. It turned out that substituents in amylopectin were distributed heterogeneously, whereas substitution of amylose was almost random. The results are rationalised on the basis of an organised framework that is built up from amylopectin side chains. The crystalline lamellae are less accessible for substitution than amorphous branching points and amylose.


Subject(s)
Amylopectin/chemistry , Amylose/chemistry , Solanum tuberosum/chemistry , Starch/chemistry , Concanavalin A/chemistry , Mass Spectrometry , Methylation , Plant Lectins
17.
EMBO J ; 19(6): 1357-65, 2000 Mar 15.
Article in English | MEDLINE | ID: mdl-10716935

ABSTRACT

The biogenesis of a number of RNA species in eukaryotic cells requires 3' processing. To determine the enzymes responsible for these trimming events, we created yeast strains lacking specific 3' to 5' exonucleases. In this work, we describe the analysis of three members of the RNase D family of exonucleases (Rex1p, Rex2p and Rex3p). This work led to three important conclusions. First, each of these exonucleases is required for the processing of distinct RNAs. Specifically, Rex1p, Rex2p and Rex3p are required for 5S rRNA, U4 snRNA and MRP RNA trimming, respectively. Secondly, some 3' exonucleases are redundant with other exonucleases. Specifically, Rex1p and Rex2p function redundantly in 5.8S rRNA maturation, Rex1p, Rex2p and Rex3p are redundant for the processing of U5 snRNA and RNase P RNA, and Rex1p and the exonuclease Rrp6p have an unknown redundant essential function. Thirdly, the demonstration that the Rex proteins can affect reactions that have been attributed previously to the exosome complex indicates that an apparently simple processing step can be surprisingly complex with multiple exonucleases working sequentially in the same pathway.


Subject(s)
Endoribonucleases/metabolism , RNA Processing, Post-Transcriptional/genetics , RNA, Ribosomal/genetics , RNA, Small Nuclear/genetics , Ribonucleases/genetics , Saccharomyces cerevisiae Proteins , Saccharomyces cerevisiae/enzymology , Conserved Sequence/genetics , Endoribonucleases/genetics , Gene Deletion , Genes, Fungal/genetics , Genes, Fungal/physiology , RNA Stability , RNA, Catalytic/genetics , RNA, Fungal/genetics , RNA, Fungal/metabolism , RNA, Ribosomal/metabolism , RNA, Ribosomal, 5.8S/genetics , RNA, Ribosomal, 5.8S/metabolism , RNA, Ribosomal, 5S/genetics , RNA, Ribosomal, 5S/metabolism , RNA, Small Nuclear/metabolism , RNA, Transfer, Arg/genetics , RNA, Transfer, Arg/metabolism , Ribonuclease III , Ribonuclease P , Ribonucleases/metabolism , Saccharomyces cerevisiae/genetics , Substrate Specificity
18.
Bone Marrow Transplant ; 25(3): 251-6, 2000 Feb.
Article in English | MEDLINE | ID: mdl-10673695

ABSTRACT

This study was designed to evaluate the efficacy of therapeutic intensification with autologous stem cell transplantation (ASCT) for mantle cell lymphomas (MCL) in terms of response rate, duration of response, and event-free and overall survivals. Twenty-four patients with confirmed MCL responding to chemotherapy received a high-dose chemo-radiotherapy regimen followed by ASCT. Transplantation was performed during first-line therapy in nine cases, second-line in 13 cases and third-line in two cases. The source of hematopoietic stem cells was peripheral blood for 19 cases. At the time of ASCT, eight patients were in complete remission (33%). Seventeen of the 24 cases received an intensified regimen with TBI and seven received the BEAM or the BEAC regimen. After transplantation, 19 patients were in CR (79%). Nine of these were alive in continued CR at a median follow-up of 34 months, while seven relapsed at a median of 18 months. One patient died from Pneumocystis carinii interstitial pneumonitis and five patients developed secondary malignancies. With a median follow-up after transplantation of 34 months, the 3-year event-free survival was 55% and the 3-year overall survival was 68%. These results indicate that therapeutic intensification with ASCT might be an effective treatment for mantle cell lymphomas. Bone Marrow Transplantation (2000) 25, 251-256.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Lymphoma, Mantle-Cell/complications , Lymphoma, Mantle-Cell/therapy , Adult , Antineoplastic Combined Chemotherapy Protocols/toxicity , Bacterial Infections/etiology , Carmustine/administration & dosage , Carmustine/toxicity , Combined Modality Therapy/adverse effects , Cyclophosphamide/administration & dosage , Cyclophosphamide/toxicity , Cytarabine/administration & dosage , Cytarabine/toxicity , Etoposide/administration & dosage , Etoposide/toxicity , Female , Follow-Up Studies , Hematopoietic Stem Cell Transplantation/adverse effects , Humans , Male , Melphalan/administration & dosage , Melphalan/toxicity , Middle Aged , Neoplasms, Second Primary/etiology , Recurrence , Survival Rate , Transplantation, Autologous/adverse effects , Treatment Outcome , Whole-Body Irradiation/adverse effects
19.
Plant Physiol ; 122(1): 169-80, 2000 Jan.
Article in English | MEDLINE | ID: mdl-10631260

ABSTRACT

Nuclease I enzymes are responsible for the degradation of RNA and single-stranded DNA during several plant growth and developmental processes, including senescence. However, in the case of senescence the corresponding genes have not been reported. We describe the identification and characterization of BFN1 of Arabidopsis, and demonstrate that it is a senescence-associated nuclease I gene. BFN1 nuclease shows high similarity to the sequence of a barley nuclease induced during germination and a zinnia (Zinnia elegans) nuclease induced during xylogenesis. In transgenic plants overexpressing the BFN1 cDNA, a nuclease activity of about 38 kD was detected on both RNase and DNase activity gels. Levels of BFN1 mRNA were extremely low or undetectable in roots, leaves, and stems. In contrast, relatively high BFN1 mRNA levels were detected in flowers and during leaf and stem senescence. BFN1 nuclease activity was also induced during leaf and stem senescence. The strong response of the BFN1 gene to senescence indicated that it would be an excellent tool with which to study the mechanisms of senescence induction, as well as the role of the BFN1 enzyme in senescence using reverse genetic approaches in Arabidopsis.


Subject(s)
Arabidopsis/genetics , Nucleotidases/genetics , Plant Leaves/genetics , Plant Proteins/genetics , Plant Stems/genetics , Amino Acid Sequence , Arabidopsis/growth & development , Arabidopsis/metabolism , Arabidopsis Proteins , Asteraceae/genetics , Asteraceae/metabolism , Base Sequence , Blotting, Northern , Deoxyribonucleases/metabolism , Molecular Sequence Data , Nucleotidases/isolation & purification , Nucleotidases/metabolism , Plant Leaves/metabolism , Plant Proteins/isolation & purification , Plant Proteins/metabolism , Plant Stems/metabolism , Ribonucleases/metabolism , Sequence Alignment
20.
Mol Cell Biol ; 20(2): 441-52, 2000 Jan.
Article in English | MEDLINE | ID: mdl-10611222

ABSTRACT

The exosome is a protein complex consisting of a variety of 3'-to-5' exonucleases that functions both in 3'-to-5' trimming of rRNA precursors and in 3'-to-5' degradation of mRNA. To determine additional exosome functions, we examined the processing of a variety of RNAs, including tRNAs, small nuclear RNAs (snRNAs), small nucleolar RNAs (snoRNAs), RNase P, RNase MRP, and SRP RNAs, and 5S rRNAs in mutants defective in either the core components of the exosome or in other proteins required for exosome function. These experiments led to three important conclusions. First, exosome mutants accumulate 3'-extended forms of the U4 snRNA and a wide variety of snoRNAs, including snoRNAs that are independently transcribed or intron derived. This finding suggests that the exosome functions in the 3' end processing of these species. Second, in exosome mutants, transcripts for U4 snRNA and independently transcribed snoRNAs accumulate as 3'-extended polyadenylated species, suggesting that the exosome is required to process these 3'-extended transcripts. Third, processing of 5.8S rRNA, snRNA, and snoRNA by the exosome is affected by mutations of the nuclear proteins Rrp6p and Mtr4p, whereas mRNA degradation by the exosome required Ski2p and was not affected by mutations in RRP6 or MTR4. This finding suggests that the cytoplasmic and nuclear forms of the exosome represent two functionally different complexes involved in distinct 3'-to-5' processing and degradation reactions.


Subject(s)
Exoribonucleases/metabolism , Mutation/genetics , Poly A/metabolism , RNA Processing, Post-Transcriptional/genetics , RNA, Small Nuclear/metabolism , RNA, Small Nucleolar/metabolism , Saccharomyces cerevisiae Proteins , Saccharomyces cerevisiae/genetics , DEAD-box RNA Helicases , Endoribonucleases/metabolism , Exoribonucleases/genetics , Exosome Multienzyme Ribonuclease Complex , Fungal Proteins/genetics , Fungal Proteins/metabolism , Genes/genetics , Genes, Fungal/genetics , Genes, Fungal/physiology , Introns/genetics , Kinetics , Multienzyme Complexes/genetics , Multienzyme Complexes/metabolism , Phenotype , Poly A/genetics , RNA Helicases/genetics , RNA Helicases/metabolism , RNA, Fungal/genetics , RNA, Fungal/metabolism , RNA, Messenger/genetics , RNA, Messenger/metabolism , RNA, Small Nuclear/genetics , RNA, Small Nucleolar/genetics , RNA-Binding Proteins/genetics , RNA-Binding Proteins/metabolism , Ribonuclease III , Saccharomyces cerevisiae/enzymology , Transcription, Genetic/genetics
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