Estudio de la respuesta a fludarabina en pacientes con síndromes linfoproliferativos crónicos / Study of the fludarabine response of patients with chronic lymphoproliferative syndromes

Objetivo: Mostrar los resultados obtenidos en 12 pacientes diagnosticados de leucemia linfocítica crónica (LLC), linfoma no Hodgkin de bajo grado de malignidad (LNH-BG) y macroglobulinemia de Waldenström (MW) tras tratamiento con fludarabina. Método: Estudio retrospectivo en el que se revisaron las hojas de petición de citostáticos, las fichas farmacoterapéuticas del servicio de farmacia, así como las historias clínicas de cada paciente. Resultados: Se estudiaron 12 pacientes: seis fueron diagnosticados de LLC, cinco de LNH-BG y uno de MW. Recibieron entre dos y nueve ciclos de fludarabina y en dos casos se asoció a ciclofosfamida. En nueve de los 12 pacientes se observó remisión parcial y en los otros tres no se produjo respuesta al tratamiento. Conclusiones: La fludarabina ha sido utilizada ampliamente en el tratamiento de las LLC y se precisan más estudios que pongan de manifiesto su eficacia en el tratamiento de otros síndromes linfoproliferativos. Debido a la escasa aparición de efectos secundarios podría ser un fármaco prometedor para el tratamiento de estas y otras enfermedades hematológicas (AU)

[Parenteral nutrition in oncologic patients]. / Nutrición parenteral en pacientes oncológicos.

The aim of this work is to carry out a follow-up of oncological inpatients who received parenteral nutrition (PN). We analysed the connection between the clinical situations and the indication and type of PN administered. A retrospective review of oncological patients who received PN during 1996 was carried out. Age, sex, primary tumor, PN indication and compliance degree, nutritional evolution, different categories of nutritional intervention, characteristics of PN as well as related complications and connected with PN were analysed. 33 patients, 23 female and 10 male, between 20 and 82 years old, were studied. 39% received PN with intensive antineoplastic therapy; 55% received PN as supportive treatment in various clinical situations related to the tumor or with antineoplastic therapy; 6% received palliative PN. 25 patients received PN without lipids and 8 total PN. The mean duration of PN was 10 days. 17 patients received PN by peripheric venous route and 16 through central venous catheter. The PN was well tolerated. In conclusion, most patients (94%) complied with some of the criteria established for the PN indication. The biggest percentage of patients in treatment with PN were divided into two main groups: patients with intensive antineoplastic therapy and patients with gastrointestinal disfunction caused by tumor or antineoplastic therapy. The role of PN in oncological patients it is not defined yet. The incidence of complications due to PN was low and without clinical relevance.

[A possible hypersensitivity reaction to total parenteral nutrition]. / Posible reacción de hipersensibilidad a una nutrición parenteral total.

We present a possible case of a hypersensitivity reaction to parenteral nutrition in a surgical patient of 61 years, weighing 49 kg, who presented facial, thoracic, and underarm erythema, proximal to the peripheral line, accompanied by pruritus: the symptoms disappeared after discontinuing the nutrition and after administration of dexchlorpheniramine. Analysis of the possible causes of this manifestation takes place, as well as of the components of the parenteral nutrition, route of administration, and concomitant medication.