[Renal vein thrombosis in newborn infants]. / Trombose venosa renal no recém-nascido.

The authors reviewed renal venous thrombosis (RVT), a frequent cause of acute renal failure in newborns. Clinical manifestations and prognosis are unsteady and, although there is agreement about the management of underlying conditions and general abnormalities, the relative role of anticoagulant and fibrinolytic therapy has not been clearly established. The 5 RVT described cases were treated in our hospital in the last 5 years. Four out of five were followed and one of these was submitted to nefrectomy to control arterial hypertension. The findings are compared to literature and present therapy is discussed.

Etoposide plus cisplatin followed by thoracic radiation for stage IIIB non-small cell lung cancer: MAOP study 2188.

Thirty-five patients with stage III B non-small cell lung cancer were treated with the combination of cisplatin (CDDP) 30 mg/M2/day and etoposide (VP16-213) 75 mg/M2/day administered as a 72-hour infusion. Twenty evaluable patients (67%) received subsequent thoracic radiation as definitive regional therapy following a clinical response or stable disease status. Complete plus partial responses to chemotherapy were observed in 15 patients (5CR and 10PR or 44%). Of the 20 patients who received radiation, six responded with five transitioning from stable disease to partial (2) or complete (3) responses. The overall response rate to the combined sequential chemotherapy plus radiation was therefore 20/35 or 59% with eight complete responders. Histopathology influenced the response rate to chemotherapy (53% versus 30% for epidermoid versus adenocarcinomas, respectively), but following radiation, the response rates were similar for the two pathologic subtypes (73% versus 71%). Median overall survival was 363 days with 20% of patients alive at 13 to 45 months. The response rate for CDDP plus VP16-213 chemotherapy administered as a 72-hour infusion was superior for stage III B non-small cell lung cancer compared with stage IV disease as previously reported by the Mid Atlantic Oncology Program (44% versus 25%). This difference between stage III B and stage IV was also reflected in median survival (363 days versus 190 days). The sequential addition of radiation therapy to this chemotherapy regimen is feasible in stage III B disease with a small proportion of patients demonstrating long-term survival.

Neutrophil life span in paroxysmal nocturnal hemoglobinuria.

We have studied neutrophil intravascular life span in six patients with paroxysmal nocturnal hemoglobinuria (PNH); four had normal neutrophil counts when studied and two were neutropenic. Five patients had enough circulating neutrophils to isolate for tests in vitro. Lysis of labeled neutrophils was greatly increased, compared to that of normal volunteers, when these neutrophils were incubated with acidified fresh serum as a source of active complement plus serum containing antineutrophil antibodies (from three different sources). Despite the in vitro lesion, however, each of these patients had a normal neutrophil intravascular life span as measured by the 32P-diisopropylfluorophosphate technique. One neutropenic patient, who had a normal neutrophil life span, had a shift of cells from the circulating to marginated pool of sufficient degree to cause the neutropenia. A second (severely) neutropenic patient was found to have developed extreme marrow hypoplasia, also explaining the neutropenia. Thus, in contrast to the shortened red cell life span, we have been unable to find a shortened neutrophil life span in PNH.