[Autologous peripheral blood stem cell transplantation as an effective treatment for recurrent Hodgkin's disease]. / Autologiczna transplantacja komórek macierzystych z krwi obwodowej jako skuteczny sposób leczenia nawrotowej ziarnicy zlosliwej.

Autologous peripheral blood stem cell transplantation (APBSCT) is a method used analogically to autologous bone marrow transplantation (ABMT) to obtain hematological reconstitution following myeloablative therapy in patients with hematological malignancies. We have now applied this procedure in two patients with recurrent high risk Hodgkin's disease. Collection of circulating stem cells mobilised with cyclophosphamide/G-CSF was performed by several leukaphereses on Fenwal 3000, with access through inferior vena cava. Nucleated cells were separated by dextran sedimentation, cryopreserved, and stored at (-) 196 degrees C. Additional marrow collection was performed in one patient. Conditioning regimen consisted of BCNU, etoposide and cyclophosphamide delivered at days -3 and -2. Collected material containing on average 3.6 x 10(8)/kg nucleated cells and 8.0 x 10(6)/kg CD34(+) cells was transfused at day 0. G-CSF was administered following transplantation to one patient to hasten the recovery. Hematological recovery was relatively quick. Neither serious adverse events nor signs of relapse were observed following transplantation. Our results supported by other's reports indicate, that APBSCT enables hematological recovery similarly to ABMT in Hodgkin's disease. The advantage of APBSCT is a possibility to collect material in patients with marrow involvement, hypoplasia or fibrosis. Outcomes obtained following APBSCT are at least as good as following ABMT. High-dose chemotherapy followed by APBSCT or ABMT should be considered in all patients with recurrent Hodgkin's disease sensitive to chemotherapy.

[Techniques of positive isolation of CD34(+) cells. Personal experience with the immunomagnetic method]. / Techniki pozytywnej izolacji komórek CD34(+). Doswiadczenie wlasne z metoda immunomagnetyczn,a.

In this article the contemporary methods of positive stem cells isolation have been reviewed, with special regard to their application in the hematological transplantology, and the results of our own studies on isolation with the immunomagnetic method have been presented.

Autologous peripheral blood stem and progenitor cells transplantation as a valid treatment approach in recurrent, refractory lymphoma.

Autologous peripheral blood stem cell transplantation (APBSCT) is used similarly to autologous bone marrow transplantation (ABMT) to reconstitute bone marrow following myeloablative therapy in patients with proliferative diseases of the blood. Eight patients with recurrent and refractory lymphoma (3 HD, 4 NHL) and multiple myeloma aged 17-55 were included into the study. Peripheral blood stem cells following their prior mobilisation with cyclophosphamide 4-7 g/m2 and/or G-CFS or Dexa-BEAM + G-CSF were collected by subsequent leukaphereses on Fenwal CS3000. Nucleated cells were separated by sedimentation, cryopreserved in a programmed freezer and then stored at-196 degrees C. Bone marrow has been additionally collected in one patient. Conditioning treatment prior to transplantation consisted of BCNU, etoposide and cyclophosphamide (CBV) in lymphomas and melphalan in multiple myeloma. Collected material with mean cellularity 5.52 x 10(8)/kg and mean CD34+ contents 6.27 x 10(6)/kg was reinfused by central line. G-CSF was given in 5 patients to hasten the bone marrow recovery. All patients fully recovered and left hospital on average 35.5 days following transplantation. No signs of relapse were seen throughout the observation period (mean 349.5 days). Neutrophils > 0.5 G/1 were obtained on day + 20, > 1.0 G/1 on day 30, platelets > 50 G/1 on day 29, > 100 G/1 on day 53, reticulocytes > 0.015 on day 30, erythrocytes transfusions were needed up to day 39. Presented outcomes together with other reports indicate, that APBSCT is a highly efficient way to rescue repeatedly relapsing patients with proliferative diseases of the lymphatic systems, even those presenting with changes in the bone marrow (neoplasmatic infiltrate, hypoplasia or fibrosis).

Epidemiologic estimation of goiter in children from Gdansk, Elblag, Olsztyn and Torun districts (Gdansk coordinating center).

The study comprised 1604 children (49.9% of boys and 50.1% of girls) of age between 6 and 13 years living in the districts of Gdansk, Elblag, Olsztyn and Torun. 55.5% of children were from urban area, 44.5% from rural area. This districts have been divided into 3 geographic regions. 1) Olsztyn region: 174 children and the villages near Olsztyn--178 children, 2) Seaside region: Gdansk and Elblag--358 children and 3 villages situated in the distance less than 60 km from the sea--533 children, 3) Torun region: Torun--181 children and villages near Torun--180 children. A significant relationship between the incidence of goiter and the place of living was found. The presence of goiter was observed in 9.2% of children in Gdansk and Elblag and in 23% of children in the seaside region (with the peak in Glincz village--35%). In Olsztyn region the incidence was 18.2%, in Torun region--12.5%. Among 1604 studied subjects in 263 (16.4%) with goiter, the nodular goiter was in 2.3% of cases. The lowest occurrence of goiter was noted in Gdansk and Elblag. Urinary iodine concentration in children with goiter from Gdansk and Elblag (123.1 micrograms/l) was higher than in those living in villages in the seaside region (90.8 micrograms/l). The thyroid size as measured by ultrasonography was different in children with and without goiter in each age group. In the age group of 6-8 years it was 4.8 ml in children without goiter and 6.3 ml in children with goiter, in the age group 9-10 years, 5.7 ml and 8.6 ml, in the age group 11-12 years, 6.6 ml and 10.0 ml, in children 13 years old--8.0 ml and 12.1 ml. All the children with goiter have greater body weight and height than those in the same age groups without goiter. 13.2% of studied persons consumed iodized salt. There was no difference in the incidence of goiter in children receiving and not receiving iodized salt (13.4% and 13.1% in all regions). There was also lack of relation between urinary iodine concentration and rate of consumption of iodized salt.

A case of organic aciduria--suspected 3-hydroxy-3-methylglutaric aciduria.

In a girl from a family with muscular hypotonia, hypoglycaemia, lactic acidosis and delayed development the analysis of organic acids in urine suggested a defect in leucine metabolism--3-hydroxy-3-methylglutaric aciduria. A good therapeutic effect was obtained with low-protein diet.

Mesangial proliferative glomerulonephritis in children.

Over a ten year period 105 children with a histological diagnosis of a mesangial proliferative glomerulonephritis were diagnosed. Patients were divided into two groups according to their clinical presentation at the time of diagnosis. Ninety two children presented with nephrotic syndrome (NS) of whom 82 received steroid therapy. No response was observed in 26 children and in 56 remissions were short in duration and subsequent relapses were frequent. Eighty nine children with the nephrotic syndrome were treated with cyclophosphamide (CP) of whom 26 had a steroid resistant NS, 53 were steroid dependent and 10 were previously untreated. Eighty four entered remission with a mean duration of 46 months. Only 5 children did not respond to treatment with CP. No correlation could be found between the results of therapy and the degree of morphological changes on examination of renal biopsy. The second group consisted of 13 children presenting with a persistent nephritic syndrome and or proteinuria. These children were untreated and no progression of renal disease was observed after several years follow up.