B-lineage acute lymphoblastic leukemia of childhood. An institutional experience.

A total of 119 children (1990-95) with acute lymphoblastic leukemia (ALL) B-lineage either CD10+ or CD10- were registered into a single non-randomized chemotherapy protocol. Only untreated patients with standard risk were included in the study. Their ages ranged from 1.8-10 years with a mean of 5.1 years. There were 82 (68%) children with early pre B-All, 35 (29%) with pre B-ALL and 2(1.6%) with transitional pre B-ALL (p < 0.00001). The patients were divided according to CD10 reactivity, either + (94 children) or -(25 patients). The event-free survival (EFS) at 60 months for the CD10+ children was of 78% (alive 73/94), while for the CD10- was 71% (alive 18/25) (p = 0.6) and 74% for both groups. The factors that influenced favorably the survival in the CD10+ group were the age between 3 to 5.99 years (p < 0.00001), sex (either male or female), leukocyte count between 10-24.9 x 10(9)/l (p < 0.00001), LDH under 300 U/I (p < 0.00001) and L1 bone marrow cytomorphology (p < 0.00001). In the CD10- patients, the EFS was favorably influenced by the female sex (p = 0.04), leukocyte count under 10 x 10(9)/l (p = 0.05) and LDH < 300 U/l (p = 0.02). CNS infiltration was documented in 4.2% (5/119). Mortality secondary to chemotherapy was seen in 7%. In conclusion, this is the first large series in Mexican children with B-lineage ALL published. Because of the relatively small number of patients in each group (pre B and transitional pre B), all the patients in the current series were treated alike. When the 119 patients were divided only on the basis of CD10 reactivity, the EFS for both groups (CD10+ and-) was similar; therefore, the reactivity to CD10 has no prognostic value in this type of ALL.

[In vitro effect against Giardia of 14 plant extracts]. / Efecto antigiardiásico in vitro de 14 extractos de plantas.

OBJECTIVE: To investigate antigiardiasic activity in plants used in Mexico as antidiarrheics and/or antiparasitics. MATERIALS AND METHODS: Fourteen species were evaluated. The antigiardiasic activity was measured in vitro in a blinded fashion using trophozoites of Giardia duodenalis incubated with plant extracts. The viability of trophozoites was ascertained using MTT (3-[4,5-dimethylthiazol-2-il]-2, 5-diphenyl tetrazolium bromide) which is reduced to MTT-formazan by the activity of live trophozoites. The reduced MTT was extracted with an acidified alcohol (2-propanol with HCI 0.04 M) and measured in a spectrophotometer at 570 nm. Negative (trophozoites without extract) and positive controls (incubated with tinadazol) were included. RESULTS: The scientific and trivial names of the plants are given (trivials in Spanish marked by an asterisk). They had the following trophozoite mortality (mean +/- SD in percent): Justicia spicigera (muicle*) = 91 +/- 0.5; Lipia beriandieri (oregano) = 90 +/- 0.6; Psidium guajava (guava) = 87 +/- 1.0; positive control of tinidazol = 79 +/- 1.9; Punica granutus (granado*) = 78 +/- 1.3; Magnifera indica (mango) = 77 +/- 1.0; Plantago major (lante*) = 76 +/- 1.2; Cupressus semperbirens (cipres) = 73 +/- 1.2; Castella tormentosa (chaparro amargoso*) = 70 +/- 0.7; Hematoxilon campechanum (palo de Campeche*) = 67 +/- 1.2. Without or with a low mean activity were Prosopis juliflora (mesquite*) and Rizophora mangle (mangle*) with 0%, Oriza sativa (rice) with 5%, Capsicum annum (pimiento*) with 21% and Persea americana (avocado) with 23%. There were no associations of the antigiardiasic effect with concentration or osmolality of the extracts. CONCLUSIONS: A clear in vitro antigiardiasic effects was seen in nine species. Three of them were superior to tinidazol which is a drug of common use in the treatment of giardiasis.