Evaluation of patient age as a risk assigment parameter in high risk acute lymphocytic leukemia.

Historically, age has been used as criteria for risk group assignment in patients with acute lymphocytic leukemia (ALL). The prognosis varies among different age groups. Differences in the biological characteristics of the leukemic clone and clinical findings at diagnosis are also used for risk assignment in ALL. It is our hypothesis that age is a lesser risk defining parameter than are the biological characteristics of the leukemic clone and the clinical characteristics at presentation. An analytic, retrospective study was conducted where fifty-seven patients were evaluated. Patients were divided in two subgroups: nine years and older (up to 18 years of age) patients with favorable biological characteristics of the leukemic clone and favorable clinical findings at diagnosis (riesgo 0) and nine years and older (up to 18 years of age) patients with unfavorable characteristics of the leukemic clone and/or unfavorable clinical findings at diagnosis (riesgo 1). All patients received treatment according to the same treatment protocols. The subgroup of patients with favorable ALL characteristics (riesgo-0) showed an increased median survival time of 11 years compared to those patients with unfavorable ALL characteristics (riesgo-1) who had a median survival time of 5.4 years. Age as a risk assignment perameter had a minimal impact in survival in patients whose leukemia had good biologic characteristics treated on these treatment protocols.

Prevention of respiratory syncytial virus infection among Puerto Rican infants.

Respiratory syncytial virus (RSV) is the leading cause of lower respiratory illness in children. Prevention of this infection is available with the use of intravenous immunoglobulin or an intramuscular humanized monoclonal antibody (palivizumab). Palivizumab has been available in Puerto Rico since 1999. The objective of this study was to follow-up infants who received RSV prophylaxis with palivizumab in Puerto Rico to assess its efficacy and safety. A total of 230 infants who received RSV prophylaxis during the 2000-2001 and 2001-2002 seasons were followed-up. Adverse events from injections were minimal including erythema (2%), fever (5%), pain (4%), and rash (2%). In none of the patients prophylaxis was discontinued due to side effects. Forty-four infants (19%) had at least one respiratory hospitalization throughout the season, with RSV confirmed in seven (3%). Most hospitalizations occurred in the month of August when infants had received only one dose of palivizumab and on December, a peak month for RSV infections. Five infants (2.2%) required admission to an intensive care unit. In none of them, RSV was confirmed. This study confirms that monthly intramuscular administration of palivizumab is effective in preventing serious RSV infections in high risk infants.

Prevention of respiratory syncytial virus infection among Puerto Rican infants

Respiratory syncytial virus (RSV) is the leading cause of lower respiratory illness in children. Prevention of this infection is available with the use of intravenous immunoglobulin or an intramuscular humanized monoclonal antibody (palivizumab). Palivizumab has been available in Puerto Rico since 1999. The objective of this study was to follow-up infants who received RSV prophylaxis with palivizumab in Puerto Rico to assess its efficacy and safety. A total of 230 infants who received RSV prophylaxis during the 2000-2001 and 2001-2002 seasons were followed-up. Adverse events from injections were minimal including erythema (2), fever (5), pain (4), and rash (2). In none of the patients prophylaxis was discontinued due to side effects. Forty-four infants (19) had at least one respiratory hospitalization throughout the season, with RSV confirmed in seven (3). Most hospitalizations occurred in the month of August when infants had received only one dose of palivizumab and on December, a peak month for RSV infections. Five infants (2.2) required admission to an intensive care unit. In none of them, RSV was confirmed. This study confirms that monthly intramuscular administration of palivizumab is effective in preventing serious RSV infections in high risk infants.