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A Iriondo

Publications and source records attributed to A Iriondo.

At least 55 records · Page 3Linked to original sources
PubMed1990

Relation between the increase of circulating CD3+ CD57+ lymphocytes and T cell dysfunction in recipients of bone marrow transplantation.

Some patients undergoing bone marrow transplantation (BMT) persistently present increased proportions of circulating CD57+ T cells. We analysed the cell surface phenotype in peripheral blood mononuclear cells (PBMC) from 69 allogeneic and 11 autologous BMT recipients. In parallel samples from 49 patients, the proliferative response to T cell mitogens was assessed, either in the presence or absence of exogenous interleukin-2 (IL-2). PBMC samples from long-term allogeneic BMT patients with increased proportions of CD57+ cells displayed significantly (P less than 0.001) lower proliferative responses, compared with samples from patients with normal proportions of CD57+ cells and from healthy subjects. Elimination of the CD57+ population by C'-dependent lysis did not normalize the proliferative response. After positive selection by cell sorting, CD57+ cells responded poorly, but in the presence of IL-2 the proliferation appeared to be similar to that displayed by the CD57- subset and still suboptimal compared with normal controls. These data suggest that the hyporesponsiveness to mitogenic stimuli in the presence of exogenous IL-2 of PBMC from allogeneic BMT recipients cannot be simply attributed either to the putative suppressor activity of CD57+ cells, or to a poor proliferative capacity of this subset. Supporting this notion we report that PBMC from long-term autologous BMT recipients containing high proportions of CD57+ T cells respond normally to T cell mitogens.

Antigens, Differentiation, T-Lymphocyte↗
PubMed1990

[Empirical treatment of febrile episodes in patients with neutropenia in bone marrow transplantation].

The results of therapy of febrile episodes during the pregraft phase in bone marrow transplant was retrospectively evaluated in 84 granulocytopenic patients. Most patients received co-trimoxazole and i.v. ticarcillin as antibacterial prophylaxis. 47 episodes were treated with a third generation cephalosporin plus an aminoglycoside, with a 55% favorable response rate. 37 episodes were treated with a wide spectrum penicillin plus an aminoglycoside, with a 41% response rate (p greater than 0.05). Among the 23 infections caused by gram-negative bacilli the response rate was 89% (8 of 9) with the first regimen, and 21% (3 of 14) with the second one (p = 0.003). The investigation of in vitro sensitivity suggested that prophylactic ticarcillin favors the infections due to bacilli with cross-resistance to wide spectrum penicillins. The antibiotic regimen did not influence the final resolution or the mortality rate of the febrile episode.

Adult↗
PubMed1989

[Prevention of acute graft versus host disease using 3 prophylactic schemes].

During 7 years 81 patients received an allogeneic bone marrow transplant (BMT) for several diseases. The prevention of graft-versus-host disease (GVHD) was undertaken with methotrexate (MTX), MTX plus antilymphocytic gammaglobulin plus prednisone (MTX + ALT + P), and elimination of the T-lymphocytes of the donor's bone marrow with the monoclonal antibody CAMPATH-1. The actuarial survival of the patients who did not develop GVHD was significantly better than that of those who developed grade II-IV GVHD: 56% [95% confidence interval (CI) 39-71%] versus 10% (95% CI 3-25%) (p less than 0.0001). However, actuarial survival was similar in each of the three groups: MTX 35%, MTX + ALT + P 38%, and CAMPATH-1 43%. The incidence of GVH disease, when the sex of the donor and the receptor were different, was significantly higher than in cases where the donor and the receptor had the same sex: 45% (95% CI 31-58%) vs 15% (95% CI 8-28%) (p less than 0.005). By contrast, significant differences were not found between the three groups in the incidence of GVHD: MTX 36%, MTX + ALT + P 34%, and CAMPATH-1 20%. In patients with leukemia, a higher number of relapses occurred in the MTX group, because a higher number of patients in second or third complete remission (CR) or with active disease underwent transplantation.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1989

Therapy of advanced myelodysplastic syndrome with aggressive chemotherapy.

Nine patients with advanced stages of myelodysplastic syndrome (MDS) received aggressive chemotherapy with high-dose cytarabine or with a standard acute myeloid leukemic regimen. Six of them were in frank acute myeloid leukemic phase. The mean age was 57 years (range 32-71). Seven patients obtained remission, 6 complete remission (CR) and 1 partial remission. The induction remission rate was 77.7%. There were 2 deaths in the aplasia period because of infectious complications. The mean duration aplasia was 36 days (range 21-69). In spite of this all responders received further consolidation chemotherapy. The mean duration of CR was 10 months. We concluded that patients with MDS with excess of blasts and blastic transformation may be treated with aggressive chemotherapy with low toxicity and high remission rate, similarly to de novo acute myeloid leukemia.

Adult↗
PubMed1989

[Prognostic value of the changes in the DNA of blast cells from patients with acute lymphoblastic leukemia].

The cytogenetic characteristics of 37 patients diagnosed of acute lymphoblastic leukaemia are presented. The studies were performed by cytofluorometry (CFM) after DNA staining with propidium iodide (34 cases) and/or chromosome identification with trypsin G bands (13 patients). Hyperdiploid DNA index was present in 15% of the patients, whereas none of them had hypodiploid DNA index. Abnormal karyotype was found in 69% of the evaluated cases. Good correlation was observed between the ploidy attained by CFM and by karyotyping cells. The highest percentage of aneuploidy corresponded to the L2 morphological subtype (55%), followed by L1 (36%). Structural alterations were the commonest in L2 variant, while numerical ones were commonest in the L1 variant. The 4 L1 patients with aneuploidy had the common immunophenotype, whereas the 6 aneuploidic patients of the L2 variant had common, early pre-B and undifferentiated immunophenotype. The actuarial survival of patients with diploid DNA index was 48.5% (IC 95%, 25-73%), whereas pseudodiploid patients have relapsed and died before 16 months from diagnosis (p less than 0.005). None of the patients with hyperdiploid DNA index and lacking structural alterations has relapsed. Patients with structural abnormalities have the poorest prognosis, while patients with hyperdiploid DNA index showed several favourable risk factors and are in the first complete remission.

Aneuploidy↗
PubMed1988

Allogeneic bone marrow transplantation versus intensification chemotherapy for acute myelogenous leukaemia in first remission: a prospective controlled trial.

In 1982 we began a prospective controlled trial to assess the effectiveness of allogeneic bone marrow transplantation and intensive post-remission chemotherapy for patients with acute myelogenous leukaemia in first complete remission. Fourteen patients, 3-45 years of age, who had an HLA-identical sibling donor, received bone marrow transplantation. Twenty-five patients who either lacked an HLA-identical sibling or were over 45 years of age received intensive consolidation chemotherapy including high-dose cytosine arabinoside with or without adriamycin. The actuarial rate of continued complete remission (CCR) at 3 years was significantly higher in the transplantation group than in the chemotherapy group: 70% (95% confidence interval 35-91%) compared with 10% (95% confidence interval 2-30%); P = 0.01. However, the actuarial rate of CCR was not significantly different between the transplantation group and patients under 45 years in the chemotherapy group: 70% (95% confidence interval 35-91%) compared with 17% (95% confidence interval 4-45%), 0.1 greater than P greater than 0.05. The actuarial probability of leukaemia relapse was significantly lower in the transplantation group than in the chemotherapy group: 10% (95% confidence interval 4-21%) compared with 88% (95% confidence interval 70-96%), 0.005 greater than P greater than 0.001. There was no significant difference between both groups if we compare only the patients who died of non-leukaemic causes: 22% (95% confidence interval 9-42%) versus 25% (95% confidence interval 7-59%), P = NS. In summary, this study shows that allogeneic bone marrow transplantation is a better anti-leukaemic treatment than is intensive consolidation chemotherapy in patients with AML in first complete remission.

Adolescent↗
PubMed1986

Treatment of myelodysplastic syndrome with 1.25-dihydroxy-vitamin D3.

1.25-dihydroxy-vitamin D3 (1.25 (OH)2D3) was tested in seven patients with myelodysplastic syndrome. The study was undertaken because 1.25 (OH)2D3 promotes differentiating myeloid cells in vitro and because of a prior report of potential benefit in a clinical study. The drug was given orally at a dose of 2.5 micrograms/day for a minimum of 8 weeks (range 8-28). After therapy, there were no significant changes in any of the parameters observed in peripheral blood or bone marrow. We did not observe any feature of granulocytic-monocytic differentiation. Treatment was well tolerated. One patient died because of bone marrow failure. Survivors have persisting myelodysplastic syndrome and continue to be transfusion dependent. 1.25 (OH)2D3 has no beneficial effect in patients with myelodysplastic syndrome with this dose regimen.

Aged↗