PubMed Health⌕ Search

Biomedical subjects

B Balint

Publications and source records attributed to B Balint.

At least 37 records · Page 2Linked to original sources

Donor leukocyte infusion--the effect of mutual reactivity of donor's and recipient's peripheral blood mononuclear cells on hematopoietic progenitor cells growth.

Donor leukocyte infusions are an effective therapy for patients who relapse with leukemia after bone marrow transplantation. We report the case of 14-year-old boy who relapsed 34 months after sibling donor bone marrow transplant for Philadelphia-positive chronic myeloid leukemia. Subsequently, he received three infusions of donor mononuclear cells (DMNC) harvested in steady state hematopoiesis and one G-CSF mobilized-peripheral blood mononuclear cells (PBMC) infusion. Simultaneously, test named as--"Test of Mixed Progenitors" (TMP) was performed for the assessment whether the outcome of donor leukocyte infusion treatment could be predicted. Prior to DMNC infusions, the CFU-GM and BFU-E colony assays were performed for donor's and recipient's PBMC individually, as well as for the mixture of these cells at 1:1 ratio. The cells were plated either directly in the semisolid medium or after 24 h preincubation treatment. Significantly lower values for CFU-GM derived colonies were determined in TMP in comparison to the CFU-GM values obtained for the recipient's cells. The reduced number of CFU-GM was determined both in TMP performed without preincubation treatment, app. 80% and after the 24 h preincubation, app. 55%. The reduced number of BFU-E derived colonies (app. 44%) was observed only related to recipient's cells and after the preincubation treatment of the cells. The patient did not develop GVHD and currently (40 months after the first infusion). He remained well in complete hematological, cytogenetic, molecular and clinical remission, which was the most direct evidence of the GVL effect. The novel in vitro TMP test in which the specific contribution of donor's leukocytes to the growth of recipient's hematopoietic precursor cell growth was determined, correlated with the clinical outcome.

Adolescent↗

[Second allogenic bone marrow transplantation after late graft rejection in a patient with severe aplastic anemia].

Allogeneic bone marrow transplantation (BMT) is the treatment of choice in young patients (pts) with severe aplastic anemia (SAA) who have an HLA identical sibling donor. Late graft rejection to following allogeneic BMT for SAA is a significant clinical problem and is associated with a high risk of mortality. The optimal treatment strategy for patients with late graft rejection after first BMT is still an open question. We report 12-year-old patient with acquired SAA who underwent BMT from his HLA identical sister. BMT was first-line treatment within 3 months of diagnosis. Preparative therapy was Cyclophosphamide (Cy) 200 mg/kg body mass (BM) during 4 days. Graft versus host disease (GVHD) was prevented with Methotrexate (MTX), Methylprednisolone (MPDN) and Cyclosporin A (CsA). After 17 months, during which patient was with normal blood counts and full donor chimaerism, graft rejection occurred. The patient was re-engrafted from the same donor after conditioning with Cy 200 mg/kg BM plus horse antithymocyte globulin (ATG)--2 vials (á 25 mg)/10 kg BM over 4 days. Before the collection, donor's bone marrow was activated with low dose rhGM-CSF (3 micrograms/kg one day). Following a secondary BMT engraftment has sustained. The patient is alive with full donor chimaerism 26 months from secondary transplantation, without acute or chronic GVHD.

Anemia, Aplastic↗

[Secondary myelodysplastic syndrome after autologous transplantation of hematopoietic stem cells in a female patient with Hodgkin's disease].

Secondary acute myeloid leukemia with threelineage displasy (sAML/MDS) has been described as a complication of therapeutic approach with high-dose chemotherapy and autologous stem cell transplantation (SCT) in the patients with Hodgkin's disease (HD). It is not yet clear whether the sAML/MDS is a consequence of a standard therapeutic regimen, applied before transplantation, or a high-dose chemotherapy. In a female patient with initially resistant form of HD at III-B-b clinical stadium (bulky disease in neck and mediastinum) after the initial treatment (MOPPx4; ABVDx3; BEA-COPPx2), high-dose chemotherapy has been applied according to BEAM protocol with autologous SCT. In a period after transplantation, radiotherapy (RT) has been applied at initial region of the disease and a patient reached complete remission (CR), which lasted for a 27 months. After that period sAML/MDS has been observed. Application of more standard therapeutic cycles and characteristic cytogenetic findings are the facts that support the opinion that sAML/MDS is a consequence of standard treatment before transplantation, rather than high-dose chemotherapy. That finding implies the need for correct choice of the HD patients suitable for early SCT therapeutic approach.

Acute Disease↗

[A severe form of falciparum malaria associated with staphylococcal endocarditis].

A case is presented of a patient, aged 56 years, with severe form of imported malaria caused by Plasmodia falciparum. Hyperparasitemia of erythrocytes > 30% was registered, and during the course of the disease CNS dysfunction, severe anemia, acute renal failure, disseminated intravenous coagulation with manifest hemorrhagic syndrome, icterus, enterocolitis, pneumonia and staphylococcal endocarditis were developed Due to hyperparasitemia and numerous complications, antimalarial drugs such as quinidine (1,200 mg/day) and artemether (160 mg/day) were administered parenterally. Infected erythrocytes were exchanged with 2.5 litres of healthy erythrocytes suspension. Hemodialysis was also performed as well as nine-week antistaphylococcal therapy. During the treatment preparation of deplasmated blood, concentrated thrombocytes, fresh frozen plasma, cryoprecipitates, human albumins and immunoglobulins were applied, along with the correction of electrolytic dysbalance, administration of diuretic, cardiotonic, antiarrhythmic, anxiolytic, antipsychotic and antidepressive drugs. Two months after the admission the patient was released from the Clinic in good condition, with normal clinical-laboratory findings.

Acute Disease↗

[Identification of bodies of soldiers carbonized in an armored transport vehicle].

The authors have presented the process and possibilities of identification of the carbonized bodies of the crew of the exploded military armoured transporter. In identification of the invaluable importance have been description, autopsy findings, questionnaires and their comparison as well as ways of identification of the carbonized bodies.

Burns↗

[Treatment of porphyria cutanea tarda using plasma exchange].

Results in the treatment of 5 patients with porphyria cutanea tarda by plasma exchange are presented. The procedure was applied every second or third day, 2-4 procedures in total. Saline solution, 5% or 12% albumin were used as plasma substitutes. The treatment lead to rapid fall in urine porphyrin level and improved clinical picture. The treatment was continued ambulatorily by 60 mg of vitamin E tbl. daily and Essentiale tbl. 3 X 1, which lead to further progressive fall in porphyrin level and improved clinical picture. In one patient citrate intoxication occurred which was prevented by Calcium Sandosten ampl. The importance of this method in the treatment of porphyria cutanea tarda and indications for this treatment are discussed.

Adult↗

[The role and morphology of thrombocyte concentrates prepared from a buffy coat].

The results of quantification and investigation of thrombocyte morphology in 112 concentrated thrombocyte units, prepared from buffy coat of the whole blood taken from the unchosen donors are shown. Immediately after the preparation of units the thrombocyte count was 66.99 +/- 7.04 x 10 cells (contribution of procedure 65.05%), the number of residual leukocytes 70.2 +/- 17.91 x 10 cells and the value of morphological thrombocyte score was 364 +/- 32.1. During the first day of storage on the temperature of 20 +/- 2 degrees C, along with the constant shaking of units the significant decrease of number of morphological score of thrombocyte (p < 0.05) was stated. Beside the mentioned side effects, the units of concentrated thrombocytes prepared in this procedure showed to be therapeutically effective after the storage of 5 days. In contribution to this spoke electronic-microscopic investigations that showed the presence of degenerative changes of thrombocytes during the fourth day of storage. Further improvement of procedure is necessary due to the prolonged preservation of the concentrated thrombocyte units quality.

Blood Component Removal↗