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Biomedical subjects

B Desablens

Publications and source records attributed to B Desablens.

At least 73 records · Page 4Linked to original sources

Chronic myeloid leukemia with unusual variant Ph translocation (22;22)(q11;q13). Two cases with chimeric BCR-ABL transcripts.

We studied two cases of chronic myelogenous leukemia (CML) with unusual variant Philadelphia (Ph) translocation (22;22)(q11;q13). Southern blot analysis showed a chromosomal break in the BCR gene within the 5.8-kilobase (kb) breakpoint cluster region (bcr), between bcr exons 2 and 3 and between bcr exons 3 and 4, respectively. Chimeric bcr-abl mRNA was detected using polymerase chain reaction (PCR) which amplified, according to the respective bcr breakpoints, bcr exon 2-abl exon II and bcr exon 3-abl exon II junction products. These results further support the involvement, even when not cytogenetically detectable, of the 9q34 chromosomal region in all variant Ph translocations and that BCR-ABL gene fusion products are causally involved in the development of Ph positive CML.

Adult↗

Low-dose cytarabine versus intensive chemotherapy in the treatment of acute nonlymphocytic leukemia in the elderly.

We conducted a randomized multicenter trial comparing low-dose cytarabine (LD ARA-C) (20 mg/m2 for 21 days) with an intensive chemotherapy (rubidazone [a daunorubicin-derived agent], 100 mg/m2 for 4 days, ARA-C 200 mg/m2 for 7 days) in 87 patients over 65 years of age with de novo acute nonlymphocytic leukemia (ANLL). Forty-one patients received LD ARA-C and 46 received intensive chemotherapy. The number of complete remissions (CRs) but also of early deaths was higher in the intensive chemotherapy group, while partial remissions (PRs) and failures were more frequent in the LD ARA-C group (P less than .001). Infectious complications during induction treatment were more numerous and more severe in the intensive chemotherapy group (P less than .01). Patients treated with LD ARA-C required fewer RBC transfusions (P less than .02), fewer platelet transfusions (P less than .01), and had a shorter hospital stay for induction treatment (P less than .01). Overall survival and CR duration were not significantly different in either group. In the LD ARA-C group, the survival of patients with PR and those of patients in CRs was identical. We conclude that in a selected group of elderly patients with de novo ANLL a higher number of CRs may be obtained with intensive chemotherapy, but that with LD ARA-C, the number of early deaths is lower, and long-lasting PRs are obtained, resulting in a similar overall survival.

Aged↗

[Gynecologic and breast granulocytic sarcomas. Review of the literature. Apropos of a case in the cervix uteri].

We report a case history of a woman of 66 years of age who had a granulocytic sarcoma of the cervix which presented as metrorrhagia and which at first was thought to be an anaplastic cancer. The poor general state of the patient made it impossible to start any anti-leukaemic treatment and the patient died two months after the diagnosis was made. A review of the literature shows that 62 cases of granulocytic sarcoma have been reported of which 22 were in the breast, 19 in the ovary, 13 in the cervix or the uterus, 6 in the vagina and 2 in the vulva. The cells seem to invade the blood and the bone marrow in all occasions by the time of diagnosis or at the most a few weeks later and cases of granulocytic solitary sarcoma are very rare. It blood has not been attacked it is difficult to make a histological diagnosis unless immunological marking and Giemsa staining is carried out together with Leder's reaction. The treatment should be similar to those used for acute myeloid leukaemia.

Aged↗

Mitoxantrone and intermediate-dose cytarabine in relapsed or refractory acute myeloblastic leukemia.

In order to reduce the incidence of severe complications noted with regimens containing high-dose cytarabine (HD ARA-C), wer used a combination of mitoxantrone (MTZ) in optimal dosage (12 mg/m2/day for 5 days) and cytarabine in intermediate dosage (1 g/m2 twice daily for 3 or 5 days). Thirty patients aged 2 to 65 years (median 51) with acute myeloid leukemia (AML), either refractory (8 patients), in first relapse (20 patients) or chemoinduced (2 patients), received this program. Seventeen (57%) achieved complete remission (CR). The main prognostic factor was the previous use of HD ARA-C (21% CR for patients previously treated with HD ARA-C versus 87% for patients treated with conventional doses: P less than 0.001). Mucositis was the most significant extrahematologic side-effect. There was no severe cerebellar toxicity. Two patients had transient congestive cardiac failure. This regimen is effective and relatively well tolerated in heavily pretreated patients. It can be used either as induction or consolidation therapy in AML.

Adolescent↗

[Treatment of localized forms of Hodgkin's disease with 3 courses of chemotherapy (ABVD-MP) in combination with wide focal and prophylactic lumbo-splenic radiotherapy. The POF 81/12 protocol].

Between October 10, 1981 and December 31, 1987, we used the Hodgkin POF 81/12 protocol to treat 235 patients aged from 5 to 65 years (mean 30 years) with localized Hodgkin's disease clinically classified as stage IA (n = 6), stage IIA (n = 128) and stage IIB (n = 53). A contiguous lesion was present in 22 cases and a mediastinal lesion in 170 cases. The patients received 3 monthly courses of ABVD-MP (doxorubicin 25, bleomycin 10, vinblastine 6, dacarbazine 375 and methylprednisolone 120 mg per sq.m intravenously on days 1 and 15), except for stage IA non-mediastinal patients who received only one course. Thereafter, in the absence of failure (lack of changes or progression under chemotherapy), a 40 Gy wide focal irradiation and a 30 Gy prophylactic lumbo-splenic irradiation were performed. Complete remission (CR) was obtained in 229 patients, and the 6 failures (4 after ABVD-MP, 2 after radiotherapy) were treated with specific programmes. On December 1, 1988 (median survival 42 months, range 12-86 months) we had recorded 9 relapses (after 9 to 51 months) and 7 deaths (2 failures, 2 relapses and 3 patients in CR: ovarian carcinoma, road accident, exploratory pleural puncture). The current actuarial relapse and survival rates at 7 years are 5 and 94 respectively. Two unfavourable forms of the disease were identified: infra-diaphragmatic with massive lumbo-aortic lesions (5 cases: 1 failure, 1 relapse) and supra-diaphragmatic with a mediastinum/chest ratio of 0,45 or more (30 cases: 5 failures, 5 relapses). In the 200 patients devoid of these 2 risk factors the results obtained were: CR 100 percent, only 2 relapses and survival at 7 years 98 percent.

Adolescent↗

[Intensive induction and early consolidation of acute lymphoid leukemia in the adult. A pilot study of feasibility and long-term development].

Between April and December, 1982, a multicentre pilot study was conducted in 45 patients aged from 16 to 73 years suffering from acute lymphoblastic leukaemia to test the feasibility of an intensive and short induction phase followed by an early consolidation phase. All patients received a 5-day course of induction chemotherapy with prednisone, vincristine, AraC and rubidazone, then a "triple A regimen" for consolidation, consisting of adriamycin, AraC and asparaginase. The complete remission rate was 73 per cent. Toxicity during induction was characterized by frequent infections, but the consolidation treatment was well tolerated. Thus, the sequence intensive induction-early consolidation proved feasible and acceptable. In terms of survival, 8 out of the 33 patients in remission are still alive and well after more than 4 1/2 years.

Adolescent↗

Prognostic value of bone marrow biopsy in chronic lymphoid leukemia. A study of 98 initial bone marrow biopsies.

This study deals with bone marrow biopsies (MB) performed at the initial assessment of our 98 patients included in the French LLC 80 and LLC 85 trials. The prognostic value of the type of medullary invasion was confirmed, with a 6-year survival rate of 44% for the diffuse type (D = 42 patients) as against 68.4% for the non-diffuse type (ND = 56 patients) (p = 0.01). However, comparison of these 2 groups showed a significant difference for 19 of the 25 parameters studied, the differences always being to the prognostic disadvantage of the diffuse group. Bone marrow involvement (BMI) was very closely correlated with the ABC staging system (p less than 0.001). Despite more frequent disease progression among the cases of diffuse BMI, the survival rates in stage A patients were similar: 73.9% for 48 ND patients as against 59.6% for 19 D patients (p greater than 0.50). The ABC system of classification seems more discriminating than that recently proposed by Rozman specially for identifying the favorable groups.

Aged↗

[Immunoblastic lymphoma of the ileocecal region in chronic lymphoid leukemia. Richter's syndrome localized in the intestine and disclosed by ascites].

The authors report the case of a patient with chronic lymphocytic leukemia well controlled during five years, and then complicated with immunoblastic lymphoma of the ileo-caecal area. The tumor was revealed by a protein-rich peritoneal effusion containing numerous large undifferentiated lymphoid cells. Only five cases of Richter's syndrome, apparently localized to the digestive tract, have been published to date.

Ascites↗

[Use of intrapleural doxycycline via lavage-drainage in recurrent effusions of neoplastic origin].

27 patients (17 F, 10 M) with a mean age of 65 +/- 11 years and suffering from recurrent pleural effusions were treated with locally administered Doxycycline by lavage-drainage to achieve pleural symphysis (17 adeno-carcinomas, 3 large cell carcinomas; 3 epidermoid cancers; 3 non-Hodgkin's lymphoma; 1 small cell carcinoma). The solution used was a dilution of 50 ml doxycycline in 250 cc of isotonic saline. 22 of the 27 patients could be evaluated long term, 5 were lost to follow up, of whom two had recurred straight away despite local treatment. An immediate response was obtained in 23 out of the 28 patients (85%). Later the absence of recurrence was seen in 90% of the patients evaluated. The incidence of antimitotic therapy did not seem to be the determining factor in the 7 patients who received this in parallel. The duration of drainage was 11 +/- 6 days, the local treatment was well tolerated in the majority of cases. The use of the technique of lavage-drainage of doxycycline could be an alternative in those patients with a malignant pleural effusion whose general condition contra-indicates a symphysis under pleuroscopy.

Aged↗

[Double breast and vertebral plasmacytoma. Acute myeloblastic leukemia 8 years later].

We report in a 40 year-old woman a bifocal mammary and vertebral plasmocytoma attended by surgery and "preventive" chemotherapy. Eight years later, an acute and apparently non secondary myeloblastic leukemia is observed without sign of diffuse myelomatosis. Plasma cell tumors of the breast are uncommon. Eleven cases have been published, combining solitary plasmocytoma and infiltration occurring in multiple myeloma.

Adult↗