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C Besses

Publications and source records attributed to C Besses.

At least 37 records · Page 2Linked to original sources
PubMed1999

Major vascular complications in essential thrombocythemia: a study of the predictive factors in a series of 148 patients.

To determine the clinicohematological factors predictive for the appearance of major vascular complications (MVC) in patients with essential thrombocythemia (ET), 148 consecutive such patients were retrospectively assessed for the development of MVC during a median follow-up of 58.5 months. Seventy-seven patients had vascular risk factors, and 37 a history of MVC at ET diagnosis. Forty-nine MVC were registered in 33 patients during the follow-up period. The actuarial probability of MVC was 27% at 6 years in the whole series, 35.6% for patients above 60 years, and 21.4% for patients younger than 60 years, whereas only one of the 36 patients younger than 45 years had MVC. At multivariate analysis, age >60 years, history of major ischemia and hypercholesterolemia were the variables associated with an increased MVC risk. These results suggest that all ET patients above 60 years should be treated, whereas in younger patients treatment decisions should be primarily based on the existence of risk factors for MVC.

Adolescent↗
PubMed1998

[Comparison of chemotherapy CHOP vs. CHOP/VIA in the treatment of aggressive non-Hodgkin's lymphoma: a randomized multicenter study of 132 patients. The PETHEMA group. Program for Study and Therapeutics of malignant hemopathies. Spanish Association of Hematology and Hemotherapy].

BACKGROUND: To compare standard chemotherapy CHOP (cyclophosphamide, adriamycin, vincristine and prednisone) with the regimen CHOP/VIA (VP-16, iphosphamide and cytarabine) in terms of response to therapy, response duration, survival and toxicity in patients with aggressive lymphoma. PATIENTS AND METHODS: 132 patients (84 males and 48 females; median age, 55 years) were included from 12 Spanish Institutions, diagnosed of non-Hodgkin's lymphoma of intermediate or high grade, in stages II-IV and previously untreated. Patients were randomized to receive CHOP or CHOP/VIA. RESULTS: After excluding 14 not assessable cases, 62 patients (52.5%) received CHOP, and 56 (47.5%) CHOP/VIA. No significant differences were found on main prognostic factors between such groups. Response was assessable in 114 cases (CHOP: 61; CHOP/VIA: 53) 39 patients (64%) receiving CHOP achieved complete response (CR), and 2 (3%) partial response (PR), whereas in the CHOP/VIA group CR and PR rates were 63% (34/53), and 7% (4/53), respectively. 14 patients (36%) treated with CHOP and 12 (35%) treated with CHOP/VIA eventually relapsed, with an actuarial risk of relapse at 36 months of 43% and 40%, respectively. Median survival was 37 months. No differences were found between both therapeutic groups, with an overall survival at 36 months from diagnosis of 53.5% (CI 95%: 40-67) for CHOP and 48% (CI 95%: 34-62) for CHOP/VIA. Finally, toxicity was not different for both arms. CONCLUSION: In the present study in patients with aggressive NHL chemotherapy regimens CHOP and CHOP/VIA showed similar results in terms of response, response duration, survival and toxicity.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1998

Two new cases of near-tetraploidy in adult acute myeloid leukemia.

Tetraploid or near-tetraploid karyotype has been described rarely in hematologic neoplasms. Herein we report two new cases of adult acute myeloblastic leukemia, M0 and M1 FAB subtypes that showed near-tetraploid clones that were studied with conventional cytogenetics and in situ hybridization (ISH). We compare our new cases with those previously reported.

Aged↗
PubMed1998

[Cytogenetic study of 93 myelodysplastic syndromes].

BACKGROUND: We describe the cytogenetic results of 93 patients with myelodysplastic syndromes (MDS). The main object of this report is to analyze the prognostic value of the karyotype in patients with MDS, in relation to the evolution to acute leukemia and the survival time. PATIENTS AND METHODS: Cytogenetic studies were performed in 93 untreated cases of MDS between 1985 and 1994. Overall survival and the evolution to acute leukemia were analyzed. RESULTS: Among 93 patients who were examined at the time of diagnosis, 40 had an abnormal karyotype (43%). The highest frequency of chromosome abnormalities was observed in refractory anaemia with excess of blasts (RAEB) (65.7%) and RAEB in transformation (RAEB-t) (40%) and the lowest in refractory anaemia with ringed sideroblasts (RARS) (10%). The chromosomes most frequently involved were: 5, 7, 8, 11, 12 and 17. No relationship was found between FAB subtypes and the type of chromosomal abnormalities. In respect to the prognosis, an abnormal karyotype, and a complex karyotype were related with a higher frequency of evolution to acute leukemia. A model based on karyotype could divide patients in two groups: poor prognosis (patients with an abnormal karyotype, with involvement of chromosome 7, trisomy 8 or with a complex karyotype), and a good prognosis (patients with normal karyotype). CONCLUSIONS: The cytogenetic studies are very useful in the study of MDS for their clinical implications.

Adolescent↗
PubMed1998

Cytogenetic abnormalities in three patients with B-cell prolymphocytic leukemia.

We present the cytological features, conventional cytogenetics, and in situ hybridization (ISH) findings of three cases of B-cell prolymphocytic leukemia (B-PLL). The diagnosis was made according to the French-American-British (FAB) criteria. We considered a diagnosis of B-PLL when a predominance (> 50%) of lymphoid cells with coarse chromatin but prominent central nucleoli and more abundant cytoplasm than typical chronic lymphocytic leukemia (CLL) cells were present. B-PLL express strong SIg, B-cell antigens, and reactivity with the monoclonal antibody FMC7. Chromosome analysis was carried out on lymphoid cells from peripheral blood and, in one patient, from lymph node. The phytohemagglutinin (PHA) mitogen was used. ISH was performed with two types of probes: the biotin-labeled chromosome 12-specific alpha satellite DNA probe to detect trisomy 12, and biotin-labeled libraries of whole chromosomes 1, 7, and 14. Clonal chromosome abnormalities were found in all three patients; in one, a complex karyotype was observed. The most frequent recurrent abnormality was trisomy 12. Our results suggest that PLL usually presents with cytogenetic abnormalities. The finding of translocation (11;14) is noteworthy; chromosomes 1 and 3 are also involved.

Adult↗
PubMed1998

[Interstitial 9q deletion: a primary change in acute non-lymphoblastic leukemia?].

Two cases of acute non-lymphoblastic leukaemia (ANLL), subtypes M1 and M5b, are presented. Both of them showed the 9q-interstitial deletion as the only abnormality. From our observations and others found in the literature it can be inferred that such abnormality might be a primary finding in ANLL, related to an unfavourable prognosis, regardless the morphological subtype.

Aged↗
PubMed1997

Cytogenetic studies in seventy-six cases of B-chronic lymphoproliferative disorders.

The results of cytogenetic studies are reported in 76 patients with B-chronic lymphoproliferative disorders (B-CLPD): 60 patients with chronic lymphocytic leukemia (CLL), six with follicular lymphoma in leukemic phase (FLLP), five with splenic B-cell lymphoma with villous lymphocytes (SLVL), two with chronic prolymphocytic leukemia (CPL), two with hairy cell leukemia (HCL), and one with plasma cell leukemia (PCL). PHA (phytohemagglutinin), PWM (pokeweed mitogen), LPS (lipopolysaccharide from Escherichia Coli), TPA (phorbol 12-myristate acetate), IL6 (interleukin 6), and DxS (dextran sulfate) were used as mitogens. Mitoses were obtained in 75 cases. Clonal aberrations could be demonstrated in 34 cases (44%). In CLL, classical type, chromosomes 6, 11, and 13 were more frequently involved, whereas trisomy 12 was frequently found in CLL mixed-cell type, in FLLP, and CPL. In SLVL the deletion del(7)(q32) is noteworthy and miscellaneous chromosome abnormalities in the remaining patients were observed. Regarding the efficiency of mitogens, PHA turned to be the most effective in obtaining metaphases and in detecting clonal chromosomal aberrations.

Adult↗
PubMed1997

Cerebrovascular disease as the initial clinical presentation of haematological disorders.

We describe 14 patients (mean age 57 years) in whom stroke or TIA was the presenting manifestation of a haematologic disorder. Twelve patients had an ischaemic stroke and 2 a haemorrhagic stroke. This group represented 1.27% (14/1,099) of the total number of patients with first-ever stroke diagnosed from 1986 to 1992 at our institution, accounted for 1.32% (12/906) of all brain infarcts and 1.03% (2/193) of all haemorrhagic strokes, and was the most common aetiology (25%) of ischaemic stroke of unusual cause. Haematological disorders included essential thrombocythaemia (6), polycythaemia vera (1), smoker's polycythaemia (1), thrombotic thrombocytopenic purpura (1), IgA lambda myeloma (1), acute lymphoblastic leukaemia (1), Waldenström's macroglobulinaemia (1), chronic granulocytic leukaemia (1) and IgG lambda myeloma (1). Stroke subtypes included definitive cerebral infarct (10), TIA (2), parenchymal haemorrhage (1) and spontaneous subdural haematoma (1). Vascular territories in ischaemic stroke were the carotid in 7 patients, the vertebrobasilar in 1 and undetermined in 4. Mean follow-up was 40 months (range, 1-96 months). The mortality rate was 18.7%.

Adult↗
PubMed1997

[Treatment of Hodgkin's disease with bulky mediastinal involvement. Study of 28 cases].

BACKGROUND: Bulky mediastinal involvement in Hodgkin disease (HD) is usually considered an adverse prognostic factor. Patients treated with radiotherapy alone (RT) or chemotherapy alone (CT) have a high relapse rate. The combined chemotherapy plus radiotherapy is the therapy of choice. The objective of the present study was to report our results and complications in the treatment of 28 patients with HD with bulky mediastinal involvement. MATERIALS AND METHODS: A retrospective analysis was made of a series of 28 patients with bulky mediastinal disease treated in our hospital from 1973-1993, with RT, CT or combined therapy. The overall survival rate and free of disease, the presence of residual mass, as well as therapy toxicity were studied. RESULTS: The overall remission rate was 85.7%. The overall survival rates and free of disease were 76% and 78% at 19 years. Five patients died due to progression of disease, and one due to pulmonary toxicity. Neither heart disease nor secondary neoplasms were documented. CONCLUSION: Our results, in agreement with those reported in literature, support the combined therapy, chemotherapy plus radiotherapy, as the therapy of choice for patients with HD and bulky mediastinal involvement.

Adolescent↗
PubMed1996

Cytogenetic abnormalities in 13 patients with multiple myeloma.

Cytogenetic analysis was successfully performed in 45 consecutive multiple myeloma (MM) patients. Cytogenetic abnormalities were observed in 13 of 45 patients (29%). Eleven patients showed numerical changes and 9 showed structural abnormalities in chromosomes 5, 9, 11, 14, 15, and 19 were most frequently gained. Structural abnormalities preferentially involved chromosomes 6, 13, and 14.

Aged↗
PubMed1996

Treatment of multiple myeloma in elderly people: long-term results in 178 patients.

The purposes of the present study have been to analyse the presenting features, response to therapy and survival of myeloma patients aged 70 years or more, in comparison to younger patients. From January 1985 to December 1989, 487 patients with multiple myeloma (MM) were randomized to receive melphalan and prednisone (MP) versus alternating cycles of vincristine, cyclophosphamide, melphalan, and prednisone (VCMP) and vincristine, BCNU, adriamycin, and prednisone (VBAP). The subset of 178 patients who were 70 or more years is the subject of this study, whereas the 309 patients younger than 70 years were used as a control group. The presenting features and response to chemotherapy of older patients were no different to those of the younger population. However, the survival of elderly patients was significantly shorter (median 23.4 vs. 33.5 months, p < 0.001). The overall response rate to MP in older patients was 50% (28% objective plus 22% partial response) compared with 61% (44% objective plus 17% partial response) to combination chemotherapy (p = not significant). Myelosuppression was moderate in both arms, although MP produced a higher degree of thrombocytopenia. There were no significant differences in survival between patients given MP versus VCMP/ VBAP (median, 20 vs. 27 months, p = 0.2). Response to treatment was associated with a significantly longer survival. Older patients with symptomatic myeloma tolerate chemotherapy and should be offered treatment.

Age Factors↗
PubMed1996

Feasibility and results of bone marrow transplantation after remission induction and intensification chemotherapy in de novo acute myeloid leukemia. Catalan Group for Bone Marrow Transplantation.

PURPOSE: To evaluate prospectively the feasibility and results of bone marrow transplantation (BMT) after induction and intensification chemotherapy (CT) in patients with de novo acute myeloid leukemia (AML). PATIENTS AND METHODS: A total of 159 patients less than 51 years of age were treated. Induction CT consisted of daunorubicin 60 mg/m2 for 3 days, cytarabine (ARA-C) 100mg/m2 for 7 days, and etoposide 100 mg/m2 for 3 days. The first intensification therapy included mitoxantrone 10 mg/m2 for 3 days and ARA-C 1.2 g/m2 every 12 hours for 4 days. Amsacrine (100 or 150 mg/m2 for 3 days) and ARA-C (1.2 g/m2 every 12 hours for 2 or 4 days) were given as the second intensification therapy. Depending on the availability of a human leukocyte antigen (HLA)-identical sibling, the intention of treatment after CT was allogeneic BMT (allo-BMT) or autologous BMT (ABMT). RESULTS: Complete remission (CR) was obtained in 120 patients (75%) and partial remission (PR) in 11 (7%), while 15 patients (10%) were refractory and 13 (8%) died during induction. There was a trend for better leukemia-free survival (LFS) at 4 years for patients assigned to the ABMT group (50% +/- 6%) compared with the allo-BMT group (31% +/- 7%) (P = .08). This difference in LFS reached statistical significance when considering only transplanted patients (63% +/- 3% at 4 years after ABMT and 38% +/- 11% after allo-BMT, P = .02). The favorable results in patients who received ABMT (no toxic deaths and 37% +/- 7% probability of relapse at 4 years) contrast with the poor outcome of allografted patients (11 patients with transplant-related mortality). CONCLUSION: Our study reflects the difficulties in the completion of a therapeutic strategy that include BMT and suggests that intensification before BMT may be useful in the setting of ABMT, but this approach was associated with a high mortality rate in allo-BMT patients.

Acute Disease↗
PubMed1996

[Cytogenetic study of 121 patients suffering from various hematologic neoplasms using the in situ hybridization technique].

PURPOSE: In situ hybridization (ISH) is an efficient tool for detecting chromosomal abnormalities in haemopoietic malignancies. Structural and numerical changes typical of most pathological entities can be detected using chromosome-specific probes on interphase or metaphase cells by means of this technique. PATIENTS AND METHODS: In this report we present chromosome analysis combining conventional cytogenetics with ISH in 121 patients affected with different haematological diseases. We have studied 92 patients with B-chronic lymphoproliferative disorders (B-CLPD), 11 myelodysplastic syndromes (MDS), 17 acute nonlymphocytic leukaemias (ANLL), 1 acute lymphocytic leukaemia and 1 aplastic anaemia. The ISH was carried out with two kind of biotin-labeled probes: a) 8 and 12 centromeric alpha satellite probes and b) whole painting chromosome (WPC) library probes from all the chromosomes except numbers 10, 16, 21, X and Y. RESULTS: The cytogenetic analysis of B-CLPD has been hampered by several problems. These leukaemic cells have very low spontaneous mitotic activity and the cell response to mitogens is often poor, unpredictable and variable. Even so, an extra chromosome 12 (+ 12) is one of the most frequent abnormal karyotypes reported. ISH and chromosome 12 specific biotinylated alpha satellite DNA probe was applied in 84 patients with B-CLPD. Among 50 patients with typical chronic lymphocytic leukaemia (CLL) the ISH studies showed two signals of hybridization in the 50 cases. By conventional cytogenetics 9 out of 18 atypical CLL showed chromosomal abnormalities and 7 of them trisomy 12. ISH detected trisomy 12 in 11 of these cases. Trisomy 8 is the most frequent karyotypic change in MDS and ANLL. Cytogenetic results revealed a clear extra copy of chromosome 8 in 13 cases. In all of these trisomic cases, the presence of trisomy 8 clone was confirmed by ISH. ISH revealed trisomy 8 not detected by conventional cytogenetics in 7 cases. The yield of trisomy is much higher with the ISH technique than with conventional cytogenetics. Finally, conventional cytogenetics combined with CISS (chromosomal in situ suppression) hybridization was performed in 15 patients affected with different haematological diseases showing structural aberrations, complex karyotypes or marker chromosomes. CONCLUSIONS: Our results show that ISH can detect both numerical and structural chromosome changes with high specificity and reliability. The fact that chromosome spreads of very poor quality can now be included in such analysis is the decisive advantage of this approach.

Biotin↗
PubMed1995

Ischemic stroke as first manifestation of essential thrombocythemia. Report of six cases.

BACKGROUND: Ischemic stroke as a presenting sign of essential thrombocythemia has been infrequently reported. We describe six patients in whom cerebrovascular disease was the first manifestation of this myeloproliferative disease. A positive endogenous megakaryocyte and/or erythroid colony growth from blood was a diagnostic criterion of essential thrombocythemia in patients with platelets counts lower than 600 x 10(9)/L. CASE DESCRIPTIONS: These six patients represented 0.54% of all patients with first stroke, 42.8% of all hematologic disorders associated with stroke, and 12.5% of all patients with essential thrombocythemia diagnosed from 1986 to 1992 at our institution. Eleven acute cerebrovascular accidents (6 transient ischemic attacks, 5 definitive cerebral infarcts) were registered. Mean time from ischemic stroke to diagnosis of essential thrombocythemia was 4.5 months (range, 1 to 12 months). The mean platelet count was 597 x 10(9)/L (range, 414 to 760 x 10(9)/L). Four patients had platelets counts lower than 600 x 10(9)/L. All patients had circulating erythroid progenitors, megakaryocytic progenitors, or both. CONCLUSIONS: Ischemic stroke as a presenting manifestation of essential thrombocythemia is probably underrecognized. The diagnosis of thrombocythemia should not be excluded on the basis of platelet counts lower than 600 x 10(9)/L. The availability of in vitro culture of hematopoietic progenitors from peripheral blood makes it possible to diagnose early and atypical cases.

Adult↗