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C Ferrán

Publications and source records attributed to C Ferrán.

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Higher cytotoxic activity and increased levels of IL-1 beta, IL-6, and TNF-alpha in patients undergoing cardiopulmonary bypass.

Extracorporeal circulation (EC) by surgical bypass is often associated with a systemic inflammatory response. The purpose of this study was to assess the effect of EC on the serum levels of pro-inflammatory mediators Interleukin (IL)-1 beta, IL-6, tumor necrosis factor (TNF)-alpha, and soluble CD-23. Peripheral blood lymphocyte subsets and natural killer cell (NK) cytotoxic activity were also analyzed before and after the bypass process. The results from eight patients who underwent cardiac surgery showed a significant increase in the levels of IL-1 beta, IL-6, and TNF-alpha, a decrease in CD4+/CD8+ lymphocyte ratio, and an overstimulated NK cytotoxic activity. These changes on serum cytokine levels and cellular immunology parameters could play an important role in the development of adverse effects associated with EC.

Aged

Presenting features and prognosis of chronic lymphocytic leukemia in younger adults.

We have analyzed 117 younger patients with chronic lymphocytic leukemia (CLL) (mean age, 44.5 years; SD, 4.8; range, 19 to 49; male/female ratio, 2.08) with three main objectives: (1) to see whether these patients have distinctive presenting clinical features; (2) to investigate the impact of the disease on survival; and (3) to analyze whether already well-known prognostic factors are also useful when applied to these patients. As compared with an older age population (greater than or equal to 50 years), there were no major differences in presenting features except for an increased proportion of males (2.08 v 1.21; P less than .025) and a higher hemoglobin level (13.47 +/- 2.70 g/dL v 12.84 +/- 2.77 g/dL; P less than .05) in the younger group. Median survival is 12.3 years (expected median from a control group, 31.2 years). Clinical stages, bone marrow patterns, blood lymphocyte counts, and its doubling time are all useful to separate different risk groups of patients. Whereas patients with favorable prognostic factors have a survival probability of about 80% 14 years after diagnosis, those with poor prognostic features have a median survival of less than 3 years. It is concluded that CLL in younger adults has no major distinctive presenting features and that known prognostic factors are useful to separate different risk groups of patients. These results should be of help in planning therapy for younger persons with CLL.

Adult

Treatment of chronic lymphocytic leukemia in advanced stages. A randomized trial comparing chlorambucil plus prednisone versus cyclophosphamide, vincristine, and prednisone.

Ninety-six patients with advanced chronic lymphocytic leukemia (CLL) (Stage C; anemia and/or thrombocytopenia of nonimmune origin) were randomized to receive either chlorambucil (CLR) (0.4 mg/kg orally, day 6) plus prednisone (PDN) (60 mg/m2 orally, days 1-5) every 2 weeks or cyclophosphamide (600 mg/m2 intravenously, day 6), vincristine (1 mg/m2 intravenously, day 6) and prednisone (60 mg/m2 orally, days 1-5) (COP) each month for 5 months. Complete remission (CR) was defined as the total disappearance of signs and symptoms related to the disease. Partial remission (PR) was considered to be achieved when, after treatment, the clinical stage changed to a less advanced one. Thirty (59%) responses (8% CR) with CLR plus PDN and 14 (31%, 2% CR) with COP were observed (P less than 0.01). The survival was not significantly different for the two groups. Patients previously treated had a lower number of responses (11/35, 31%) than those with no previous treatment (33/61, 54%) (P less than 0.05). Patients who attained a CR or a good PR had longer survivals (median not reached) than those with a poor PR (median, 25.2 months) or those who did not respond to treatment (median, 11.5 months) (P less than 0.005).

Aged

[Amniotic fluid].

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Amniotic Fluid