We describe a case of early myeloid blastic transformation in a 64-year-old man suffering from myelofibrosis with myeloid metaplasia. Both chronic and blastic phase cytogenetic analysis showed trisomy 13 to be the sole chromosome aberration. A potential role for this rare abnormality in determining such an unusually poor clinical outcome is discussed.

Blast Crisis↗

PubMedDate not supplied

[A case of isolated renal hamartoma].

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Adult↗

PubMedDate not supplied

Treatment of multiple myeloma and acute myelogenous leukemia in the elderly: an update.

The optimal management of hematopoietic malignancies in the elderly requires the development of specific therapeutic strategies based on the peculiar clinico-biologic features of aged patients. Multiple myeloma arising in elderly patients remains at this time an incurable disease, while attention to supportive therapy and palliation can make a great impact on the quality of life. Fortunately advances have been made in last years in this field. Therapy at the time of diagnosis is usually recommended for patients with symptomatic disease, or for those who may be asymptomatic, but have evidence of high tumor burden of a biologically aggressive disease, and may be expected to progress and develop complications over a short period of time. Melphalan combined with prednisone remains the standard therapy choice in elderly patients. Radiotherapy maintains an important place in the palliation of destructive bone disease in poorly controlled myeloma, particularly in elderly patients. In Acute Myelogenous Leukemia, age has been concordantly reported as an adverse prognostic indicator in affecting both remission rates and survival. The overall unsatisfactory therapeutic results appear connected with host-related factors, and intrinsic differences in the biology of leukemia. Patients with standard risk should be included in collaborative trials aimed at improving the long-term results of conventional therapy. Patients with high risk and unfavorable prognostic factors, could be enrolled in controlled studies aimed at better assessing, in the elderly, the long term results of newer drug combinations. A watch and wait strategy, consisting of transfusion support and leukocytosis control, should be limited to patients with extremely poor performance status (PS), very limited life-expectancy and/or severe comorbidity displaying unfavorable biologic factors, including secondary Acute Myelogenous Leukemia.

Age Factors↗

PubMedDate not supplied

[Angiogenesis and antitumor therapy].

We have examined the most recent literature dealing with the relationship between tumor growth and neovascularization (tumoral neoangiogenesis). It is quite evident that antiangiogenic therapy against solid tumors has an important theoretical basis. Many antiangiogenic substances are presently under study, and some inhibitors of angiogenesis, such as TNP-740, platelet factor 4, linomide, tecogalan, etc., are currently being tested in phase 1 or 2 clinical trials. These studies have, however, underscored the possibility of numerous side effects due to the lack of specificity of these substances against endothelial cells. The most promising and rational use of antiangiogenic factors in anticancer therapy seems to be their association with traditional chemo- or radiotherapy. Gene therapy also offers considerable theoretical promise as demonstrated by the transfection of thrombospondin 1 complementary DNA into a human breast carcinoma cell line.

Humans↗