Treatment of myeloproliferative syndrome with hydroxyurea.
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Aged↗
Biomedical subjects
F Radaelli
Publications and source records attributed to F Radaelli.
p53 tumour suppressor gene and RAS oncogenes: molecular analysis in the chronic and leukaemic phases of essential thrombocythaemia.
A panel of 51 cases of essential thrombocythaemia (ET), in chronic or leukaemic phase, was investigated for p53 gene and RAS oncogenes mutations by PCR-SSCP-direct sequencing. No RAS oncogenes mutations were detected, but p53 mutations were identified in three cases: 1/27 cases (approximately 4%) in chronic phase not undergoing chemotherapy, 1/19 cases (approximately 5%) in chronic phase undergoing chemotherapy, and 1/5 cases (20%) which had progressed to leukaemia. Our results suggest that: (1) p53 gene mutations occur sporadically in the chronic phase of ET, independent of chemotherapy, and may contribute to the progression to the leukaemic phase in a limited number of ET patients; (2) the RAS genes family does not seem to be involved in the pathogenesis of ET, unlike other bcr/abl negative chronic myeloproliferative diseases (CMPDs).
Adult↗
[Our experience with short-term ceftriaxone prophylaxis].
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Adolescent↗
[Rare metastases].
The paper reports a number of cases of uncommon metastasis confirmed by histological tests in surgical biopsies; following a brief discussion of the literature on this topic and in particular on the basis of an earlier study by one of the authors, the paper affirms that metastasis is related to general and local biological factors, that the diffusion of neoplastic cells is an early and generalised phenomenon opposed by organic defence mechanisms, and that the concept of uncommon metastasis should be revised, without resorting to fixed anatomical references, according to a general "impregnation" of tumour cells.
Breast Neoplasms↗
No correlation between response and survival in patients with multiple myeloma treated with vincristine, melphalan, cyclophosphamide, and prednisone.
A vincristine, melphalan, cyclophosphamide, and prednisone (VMCP) multi-drug regimen was used in 85 previously untreated patients with multiple myeloma (MM) (symptomatic Durie Stages II and III) until they became refractory. The prognostic significance of various pretreatment characteristics was evaluated in terms of therapeutic response (according to Southwest Oncology Group [SWOG] and Chronic Leukemia-Myeloma Task Force [TF] criteria) and survival. Therapeutic responses, obtained in 31.2% (SWOG) and 68.7% (TF) of patients, had a significant inverse correlation with myeloma cell mass, serum calcium, and bone status. Median survival time of Stage II and Stage III patients was 39 and 34 months, respectively. Serum B2 microglobulin greater than or equal to 6 micrograms/ml was the only variable correlating unfavorably with survival duration after multi-variate analysis (increased risk = 2.79), although therapeutic response as a time-dependent variable had no effect on survival. These data suggest no correlation between response and survival, partially because of inadequate response assessment criteria and partially because no existing treatment is curative (although current therapeutic approaches may prevent death from complications).
Adult↗
Thrombotic and hemorrhagic complications in essential thrombocythemia. A retrospective study of 103 patients.
A retrospective study of 103 patients with essential thrombocythemia was carried out to evaluate the incidence of thrombohemorrhagic complications and establish whether there were any correlations between these events and clinical or laboratory data. At onset or during the course of the disease, 26 patients (25.2%) presented thrombotic and 12 (11.6%) hemorrhagic complications: among the latter, six patients had gastrointestinal bleeding during antiaggregant therapy. No significant correlations were observed between thrombohemorrhagic complications and platelet count, age, sex, platelet function, bleeding time, or therapeutic regimen. However, there was a statistically significant correlation between a positive patient history for thrombotic events and an increase in thromboses. In agreement with other authors, it is believed that the best approach in asymptomatic patients is strict surveillance without treatment. Chemotherapy and/or treatment with antiaggregant agents should be reserved for symptomatic patients or patients with a positive history for thrombotic events.
Adolescent↗
Lung cancer with a single brain metastasis: therapeutic options.
Between January 1983 and December 1988 67 patients presenting with solitary cerebral recurrence from lung cancer were observed in our Institution. Resection was possible in 21 cases (31%). The surgical treatment included craniotomy with radical thoracotomy in 10 patients, craniotomy alone (with thoracotomy not including radical lung resection) in 5 patients and craniotomy performed within months of the initial elective thoracic surgery in 6 patients. In our series routine brain CT was carried out as a part of the staging procedure for lung cancer. Based on our results, we recommend an aggressive surgical approach to both cerebral recurrence and lung primary (scheduling craniotomy before thoracotomy), followed by whole brain RT, in order to prolong survival and improve the quality of life.
Adult↗
[Carcinosarcoma of the lung].
The Authors report about one surgical case of pulmonary carcinosarcoma recently observed. The literature is reviewed and the histogenesis of this rare affection is discussed.
Adult↗
[A critical analysis of the transfusion protocol in lung surgery].
Autotransfusion carried out in 100 patients undergoing chest surgery is discussed. The Authors emphasize the need to determine a protocol in transfusion procedures for thoracic surgery and stress the importance of using haemocomponents in lieu of whole blood, taking into consideration transfusional risks.
Adult↗
Biological and molecular analysis of LCV, an endogenous retrovirus with defective env gene.
Retrovirus infectivity is the result of a cooperative interaction of three structural genes, gag, pol, and env. Since the L-cell endogenous retrovirus (LCV) lacks the env gene translation product, our aim was to study the biological and molecular basis of its non-infectiousness. Fusion experiments between LCV and homologous or heterologous cells demonstrated that virus production could be obtained only after LCV artificial penetration in murine cells and that the new progeny was still noninfectious. Northern blot analysis and heteroduplex mapping of the genomic RNA revealed a 0.99 kb deletion including the 3' region of the pol reading frame, the whole xenotropic and part of the ecotropic domain of the env gene. The results suggest that the observed deletion is responsible for the absence of the gp 70 and the gp 15 E molecules in the virion and seems therefore to be the molecular basis for the non-infectiousness of this retrovirus.
Blotting, Northern↗
Acute gangrene of the scrotum and penis in four hematologic patients. The usefulness of hyperbaric oxygen therapy in one case.
We describe four cases of Fournier's gangrene complicating the postchemotherapy aplastic phase (polymorphonuclear cells [PMN] less than 500/microliter) in three patients with acute leukemia and one patient with non-Hodgkin's lymphoma. Blood and local cultures from two patients contained Pseudomonas aeruginosa, and local cultures from another patient grew both P. aeruginosa and Proteus rettgeri. Early recognition and aggressive antibiotic and surgical treatment with granulocyte recovery were fundamental factors in resolution of the gangrene in three of the four patients. Hyperbaric oxygen therapy, never reported in hematologic patients, was also very useful in one patient in whom the clinical course was particularly acute.
Adolescent↗
[Prevention of deep venous thrombosis with defibrotide in chest surgery. Controlled multicenter study versus heparin].
The effectiveness and tolerability of defibrotide in the prevention of post-surgery deep vein thrombosis (DVT) were compared with those of heparin in a multicentric randomized controlled study. One hundred-eight-four both sexes patients submitted to thoracic surgery were randomly allocated to defibrotide (400 mg b.i.d. by IV route, n = 94) or to calcium heparin (5000 I.U. t.i.d. s.c., n = 90); both treatments were started the day before the operation and withdrawn when patients were allowed to stand up (i.e., after 7 days). No patients developed DVT in the defibrotide group, while a single case of DVT was detected in the heparin group; furthermore, a more prominent bleeding was observed in the latter, in the early post-operative period (normal bleeding: 2nd day: defibrotide 70/92 pts, heparin 53/90 pts, p less than 0.02; 3rd day: defibrotide 87/92 pts, heparin 76/90 pts, p less than 0.05, chi 2 test), while the healing rate of surgical wounds was similar in the two groups. No relevant modifications in laboratory parameters were seen throughout the observation period. Thus, these preliminary data suggest that defibrotide is at least as effective as heparin in the prevention of post-thoracic surgery DVT and that the former drug has a possibly better tolerability profile, due to a lesser tendency to bleeding.
Adult↗
[Hypertension and polycythemia in a case of acute lymphatic leukemia].
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Child↗
Prognostic significance of immunoglobulin phenotype in B cell chronic lymphocytic leukemia.
Seventy-six consecutive untreated patients with B cell chronic lymphocytic leukemia (B-CLL) and classified according to Binet's staging system were studied at the clinical presentation. Several immunologic parameters (number of total and T circulating lymphocytes and their surface membrane immunoglobulin [Smlg] phenotypes and levels of serum Ig) were evaluated with the aim of identifying a biologic marker of prognostic relevance. In this series of persons, Binet staging confirmed its usefulness as a prognostic index (P less than .001). With regard to Smlg, they were mu-type in 41 cases (53.9%), mu-type plus delta-type in 29 cases (38.2%), alpha-type in one case, and not detectable in five cases. No correlations were found between clinical stage and immunoglobulin phenotype, although all but one patient in stage C showed mu-type Smlg alone. On analyzing the survival curves of our patients according to different Smlg phenotypes, we found that patients with only mu-type Smlg had a poorer prognosis (P less than .05) than those with mu-type plus delta-type; this difference was even more significant (P less than .01) in patients in stage A, whereas there were no statistical differences in those in stages B and C. Because the appearance of surface heavy chain of delta-type could be an expression of cell maturation, these results suggest that in B-CLL the presence of phenotypically more mature leukemic cells may correlate with better clinical prognosis, particularly in the early phase of the disease.
Actuarial Analysis↗
Value of CT scanning in the diagnosis of CNS mycotic involvement: report of 3 cases.
Fungal infections of the CNS are becoming an increasingly serious problem in immunosuppressed patients. We describe three patients with malignant blood disease who in the course of systemic fungal infection presented cerebral involvement. The nature, site and extent of the cerebral involvement were defined by computed tomography (CT). Further, in one patient it was possible to follow the course of the lesion and assess the effectiveness of antimycotic therapy by CT because of its noninvasiveness and repeatability.
Adult↗
Clinical stage and immunological findings in chronic lymphocytic leukemia.
The total and T-lymphocyte counts, different types of lymphocytic surface immunoglobulins and levels of serum immunoglobulins were studied in 112 consecutive patients with chronic lymphocytic leukemia in order to investigate possible correlations between the immunological picture and the different stages according to the staging criteria recently proposed by Binet et al. Patients were also subdivided according to the form of their disease, "indolent" or "active", and correlations with the immunological picture investigated. The total lymphocyte count showed a significantly increasing trend through the three different stage (p less than 0.01), and it was higher in the "active" than in the "indolent" disease (p less than 0.01). Also the number of T-lymphocytes increased in the "active" forms (p less than 0.01). No statistically significant correlations were observed between the different surface immunoglobulin subclasses and the clinical pattern. As regard the various classes of serum immunoglobulins, the number of patients, with a reduction of at least one of the classes tended to increase with worsening of the clinical stage.
Adult↗
[Behavior of blood folate in children with thalassemia major under transfusion therapy and in thalassemia trait].
The folic acid plasma level in 12 out of 13 children with thalassemia major was lower than 3 ng/ml. This deficiency is not due to intestinal malabsorption. Folate deficiency should then be provoked by an increased allowance due to the compensatory erythropoiesis and to the lack of. Folic acid level less then 3 ng/ml in 24% and not more then 6 ng/ml in 50% of thalassemic heterozygotic children has been found. Therefore the necessity of folic acid treatment in thalassemic children with a low blood transfusional therapy and in beta-thalassemic heterozygotic children has been recommended.
Blood Transfusion↗
Unusual bone marrow hyperplasia in a case of thalassemia intermedia.
A case of beta thalassemia intermedia is described. Beside the typical hematologic picture and extramedullary erythropoiesis in the liver always present in such a clinical form, atypical masses due to foci of erythropoiesis were found at paravertebral, parasternal and subcostal sites. The size of these masses caused problems in differential diagnosis; they have been solved by computerized axial tomography.
Adult↗