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Biomedical subjects

G Masera

Publications and source records attributed to G Masera.

249 records · Page 14Linked to original sources
PubMedDate not supplied

Parenchymal brain leukemia. Case report: problems related to the diagnosis and treatment.

A case of intracerebral nodular leukemic mass that developed in a girl eight years after a diagnosis of acute lymphoblastic leukemia (ALL) and 18 months after second discontinuation of therapy for a central nervous system (CNS) relapse is reported. The morphologic picture and the long time that elapsed from the diagnosis raised the suspicion of a cerebral neoplasm; the immediate and dramatic effect of steroid treatment, on the contrary, indicated the presence of a leukemic infiltration and in the meantime, a bone marrow relapse occurred. The patient soon after received high-dose Cytosine Arabinoside (HD ARA C) + Vincristine (VCR) + Levo-Asparaginase (L-ASE) + Prednisone (PDN) without any intrathecal antiblastic drug. We observed a neurological recovery and a complete disappearance of the mass. After consolidation of the remission the patient began an ablative regimen for bone marrow transplantation. The efficacy of HD ARA C in the treatment of the intracerebral nodular leukemic mass is emphasized.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Isolated testicular relapse in a boy with acute lymphoblastic leukemia following allogeneic bone marrow transplantation.

About 5-10% of boys with acute lymphoblastic leukemia (ALL) present with isolated testicular relapse. Very frequently these relapses occur during treatment or in the following six months, and in these cases the prognosis is very severe. The patients are usually treated with radiotherapy and chemotherapy or bone marrow transplantation (BMT). Testicular relapses after BMT are relatively rare. We report the case of a child with ALL who presented testicular relapse during therapy and was treated with local radiotherapy (2000 cGy), chemotherapy and allogeneic matched BMT. The preparative regimen consisted of Cyclophosphamide (60 mg/kg/day x 2 days) and total body irradiation (200 cGy x 2/day x 3 days). Engraftment was documented at day + 14. The patient presented again with testicular relapse at day + 146, and was therefore treated with orchiectomy, local radiotherapy and systemic chemotherapy. A marrow relapse followed, however, at day + 284 and the patient died of progressive disease.

Bone Marrow Transplantation↗
PubMedDate not supplied

Congenital refractory anaemia with vacuolisation of bone marrow precursors, sideroblastosis and growth failure in a girl with normal endocrine pancreatic function.

The case is described of an 8-years-old girl with consanguineous parents. She was apparently well, apart, from growth retardation, until 18 months of age when she developed severe normocytic hypochromic anaemia. Bone marrow examination revealed vacuolisation of the erythroid and myeloid precursor, and electron microscopic studies showed striking sideroblastosis with ringed arrangement of the iron granules. Porphyrin metabolism was apparently normal, whereas blood levels of iron and ferritin were high. A careful study of the exocrine pancreas showed completely normal function. Vitamin B6 administration was unsuccessful. The patient is transfusion-dependent, and iron chelation treatment has produced good results. The case could be a new entity or a variant of congenital sideroblastic anaemia, since it has some features in common with the syndrome described by Pearson et al.

Anemia, Refractory↗
PubMedDate not supplied

[Leukemia in childhood].

The prognosis of leukemia in children has changed remarkably in the last 20 years. Today more than 50% of children with Acute Lymphoblastic Leukemia (ALL) and about 30% of children with Acute non Lymphoblastic Leukemia (ANLL) can be cured with chemotherapy. The German Group BFM has obtained a significant improvement of results, both in ALL and ANLL using multidrug intensive treatment schedules. In Italy, thanks to the Italian Pediatrics Association of Hematology and Oncology (AIEOP), results have been improved in the last 10 years; very recently, new protocols with the BFM strategy have been started. Allogenic matched bone marrow transplantation (BMT) is indicated in children with ALL in 2nd complete remission (CR) following a relapse during or shortly after discontinuing treatment and in patients with Chronic Myeloid Leukemia. Chemotherapy results remain very poor in these patients. Allogenic BMT in usually performed also in children with ANLL in 1st CR. Autologous BMT, and allogenic BMT mismatched or from unrelated donors are being used with promising results when matched donors are not available. Most children cured of leukemia can enjoy a normal quality of life. However long term studies are still needed to determine the incidence of late effects, and to evaluate the psychosocial impact of the disease. In this context is becoming more and more important the role of the family doctor.

Antineoplastic Agents↗
PubMedDate not supplied

[Evaluation of family satisfaction in pediatric oncology].

The satisfaction for the care receveid following the diagnosis of acute linfoblastic leukemia in the Pediatric Division of the San Gerardo Hospital of Monza was explored with a questionnaire to the families of patients diagnosed from January 1984. 217 questionnaires were returned (59.2%); 67% were completed by both parents. Parents expressed overall a very high satisfaction for several areas of care: 93.8% for the information about diagnosis; 83% approved the use of the word "leukemia". Judgements on technical competence and communication skills of the health care professionals were analyzed separately for hospitalized and day-hospital patients, and for survivors and dead: results were highly positive for both groups. The expected higher of missing data for the questions related to satisfaction for communication on relapses, highlights the difficulty and the emotional load of the question. Data were discussed by the health care team as well as parents in order to obtain a feedback and practical suggestions for further improvement of care.

Child↗
PubMedDate not supplied

[Dear parents ...: the communication of the diagnosis of leukemia].

The diagnosis of childhood cancer is very dramatic and stressful. The management of the communication process has important influences on all involved: the child her/his parents other family members and all the health care personnel that work and care for the child. There are no ready to use rules about when, how and what should be explained. The most relevant suggestions for parents and their children are presented in a recently published book. Instead of providing a list of suggested behaviours, the communication process of the diagnosis to the child is illustrated with vignettes that stress (often with paradoxes) the point of view of the child.

Attitude to Health↗