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H K Mahmoud

Publications and source records attributed to H K Mahmoud.

34 records · Page 2Linked to original sources
PubMed1986

The incidence of interstitial pneumonitis: comparison of total body irradiation schedules for allogenic bone marrow transplantation.

Interstitial pneumonitis (IP) is one of the major causes of death following bone marrow transplantation (BMT). This report deals with a comparison between data compiled from six centers concerning the essential factors responsible for the development of IP. Special concern has been paid to the idiopathic form of disease where TBI is thought to be the most important factor in its pathogenesis. Our own experience using different TBI modalities shows that the instantaneous dose rate seems to be an important factor in the development of IIP. Comparing the data from various centers it is not possible at the present time to recommend one optimal modality.

Bone Marrow Transplantation↗
PubMed1986

[Toxoplasmosis after bone marrow transplantation].

An opportunistic infection with Toxoplasma gondii is a rare complication in the immunocompromised host following bone marrow transplantation. In addition to the variability in the clinical picture, difficulty in interpretation of the antibody titers is one of the main obstacles limiting early diagnosis of manifest toxoplasmosis. This report deals with 3 patients out of 86 bone marrow transplant recipients who had manifest toxoplasmosis mainly affecting the central nervous system and cardiac muscle. The clinical picture was that of acute disseminated encephalitis and myocarditis, while the nature of the disease was only disclosed at autopsy.

Adult↗
PubMed1985

Relapsing acute non-lymphatic leukemia with changing phenotypes.

Morphological and cytochemical findings in a case of acute myeloid leukemia (AML) with 3 relapses are described. The disease began as a subtype M4 with atypical eosinophils according to the French-American-British (FAB)-classification. At the time of the first relapse, the phenotype had converted into an M2-subtype, while the second relapse presented the picture of an M1-type of acute myeloid leukemia with non-granulated peroxidase-positive blasts. When the third relapse occurred, the diagnosis was again an M4-type of acute myeloid leukemia. The observed changes of the phenotype can be interpreted as an expression of tumor cell heterogeneity, even though the observed emergence of new leukemic clones would be attributed entirely or in part to effects of the applied cytostatic drugs, because tumor cell heterogeneity concerns also the response to therapy, which may result in a growth advantage for certain leukemic subpopulations. In so far, AML behaves like all other human malignant neoplasias. In addition, morphological changes in leukemias such as are reported here, have been observed long before the introduction of cytostatic drugs. Also, the validity of the FAB-classification is discussed in the light of the presented observation. It is concluded that the FAB-classification is not a classification in a strict sense, but merely a crude and simplistic list of subtypes of acute myeloproliferative diseases that is difficult to reproduce and that disregards major aspects of this group of diseases, for instance tumor cell heterogeneity.

Adult↗
PubMed1985

Bone marrow transplantation for chronic granulocytic leukaemia.

Twenty-one patients with chronic granulocytic leukaemia underwent marrow transplantation. The donors were human-lymphocyte antigen-identical siblings in 19 cases. In the remaining 2 cases the donor was a parent in one and an identical twin in the other. The preparatory regimen included cyclophosphamide and 8.6 Gy total body irradiation given at either a dose of 0.1 Gy/min or 0.04 Gy/min. Five patients were in the accelerated phase of the disease, one was in remission following blast crisis, and the rest were all in the chronic phase. After chemotherapy and irradiation, all patients received bone marrow transplants. To date, nine patients are still alive, with a median survival of 64 days (range 28-683 days). One patient continued to have leukaemic cells and in another, the leukaemia recurred 18 months following transplantation. Interstitial pneumonitis was the cause of death of eight patients (38%). Graft-versus-host disease occurred in ten patients (47%).

Adolescent↗
PubMed1985

Marrow transplantation for pancytopenia in dyskeratosis congenita.

A 33-year-old man with dyskeratosis congenita received a marrow transplant to treat severe pancytopenia. The graft was successful-, but the patient developed severe acute graft-versus-host-disease grade IV and died 51 days postgrafting. - The outcome of transplantation in dyskeratosis congenita is compared to that in Fanconi's anaemia due to the resemblance of both diseases in some aspects.

Adult↗
PubMed1985

Ph-positive CML in a family with a constitutional Robertsonian translocation 14;15.

A patient with CML in chronic phase was admitted to our center for bone marrow transplantation. Cytogenetic analysis of bone marrow cells revealed a Ph chromosome due to a standard t(9;22) and a Robertsonian t(14;15). This Robertsonian translocation was also found in PHA-stimulated lymphocytes of the patient's sister, the donor of the bone marrow. A chromosome study of the whole family proved the constitutional character of the t(14;15) abnormality and showed that it was inherited from the father's side. All family members were phenotypically normal with normal mental status. Female carriers of the t(14;15), as well as wives of male carriers, had a high incidence of miscarriages and early death of their offspring. The occurrence of Ph-positive CML in a patient with a Robertsonian t(14;15) might indicate increased risk for the development of leukemia in patients with this constitutional chromosome abnormality. This assumption however, is limited by the rarity of the Robertsonian translocations.

Adult↗
PubMed1985

[Complication-free pregnancy following bone marrow transplantation for severe aplastic anemia].

A bone marrow transplant had to be performed in a woman of 25 years of age because of severe aplastic anaemia. Immunosuppressive conditioning treatment consisted of 50 mg/kg cyclophosphamide given for four consecutive days. Regular menses reappeared already after four months. Pregnancy was confirmed after a year that resulted in giving birth to a healthy child in the 38th week of pregnancy via Caesarean section.

Adult↗
PubMed1985

[Eye changes following bone marrow transplantation].

Blood diseases such as acute leukemia can now be cured by bone marrow transplants. Complications such as a chronic host-versus-graft reaction lead to typical conjunctival changes, as described for Sjögren's syndrome and ocular pemphigoid. A patient with typical eye complications is described and the probable immunological course discussed.

Adult↗
PubMed1985

Treatment of hairy-cell leukemia with recombinant leukocyte A interferon.

A 29-year-old male patient with hairy-cell leukemia was referred for bone marrow transplantation. For tumor mass reduction a treatment with recombinant leucocyte A interferon was started. A complete remission could be achieved in the third month of treatment and no adverse side effects were observed. The patient refused bone marrow transplantation and a relapse was diagnosed 51 days after discontinuation of interferon therapy. Treatment of hairy-cell leukemia with recombinant leukocyte A interferon seems to be a promising approach.

Adult↗
PubMed1985

[Cytomegalovirus hyperimmune globulin and cytomegalovirus-tested blood products--a pilot study in bone marrow graft recipients].

Nineteen bone marrow transplant recipients had cytomegalovirus prophylaxis using a commercial hyperimmune globulin. Seronegative donors were selected for blood component substitution. The incidence of seroconversion was 25%. One patient acquired fatal cytomegalovirus associated interstitial pneumonitis. The value of this combined cytomegalovirus prophylaxis in bone marrow transplant recipients in comparison to sole passive immunization is recommended to be the subject of a controlled trial.

Adolescent↗
PubMed1984

[Bone marrow transplantation in panmyelopathies and leukemias with special regard to gnotobiotic measures].

Bone-marrow transplantations were performed in 71 patients, 11 with panmyelopathy, 17 with recurrence of acute leukaemia, 25 with acute leukaemia and remission, 18 with chronic myeloid leukaemia. The transplantation was allogenic in 67, autologous in 2, isologous in 2. Eight patients each survived in the panmyelopathy and chronic myeloid leukaemia groups. In the group of patients with acute leukaemia only one patient of those in a recurrence survived the transplantation for several years, but after 6 years there was another recurrence. Of the 20 patients with acute myeloid leukaemia who received the transplantation during their first remission, 11 are still alive. Retransplantation because of the recurrence was employed in one case each of acute and chronic myeloid leukaemia. Main cause of death was interstitial pneumonia with an overall risk of 23%. Only 5% of patients developed severe acute graft-versus-host reaction, grades III-IV. The low incidence of this reaction is possibly due to the strict gnotobiotic measures which in most of the patients led to decontamination of the intestinal tract.

Adolescent↗
PubMed1984

Clonal evolution with isodicentric Ph1 chromosome in Ph1-positive CML: karyotypic conversion after bone marrow transplantation.

Clonal chromosomal evolution was observed in a 16-year-old boy suffering from Ph1-positive CML. An isodicentric Ph1 chromosome appeared 20 weeks after the initial diagnosis. At that time an allogeneic bone marrow transplantation was performed. Thereafter, during an observation period of more than 13 months, chromosome analyses showed neither the Ph1 chromosome nor the abnormal isodicentric variant. Close cytogenetic monitoring is suggested to reveal early unfavorable prognostic signs of the onset of blast crisis before it becomes evident in the bone marrow morphology.

Adolescent↗
PubMed1984

Laminar air flow versus barrier nursing in marrow transplant recipients.

Forty-eight patients with acute leukaemia in relapse (n = 14), acute leukaemia in complete remission (n = 19), chronic myeloid leukaemia (n = 8) or severe aplastic anaemia (n = 7) received a marrow transplant. The first 26 patients were nursed in laminar-air-flow plastic isolators while the next 22 patients were treated in barrier nursing rooms. Gnotobiotic parameters and morbidity in the 2 groups are compared. Good decontamination of the gastro-intestinal tract was obtained using either of the 2 isolation techniques. The incidence of bacterial and mycotic infections, as well as the supportive care required by the patients was almost equal in both groups. Our results also suggest that the incidence of graft versus host disease may decrease with efficient decontamination of the patients.

Anemia, Aplastic↗
PubMedDate not supplied

The "clostridial effect" of selective decontamination of the human gut with trimethoprim/sulphamethoxazole in neutropenic patients.

During 59 periods of hospitalisation, 39 patients with either acute myeloid leukemia (22), acute lymphatic leukemia (9), acute undifferentiated leukemia (1), blastic crisis of chronic myeloid leukemia (6) or high-grade malignant non-Hodgkin lymphoma (1) were subjected to aggressive polychemotherapy after selective decontamination of the gut. The patients were given an amphotericin B suspension in a dosage of 1.2 g/day for two days, after which one tablet of trimethoprim/sulphamethoxazole (TMP/SMZ) (160 mg TMP and 800 mg SMZ) t.i.d. was added to prevent endogenous infections by gram-negative aerobic bacteria or moulds and to maintain the "colonisation resistance" endowed by the anaerobes. During 16 of the 59 periods of hospitalisation, no potentially pathogenic aerobic bacteria were isolated. TMP/SMZ-resistant Escherichia coli were the etiological agent of septicemia in two patients, and resistant Klebsiella pneumoniae and Pseudomonas aeruginosa in two other patients. These bacteria were cultured from the patients' fecal samples prior to the development of septicemia. We observed that long-term prophylaxis with TMP/SMZ modified the normal aspect of the fecal biotop culture, not only by suppressing the aerobic gram-negative bacteria, but also by allowing certain clostridia to appear. We differentiated 207 clostridia from the fecal samples of 29 patients and observed a predominance of TMP/SMZ-resistant Clostridium difficile, Clostridium innocuum and Clostridium clostridiiforme. C. difficile was also isolated from the blood culture of a neutropenic patient treated with TMP/SMZ and proved to be very toxic in the Verocell culture.

Agranulocytosis↗