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Biomedical subjects

J Cubells

Publications and source records attributed to J Cubells.

At least 37 records · Page 2Linked to original sources
PubMed1995

High-dose busulfan and melphalan before bone marrow transplantation for acute nonlymphoblastic leukemia.

Fourteen patients with acute nonlymphoblastic leukemia (ANLL) (n = 13) or juvenile chronic myelomonocytic leukemia (n = 1) were transplanted after conditioning with high-dose busulfan (4 mg/kg daily on days -7 to -4) and melphalan (180 mg/m2 on day -2). This protocol was designed for patients considered unable to receive standard conditioning regimens with cyclophosphamide and/or TBI. Five patients (4 children and 1 adult) received a second allogeneic BMT in untreated early marrow relapse after a first BMT. There were 3 procedure-related deaths (PRD), 2 during aplasia and 1 from acute GVHD. Two patients survived the procedure; 1 relapsed at 6 months and 1 is alive at 43+ months. Nine subjects (8 children and 1 adult) received an autologous BMT, 7 in first and 2 in second complete remission (CR). Of the 7 patients grafted in first CR, there was 1 PRD, 2 relapses at 3 and 15 months, and four are alive at 38 to 82+ months. One patient grafted in second CR relapsed at 7 months and 1 is alive at 67+ months. Toxicities were mild or moderate in autologous BMT recipients, mainly affecting the gastrointestinal tract. In the allogeneic BMT group, there were more moderate to severe toxicities, including 3 cases of moderate-severe renal toxicity; no cases of such toxicity were seen in ABMT recipients. Two cases of HVOD occurred, 1 in each group. These results are encouraging, although the small patient group does not allow any firm conclusions.

Adult↗
PubMed1995

Bone marrow transplantation in 46 pediatric patients with non-Hodgkin's lymphoma. Spanish Working Party for Bone Marrow Transplantation in Children.

We report a retrospective analysis on 46 pediatric patients (median age 9 years, range 1-17 years) with non-Hodgkin's lymphoma (NHL), transplanted in six Spanish centers. Fourteen patients underwent allogeneic bone marrow transplantation (BMT) and 32 autologous BMT. Most patients were boys (36 of 46). Twenty one cases were of lymphoblastic lymphoma, 19 Burkitt's lymphoma and six diffuse large cell lymphoma. Maximal Murphy's stage any time before BMT was stage III in 17 cases and stage IV in 29 cases. At BMT, 13 cases were in first CR, 21 in second CR, seven in third CR, four with sensitive active disease and one with refractory disease. All patients transplanted in CRl were considered candidates for BMT because of delayed CR (two cases), failure of the first-line therapy (seven cases) or central nervous system (CNS) or BM infiltration at diagnosis (four cases). Conditioning therapy included TBI in 33 patients and 13 cases were conditioned with chemotherapy alone. Toxic mortality was 13% (three of 14 in the allogeneic BMT group and three of 32 in the autologous group). No toxic deaths were registered in 13 patients undergoing BMT in CR1 (three allogeneic BMT and ten autologous BMT). Twelve patients relapsed 1-7 months after BMT. Overall event-free survival (EFS) was 58% (42-73%; confidence interval (CI) 95%), with a median follow-up of 33 months. EFS was similar for allogeneic BMT and autologous patients. Disease status at BMT was the only predictive factor for EFS (P < 0.01). There were no significant differences between patients in CR1 (82.5%) and CR2 (68%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

Progression of natural immunity during one-year treatment of residual disease in neuroblastoma patients with high doses of interleukin-2 after autologous bone marrow transplantation.

The aim of this work was to monitor the functional and phenotypic variations of natural killer (NK) cells in seven children with stage IV neuroblastoma (NB) treated with recurrent 5-day cycles of interleukin-2 (IL-2) at a dose of 18 x 10(6) IU/m2/d by continuous intravenous infusion. All patients who entered the study had no detectable disease after hematologic recovery from intensive chemotherapy and autologous bone marrow transplantation (ABMT). To evaluate the effect of this treatment on tumor relapse, IL-2 immunotherapy was adjusted to maintain levels of NK activity above those of age-matched controls (threshold of 40 lytic units [LU]/10(9) mononuclear cells) during a 1-year period since hematologic recovery of ABMT. The levels of NK and endogenous lymphokine-activated killer (eLAK) cell cytotoxic activities, as well as phenotype-differentiated lymphocyte counts, were determined from patients' freshly isolated peripheral blood mononuclear cells (MNC). Data were analyzed at different points between each cycle of IL-2, and before and 36 hours after each infusion. NK and eLAK activities significantly increased in response to IL-2. Both cytotoxic parameters correlated with the serum levels of the soluble IL-2 receptor (sIL-2R). IL-2 increased the amounts of NK and T cell subsets but not of B cells. The effects of IL-2 were time-dependent. Early cycles of IL-2 preferentially increased cell numbers, especially of cells bearing a CD3-/CD16-/CD56+bright and CD8+dim phenotype. Conversely, late courses promoted higher cytotoxic effects but with a smaller increase in NK and T cell counts; the main NK subset became CD16+, and CD8+dim cells remained a minor subset. It is worthy to note that the patient who relapsed after completing immunotherapy showed only a slight increase of the NK subset in response to IL-2. These results show the feasibility of sustaining an increased NK activity during 1 year after ABMT in children with advanced neuroblastoma and suggest the occurrence of changes in the functional and phenotypic characteristics of the NK cells generated throughout the 1-year treatment.

Adrenal Gland Neoplasms↗
PubMed1994

Second bone marrow transplantation for leukemia in untreated relapse.

Seven patients with relapsed acute leukemia (4 ANLL, 3 ALL) and one with juvenile chronic myelomonocytic leukemia (JCMML) received a second BMT (BMT2). Patients were conditioned with CY/TBI (n = 7) or BU/CY (n = 1) for the first BMT (BMT1), with adequate recovery in all and without the appearance of acute GVHD (n = 3) or with mild forms (grade I, n = 2; grade II, n = 3). Relapse after BMT1 occurred in < 6 months (n = 2), between 6 and 12 months (n = 5) and > 12 months (n = 1), and the interval from BMT1 to BMT2 was < 6 months (n = 1), from 6 to 12 months (n = 5) or > 12 months (n = 2). Conditioning for BMT2 was done in untreated relapse and included combinations of BU/CY (n = 2), CY/TBI (n = 1) or BU 1 mg/kg at intervals of 6 h by mouth on days -7 to -4 and melphalan 180 mg/m2 i.v. on day -2, with the addition of VP-16 in the patient with JCMML. Two patients died on day +11 with no evidence of residual leukemia at autopsy. Six patients engrafted, one of whom had an uneventful BMT2, but he relapsed 6 months later. The other five developed severe acute GVHD (grades III-IV), with a fatal outcome in three cases, while two responded to treatment and are currently alive in continuous CR at 12 and 36 months. All patients had received conventional prophylaxis against acute GVHD.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

Hematological recovery after autologous bone marrow transplantation in acute leukemia: predictive factors.

The kinetics of hematological recovery after autologous marrow transplantation have been studied in 70 patients with acute leukemia (38 acute nonlymphoblastic leukemia [ANNL] and 32 acute lymphoblastic leukemia [ALL]). The incidence of graft failure in this group was 3.2%, and a persistent severe thrombocytopenia was observed in 24% of the cases. Variables influencing engraftment have been studied using univariate and multivariate statistical analysis. Analysis of the entire group showed a correlation between graft colony-forming unit granulocyte-macrophage (CFU-GM) content and granulocyte recovery (p < 0.001). Marrow purging was associated with a delayed engraftment (p < 0.001). In ANLL patients, we found that high cummulated AraC doses before marrow cryopreservation correlated with poor granulocyte recovery after marrow infusion (p < 0.002). Platelet recovery was essentially affected by age, with shorter thrombocytopenia periods in younger patients (p < 0.001). Finally, excluding autotransplants with purged marrows, ALL patients showed better platelet recoveries than ANLL patients (p < 0.005). These findings will be useful to evaluate the risk of delayed engraftment after autologous bone marrow transplantation (ABMT) in patients with acute leukemia.

Acute Disease↗
PubMed1989

[Genitourinary rhabdomyosarcoma in childhood].

We present the result obtained by GICOP in the treatment of 12 genitourinary rhabdomyosarcoma, located in vagina-uterus (5), bladder-prostate (4) and paratesticular (3). The age of the patients ranging from 1 to 15 years. Embryonal rhabdomyosarcoma was the most common histologic type (58 for 100) being the major number of cases in stadium II. The treatment was based in the combination of chemotherapy protocolised with vincristine, d-actinomycin, cyclophosphamide (VAC), vincristine, adriamycin (VAC-VAD) and/or iphosphamide, vincristine, d-actinomycin (IVA), use of radiotherapy, marrow auto-transplantation and radical surgery avoidance. Complete remission was achieved in 11 out of 12 cases (92 for 100), relapsing in 5 cases (38 for 100) of which 4 (80 for 100) achieved a second remission. An 82 for 100 disease free survival was achieved in a 5 year period.

Adolescent↗
PubMed1988

[Tumors of the CNS in childhood].

Brain tumors are the most common group of solid malignancies in childhood. The therapeutic arms available nowadays: surgery, radiotherapy and chemotherapy, have achieved considerable improvement in the survival of some types of CNS tumors, mainly due to the first two. We have carried out a retrospective study of 252 CNS tumors, diagnosed in the GICOP group during the last ten years. The primary location was: supratentorial, 42%; infratentorial, 51%; and both, 7%. Biopsies were performed in 190 cases (75%), resulting in the following histologic types: astrocytoma (38%), medulloblastoma (19%), ependymoma (14%), craniopharyngioma (7%), others (22%). The treatment was individualized according to the patient characteristics: age, location, histologic type and tumor spreading. Surgery was performed in 82% of patients (8% only derivative shunt), radiotherapy in 48% and chemotherapy in 23%. The life survival was 60% at 50 months.

Adolescent↗
PubMed1986

Testicular pseudolymphoma.

Pseudolymphomas are reactive processes which by their morphology can be confused with lymphomas. They have been described in non-lymphoid organs (gastrointestinal tract, lung, breast, etc.), although cases have also been reported in the spleen. In this article we present the case of a 3-year-old child in whom the location was in the testes. It is the 4th case reported in the literature and the first in a child. The main criteria for establishing such a diagnosis are the delimitation of the lesion, the presence of mature lymphocytes intermingled with other cells which are mainly plasma cells of polyclonal type and the formation of lymphoid follicles with active germinal centers. A differential diagnosis within the testicle should be made with the lymphoma (primary or secondary), the leukemic infiltration and the seminoma with marked stromal lymphoid reaction.

Child, Preschool↗
PubMed1986

[Effectiveness of rectal metromidazole in acute infantile appendicitis].

Thirty two consecutive children who underwent surgery for suspected acute appendicitis, were treated with prophylactic metronidazole suppositories. A serum sample was taken at surgery to determine the serum concentration of the drug. After a preoperative dose of 15-20 mg/kg the minimal bactericidal concentration was achieved in almost all cases at the time of anesthetic induction. This drug showed an optimal biodisponibility when used rectally and no side-effects was noted. Neither a wound-infection, nor a wound-sepsis was reported and a satisfactory outcome was registered. We conclude that rectal dosing with metronidazole is effective for prophylactic wound infection in acute appendicitis.

Administration, Rectal↗
PubMed1983

Evidence for a role of endogenous opioids in the nigrostriatal system: influence of naloxone and morphine on nigrostriatal dopaminergic supersensitivity.

The effects of morphine and naloxone on nigrostriatal function were evaluated by their influence on rotational behavior in rats with unilateral lesions of the substantial nigra. Two different rotational syndromes which result from different lesion placements, were examined. Rats with the contraversive syndrome, when given apomorphine, rotate away from the lesioned side, while rats with the ipsiversive syndrome rotate toward the lesioned side. In both syndromes, rats rotate toward the lesioned side when given amphetamine. Morphine or naloxone, alone, was without effect in either syndrome. Morphine antagonized rotation by either apomorphine or amphetamine in both syndromes. Naloxone stimulated apomorphine-induced rotation in contraversive rats and antagonized amphetamine-induced rotation in ipsiversive rats. These findings support a functional role of endogenous opioids in this dopaminergic system. The effects of morphine and naloxone on apomorphine-induced rotation indicate that opiates act at a postsynaptic site in this system. Finally, the different responses to naloxone and morphine in the two rotational syndromes suggest that an enkephalinergic asymmetry may underlie the differences in behavioral responses between these two syndromes.

Amphetamine↗
PubMed1983

Primary liposarcoma of the right ventricle and pulmonary artery: surgical excision and replacement of the pulmonic valve by a Björk-Shiley tilting disc valve.

A case of primary liposarcoma of the right ventricle and pulmonary artery is presented. The clinical picture, diagnostic studies, operative treatment and postoperative evolution are commented upon. Attention is drawn to the fact that this is the third case of liposarcoma of the heart to be operated upon, and the first needing pulmonary valve replacement. The literature related to this exceedingly rare primary neoplasm of the heart is reviewed.

Female↗