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J Díaz Mediavilla

Publications and source records attributed to J Díaz Mediavilla.

At least 19 recordsLinked to original sources
PubMed1999

[A case of pneumonia by cytomegalovirus in a patient with acute myeloid leukemia].

The objective of this clinical case is to suggest that Cytomegalovirus (CMV) should be taken into consideration when dealing with infections produced by opportunistic microorganisms in immunocompromised patients who have fever of unknown origin and especially when accompanied by symptoms and signs of interstitial pneumonia. In the case we report of CMV active infection in a patient with acute myeloid leukemia, the anti-CMV specific treatment (ganciclovir) was iniciated following a positive polymerase chain reaction (PCR) result for CMV. The patient initially experienced an improvement but later worsened and expired. At present there are sensitive and specific techniques such as PCR which make it possible to start specific treatment as soon as the diagnosis of CMV active infection is made.

Cytomegalovirus Infections↗
PubMed1999

[Acute leukemias].

Explore the source record for details and available documents.

Acute Disease↗
PubMed1997

[PCR study of bcl-2 rearrangement in autologous transplantation of peripheral stem cells in follicular non-Hodgkin's lymphoma].

OBJECTIVE: To value the usefulness of the bcl-2 rearrangement analysis by PCR in the study of the minimal residual disease in patients with follicular non-Hodgkin's B cell lymphoma (NHL) submitted to peripheral blood stem-cell transplantation (PSCT). PATIENTS AND METHOD: The study was done on 12 patients diagnosed with low grade B-cell NHL, who were entered in a program of myeloablative chemotherapy followed by rescue with progenitor cells obtained from peripheral blood. At the time of peripheral stem-cells (PSC) harvesting, 8 patients did not present medullar infiltration and four of them presented medullar infiltration according to conventional histological criteria. The study was done on DNA from samples taken from bone marrow and cells taken in the apheresis. The DNA samples were studied by PCR to determine the existence of the bcl-2 rearrangement. RESULTS: At the time of apheresis, 8 patients did not present medullar infiltration according to conventional histological criteria but 7 of them presented bcl-2/JH rearrangement. Most patients studied (10 out of 12) showed bcl-2/JH rearrangement (minimal residual disease) in apheresis products. However, in 2 of these 10 patients, such rearrangement was negative in the bone marrow samples obtained 3-6 and 12 months after transplantation. CONCLUSION: In some patients with follicular NHL submitted to PSCT, the bcl-2/JH rearrangement had negativized after transplantation, this implies that the tumoral cells present in apheresis products lost their clonogenic capacity and were not able to subsist in vivo and that the myeloablative polychemotherapy schedules are able to eradicate the t(14; 18) translocation bearing cells or, at least, to decrease their number in bone marrow to levels below those of PCR detection.

Adult↗
PubMed1992

[Second neoplasms as a late complication of the treatment of Hodgkin's disease].

PURPOSE: To determine the incidence of a second malignancy in patients with Hodgkin's disease (HD) diagnosed and treated in the same hospital. PATIENTS AND METHODS: A retrospective study was performed on 99 patients diagnosed and treated for HD in the Hospital San Carlos, in Madrid, between January 1976 and december 1987. The clinical records were revised; the diagnosis and staging followed the Rye and Ann Arbor criteria, and the treatment included radiation therapy (RT), chemotherapy (CT), or a combination of both. The diagnosis of the second malignancy was based upon clinical, analytical, radiological and histological records. RESULTS: The median age in the series was 31 years (16-82) and the M/F ratio was 61/38. The stage distribution was: I-9; II-29; III-31, and IV-30. Twenty-six patients received RT alone, 59 were treated with CT, and 14 received RT plus CT. A second neoplasm was found in 6 patients (6%), of whom 4 developed a myelodysplastic syndrome (MDS) and 2 a solid tumour. All the patients who had MDS had received MOPP or C-MOPP chemotherapy, associated in two of them with extensive RT. Both patients with solid tumour had been given CT+RT. The median time of presentation of the second malignancy since the diagnosis od HD was 89 months (48-174) for MDS and 120 months for the solid tumours. The four MDS patients have died, 2 for ANLL-M5, one for SRA and the remainder for cerebral haemorrhage, not yet evolved into acute leukaemia. The two patients which solid tumours are alive and seemingly in complete remission at 12 and 10 months, respectively, of the diagnosis of the second malignancy. CONCLUSIONS: 1) All the patients with second neoplasms had been previously treated with CT (MOPP or C-MOPP) or CT+RT. 2) Non-Hodgkin's lymphoma has not appeared in any of the patients in this series. 3) An endless follow-up of patients with HD seems important in order to achieve an early diagnosis of other malignant complications which, although in case of MDS have poor prognosis, in case of solid tumours may do well with adequate treatment.

Adolescent↗
PubMed1991

[The successive presence of acute lymphoblastic leukemia, Hodgkin's disease and acute myeloblastic leukemia in a female patient].

A case is presented of a female patient initially diagnosed of acute lymphoblastic leukemia who was treated achieving complete remission. Twenty six months later and while in remission of her leukemia, she presented an abdominal mass the histological study of which showed infiltration due to Hodgkin disease. She was treated with chemotherapy type MOPP and complete remission was achieved. Four months after completing treatment she presented pancytopenia in peripheral blood. A bone marrow study was performed observing a blastoid infiltration with morphological and cytochemical characteristics of acute non-lymphoblastic M-5 leukemia. The possible common origin of the three clinical pictures is discussed given the recent findings regarding the origin of Reed-Sternberg cell.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1990

[Infectious complications in neutropenic patients with malignant hemopathies. A prospective study of 279 cases of neutropenia].

We prospectively evaluated the infective complications in 279 neutropenic episodes which developed during the treatment of 79 patients with malignant hemopathies over a 35 month period. In 150 episodes (53.73%) infections were detected: one infection in 121 episodes and two in 29 episodes. Overall 179 infections were detected. 75 of them (41.89%) were considered as possible, 57 (31.84%) were microbiologically documented with bacteremia/fungemia 24 (13.40%) were clinically documented, and 23 (12.84%) were microbiologically documented without bacteremia/fungemia. The portal of entry could not be identified in 121 infections (67.59%), 26 (14.76%) originated in the skin and soft tissues, 14 (7.82%) in the lung, 7 (3.91%) in the oropharynx, 5 (2.79%) in a catheter, and 6 (3.33%) were of miscellaneous origin. Of 80 microbiologically documented infections, 39 (48.75%) were due to gram-negative bacteria, 23 (28.75%) to gram-positive bacteria, 12 (15%) to fungi, and 6 (7.5%) to polymicrobial flora. The overall mortality rate was 4.3%. It was 8% for episodes complicated by infection and 0 in episodes of neutropenia without infection.

Bacterial Infections↗
PubMed1990

[Chromosomal changes in 60 patients with acute myeloblastic leukemia. Frequency, characteristics and prognostic significance].

Sixty patients diagnosed of acute myeloblastic leukaemia (AML) on whom a chromosomal study was performed at diagnosis were evaluated. Their median age was 43 years (range: 8-89). Normal karyotype was present in 59% of the cases, it being abnormal in the remaining 41%. Chromosomal alterations appeared in 64% of the patients with M-4 morphology, in 43% of M-5, 40% of those with M-1, 33% of the M-2, and in 14% of the cases with M-3 morphology. The two patients with M-6 had abnormal karyotype. No correlations could be established between normal or abnormal karyotype and the clinical or laboratory data. Structural alterations were commonest amongst the patients with abnormal karyotype. Such alterations included t(8; 21), t(9; 22); t(7; 22), del 11q23, inv 16 (p13;q22), plus multiple major abnormalities in the M-6 patients. A strikingly low incidence of t(15; 17) was found in the acute promyelocytic leukaemia cases. Two chromosomal alterations not previously reported in AML were found in this series, namely, inv 13 (p11;q32) and t(21;1) (q22;q22). The finding of an abnormal karyotype had no unfavourable influence on the complete remission (CR) rate, which reached 65% of the patients with normal karyotype and 81% of those with abnormal karyotype. No differences were found in the duration of CR in this connection (80 and 77 weeks, respectively). Despite the lack of definite prognostic significance, the study of the karyotype appears as an important information in the diagnosis of AML.

Adult↗
PubMed1989

[Remission induction treatment in adults with acute myeloid leukemia. 8-year experience with 2 successive protocols].

We report our eight year experience remission induction therapy in adult patients with acute myeloblastic leukemia. Overall 67 patients were treated, with a mean age of 43.3 years (range 15-75). Two treatment protocols were used. Complete remission (CR) was achieved in 23 patients of 39 receiving protocol A (58%). The 28 last patients were treated with the more aggressive protocol B, and CR was achieved in 23 patients (82%). CR was achieved in 68% of the overall group. The most outstanding predictive factors were age above 30 years, and M-5 morphology as indicating a poor prognosis.

Adolescent↗
PubMed1989

[Complete remission without marrow aplasia phase in a patient with acute promyelocytic leukosis treated with aggressive chemotherapy].

A patient diagnose of acute promyelocytic leukemia treated with chemotherapy schedule type VAPA. 2 weeks after the administration, there was no response this being the reason to administer a new induction course. 2 weeks after this, a new bone marrow aspiration was performed showing leukemic infiltration with 78% promyelocytes. The clinical situation of the patient did not recommend the addition of more chemotherapy. 10 days later complete remission in bone marrow and blood were demonstrated. The importance of this finding is discussed, complete remission without aplasia, as well as the diagnosis and therapeutic remarks of the case.

Adult↗