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J M Ribera

Publications and source records attributed to J M Ribera.

At least 181 records · Page 10Linked to original sources

[Erythroblastopenia associated with chronic myelomonocytic leukemia].

A patient is presented in whom the diagnoses of chronic myelomonocytic leukaemia (CMML) and erythroblastopenia were simultaneously established. Besides the conventional criteria for both haemopathies, the culture of bone-marrow precursor cells showed lack of growth of the erythroid stem cells. 6-Mercaptopurine given as therapy for CMML failed to induce any favourable changes in erythroblastopenia, which in turn improved with prednisone. Nevertheless, the patients died five months after diagnosis due to acute transformation of the CMML.

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Y-body study in bone marrow precursors, peripheral blood cells and alveolar macrophages for demonstration of haemopoietic engraftment in allogeneic bone marrow transplantation.

The value of Y-body study for assessment of haemopoietic engraftment was analyzed in 50 consecutive patients submitted to allogeneic bone marrow transplantation (BMT) (sex-matched in 28 cases, sex-mismatched in 22). The study was performed weekly on bone marrow and peripheral blood smears in all cases, and alveolar macrophages were also studied in 15 patients in whom bronchoalveolar lavage was carried out because of concurrent respiratory disturbances. The analysis was performed blindly by 2 independent observers. In both sex-matched and sex-mismatched cases there was an absolute concordance between recipient and donor Y-body results, as well as with the simultaneous cytogenetic study. The engraftment of erythroid and granulopoietic lines was documented at day +14 in all cases of sex-mismatched BMT, whereas megakaryocyte and lymphocyte take was demonstrated at d +21. On the other hand, the results from alveolar macrophages were in accordance with those obtained in the simultaneous study of bone marrow precursors after BMT. The above results indicate that Y-body analysis is a simple and useful tool for the demonstration of bone marrow take in sex-mismatched BMT.

Blood Cells↗

Recombinant alpha 2-interferon in the treatment of B chronic lymphocytic leukemia in early stages.

Ten previously untreated patients with early B cell chronic lymphocytic leukemia (B-CLL) (seven in Rai's stage 0, three in stage I) were given recombinant alpha 2-interferon (alpha 2IF) (2 X 10(6) U/m2 intramuscularly three times a week for a minimum of 14 weeks) to assess its effectiveness. All patients were evaluable for response to therapy and toxicity. No complete response was achieved. In all cases a definite, although transient reduction in the absolute number of peripheral blood lymphocytes was observed. In eight patients an increase in the absolute number of granulocytes was detected. None of the patients experienced severe hematologic toxicity. Fatigue, malaise, and fever were the more common side effects, but all patients were able to finish their treatment as planned. The results of this pilot study suggest that low doses of recombinant alpha 2-IF have some activity in early and previously untreated B-CLL and that further studies of IF effectiveness in B-CLL seem warranted.

Adult↗

Characteristics of red cell pyruvate kinase (PK) and pyrimidine 5'nucleotidase (P5N) abnormalities in acute leukaemia and chronic lymphoid diseases with leukaemic expression.

Red cell pyruvate kinase (PK), pyrimidine 5'nucleotidase (P5N) and reduced glutathione content (GSH) were studied in 126 untreated patients with acute leukaemia (AL, 80 cases), chronic lymphocytic leukaemia (B-CLL, 38 cases) and B-cell lymphoma with leukaemic expression (LSCL, eight cases). Acute leukaemias were classified into lymphoblastic (ALL) and non-lymphoblastic (ANLL), the latter have been further sub-divided into four different variants according to FAB morphological criteria (1976). A significant decrease of PK activity was observed only in the ANLL group, leading to a clear-cut difference with the ALL group where a normal value was obtained. The decrease of P5N activity was similar in all the morphological variants of ANLL and no abnormalities in the low PEP assay system or after fructose 1,6-bisphosphate (Fru 1,6-P2) activation were observed. P5N activity was found to be significantly decreased in all groups of patients except in B-CLL, where it was normal. In regards to the different morphological groups of ANLL, a striking decrease of P5N activity was observed in the M3 variant. Although red cell GSH content was significantly increased in all groups of patients, no correlation was demonstrated between the raised GSH levels and the decreased P5N activities.

5'-Nucleotidase↗

A multivariate analysis of prognostic factors in chronic myelomonocytic leukaemia according to the FAB criteria.

In an attempt to characterize the prognostic significance of the main initial clinical, haematological and biochemical features of chronic myelomonocytic leukaemia according to the FAB criteria, 29 such patients were analysed by means of univariate and multivariate statistical methods. At the time of the analysis 21 patients had died, with a median survival for the overall series of 8.2 months. The univariate analysis identified three parameters associated with poor prognosis: high monocyte counts, low platelet counts and splenomegaly. When all the initial features were included in a multiple regression model, only high monocyte counts and spleen enlargement retained their unfavourable prognostic influence (P = 0.002 and P = 0.02, respectively). Based on the presence or not of these prognostic factors, two populations of patients with different survival (median survival 5.6 and 16.5 months, respectively, P less than 0.005) could be identified. It seems therefore that monocytic proliferation serves not only as the diagnostic marker for chronic myelomonocytic leukaemia but also as the most important feature in the assessment of the patient's prognosis.

Actuarial Analysis↗

"Spontaneous" complete remissions in chronic lymphocytic leukemia: report of three cases and review of the literature.

"Spontaneous" complete remissions (SCR) are a rare event in chronic lymphocytic leukemia (CLL). In this article, we report three cases of SCR observed in a series of 285 patients followed at a single institution during the last 15 years. SCR was documented by clinical and hematologic data, including bone marrow biopsy, and immune cell markers. A delay of 0.9-1.6 years between "clinical" and "clonal" remission was observed. A review of other cases of SCR in CLL is also performed.

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