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Biomedical subjects

J M Ribera

Publications and source records attributed to J M Ribera.

At least 163 records · Page 9Linked to original sources
PubMed1990

[Adult acute lymphoblastic leukemia: preliminary results of the LAL-86 protocol].

The preliminary results of the LAL-86 protocol applied to 43 patients diagnosed of acute lymphoblastic leukaemia (ALL) or lymphoblastic lymphoma (LL) between May 1986 and April 1989 are reported. Induction treatment consisted of one or two courses of vincristine, daunorubicin, prednisone, cytosine arabinoside and 6-thioguanine combination therapy. This phase was followed by consolidation treatment, in which VM-26, cyclophosphamide, BCNU and L-asparaginase were added to the former agents. Central nervous system prophylaxis was done with intrathecal methotrexate. Patients under 45 years of age with HLA identical sibs were subjected to allogeneic bone marrow transplantation (BMT) in the first complete remission (CR); when no HLA-identical sibs were available patients were randomised into autologous BMT or maintenance therapy. The remaining patients received maintenance chemotherapy. CR was achieved in 34 ALL patients (79%), 5 were refractory to treatment and 4 died during remission induction. Allogeneic BMT was carried out in 6 cases, autologous BMT in 3, and the remainders received chemotherapy. When performing this review, 7 patients had relapsed and the actuarial probability of 2-year duration of CR was 70%. Sixteen patients have died with a two-year disease-free survival probability of 60%. The preliminary results of the LAL-86 protocol are encouraging, but greater number of patients is needed, as well as a longer follow-up, to assess the effect of chemotherapy and compare these findings to the results of autologous or allogeneic BMT in the first RC.

Actuarial Analysis↗
PubMed1989

[Acute T-cell lymphoproliferative syndromes. A study of 29 cases].

The clinical and hematological profile, the response to therapy and the clinical evolution of 29 patients with acute T lymphoproliferative syndromes (ATLS) diagnosed during the last 5 years were evaluated. Mean age was 22.6 (SD 9.5) years. 24 patients were males and 5 females. Lymphadenopathy was present in 25 patients, hepatomegaly in 16 and splenomegaly in 14. Seventeen patients had a mediastinal mass. Anemia was present in 41% of patients and thrombocytopenia in 50%. The mean leukocyte count was 71 x 10(9)/l (SD 93). Bone marrow infiltration was found in 25 patients. The acid phosphatase reaction was positive, centrosomal type, in all cases except two. The immunophenotypic study classified the ATLS patients in the subtypes pre-T (10 cases), cortical thymic (15 cases), and mature thymic (4 patients). The cases with pre-T phenotype had a greater degree of bone marrow infiltration and lower frequency of mediastinal mass than the rest of patients. The rate of complete remissions (CR) was 83%. At the time of closing the study 12 patients had relapsed, with a median time of CR of 9.4 months. In addition, 11 patients had died, with a median survival of the series of 19 months. The results of the present study indicate that, despite some heterogeneity, those cases of ATLS with a more immature immunological phenotype (pre-T) have clinical and biological features more akin to acute leukemia, unlike those with a thymic phenotype (cortical or mature), which would be closer to lymphoblastic lymphoma.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1989

[Malignant lymphomas (non-Hodgkin's lymphomas and Hodgkin's disease) associated with infection by the human immunodeficiency virus. Study of 9 cases].

Six cases of non-Hodgkin's lymphoma and three of Hodgkin's disease in patients carrying antibodies against human immunodeficiency virus are reported. Mean age was 30.6 years (SD: 6). From the patients with non-Hodgkin's lymphoma, three were homosexual and three were parenteral drug users. The three patients with Hodgkin's disease were parenteral drug users. The primary features of the patients with non-Hodgkin's lymphoma were: degree of malignity intermediate (three patients) or high (three patients), initial extralymphatic involvement (five patients) and advanced stages (IIIA one patient, and IVB four patients). In turn, the patients with Hodgkin's disease presented the following histopathologic varieties: mixed cellularity (two cases) and lymphocytic depletion (one case); advanced stage (III two cases and IV one case) and B symptoms. We wish to emphasize the necessity of determining the existence of antibodies against human immunodeficiency virus in all patients with Hodgkin's disease or non-Hodgkin's lymphomas with high degree of malignity and extralymphatic involvement. In patients with antibodies against the human immunodeficiency virus who present a marked impairment of general condition and/or changes in the clinical features of their adenopathies, the development of a lymphoma must be ruled out.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Acute transformation of chronic myelomonocytic leukaemia: a multivariate study of predictive factors.

In an attempt to determine the possible predictive value of the main clinical and haematological initial features of chronic myelomonocytic leukaemia (CMML) on the evolution to acute leukaemia, as well as the real impact of such an event on survival, 35 such patients were submitted to multiple regression analyses. At the time of the study 30 out of the 35 patients had died, with a median survival of 8.2 months for the whole series. 12 patients (34%) developed acute leukaemia, between 1.5 and 42.1 months from diagnosis of CMML, the actuarial median time of acute transformation being 29.4 months. The initial bone marrow blast cell percentage was the only factor influencing the development of acute leukaemia. On the other hand, the multivariate survival study showed that acute transformation introduced in the model as a time-dependent variable had a clear-cut unfavourable influence on the outcome of CMML patients, as did palpable spleen, advanced age and marked monocytosis.

Adult↗
PubMed1989

Cardiac rate and hyperkinetic rhythm disorders in healthy elderly subjects: evaluation by ambulatory electrocardiographic monitoring.

We performed 24-hour ambulatory electrocardiographic (Holter) examinations in 50 retired hospital workers (30 men, 20 women), aged 58-85 years (mean age +/- SD: 65.9 +/- 4.6 years), with a normal clinical history, physical examination and baseline ECG. There was a significant difference between daytime and nocturnal mean heart rates (79.2 +/- 8.4 vs. 65.3 +/- 7.8 beats per minute), and between maximal (122.4 +/- 15.6 vs. 99.9 +/- 13.7) and minimal (57.9 +/- 10.8 vs. 51.3 +/- 8.0) diurnal and nocturnal heart rates. 92% of the subjects were shown to have supraventricular extrasystoles (SVE) in the 24 h recording, with 16% having more than 100 SVE/h. 68% had ventricular extrasystoles (VE), but only 6% had more than 100 VE/h. SVE were mainly diurnal, and VE were equally distributed between day and night. No other rhythm disturbances were found in this group of healthy elderly individuals.

Aged↗
PubMed1989

[Effect of treatment with recombinant interferon alfa on natural killer activity in patients with chronic type B lymphatic leukemia].

The role played by alpha interferon (alpha-IFN) in the treatment of B-type chronic lymphocytic leukaemia (B-CLL) has been studied by different authors. Despite the inconclusiveness of the results, alpha-IFN seems to be more effective in those patients with low tumour burden (early stages) who have been previously untreated. Although the mechanism of action of alpha-IFN is not wholly understood, it is known that this agent is a strong stimulant of the natural killer lymphocytes (NK). NK activity has been found decreased in B-CLL. In the present work the effect of alpha-IFN on NK activity was studied in 9 previously untreated B-CLL patients in stage A, who received chlorambucil (CLB) followed by alpha-IFN for at least 4 months. The disease stage did not change in most of the patients during alkylating or IFN therapy. CLB failed to increase NK activity, although it diminished the lymphocyte count. Although the lymphocyte count of the patients treated with alpha-IFN was not reduced beyond the values attained by CLB, NK activity reached normal values in 5 of the 7 patients in whom this was low, and kept within normal ranges in the two patients with normal NK activity. The number of CD57+ lymphocytes (this being the antigen present in NK cells) increased after alpha-IFN treatment, without any changes in the remaining T-lymphocyte (CD2, CD4 and CD8) and NK (CD16 and CD11b) subpopulations. These results show that alpha-IFN enhances NK activity in vivo.

Adult↗
PubMed1989

[Mycosis fungoides associated with chronic myelomonocytic leukemia with specific skin lesions].

A 77 year old man, who presented cutaneous T cell lymphoma, was treated with polychemotherapy and cyclosporine. After one year, erythemato-papulonodules were seen on the face, neck and trunk. Histologic examination showed specific infiltration myelomonocytic, bone marrow examination revealed the same characteristics. The patient died one month after the diagnosis. We comment the association between these two hemoproliferative processus.

Aged↗
PubMed1989

[Chronic myelomonocytic leukemia and solid neoplasms: is it a causal or a fortuitous association?].

Out of a series of 36 patients with chronic myelomonocytic leukaemia (CMML), five cases are reported with the association of this hemopathy to solid neoplasms. In two patients this last was a cutaneous tumour, while the remainders had, respectively, papilloma of the bladder, carcinoma of the sigma, and cutaneous T-cell lymphoma. These neoplasms were diagnosed in all cases prior to the discovery of CMML. When applying the "patient/year" method, significantly higher frequency of solid tumours was found for CMML patients, which would support the hypothesis that this myelodysplasia could be regarded as a paraneoplastic condition.

Aged↗