PubMed Health⌕ Search

Biomedical subjects

J Trédaniel

Publications and source records attributed to J Trédaniel.

43 records · Page 3Linked to original sources
PubMed1990

Treatment of severe cytomegalovirus infection with ganciclovir and high-dose intravenous immunoglobulin in patients with allogeneic bone marrow transplants. A pilot study.

Cytomegalovirus (CMV) infection is the leading infectious cause of death after bone marrow transplantation (BMT) because of the high mortality rate associated with CMV pneumonia. However, very interresting results were recently reported when treating CMV penumonia with the combination of ganciclovir and high doses of intravenous anti-CMV immunoglobulin. In order to achieve an even better therapeutic efficacy, we have conducted a pilot study consisting of early administration of the combination therapy, as soon as CMV was isolated from the material obtained by bronchoalveolar lavage (BAL). A BAL was performed when symptoms of severe CMV infection were present and sometimes also systematically when an asymptomatic CMV viremia was diagnosed. Out of 18 BMT patients with CMV isolated from BAL in the absence of pulmonary signs, 9 became long-term survivors without any episode of CMV pneumonia and 9 died. However, only 2 patients died because of CMV pneumonia. Early treatment with the combination of ganciclovir and anti CMV immunoglobulin seems thus to decrease the incidence of CMV pneumonia (2/18) as it is known that about half of the untreated patients with CMV viremia will develop CMV pneumonia. We have also used the combination therapy to treat 3 cases of CMV pneumonia. As 2 patients survived the CMV pneumonia episode, this confirms the possible effectiveness of the combination therapy for the treatment of established CMV pneumonia. However, our pilot study points out the usefulness of an early treatment. At such an early stage, application of the combination therapy could affect the intensity and length of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Bone Marrow Transplantation↗
PubMed1990

Kikuchi's histiocytic necrotizing lymphadenitis.

Histiocytic necrotizing lymphadenitis (HNL) or Kikuchi's Disease is a peculiar condition most commonly affecting cervical lymph nodes in young women. Histology and immunohistochemistry demonstrate a florid T-cell and histiocytic reaction associated with necrotic areas which must be carefully distinguished from malignant lymphoma. Usually, the disease resolves spontaneously within a few weeks or months. The etiology is unknown and the physiopathology discussed.

Diagnosis, Differential↗
PubMed1990

Aggressive non Hodgkin lymphoma in the elderly. A retrospective study of 72 patients with clinical features and treatment.

Aggressive non Hodgkin lymphoma (NHL) occurs frequently in the elderly and because of drug related toxicity treatment remains controversial. Seventy-two patients over 65 years (68-83 y, median 73 y) with intermediate and high grade NHL were retrospectively studied. We found 22 cases of high grade NHL and diffuse large cell the most frequent type encountered (54%). Seven patients had stage I, 8 stage II, 14 stage III, and 43 stage IV disease. Treatment for localized disease was radiotherapy or chlorambucil, and disseminated stage patients were treated by three different chemotherapy regimens, group I: classic dose chemotherapy without Adriamycin (15 pts), group II: same type of regimen with Adriamycin (45 mg/m2) (42 pts), group III: high dose chemotherapy with Adriamycin (75 mg/m2) (8 pts). Overall complete response (CR) rate was 53% without significant differences between treatment groups. Median duration of survival was 38 months and estimated 5 year survival at 40%. Following complete remission, 15 patients (40%) relapsed. Thirty-seven patients have died, 6 from toxic deaths (5 toxic deaths in group II and III), 28 from NHL, and 3 from other diseases. Toxicity was greater among patients treated with Adriamycin. In a multivariate analysis, the attainment of complete remission was the only factor influencing survival. Our data shows that classical dose chemotherapy leads to the same CR rate and survival as more intensive regimens.

Age Factors↗
PubMed1988

[The place of bone marrow autografts in the treatment of Hodgkin's and non-Hodgkin's lymphoma].

The therapeutic approach to relapses in aggressive non-Hodgkin's lymphoma has been changed by high dose chemotherapy and autologous bone marrow graft. In the absence of dramatic improvement following the conditioning regimen, such a procedure should be reserved for patients still sensitive to salvage therapy. Up to 40%-50% of these selected cases can expect prolonged disease-free survival. Autologous bone marrow graft in first remission should only be considered in poor prognosis patients in a carefully randomized study. In Hodgkin's disease, relapses and patients in partial remission after MOPP and ABVD treatment are potential candidates for autologous bone marrow graft. Preliminary results indicate a disease-free survival up to 50%.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1988

[Residual masses after chemotherapy of non-Hodgkin's lymphoma].

Among 149 patients treated for high grade non-Hodgkin's lymphoma, 22 post-therapy mediastinal and abdominal residual masses were observed (14.7%). In 12 cases, initial histology was malignant lymphoma, diffuse large cell. The follow-up of these patients was similar to those without residual masses. Magnetic resonance imaging may be helpful in distinguishing viable tissue from fibrotic tissue.

Fibrosis↗
PubMed1987

Peripheral T cell lymphoma following angioimmunoblastic lymphadenopathy.

We report 5 cases of peripheral T cell lymphoma (PTCL) which initially presented as angioimmunoblastic lymphadenopathy (AIL). In 4 cases, the delay between the 2 phases was less than 1 year, and 3 patients were under corticosteroid therapy when the second biopsy was performed. Clinical and biological features were very similar during the 2 phases. The initial disease was morphologically characterized by a high cellular pleomorphism with immunoblasts, plasma cells, eosinophils and lymphoid cells of various size with abundant venules; this pleomorphism then regressed, emphasizing the T cell nature of the lymphoma, as proven by immunological staining with monoclonal antibodies raised against T cell subpopulations. In 4 cases, T cell proliferation bore T helper (CD4) and T cytotoxic/suppressor (CD8) antigens and, in 1 case only, CD4 antigen. The entity of AIL and the role of corticosteroid therapy is discussed; the short interval between the 2 diagnose suggests that T cell proliferation was present initially, but was masked by reactive B lymphocytes.

Adult↗