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Biomedical subjects

M Delforge

Publications and source records attributed to M Delforge.

At least 37 records · Page 2Linked to original sources
PubMed1997

Autologous peripheral blood progenitor cell transplantation in patients with high-risk myelodysplastic syndromes.

Most patients with myelodysplastic syndromes (MDSs) who achieve a complete remission under aggressive chemotherapy develop a recurrence within 18 to 24 months. Autologous stem cell transplantation has therefore been suggested as a potential means of increasing treatment efficacy. As compared with bone marrow stem cell autografts, peripheral stem cell autografts have a higher harvesting yield and a shorter duration of aplasia after reinjection. Also, the results reported herein suggest that polyclonal stem cells harvested after chemotherapy-induced aplasia and growth factor therapy are capable of ensuring normal hematopoiesis and may provide prolonged remissions in some patients.

Adult↗
PubMed1996

Feasibility of peripheral blood progenitor cell harvest and transplantation in patients with poor-risk myelodysplastic syndromes.

Myelodysplastic syndromes (MDS) are a group of clonal haematological disorders with a highly unfavourable prognosis. Allogeneic bone marrow transplantation offers the sole possibility for cure and prolonged survival, but is only available for a minority of patients. Therefore, we investigated the feasibility of PBPC collection and transplantation in 11 patients with high-risk myelodysplasia who were not eligible for allogeneic bone marrow transplantation. In six patients, PBPC were harvested after mobilization with G-CSF alone. Five patients were harvested during the recovery phase of intensive chemotherapy combined with G-CSF. This resulted in seven patients in an adequate CD34 progenitor yield > 1 x 10(6)/kg. Six patients obtained a CFU-GM content of the PBPC harvest > 10 x 10(4)/kg. Five patients were subsequently transplanted following a standard BuCy4 regimen. The median to ANC (absolute neutrophil count) > or = 0.5 and 1.0 x 10(9)/l was respectively 14 d (range 10-18) and 16 d (range 11-25). Platelets were self-supporting > or = 20 x 10(9)/l after a median of 41 d (ranges 8-144). One patient had a persistent lack of platelet engraftment unresponsive to infusion of back-up bone marrow. These data demonstrate that in selected patients with high-risk MDS, adequate PBPC collection appears feasible, enabling the harvest of sufficient cell numbers required for rapid and stable engraftment after reinfusion. Improvement in mobilization efficiency may enable the collection of higher CD34+ progenitor cell numbers required for more rapid platelet engraftment. PBPC transplantation may be an alternative treatment option for patients who lack an allogeneic marrow donor. Follow-up is, however, still too limited to draw any conclusion regarding the long-term cure rate.

Adult↗
PubMed1995

Polyclonal primitive hematopoietic progenitors can be detected in mobilized peripheral blood from patients with high-risk myelodysplastic syndromes.

Myelodysplastic syndromes (MDS) form a heterogeneous group of clonal hematopoietic disorders with unfavourable prognosis. Allogeneic bone marrow transplantation is the only potentially curative treatment, but remains limited to a small subgroup of younger patients with HLA-compatible donors. As autologous stem cell transplantation is currently being explored as an alternative treatment strategy for MDS, more information needs to be acquired regarding the clonal nature of the progenitor cells in these autografts. Therefore, we have analyzed the clonal patterns of highly purified hematopoietic progenitors and their mature daughter cells in mobilized peripheral blood collections produced from five female patients with high-risk MDS in complete hematologic remission. X-chromosome activation patterns of flow-sorted immature (CD34 + 38low, CD34 + 33low) and committed (CD34 + 38high, CD34 + 33high) progenitors were studied with the polymerase chain reaction-based HUMARA assay. In four patients, a polyclonal remission was shown in all stem cell subpopulations and their mature daughter cells whereas one patient was found to remain skewed in all fractions, except T lymphocytes. This study provides strong evidence that polyclonal immature hematopoietic progenitors can be mobilized and harvested in patients high-risk MDS after treatment with high-dose chemotherapy.

Adult↗
PubMed1995

An update on peripheral blood progenitor cell transplantation.

High-dose therapy with stem cell rescue is increasingly being used as a salvage or consolidation therapy for patients with poor-risk malignant disease. The availability of peripheral blood progenitor cells (PBPC) has opened new therapeutic perspectives to alleviate the severe toxicity related to prolonged myelo-suppression. The preferred method of collection is still a matter of much debate. PBPC can be collected in steady state and after chemotherapeutic conditioning, growth factor priming, or both. Usually a heterogeneous population containing both committed progenitors and pluripotent stem cells can be harvested. Studies comparing engraftment after mobilized PBPC with recovery after autologous bone marrow transplantation confirm the beneficial effect on neutrophil and platelet engraftment. The accelerated hematological recovery can be associated with a number of clinical benefits including a reduction of platelet transfusions and shorter hospital stay. Only a few randomized studies are currently available on the long-term outcome after PBPC transplantation. Recent findings on tumor cell mobilization stimulated the development of techniques for tumor cell reduction, based on negative selection ("purging") of tumor cells or positive selection of CD34-positive progenitor cells. Positive CD34 selection is also imperative for successful ex vivo expansion of progenitor cells and gene transfer experiments. The value of PBPC in the field of allogeneic transplantation is currently being examined.

Blood Specimen Collection↗
PubMed1995

Comparative study of peripheral blood progenitor cell collection in patients with multiple myeloma after single-dose cyclophosphamide combined with rhGM-CSF or rhG-CSF.

Patients suffering from high-risk multiple myeloma (MM) were randomized to receive single high-dose cyclophosphamide followed by either rhGM-CSF or rhG-CSF in order to harvest circulating peripheral blood progenitor cells. The safety of the procedure, the mobilization kinetics, the relative efficacy of rhGM-CSF and rhG-CSF to mobilize progenitor cells and their relative toxicity were studied. Special attention was paid to the antigenic profile of CD34+ progenitor cells. Group I patients (n = 11) were treated with cyclophosphamide 4 g/m2 i.v. followed by rhGM-CSF at 10 micrograms/kg/d by subcutaneous administration. Group II (n = 11) patients received rhG-CSF s.c. at 10 micrograms/kg/d after the same dose cyclophosphamide. Both mobilization regimens appeared to be equally effective. No significant differences in absolute numbers of circulating progenitors, determined by CD34 expression or in yields of MNC, CFU-GM, BFU-E and CD34 subsets were observed. rhGM-CSF administration resulted however in delayed haemopoietic recovery and an increased complication rate. We conclude that rhG-CSF may be preferred because of its markedly lower toxicity and lower in-hospital costs.

Adult↗
PubMed1994

[An unusual case of clear-cell carcinoma of the pancreas].

This case of clear-cell carcinoma of the pancreas was a rare for three reasons: a) discovery: the investigation was indicated after sudden digestive hemorrhage revealed by melena and anaemia; b) morphology: the tumour began in the head with a spheric tumoural bud and a pediculated extension into the duodenum; c) pathology a clear-cell tumour similar to the type seen in renal localizations. Only one other case of such a primitive tumour was found reported in the literature.

Adenocarcinoma, Clear Cell↗
PubMed1993

Percutaneous catheter drainage of abdominal abscess after abdominal surgery. Results in 121 cases.

One hundred and twenty-one peritoneal, retroperitoneal and pelvic abscesses were treated percutaneously using CT or US guidance. The lesions developed after abdominal surgery. Sixty-three abscesses (52%) were situated in the peritoneal cavity, 31 (26%) in the retroperitoneal cavity and 27 (22%) in the pelvis. A definitive treatment was obtained in 74% of peritoneal abscesses, 67% of retroperitoneal abscesses and 82% of pelvic abscesses. Failure most commonly occurred with multiloculated lesions or lesions associated with fistulous communication. There was a low rate of complication (1%). percutaneous drainage avoids the risks inherent in surgery and anesthesia, saves considerable time and meets greater patient acceptance. If a total cure is not systematic, a beneficial temporizing effect may however be obtained by percutaneous drainage. This procedure should be indicated for the initial treatment of postsurgical abscesses.

Abdomen↗