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Biomedical subjects

M Federico

Publications and source records attributed to M Federico.

At least 109 records · Page 6Linked to original sources
PubMed1990

Splenectomy after initial therapy with alpha-IFN in patients with hairy-cell leukemia (HCL): a multi-center study by the Italian Cooperative Group for HCL. Preliminary results.

Since December 1987, 115 patients with HCL have been enrolled in a prospective multicenter study to evaluate the role of splenectomy after an induction therapy with alpha interferon. The group of patients was divided into two categories: those younger and those older than 65 years. The schedule of treatment with IFN was, respectively, 1.8 MU/sm/daily and 1.0 MU/daily, 33 patients were treated with r-alpha-2a, 34 with r-alpha-2b, and 25 with alpha-Ly. To date, 92 patients are fully evaluable. The response was assessed every 3 months by bone marrow trephine biopsy. Patients in CR continued IFN therapy for 3 months and, if they were still in CR, could undergo an optional splenectomy. Patients in PR continued therapy for 12 months and subsequently were randomized for splenectomy or observation only. In these preliminary results of an ongoing protocol, CR was obtained in 5 cases (6%), PR in 59 (64%), MR in 25 (27%), NR in 3 (3%). Only 2 of the 5 patients in CR underwent splenectomy and are still in CR. Of the 59 patients in PR, only 15 completed 12 months of therapy. 9 patients in Group A were randomized, 4 were splenectomized and 5 were in the observation arm. All patients were splenectomized safely and no complications occurred. These preliminary results suggest that splenectomy could be effective in consolidating the response obtained with IFN.

Adult↗
PubMed1989

Detection of bone marrow involvement in patients with cancer.

Current methods for the study of bone marrow to evaluate possible primary or metastatic cancers are reviewed. Bone marrow biopsy, radionuclide scan, computed tomography and magnetic resonance imaging (MRI) are analyzed with regard to their clinical usefulness at the time of diagnosis and during the course of the disease. Bone marrow biopsy is still the examination of choice not only in hematologic malignancies but also for tumors that metastasize into the marrow. Radionuclide scans are indicated for screening for skeletal metastases, except for those from thyroid carcinoma and multiple myeloma. Computed tomography is useful for cortical bone evaluation. MRI shows a high sensitivity in finding occult sites of disease in the marrow but its use has been restricted by high cost and limited availability. However, the future of MRI in bone marrow evaluation seems assured. MRI is already the method of choice for diagnosis of multiple myeloma, when radiography is negative, and for quantitative evaluation of lymphoma when a crucial therapeutic decision (i.e. bone marrow transplantation) must be made. Finally, methods are being developed that will enhance the sensitivity and specificity of MRI studies of bone marrow.

Adult↗
PubMed1989

Bone marrow uptake of liposome-entrapped spin label after liver blockade with empty liposomes.

Using an ESR spectrometer, we studied the time course of the uptake of the liposome-entrapped spin label 2,2,6,6-tetramethylpiperidine-N-oxyl-4-trimethylammonium in liver, spleen, and bone marrow following reticuloendothelial liver blockade. Our results show that suppression of the phagocytic activity of the liver increases the delivery of liposomes to the spleen and bone marrow without substantially altering uptake by the liver.

Animals↗
PubMed1989

Bone marrow infiltration in hairy cell leukemia after interferon therapy detected by magnetic resonance imaging.

Magnetic resonance imaging (MRI) can detect bone marrow infiltration by neoplastic cells in many hematological malignancies. We studied 10 patients affected by hairy cell leukemia (HCL) and treated with interferon (IFN) with both MRI and bone marrow biopsy. T1-weighted MR scans of femurs and pelvis proved to be effective to score hairy cell infiltration, while less information was obtained from the study of the lumbar vertebral column. A good correlation (less than 10% difference) was noted between biopsy and MRI in over 90% of cases. MR scans showed, in general, a higher grade of infiltration. MR scan, however, can be useful for monitoring the course of HCL and the response to the treatment. Moreover, MRI evaluating a large amount of tissue, can detect a nodular type of infiltration which can be missed in biopsy specimens.

Bone Marrow↗
PubMed1989

Biologic and molecular characterization of producer and nonproducer clones from HUT-78 cells infected with a patient HIV isolate.

HUT-78 cells were infected with a reverse transcriptase (RT)-positive supernatant of a culture of peripheral blood lymphocytes (PBL) from an AIDS patient and then cloned. Of these clones, two have been isolated and characterized. Clone D10 is persistently and productively infected with an HIV variant. The clone F12, in spite of the presence of an integrated full-length HIV provirus, does not release virus particles in the medium. D10 and F12 clones substantially differ in terms of protein pattern; that is, D10 is super-imposable to infected HUT-78 cells, whereas F12 exhibits a decreased uncleaved p55 gag precursor and the presence of uncleaved gp160 and of a unique p19, although they do not show qualitative or quantitative differences in viral RNA synthesis. Restriction patterns of F12 proviral DNA do not show major genomic deletions. These results indicate that F12 clone cells carry an HIV genome with minor mutations that probably affect the correct production of viral proteins at a posttranscriptional level. In addition, the F12 clone is resistant to high-multiplicity superinfection with HIV-1 or HIV-2.

Cells, Cultured↗
PubMed1989

Human lymphoblastoid interferon as initial therapy in hairy cell leukaemia: a multicentre study in non-splenectomized patients. Italian Cooperative Group for Hairy Cell Leukemia.

The Italian Cooperative Group for Hairy Cell Leukaemia (ICGHCL), between April 1985 and June 1987, conducted a multicentre study using human lymphoblastoid alpha-interferon as primary therapy as an alternative to splenectomy. Forty-eight evaluable patients with HCL entered the study, 38 of them had splenomegaly, in five patients the spleen was not palpable and five were unfit for surgery because of age and general condition. Daily dose of 3 MU s.c. alpha-IFN was given for 12 weeks, or until a satisfactory and stable response was obtained. Among these 48 patients the response rate after 3 months of therapy was 63%, with seven patients (15%) achieving complete remission and 23 (48%) partial remission; 13 (27%) patients had a minor response. In five patients no response was observed and they died within 2 months of treatment. Five other patients, after an initial response, presented a re-expansion of the disease. Actuarial survival at 30 months was 88.8% for the entire group of 48 patients and 92% for the 38 patients who would normally be treated by splenectomy. Thus, alpha-IFN as primary treatment in HCL offered a reasonable therapy for splenomegalic patients. The timing and validity of splenectomy still remains an open question.

Adult↗
PubMed1989

Free-from-failure survival in Hodgkin's disease. Long-term analysis of 148 cases treated with a MOPP-modified protocol.

The incidence of relapses and second malignant neoplasms was investigated in a group of 148 patients with bad-risk stage II, or stage III and IV Hodgkin's disease treated with a MOPP-modified protocol between 1973 and 1979. Sixty-eight patients received chemotherapy alone, 80 a combined modality treatment including radiotherapy. One hundred and twelve patients achieved complete remission with induction therapy. Thirty-six patients relapsed 3-120 months (median 27 months) after the induction program with a 10-year cumulative risk of relapse of 33.6%. Seven out of 112 complete responders developed a second malignancy 65-145 months from the start of therapy; one more neoplasm has been recorded in a patient with active Hodgkin's disease. Survival after diagnosis of second malignant neoplasm did not exceed 12 months. The cumulative risk of developing a second malignancy was 6.2% at 10 years. The free-from-failure survival was 49.2% at 10 years, being 64.7% for patients achieving complete remission and 92.4% for long-term complete responders. Although an increased number of second malignant neoplasms may occur in patients treated for Hodgkin's disease, the high risk of early relapse, together with the limited effectiveness of salvage therapy, suggests that intensive induction programs should be carried out in patients with advanced or poor-prognosis Hodgkin's disease in order to achieve long-lasting complete remission.

Adolescent↗
PubMed1989

Increasing interdependency of prognosis- and therapy-related factors in Hodgkin's disease.

Two subsequent series of patients with Hodgkin's disease (HD) treated according to different therapeutic plans were compared: the study made it possible to analyze the role played by therapy in influencing the individual importance of a group of well-known prognostic factors. Study 1 concerned 667 patients treated in the period 1971-1979 without special measures for mediastinal bulky disease and with four-drug chemotherapy regimens (MOPP, COPP, ABVD) for stage B or IV. Study 2 included 220 patients treated between 1980 and 1984 with combined sandwich chemoradiotherapy when mediastinal bulk was present, and with eight-drug alternating chemotherapy regimens for stages B or IV (MOPP/ABVD, CcVPP/ABVD). Distribution of epidemiologic and clinical characteristics as well as staging accuracy were comparable in the two series. Only sex, serum albumin at onset and success or failure in achieving complete remission showed the same ability to discriminate survival in both studies. Age, stage and histology retained a reduced role in Study 2, where it was found they could be handled as binary variables, i.e. more or less than 50 years of age, stage IV or other stages, lymphocyte depletion histotype or other types. The influence of B symptoms on survival was sharply decreased in patients treated with alternating chemotherapy regimens, whereas combined sandwich therapy showed a truly leveling effect on the role of mediastinal bulk, which has to be considered a very unfavorable factor with other treatments. In HD the evaluation of clinical findings with respect to their impact on prognosis is crucial for validating and graduating the staging process, and for matching the intensity of the therapy to the needs of the patient. The ongoing evolution in the roles of single prognostic factors due to therapy needs periodic reevaluation for proper adjustments of therapeutic strategies.

Adolescent↗
PubMed1989

[The onset of double metachronous neoplasms 29 years after the diagnosis of Hodgkin's disease].

The occurrence of two new cancers (a diffuse centrocytic lymphoma and a basal cell cancer) in a patient successfully treated for Hodgkin's disease 29 years before is reported. The centrocytic lymphoma mainly involved the skin, the basal cell carcinoma developed on the dorsum of the right hand. The patient had received high-dose Roentgen-radiation therapy on the mediastinum and lymph nodes for his Hodgkin's disease. The possible relationship between performed therapy and occurrence of new malignancies is discussed.

Aged↗
PubMed1988

Hodgkin's disease prognosis: a directly predictive equation.

586 patients with Hodgkin's disease diagnosed between 1970 and 1979 were staged and treated in the same way. Multivariate analysis was used to delineate the prognostic roles of several clinical features at diagnosis. A multiple regression analysis was applied to an exponential model for survival-time distribution, which proved to fit the data accurately. Several clinical characteristics were studied and those that could singly discriminate survival significantly were chosen as predictive variables for the multiple regression. These were: sex, age, stage, histological subtype, presence of constitutional symptoms, mediastinal mass, and erythrocyte sedimentation rate (ESR), and haemoglobin and serum albumin concentrations. ESR, stage, histological subtype, and age proved to be the best prognostic factors, while sex and albumin had minor value. The presence of symptoms, mediastinal bulk, and haemoglobin were not so important. A linear equation for the six variables was derived to calculate the estimated median survival time for any given patient. This equation was validated on an external group of 179 similar patients.

Actuarial Analysis↗
PubMed1988

Opposite effects of murine interferons on erythroid differentiation of Friend cells.

Interferons (IFNs), in addition to inducing an antiviral state in uninfected cells, are able to affect cell physiology, including cell differentiation. In this respect hematopoiesis is certainly the area in which most data have accumulated. In general IFN-alpha or -beta inhibit cell growth of normal progenitors of hematopoietic lineages. In leukemia cell cultures IFNs may either stimulate or inhibit cell growth and differentiation. We report here different biological effects of murine (mu) IFN-alpha 1, -beta, and -gamma species on the erythroid differentiation of dimethyl sulfoxide (DMSO)-induced Friend leukemia cells. Treatment with mu recombinant IFN-beta enhances DMSO-induced FLC differentiation, whereas treatment with IFN-alpha 1 species as well as with natural and recombinant mu IFN-gamma preparations only inhibits it. All these observed effects are neutralized by monoclonal antibodies against IFN-alpha, -beta, and -gamma species. When mu fibroblast IFN (a mixture of alpha and beta species) was used, the inhibitory effect attributable to IFN-alpha was partly overshadowed by the simultaneous presence of a majority of IFN-beta molecules exerting the opposite effect. This is in agreement with data obtained neutralizing fibroblast IFN preparations with excess amounts of monoclonal antibodies against IFN-beta (G.B. Rossi et al., 1988, "The Status of Differentiation Therapy of Cancer," Raven Press, New York) and with our previous reports indicating that mu fibroblast IFN can either enhance or inhibit DMSO-induced differentiation when administered at low (less than 500 U/ml) or high (greater than 5000 U/ml) doses, respectively. The inhibitory effect of IFN-alpha 1 on cell differentiation is not linked to any inhibitory effect on cell growth. Results obtained analyzing the effect of IFN-alpha 1 and -beta on various IFN-resistant FLC clones indicate that different mechanisms underlie the stimulatory effect of IFN-beta and the inhibitory effect of IFN-alpha 1. These results shed light on possibly distinct physiological roles of the various species of IFNs.

2',5'-Oligoadenylate Synthetase↗
PubMed1988

Interferons-alpha/beta- and -gamma-resistant Friend cell variants exhibiting receptor sites for interferons but no induction of 2-5A synthetase and 67K protein kinase.

A number of Friend leukemia cell variants with a interferon-gamma (IFN-gamma)-resistant phenotype have been isolated. They appear resistant to the antiproliferative action of IFN-gamma and to the induction of the antiviral state assessed by Friend leukemia virus release and vesicular stomatitis virus yield. Selection was performed via a prolonged exposure to increasing amounts of highly purified recombinant IFN-gamma of wild-type Friend cells or of variant clones thereof already resistant to IFN-alpha/beta (Affabris et al., 1982, Virology 120, 441-452). Only the clones derived from IFN-alpha/beta-resistant variants showed a phenotype fully resistant to IFN-gamma treatment while keeping their previously acquired resistance to IFN-alpha/beta. These cells are not deficient in high-affinity receptors for IFN-gamma so that their resistant phenotype appears to be mediated by events distal to binding of IFN-gamma to its receptors. Furthermore, analysis of IFN-induced dsRNA-dependent 2-5A synthetase and 67K protein kinase enzymatic activities, biochemical markers for cellular responses to IFN, showed that both these activities were not induced in IFN-alpha/beta and IFN-gamma-resistant clones when treated with either type of IFN. Accordingly, no increased expression of 2-5A synthetase mRNA(s) could be detected by probing poly(A)+-enriched RNA from cells exposed to IFN-alpha/beta or IFN-gamma treatment with murine or human specific cDNAs. On the other hand, no major changes in restriction patterns of 2-5A synthetase gene(s) were observed in these variant cells by restriction endonuclease digestion and Southern blotting. In addition, analysis of 2-5A synthetase mRNA induction, performed on wild-type cells, showed that the kinetic of induction due to IFN-gamma treatment is slower than that obtained with IFN-alpha/beta.

2',5'-Oligoadenylate Synthetase↗
PubMed1987

[A case of Hodgkin's disease complicated by Strongyloides stercoralis infestation].

A case of Hodgkin's disease complicated by severe Strongyloides stercoralis infection is reported. Strongyloides is an opportunistic parasite that can produce particularly dangerous clinical pictures by autoinfestation in patients with impaired immunity. The appearance of aspecific gastrointestinal symptoms in such patients should trigger careful examination to discover the presence of parasites as well as the more common pathogenic bacteria. reduced among the elderly.

Aged↗
PubMed1987

Recovery of HIV-related retroviruses from Italian patients with AIDS or AIDS-related complex and from asymptomatic at-risk individuals.

Human retroviruses have been detected in supernatants of cultures of Ficoll-enriched lymphocytes from peripheral blood, lymph nodes and bone marrow of (a) 32 out of 42 patients with Acquired Immunodeficiency Syndrome (AIDS), (b) 34 out of 64 patients with AIDS-related Complex (ARC), (c) 9 out of 18 asymptomatic children born from Human Immunodeficiency Virus (HIV) seropositive mothers, and (d) 9 out of 28 asymptomatic drug abusers or hemophiliacs. Virus detection was monitored by assaying culture supernatants for the presence of Mg++-dependent reverse transcriptase (R.T.) activity. A number of these virus-positive sups were passaged repeatedly in cultures of phytohemagglutinin-stimulated and Interleukin-2 (IL-2) treated fresh lymphocytes from healthy blood donors. Occasionally, multiple samples were obtained at varying time intervals from the same patient and consistently yielded detectable retroviral activity. Several isolates were characterized as closely related if not identical to HIV, HTLV-IIIB strain, since cells from either patients' own lymphocyte cultures or subcultures infected with passaged virus were stained in an indirect immunofluorescent assay with both patients sera and monoclonal antibody against p24 antigen of the HTLV-IIIB strain. Representative isolates, grown on fresh lymphocytes of healthy donors and metabolically labelled with 35S-cysteine, were also analyzed in a radioimmunoprecipitation assay (RIPA) against patients' sera to define their antigenic pattern, which was widely superimposable to that obtained with HTLV-IIIB-infected H9 cells. DNA from lymphocytes infected with 2 representative isolates were Southern-blotted and probed with an insert from a plasmid containing the entire genome of the HTLV-IIIB strain. The hybridization patterns were comparable with those obtained with DNA from H9-infected cells.

AIDS-Related Complex↗