PubMed Health⌕ Search

Biomedical subjects

M Spriano

Publications and source records attributed to M Spriano.

30 records · Page 2Linked to original sources
PubMed1984

Hairy cell leukemia: a retrospective study of 235 cases by the Italian Cooperative Group (ICGHCL) according to Jansen's clinical staging system.

This is a report from a cooperative study on hairy cell leukemia (HCL) involving 20 Hematology Departments in Italy. Data for the patients was collected between January 1967 and December 1981 and included 235 cases of which 203 could be evaluated; 160 were males (78.8%) and 43 females (21.2%) with an M:F ratio of about 3:1; mean age was 54 years (range 26-82 yrs). The diagnostic criteria of admission were: typical aspect of hairy cells, in peripheral blood and bone marrow smears, tartrate resistant acid phosphatase (TRAP) positivity, typical bone marrow, spleen, liver and/or lymph node histology, and/or electronmicroscopy. On the basis of hemoglobin level and spleen size at the time of diagnosis, three stages could be distinguished according to Jansen: 51 patients, 27 of which splenectomized, were in stage I; 67 patients, of which 44 splenectomized, were in stage II; 85 patients of which 60 splenectomized, were in stage III. The actuarial survival curves of these patients showed clear distinction between the three stages. In the first stage the difference in survival, between splenectomized and nonsplenectomized groups, was not statistically significant (p less than 0.5): on the contrary, in stages II and III the difference in survival was statistically significant (stages II and III; p less than 0.01).

Aged↗
PubMedDate not supplied

HIV-related thrombocytopenia: a therapeutical update.

HIV-seropositive patients who belong to the three major acquired immunodeficiency syndrome (AIDS) risk groups may develop an idiopathic thrombocytopenic purpura (ITP) which is related to the HIV infection. HIV-associated ITP clinically resembles classic ITP but, in spite of very low platelet numbers, bleeding is rarely severe, and moderate splenomegaly and lymphadenomegalies are seldom present. Treatment is the same as that given for classic ITP because the pathogenesis is in many ways similar. Immunosuppressors can be dangerous in the case of retrovirosis, and splenectomy may lead to AIDS. High doses of immunoglobulins often give an improved platelet count but this tends to be short-lived, and long-term periodical infusions usually lose therapeutical effect. Alpha interferon gives conflicting results and Danatrol is not usually effective. Specific anti-D immunoglobulins produce a high percentage of positive results and may be administered for long-term maintenance without side effects. Zidovudine (AZT) may produce a good platelet increase in a large number of patients, but there is no consensus for the use of this anti-retroviral drug in otherwise asymptomatic HIV-positive patients. In conclusion, since it is very unusual for bleeding to occur, moderate thrombocytopenia is best left untreated because a spontaneous increase in platelet count is possible. But if the platelet count is very low, or if bleeding is present, treatment is mandatory and must produce a rapid platelet increment with minimal side effects.

Danazol↗
PubMedDate not supplied

Fludarabine in untreated and previously treated B-CLL patients: a report on efficacy and toxicity.

BACKGROUND: It has been shown that fludarabine (FLU) is superior to conventional treatment in B-CLL for rate and quality of response, leading to CR even at the molecular level. In this paper we report our preliminary results with this drug in B-CLL patients. METHODS AND PATIENTS: Twenty-seven B-CLL patients (16 refractory to previous therapy, 7 responsive and treated for subsequent disease reexpansion, 4 untreated with active disease) were administered FLU at a dose of 25 mg/sqm for 5 days every 4 weeks. RESULTS: Twenty-five patients were evaluable and 14 of them (56%) were responsive. All four untreated patients responded: 1 CR (PCR analysis showed the persistence of clonal VDJ rearrangement) and 3 PR, while 67% of the previously responsive group again showed a reaction: 2 PR (33%) and 2 nodular PR (33%). Among the refractory patients we recorded 6 responses (39%): 1 CR (6%) and 5 PR (33%). Besides 2 cases of lethal myelotoxicity, we observed 2 cases of encephalopathy and 2 cases of heart failure. Four deaths may have been related to FLU therapy (15%). CONCLUSIONS: We confirm the effectiveness of FLU and the improved outcome, in terms of toxicity and response rate, it provides in untreated B-CLL patients. Further studies are needed to explore the possible negative effects of FLU on neuronal and heart function, and the impact of this drug on survival in selected groups of patients.

Adult↗
PubMedDate not supplied

Multiple myeloma in the elderly: clinical features and response to treatment in 113 patients.

BACKGROUND: Considering the conflicting results of the few reports on geriatric MM patients and the increasing relevance of the problem, we analyzed a series of 113 patients over 64 years of age treated with conventional chemotherapy. PATIENTS AND METHODS: The median age was 71 (range 65-92). Stage IA, IIA, IIIA and IIIB patients numbered 28, 33, 45 and 7, respectively. The M component was IgG in 73 patients (65%), IgA in 30 (26%), IgD in 3 (3%), light chain in 5 (4%); no monoclonal component was detected in 2 (2%) cases. Sixty-three patients showed symptomatic skeletal disease. Melphalan/prednisone (MP) was the first-line treatment in 84 patients (74%). Patients were grouped according to age (> 64 < or = 74; > or = 75) in order to carry out analysis. RESULTS: Seventy-eight cases (69%) showed a sizable reduction in the tumor mass; objective and partial response was achieved in 57 (50%) and 21 (19%) patients, respectively. Patients with stage I-II disease fared significantly better than stage III patients (median survival: 70 vs 38 months; p = 0.017). Response to first-line treatment correlated with overall survival; patients with responsive or refractory disease had median survival rates of 64 and 20 months, respectively (p = 0.0001). CONCLUSIONS: Neither patients above nor below 75 years of age showed any difference in presentation features or in response to treatment. These results suggest that advanced age should not be considered a major obstacle to active treatment.

Aged↗