PubMed Health⌕ Search

Biomedical subjects

M Tribalto

Publications and source records attributed to M Tribalto.

63 records · Page 4Linked to original sources
PubMedDate not supplied

Effective pre-emptive therapy with Ganciclovir and specific immunoglobulins for CMV infection in a bone marrow transplanted patient.

BACKGROUND: A 29-year-old man, who underwent allogeneic bone marrow transplantation (BMT) for acute non lymphoid leukemia (ANLL), presented with blood pancytopenia and mild hypoxemia on day +39, without signs of acute graft versus host disease (GVHD). METHODS AND RESULTS: Cytomegalovirus (CMV) antigens were detected on WBCs and cells from bronchoalveolar lavage by immunofluorescence (IF) with specific murine monoclonal antibodies. Prompt treatment with Ganciclovir and high titer CMV immunoglobulins was followed by disappearance of the laboratory findings of CMV infection. Therapy was well tolerated and no side effects were recorded except for hematological depression that did not reverse after withdrawal of the therapy. The patient is relatively well on day + 210. CONCLUSIONS: Detection of CMV antigenemia appears to be a valuable tool for deciding whether to start CMV therapy with potentially toxic antiviral drugs in BMT patients in early engraftment, with or without overt signs of CMV infection.

Adult↗
PubMedDate not supplied

Bone marrow processing with a gravity sedimentation technique: experience of 13 cases.

The experience of 13 bone marrow processings is reported: 7 patients were affected by Acute Leukemias, 4 by Non Hodgkin's Lymphomas, 1 by Chronic Myelogenous Leukemia in complete remission after induction chemotherapy, 1 by Ewing's Sarcoma. Gravity sedimentation technique with 6% hydroxyethyl starch was used in all cases. A mean value of 0.754 x 10(8)/kg body weight mononuclear cells was harvested after sedimentation, with a mean recovery of 74.554%. Mean CFU-GM value was 0.543 x 10(4)/kg body weight. Only one evaluable patient, affected by ANLL, underwent Autologous Bone Marrow Transplantation and a full engraftment was noted on day +14. Results are discussed and further studies are proposed to clarify the relationship between the in vitro CFU-GM growth and the bone marrow engraftment.

Adolescent↗
PubMedDate not supplied

Mitoxantrone in combination with etoposide and cytarabine for treatment of poor prognosis acute non lymphoid leukemia patients.

BACKGROUND: The proved effectiveness and relatively low extrahematological toxicity of Mitoxantrone, Ara-C and Etoposide as single agents and in combination in the treatment of acute non lymphoid leukemia (ANLL) are well established. In a phase II study the efficacy and toxicity of an induction combination regimen with Mitoxantrone, Ara-C and Etoposide were evaluated for treatment of poor risk ANLL patients. METHODS: Twenty-seven poor prognosis ANLL patients were treated with Mitoxantrone, 7 mg/sm days 1-3; VP16, 150 mg/sm days 1-3; Ara-C, 200 mg/sm continuous infusion days 1-5. Median age of treated patients was 63 (17-78): 10 de novo leukemias (4 greater than 65 yrs 3 with cardiomyopathy); 12 secondary leukemias (5 secondary to a myelodysplastic syndrome, 5 to myeloproliferative syndrome, 2 to other neoplasias); 3 relapses; 2 refractory. RESULTS: Fifteen patients (55.5%) achieved CR (8 de novo leukemias, 3 relapses, 4 secondary leukemias); 7 died in induction, 5 progressed. Median remission duration was 27 weeks (range 5-70 wks) and overall median survival 13 weeks (range 4-80). Extraematological toxicity was low, but five patients died from infections and two from hemorrhages. CONCLUSIONS: The combination tested in this trial proved effective in the treatment of "poor risk" ANLL, but the results need to be confirmed on greater numbers of patients, mainly in the group of de novo leukemias that can't be treated with more aggressive regimens.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Sequential combination of methotrexate and L-asparaginase in the treatment of refractory acute leukemia.

Seventy-six patients with advanced acute leukemia refractory to conventional chemotherapy were treated with a sequential combination of methotrexate (MTX) and L-asparaginase (L-ASP), based on the reported schedule-dependent synergism between the two drugs in human leukemic cells in vitro. On Day 1, patients received 60 mg/m2 of MTX iv, followed 24 hours later by L-ASP at a dose of 10,000 IU/m2 iv. This sequence was repeated weekly with 50% escalations in the dose of MTX with each course. Overall, 31 of 76 patients (40.7%) achieved complete remission after a median of three courses; the response rate was 35.5% in patients with acute nonlymphocytic leukemia (21 of 59 patients) and 58.8% in patients with acute lymphocytic leukemia (ten of 17). Increasing the starting dose of MTX to 200 mg/m2 did not improve the response rate. Maintenance therapy with the same combination given every 2 weeks produced a median complete remission of 10 weeks. Toxicity was manifested by: acute hypersensitivity reactions to L-ASP (five patients), stomatitis (36 patients), and mild liver abnormalities (five patients). MTX in doses up to 200 mg/m2 caused minimal myelosuppression. We conclude that the MTX-L-ASP combination is a well-tolerated, highly effective induction regimen for refractory acute leukemia.

Acute Disease↗
PubMedDate not supplied

Diagnosis of acute myeloid leukemia and system Coulter VCS.

BACKGROUND: The aim of this study was to evaluate the possible contribution VCS could make in a hematological laboratory for the diagnosis of acute myeloid leukemia (AML). MATERIALS AND METHODS: Peripheral blood samples from 42 AML patients and 58 normal donors were analyzed by flow cytometry with the VCS. Normal and leukemic peripheral blood samples were tested to establish a correlation between VCS data and the reference manual method. We evaluated the sensitivity threshold of the VCS for blast cell detection in progressively diluted samples. We looked at a correlation between different scatterplots and flags and the FAB classification of acute myeloid leukemia in order to identify a characteristic VCS image for each subtype. Thirty-four bone marrow samples (18 normal donors and 16 leukemic patients) were analyzed by the VCS system to demonstrate a characteristic scattergram distribution. Further, we tried to compare scatterplots to the flags of leukemic bone marrow samples and, finally, we compared VCS scatterplots with aberrant antigen expression in AML cases. RESULTS AND CONCLUSIONS: Overall VCS specificity was 93.1% (54/58) in peripheral blood samples; sensitivity was 100% (42/42) and VCS efficiency was 96%. In AML the characteristic X6 flag was observed in 95.23% of the cases (40/42). In peripheral samples discrimination was made between AML M1 with agranular blasts > 50% of the non erythroid cells (NEC), M4, M5 on the one hand, and AML M1 with granular blasts > 50% of NEC, M2, M3 on the other: the X5 flag was often present in the second group because of the different localization of the cells (p = 0.001). In all normal bone marrow samples we observed granuloblasts in different maturation stages in the neutrophil region of the DF1 VCS scatterplot corresponding to the X5X6 flags or, rarely, to the X5X6X1, because of the presence of immature erythroid cells. This association X5X6 was never observed alone in patients affected by AML. In our study, it was difficult to identify peculiar scatterplots and alarms for each FAB class of AML. Nevertheless, we observed that in all M4 and M5 FAB cases the blastic cells both in the peripheral blood and in the bone marrow samples were located in the monocyte region, with the frequent presence of the X3 flag often associated with the X6 flag. Eight out of the 16 AML bone marrow samples (1 FAB M0, 1 M2, 1 M3, 2 M4, 3 M5) showed the X2 flag and partial localization of blasts in the lymphoid region. In all these cases the presence of some small blastic cells with agranular cytoplasm was confirmed by morphological observation and cytochemical stainings.

Acute Disease↗