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R Notaro

Publications and source records attributed to R Notaro.

26 records · Page 2Linked to original sources

In vitro photoinhibition by psoralen and ultraviolet A radiation of human hematopoietic progenitors.

The in vitro sensitivity of human hematopoietic progenitors to PUVA, 8-MOP and UVA alone was investigated. 8-MOP alone at final concentrations of 150, 200, 600 and 1,000 ng/ml did not modify colony growth of circulating and bone marrow erythroid (BFU-E), myeloid (CFU-GM) and immature (CFU-GEMM) hematopoietic progenitors obtained from normal controls. The exposure of the same progenitors to increasing doses of UVA, up to 12 J/cm2, progressively decreased hematopoietic colony growth (with estimated 50% inhibition occurring at about 5 J/cm2). In vitro PUVA treatment (8-MOP 200 ng/ml followed by UVA 5 J/cm2) caused 90% growth inhibition of circulating and bone marrow hematopoietic progenitors. In addition, the treatment completely inhibited the formation of spontaneous erythroid colonies, obtained from 5 polycythemic patients, that are considered to be a marker of this neoplastic disease. PUVA cytotoxicity was assessed by the colorimetric MTT assay. The percentage of cell death after PUVA exposure was 29 +/- 10% for both peripheral and bone marrow mononuclear cells. Our findings indicate that 8-MOP alone is not toxic to hematopoietic progenitors whereas UVA treatment determines in vitro a dose-dependent inhibition of the clonogenic capacity of normal hematopoietic cells. PUVA treatment enhances this effect, causing a quite complete inhibition of hematopoietic progenitors colony formation from normal donors and spontaneous BFU-E colony formation from polycythemic patients.

Cell Survival↗

Danazol: in vitro effects on human hemopoiesis and in vivo activity in hypoplastic and myelodysplastic disorders.

We examined the effects of danazol on in vitro growth of human bone marrow and peripheral blood progenitor cells from 15 normal donors and 5 myelodysplastic patients, and on in vivo hemopoiesis in 30 patients with hypoplastic or myelodysplastic disorders. At concentrations similar to that reported as the plasma level after oral administration, danazol significantly increased CFU-GM colony growth in all normal donors, while the influence on CFU-E, BFU-E, CFU-MK and CFU-GEMM colony growth was less evident. The stimulatory effect on CFU-GM was observed even after accessory cell depletion. Np stimulatory effect either in vitro on the growth of all hemopoietic progenitors or in vivo was observed in 15 myelodysplastic patients, while 7 complete and 3 partial hematological responses occurred in 15 patients with hypoplastic disorders. In conclusion, our results suggest that danazol exerts a direct stimulatory activity in vitro at least on CFU-GM, and a hemopoietic stimulatory effect in vivo in hypoplastic but not in myelodysplastic disorders.

Adult↗

Cytopenia caused by parvovirus in an adult ALL patient.

A young woman in maintenance therapy for acute lymphoblastic leukemia in second complete remission developed fever and a skin rash associated with severe anemia, neutropenia and erythroblastopenia. A complete recovery was obtained in 4 weeks' time after red cell transfusion, i.v. immunoglobulin and withdrawal of the maintenance chemotherapy. Parvovirus B19 infection was demonstrated by detection of B19 DNA in the patient's serum using a dot-blot hybridization assay and a nested polymerase chain reaction. Serological tests were positive for anti-B19 IgG but not for IgM. Erythroblastopenia due to parvovirus infection has already been reported in ALL patients. B19 infection should be suspected in leukemic patients if unexplained cytopenia (mainly anemia) follows an acute febrile illness. Very sensitive methods are often needed to confirm the diagnosis, since routine serological tests may be unreliable in immunocompromised patients.

Adult↗

Identification and treatment of late onset Fanconi's anemia.

We diagnosed Fanconi's anemia (FA) in a 34-year-old lady, daughter of consanguineous parents, from a small Southern Italian town. The patient was pancytopenic when she was 31, and was found to be aplastic at the age of 34. Spontaneous chromosomal breakages were not evident in peripheral blood lymphocyte cultures but the diepoxybutane (DEB) test, carried out during the aplastic phase, was clearly positive. Danazol treatment significantly improved her hematological condition, yielding a Hb peak value of 13.4 g/dL. Four years later moderate pancytopenia has recurred. This case demonstrates that even adult pancytopenic patients may have FA and that a test detecting chromosomal hypersensitivity to cross-linking agents is the only key to a correct diagnosis, which in turn is essential to avoid improper treatment.

Adult↗

Small bowel infarction by Aspergillus.

Primary gut involvement by Aspergillus is a rare and often fatal complication of intensive antileukemic therapy. We describe the case of an adult patient affected by acute leukemia who developed a small bowel fungal thromboembolism without radiographic evidence of lung involvement during the post-induction aplastic phase. The diagnosis was made histologically at laparotomy performed for small bowel perforation. The patient died a week later in spite of amphotericin-B treatment and neutrophil recovery. Anti-Aspergillus prophylaxis and early introduction of amphotericin-B in the treatment of febrile neutropenia is probably advisable in all cases of AML.

Acute Disease↗