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S Issaragrisil

Publications and source records attributed to S Issaragrisil.

At least 37 records · Page 2Linked to original sources
PubMed1996

Incidence and non-drug aetiologies of aplastic anaemia in Thailand. The Thai Aplastic Anaemia Study Group.

A population-based, case-control study of aplastic anaemia has been conducted in Thailand since 1989. Up to December 1994, the overall annual incidence was 3.9/10(6) in Bangkok, 5.0/10(6) in Khonkaen and 3.0/10(6) in Songkla. In Bangkok, the incidence peaked in 2 age groups (at 15-24 yr and > or = 60 yr), whereas in Khonkaen and Songkla there was a consistent increase in incidence with increasing age. The results of case-control analyses for non-drug risk factors indicate a strong inverse association with socio-economic status present in all 3 areas; a strong association with grain farming in the 2 rural areas that does not appear to be explained by pesticides; an association with occupational exposure to solvents in Bangkok; and a positive association with hepatitis A seropositivity.

Adolescent↗
PubMed1996

An epidemiological study of aplastic anaemia: relationship of drug exposures to clinical features and outcome.

Two hypotheses were examined in the combined data from 3 case-control studies of aplastic anaemia, conducted in Thailand, Europe/Israel and the US: 1. Cases exposed to drugs associated with a significantly increased risk of aplastic anaemia are more likely to present with thrombocytopenia (e.g. petechiae, easy bruising); and 2. cases exposed to these drugs are more likely to recover quickly than non-exposed cases. After excluding all cases who lacked information on timing of symptoms and those whose symptoms began > or = 180 d before hospital admission, 392 cases remained for analysis. A total of 51 (13%) had been exposed to one of the significantly associated drugs; the remaining 341 (87%) had not. Among the former, 31% reported thrombocytopenia either before or at the same time as non-bleeding symptoms (e.g. pallor, fatigue); the corresponding proportion among the non-exposed was 53%. Data on time to recovery (return of the 3 blood cell lines to normal levels) were not available for the Thai cases; among the others, the median time to recovery for the non-fatal cases was 7 and 6 months in the 29 exposed and the 83 non-exposed cases, respectively. The data do not support either hypothesis: the two groups of aplastic anaemia cases appeared to be similar in both the presenting symptoms and the recovery time.

Adult↗
PubMed1995

Collection of cord blood stem cells for transplantation in thalassemic patients.

Thalassemia is widely distributed throughout the world and is one of the major public health problems. The use of bone marrow transplantation, the only curative therapy for thalassemia, is limited because less than 30% of the patients have unaffected and HLA-identical siblings as donors. Cord blood stem cells, an alternative source of stem cells for transplantation, have been successfully transplanted into patients with several diseases after myeloablative therapy. Twenty cord blood samples from unaffected neonates whose siblings had severe thalassemia were collected. The median volume was 80 ml. The median number of cells and colony forming units-granulocyte-macrophage in cord blood was 9.2 x 10(8) and 3.4 x 10(5), respectively. Four of 20 cord blood samples had HLA-matched to the affected siblings. One patient underwent cord blood transplantation with success; one patient is waiting for transplantation.

Blood Specimen Collection↗
PubMed1995

An association of aplastic anaemia in Thailand with low socioeconomic status. Aplastic Anemia Study Group.

The relationship of socioeconomic status to the risk of aplastic anaemia was evaluated in a case-control study conducted in Bangkok and two rural regions of Thailand (Khonkaen and Songkla). Among 152 cases and 921 controls there were significant trends of increasing risk with decreasing years of education (P = 0.01) and total household income (P = 0.0001), after control for confounding. The relative risk estimate for those with monthly incomes of < 1500 baht (about $60 U.S.) was 3.9 (95% confidence interval 2.1-7.3) compared to those with monthly incomes of at least 5000 baht (about $200). The pattern of increasing risk with decreasing income was observed in all three regions, with significant trends in Bangkok (P = 0.004) and Khonkaen (P = 0.003). This finding may partly explain the high incidence of aplastic anaemia in Thailand. Low socioeconomic status may be a surrogate for one or more environmental factors that could cause aplastic anaemia, such as infectious pathogens or toxic exposures.

Adolescent↗
PubMed1995

Study of hematopoietic progenitor cells in thalassemia after bone marrow transplantation.

The hematopoietic committed progenitor cells (BFU-E and CFU-GM) in blood and bone marrow were studied in thalassemic patients before and after bone marrow transplantation. Eighteen transplants were performed in 17 patients with thalassemia. Five were homozygous beta-thalassemia and 12 were beta-thalassemia/hemoglobin E disease. The age ranged from 1.2-14 years (median = 3.4 years). The conditioning regimen comprised busulfan 3.5-4 mg/kg/day for 4 days and cyclophosphamide 50 mg/kg/day for 4 days. Cyclosporin in combination with methotrexate were administered post transplant for GVHD prophylaxis. Before transplantation, BFU-E and CFU-GM in the blood of the patients were significantly higher compared with normal (p < 0.05) but were normal in the bone marrow. Only the CFU-GM in the bone marrow of the successful cases after transplantation recovered to the normal level at the first month through the 12th month whereas the BFU-E were low. Both CFU-GM and BFU-E in the blood were lower than normal after follow up to the 12th month. Inspite of the low number of progenitor cells, there was hematological recovery in the blood of the patients. It may be due to the capacity of the hematopoiesis react to stress which could be amplified the differentiation compartment or the shortened-transit time through the stem cell compartment.

Bone Marrow↗
PubMed1994

Cord blood transplantation in thalassemia.

Thalassemias and hemoglobinopathies are prevalent in Thailand. Bone marrow transplantation can cure thalassemia, but less than 30% of the patients have an HLA-identical sibling. Cord blood is an alternative source of stem cells for transplantation. By prenatal diagnosis, the fetus can be diagnosed as having thalassemic disease. DNA typing for HLA will be performed. Cord blood can be collected for transplantation if the fetus is not affected and is HLA-identical to the patient. We report a successful cord blood transplantation in a patient with beta-thalassemia/hemoglobin E disease.

Bone Marrow Transplantation↗
PubMed1994

Bone marrow transplantation in Thailand.

In Thailand aplastic anemia and thalassemias as well as leukemias and lymphomas are prevalent. Bone marrow transplantation has been used to cure these patients. The results are more favorable in non-malignant diseases than in hematological malignancies. The incidence of GVHD and CMV infection is low. There are still some unresolved problems, especially lack of personnel, limited facilities and high cost.

Anemia, Aplastic↗
PubMed1993

Bone marrow transplantation for thalassemia in Thailand.

We report our experience of bone marrow transplantation for thalassemia in Thailand. From July 1988 to September 1992, 10 thalassemic patients underwent allogeneic bone marrow transplantation. Two of them were homozygous beta-thalassemia and 8 were beta-thalassemia/Hb E disease. Seven were male and 3 female. The age ranged from 1.8-14 years. The conditioning regimen comprised busulfan 14 mg/kg and cyclophosphamide 200 mg/kg. For GVHD prophylaxis, either cyclosporine alone or in combination with short methotrexate was given. Five patients were alive and well 104-1534 days after transplantation. Three patients with severe manifestations at the time of transplant had partial engraftment, and lost their graft within 3 months. They survived with thalassemia 1041-1357 days after transplantation. One patient who received one antigen mismatched marrow from her brother had no engraftment and was alive with thalassemia 1429 days posttransplant. One patient died early on day 9 from CNS complication. No GVHD was observed in this series. These results indicate that bone marrow transplantation can cure thalassemia but there is still high autologous recovery rate in those with severe manifestations.

Adolescent↗
PubMed1992

High prevalence of hepatitis C viremia among aplastic anemia patients and controls from Thailand.

Aplastic anemia is a rare, life-threatening disease of unknown etiology, with unusually high prevalence in Thailand. It is sometimes associated with non-A, non-B hepatitis (NANBH). The hepatitis C virus (HCV), one of the causes of NANBH, is similar to flaviviridiae, a family of viruses many of whose members cause acute bone marrow suppression. To test the hypothesis that HCV viremia is associated with aplastic anemia among patients in Thailand, we compared 53 untransfused hospitalized aplastic anemia patients and 39 untransfused controls hospitalized for other conditions. We used the polymerase chain reaction to identify HCV viremia in three (5.7%) untransfused patients and two (5.1%) untransfused controls (P = 1.0, by Fisher's two-tailed exact test). Although our data do not exclude the possibility that a small subset of aplastic anemia cases are precipitated by HCV, we conclude that HCV viremia is not generally associated with aplastic anemia in Thailand. Our results also imply that the prevalence of HCV viremia may be unexpectedly high among untransfused persons in Thailand, a hypothesis that should be tested in other populations.

Adolescent↗
PubMed1991

Incidence of aplastic anemia in Bangkok. The Aplastic Anemia Study Group.

The annual incidence of aplastic anemia in metropolitan Bangkok, Thailand, and its five suburban provinces was prospectively determined. All patients first diagnosed during the period from January through December 1989 who met specific clinical and pathologic criteria were included. Thirty-two cases were identified, yielding an overall incidence of 3.7 per million. The incidence rates for the age groups 0 through 24, 25 through 59, and over 60 years were 4.3, 3.2, and 2.1 per million, respectively; the highest rate, 7.2 per million, was found for individuals aged 15 to 24 years. The male-to-female ratio was 1.9. The incidence of aplastic anemia in Bangkok is higher than that reported in recent European studies. The peak rate in young persons is almost fourfold higher than in comparable recent western studies and suggests an environmental etiology peculiar to Thailand.

Adolescent↗
PubMed1991

Cytochemical stainings in acute promyelocytic leukemia: chloroacetate esterase reaction as a prognostic index.

Cytochemical studies including peroxidase, sudan black B and esterases were used for staining peripheral blood and bone marrow smears from 42 patients with acute promyelocytic leukemia. The most sensitive methods were sudan black B (mean 98%, range 81-100%) and peroxidase (mean 92% range 70-100%). Naphthol AS-D chloroacetate esterase activity was less sensitive and was positive in only 49.4 per cent (range 2-100%). All of the population of leukemic cells contained less than 3 per cent of alpha-naphthyl acetate esterase staining. For stability tests of the storage specimens compared to fresh stains, there was no difference in naphthol AS-D chloroacetate esterase (mean 45% vs 49% P greater than 0.7) and sudan black B (mean 74% vs 98% P greater than 0.3), but the enzyme activity was significantly decreased in peroxidase staining (mean 42% vs 92% P greater than 0.05). When the patients were divided into 2 groups according to the degree of AS-D chloroacetate esterase activity, those with lower activity had a higher number of white blood cells, promyelocytes and shorter survival compared to those with higher activity. Therefore, naphthol AS-D chloroacetate esterase may be useful as a prognostic index.

Adolescent↗
PubMed1990

Massive chemotherapy and autologous bone marrow transplantation in Burkitt's lymphoma: the first two patients successfully treated in Thailand.

Massive chemotherapy and autologous bone marrow transplantation (ABMT) have been successfully used for the treatment of Burkitt's lymphoma. We report our first success with such treatment in two children with Burkitt's lymphoma in Thailand. Both patients had massive abdominal tumors with ascites and minimal bone marrow metastasis at the first presentation. They received induction chemotherapy and intensive treatment including central nervous system prophylaxis with cranial irradiation and intrathecal methotrexate until being in complete remission before starting massive chemotherapy, comprising the combination of BCNU, cytosine arabinoside, cyclophosphamide and 6-thioguanine followed by ABMT. Both patients recovered completely following intensive supportive treatments post ABMT and are still good health without evidence of the disease for 18 and 8 months after transplantation respectively. The role of massive chemotherapy and ABMT for the treatment of non-Hodgkin's lymphoma especially Burkitt's lymphoma was discussed.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

Glucose intolerance, hyperinsulinemia and insulin resistance in aplastic anemia.

Oral glucose tolerance tests were conducted in 29 patients with aplastic anemia and 20 nondiabetic controls. Seventeen were men and 12 were women, ranging in age from 15 to 67 years. Based on the results of oral glucose tolerance test, the patients were divided into three groups: 14 previously treated cases with normal glucose tolerance; eight previously treated cases with abnormal glucose tolerance, of whom six had diabetes and two had impaired glucose tolerance; and seven newly diagnosed cases with normal glucose tolerance. Hyperinsulinemia and insulin resistance were observed in all patients. Multivariate analyses show that sex, age, body mass index, previous androgen and corticosteroid therapy, previous blood transfusion, initial hemoglobin and white blood cell and serum ferritin concentrations were not significantly related to hyperinsulinemia as expressed by the integrated insulin area under the curve of glucose tolerance test. Patients in the second group who had abnormal glucose tolerance had a delay in insulin secretion in response to glucose, indicating a deterioration of insulin reserve in the beta cells. Patients in this group were significantly older at the time of diagnosis than those in the first group. No other determinants of the development of abnormal glucose tolerance were demonstrated.

Adolescent↗
PubMed1989

Abnormalities of hematopoietic progenitor cells in patients with aplastic anemia after hematologic recovery.

Hematopoietic progenitor cells were studied in 11 patients with aplastic anemia who had hematologic recovery after androgen therapy. The mean numbers of colonies derived from erythroid and granulocyte-macrophage progenitor cells (BFU-E and CFU-GM) were markedly decreased compared to normal controls. Cell-mediated suppression of colony growth as detected by coculture studies was observed in 5 patients; 4 patients for CFU-GM and one for both CFU-GM and BFU-E. It is thus concluded that the pool of hematopoietic stem cells in patients after hematologic recovery is still not fully reconstituted. In addition, this impaired reconstitution appears due in some cases to cell mediated suppression of progenitor colony growth.

Adolescent↗