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W Arcese

Publications and source records attributed to W Arcese.

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

Cytogenetic follow-up after allogeneic bone-marrow transplantation for Ph1-positive chronic myelogenous leukemia.

Serial cytogenetic studies were carried out on 36 patients with Ph1-positive chronic myelogenous leukemia treated with allogeneic bone-marrow transplantation from unlike sex (21 patients) or like sex (15 patients) donors. Fourteen of the 21 sex-mismatched and 12 of the 15 sex-matched donor marrows were T cell depleted. Disease relapse was documented in 19 of the 26 patients who received T cell-depleted marrow, and in none of the 10 patients who received non-T cell-depleted marrow. In the group of patients with unlike sex donor, a triple donor/normal recipient/Ph1-positive recipient or a double donor/Ph1-positive recipient chimerism was documented during the subsequent months, while on alpha-interferon treatment for relapse. Two of these patients subsequently showed a complete disappearance of the Ph1 chromosome. Unstable and/or stable, clonal or non-clonal chromosome changes were detected in Ph1-positive cells from 12 of the 19 patients who relapsed. Analysis of the identified stable changes showed a non-random distribution of breakpoints with clustering to chromosome nos. 1, 4, 7 and 12.

Adolescent↗
PubMed1990

Interferon therapy for Ph1 positive CML patients relapsing after T cell-depleted allogeneic bone marrow transplantation.

Eighteen chronic myeloid leukemia patients with hematological (four patients) or only cytogenetic (14 patients) relapse occurring after T cell-depleted allogeneic bone marrow transplantation (BMT) have been treated with alpha 2b interferon (IFN) at a starting dose of 5 x 10(6) i.u./m2 subcutaneously three times a week. All four patients with hematological relapse achieved long-lasting hematological remission without reduction of bone marrow Ph1 positive cells. When IFN was started the median percentage of bone marrow Ph1-positive metaphases was 50% (range 9-100) for the 14 patients with cytogenetic relapse. Twelve (85.7%) of these patients are alive with a median follow-up of 25 months (range 20-37 months) from cytogenetic relapse and 33 months (range 27-49 months) from BMT. Six (43%) of the 14 patients progressed to hematological relapse and eight patients (57%) are still in hematological remission with two patients achieving complete cytogenetic remission confirmed at molecular level by disappearance of the M-BCR rearranged band. IFN therapy may be a good alternative to conventional chemotherapy for transplanted CML patients with hematological relapse and the treatment of choice for patients with a persistent cytogenetic relapse occurring after T cell-depleted BMT.

Adolescent↗
PubMed1989

Effects on oral and intestinal microfloras of norfloxacin and pefloxacin for selective decontamination in bone marrow transplant patients.

We monitored the modifications of oral and intestinal microfloras of 10 allogeneic bone marrow recipients who received randomly either norfloxacin or pefloxacin (400 mg three times a day) as selective decontamination for infection prevention. After 1 week of treatment, in all patients members of the family Enterobacteriaceae were no longer detectable and in all but one pefloxacin-treated patient enterococci were also eliminated in the intestine. The anaerobic flora was not affected, with the exception of Bacteroides spp., markedly reduced after treatment with pefloxacin. In most patients the most striking effect was the increase in staphylococcal counts. These strains were found to be resistant to both quinolones in the study. Less consistent changes were observed in oral flora. No relevant difference could be demonstrated between the two regimens on bacterial counts either in feces or in saliva. This study shows the efficacy of both quinolones in eradicating gram-negative bacilli in the alimentary tract of bone marrow transplant patients; however, the finding of the overgrowth of resistant gram-positive organisms during treatment with these agents deserves further evaluation.

Adult↗
PubMed1988

Bone marrow transplantation for chronic myeloid leukaemia in first chronic phase: importance of a graft-versus-leukaemia effect.

We analysed the incidence of graft failure, graft-versus-host disease (GVHD) and relapse of leukaemia in 208 patients undergoing allogeneic bone marrow transplantation (BMT) for chronic myeloid leukaemia in chronic phase in eight transplant centres in Europe and the United States. 106 patients received unmanipulated donor bone marrow (Group 1) and 102 patients received marrow depleted of T-cells by incubation with the monoclonal antibodies Campath-1 or CT-2 and complement (Group 2). The incidence of graft failure was higher and of GVHD was lower in Group 2 than in Group 1. Relapse of leukaemia occurred more frequently in patients in Group 2 than in Group 1 (17 v. 2, P less than 0.001). Multivariate analysis showed that the following factors were associated with an increased risk of relapse: the use of T-cell depletion, the absence of GVHD and a high platelet count at the time of admission for transplant. The findings support the concept that a graft-versus-leukaemia effect mediated by T-lymphocytes is important for cure of leukaemia after BMT.

Adolescent↗
PubMed1988

Thyroid and pituitary function following allogeneic bone marrow transplantation.

Thyroid function was evaluated in 13 consecutive patients with chronic myelogenous leukemia to verify in allogeneic bone marrow transplantation if the fractionated irradiation protocol with low dose rate, previously applied to reduce the damage to various organs, also prevents the 43% incidence of primary hypothyroidism that occurs after the administration of single dose with higher dose rate. Following bone marrow transplantation, decreased plasma levels of total thyroxine and triiodothyronine and impaired response of thyrotropic cells to thyrotropin-releasing hormone were observed. These alterations reverted to normal in nine months and none of the patients was hypothyroid at the end of follow-up. The damage to thyrotropic cells appears to be selective because the secretion of prolactin was not impaired and that of gonadotropins even increased, as a consequence of gonadal failure. Longer follow-up is needed to determine if this irradiation protocol, which prevents the complication of permanent primary hypothyroidism and does not cause any destruction of thyroid cells, may increase the risk of irradiation-related thyroid tumors.

Adolescent↗
PubMed1987

Chromosome studies in patients with Philadelphia chromosome-positive chronic myeloid leukemia submitted to bone marrow transplantation--results of a European Cooperative Study.

The karyotypes of 74 patients with Ph-positive chronic myeloid leukemia submitted to bone marrow transplantation collected from nine institutions were studied serially before and after transplantation. In 13 cases sporadic Ph-positive metaphases were detected without signs of relapsing disease at various intervals after transplantation. These data indicate that the leukemic clone may not be completely suppressed by the conditioning treatment and that other biological mechanisms may be involved in destroying this clone or controlling its expansion.

Adolescent↗
PubMed1986

Standard conditioning regimen and T-depleted donor bone marrow for transplantation in chronic myeloid leukemia.

Between January 1984 to June 1985, 18 Ph1 positive chronic myeloid leukemia (CML) patients in chronic phase (CP) underwent allogeneic bone marrow transplantation (BMT) from HLA identical and MLC negative siblings. The median age was 32.5 yr and median disease duration of CML at time of BMT was 19.3 months. The pretransplant conditioning regimen consisted of cyclophosphamide (CTX) (120 mg/kg) and 10.20 Gy total body irradiation (TBI) at 6 doses of 1.7 Gy each, administered in 3 daily fractions over 2 days at a dose rate of 15-20 cGy/min. To prevent graft-vs-host disease (GvHD) we used methotrexate (MTX) in one patient and cyclosporin-A (CYA) in the other 17 patients. In addition to CYA, given until day +365, 10 patients received donor marrow depleted of T cells with CAMPATH-1. The residual marrow lymphocytes were always less than 1%. The rate of engraftment was significantly correlated with the number of nucleated cells infused. Neither GvHD nor graft failure were observed among CAMPATH-1 patients. In this group one cytogenetic and one hematologic relapse occurred. The overall actuarial survival at 24 months is 78%. Of the 10 patients treated with donor marrow depleted of T cells, 9 are alive after a median follow-up of 9 months (range 5-18), with an actuarial survival of 90%. Of the other 8 patients transplanted with untreated marrow, 5 are alive after a median follow-up of 19.3 months (range 3.7-24) and the actuarial survival is 63.8%. This pilot study seems to demonstrate that T-cell depletion of donor bone marrow with CAMPATH-1 is effective to prevent GvHD, while the risk of graft failure can be avoided using a "standard" conditioning regimen including a fractionated TBI with a fast dose rate and a prolonged administration of CYA at the maximum tolerable dosage. While the high frequency of relapses suggests the employ of more aggressive anti-leukemic conditioning regimens in CAMPATH-1 treated marrow recipients.

Adolescent↗
PubMed1985

A case of Burkitt lymphoma-L3ALL with t(8;14) translocation, developed 10 years after Hodgkin's disease.

We report the case of a 38-year-old man, previously treated for Hodgkin's disease (HD) with chemo-radiotherapy who, 10 years later, developed a Burkitt lymphoma (BL) as a tumour mass of the ascendent colon and regional lymph nodes and, subsequently, on leukaemic bone-marrow cells, on the basis of histological, immunological (B phenotype, IgM-lambda) and cytogenetic, translocation t(8;14) features. The patient died a few days later; at autopsy no evidence of HD was found. This is the 2nd case of BL developing after HD so far described. The relationship between the 2 diseases is discussed and the importance of the immunodepression in the pathogenesis of the secondary Burkitt lymphoma is emphasized.

Adult↗
PubMed1981

Bone marrow transplantation in severe aplastic anaemia: a survey of the European Group for Bone Marrow Transplantation (E.G.B.M.T.).

A survey of the results of bone marrow transplantation for severe aplastic anaemia in 13 European teams is reported. 159 questionnaires were analysed by univariate and multivariate analysis. The overall 1 year survival was 41.2%. The chance of survival was decreased by the presence of infection before grafting and by the use of female donors. The conditioning regimen did not influence survival. Graft rejection was influenced by the conditioning regimen and the sex of the donor. Graft-versus-host disease was influenced by the conditioning regimen, and the age and the sex of the recipient. This study defines prognostic indices which may be helpful in determining the likelihood of success after marrow transplantation for severe aplastic anaemia.

Adolescent↗