PubMed · 3824589
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B Søgaard, E Skomorowska. 1987-01-19. [Acute interhemispherical hematoma].. https://pubmed.ncbi.nlm.nih.gov/3824589/
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Transplantation of hematopoietic stem cells from an HLA-compatible unrelated volunteer is an option for patients with acute leukemia lacking a family match. However, criteria for patient and donor selection and the most effective transplant procedures, including the number of hematopoietic cells, remain to be defined. We tested factors influencing outcome of 174 patients with primary acute leukemia receiving non-T-cell depleted marrow from unrelated donors. Median patient age was 20 years (range, 0.5 to 54 years). A multivariable analysis found that leukemia in remission at the time of transplantation was associated with improved leukemia-free survival (relative risk [RR] of treatment failure: 0.5, confidence interval [CI]: 0.3 to 0.7), and presence of blasts in the peripheral blood, as opposed to marrow involvement only or isolated extramedullary relapse, was associated with impaired outcome (RR of treatment failure: 2.5, CI: 1.7 to 5.0). The use of donors with a limited HLA-mismatch was associated with decreased leukemic relapse (RR: 0.5, CI: 0.3 to 0.9) but no improvement in leukemia-free survival compared with HLA-matched unrelated donors. Transplantation of a marrow cell dose above the median value of 3.65 x 10(8)/kg was associated with faster neutrophil (RR: 1.5, CI: 1.1 to 2.0) and platelet (RR: 4.5, CI: 2.7 to 7.5) engraftment, and decreased incidence of severe acute graft-versus-host disease (RR: 0.6, CI: 0.4 to 0.9). In patients transplanted in remission, the use of a marrow cell dose above the median translated into less nonleukemic death (RR: 0.2, CI: 0.1 to 0.4) and better leukemia-free survival (RR of treatment failure: 0.3, CI: 0.2 to 0.6). Transplant in remission with a high dose of marrow cells was associated with the best outcome in both children and adults.
We herein describe 4 adult patients with upper cervical myelitis presenting with paresthesia in the distal parts of all four limbs and who also all had hyperIgEemia. Two of them had full-blown atopic dermatitis at the time of neurologic illness, while the others had a preceding history of atopic dermatitis. All showed high signal intensity lesions at either the C3 or C4 segment, which mainly affected the posterior column on the T2-weighted spinal cord magnetic resonance imaging. All patients had specific IgE antibodies to two mite antigens and their onset of myelitis coincided with the seasonal increase of the mite antigens in Japan. Therefore, it is possible that the atopic conditions with hyperIgEemia in these patients may thus have contributed to the development of myelitis.
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