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PubMed2004

Health-related quality of life assessment in hematologic disease.

Evaluating health-related quality of life (HRQL) for children who have benign hematologic disorders can: (1) aid in the evaluation of different therapies and emerging new technologies; (2) serve as an invaluable source of anticipatory guidance, for current and future patients; and (3) serve an important evaluative function of clinical services or programs to identify potential areas in which additional services, supports, or interventions are needed. The past 20 years have been marked by the dramatic growth in the field of HRQL research, although much of the progress in conceptualization, instrument development, and refinement has occurred in adults. Pediatric health services researchers and their clinical colleagues have had to grapple with the methodologic challenges in evaluating HRQL in children. This article includes a discussion of instrumentation, respondent selection, and study design consideration in the evaluation of HRQL in children who have benign hematologic disorders.

Attitude to Health↗
PubMed1990

[Immunocorrective therapy of hematologic diseases].

Changes in the immunological parameters have been studied in the course of treatment with antithymocytic globulin and chemotherapeutic preparations included in the treatment protocols for aplastic anemia and acute leukemia. A possibility of determining the optimal immunocorrective agent dosage is demonstrated as related to its effect on the functioning of the immunocompetent cells in vitro.

Acute Disease↗
PubMed1993

[A combined sulbactam/cefoperazone and amikacin therapy for the treatment of infections complicated with hematological diseases].

Eighty-six patients with infections associated with hematological disorders were treated with sulbactam/cefoperazone (SBT/CPZ) and amikacin (AMK). Among 71 evaluable cases, 30 cases had acute non-lymphocytic leukemia, 3 acute lymphoblastic leukemia, 25 malignant lymphoma, and 7 myelodysplastic syndrome as underlying diseases. Excellent responses were obtained in 33 cases (46.5%) and good responses in 14 cases (19.7%), with an overall efficacy rate of 66.2%. The efficacy rate among cases with suspected sepsis was 72.5%. This treatment was also effective in 69.2% of cases in which neutrophil counts were less than 500/microliter through the course of administration. The eradication rate was 83.3% among 6 strains in which Gram-negative rods were detected. Side effects were minimum; skin rash in 1 case, slight elevation of APTT in 3 and slight elevation of total bilirubin in 1. Thus, this combination antibacterial chemotherapy is an effective and safe regimen for the treatment of severe infections in patients with hematological disorders.

Adult↗
PubMed1987

[Splenic artery embolization in hematologic diseases in children].

In the past four years or so splenectomy used in children with hematological defects, who showed hypersplenism has been replaced with partial arterial splenic embolization (Pase), in general, 2/3 of the lower spleen were embolized. Pase was performed after the selective catheterization of the splenic artery up to the hilum with local anesthesia. As an embolizing agent, with the first 2 patients a suspension of Gelaspon microparticles and absolute alcohol (90 degrees) was used, and with the others (7 patients with 9 embolizations) only absolute alcohol. The Pase indication was: congenital hemolytic anemia in 5 cases; thrombocytopenia in 3 cases (5 pase); portal hypertension by extra-hepatic blockage with secondary hypersplenism in one case where the endoscopic sclerosis of the esophageal varices had been done first, followed by Pase after weeks. The evolution after Pase was simple in 6 patients: fever, pain in the left hypochondrium, and moderate ileus for 2-3 days. In 3 cases the evolution was both complicated and difficult excessive Pase in the first 2 patients, that practically resulted in total splenectomy, and, in the other one, the growth of a big subcapsular hematoma with effusion that had to be eliminated through transparietal drainage, under echographic control and operated secondary for peritonitis. Hematologically, in all cases but one (1 failure) hypersplenism remission was obtained and the results are the same 1-3 years after Pase. Partial arterial splenic embolization can very well replace splenectomy in hematological defects manifested as hypersplenism. The use of absolute alcohol (90 degrees) as an excellent embolization agent has not been reported so far in children.

Adult↗
PubMed1979

Splenectomy for hematologic disease.

One hundred and thirty splenectomies were performed at the University Hospital in Birmingham for hematologic disorders during a 12 year period. There were seven deaths of which four were related to sepsis in patients with malignant growths which probably impaired immune competence. Splenectomy was found to be uniformly satisfactory for hereditary hemolytic anemia, for hypersplenism complicating rheumatoid arthritis and for the rare instance of primary hypersplenism. Splenectomy was usually salutary in didopathic thrombocytopenic purpura and in antoimmune hemolytic anemia. When done for diagnosis, splenectomy was definitive in about 50 per cent of the instances. Individual patients with thrombotic thrombocyeosinophilia syndrome benefited. Splenectomy for hypoplastic or aplastic anemia in an actual circulation offered only questionable benefit and is rarely necessary for hyperplenism secondary to portal hypertension.

Adult↗