Assuntos
Anemia Hemolítica Autoimune/tratamento farmacológico , Infecções por Citomegalovirus/virologia , Citomegalovirus/efeitos dos fármacos , Imunossupressores/uso terapêutico , Ativação Viral/efeitos dos fármacos , Idoso , Anemia Hemolítica Autoimune/virologia , Citomegalovirus/fisiologia , Infecções por Citomegalovirus/induzido quimicamente , Feminino , Humanos , Imunossupressores/efeitos adversos , Masculino , Pessoa de Meia-IdadeRESUMO
Our case highlights the possible coexistence of essential thrombocythemia (ET) and idiopathic thrombocytopenic purpura (ITP), two pathological entities with opposite clinical and laboratory manifestations. It also underlines how an autoimmune attack has been temporarily able to overcome a neoplastic clone.
Assuntos
Leucemia-Linfoma Linfoblástico de Células T Precursoras/patologia , Neoplasias Retais/diagnóstico , Neoplasias Retais/secundário , Adulto , Biomarcadores , Biópsia , Colonoscopia , Humanos , Imunofenotipagem , Imageamento por Ressonância Magnética , Masculino , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Leucemia-Linfoma Linfoblástico de Células T Precursoras/metabolismoAssuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Citarabina/uso terapêutico , Quimioterapia de Indução/métodos , Leucemia Mieloide Aguda/tratamento farmacológico , Vidarabina/análogos & derivados , Idoso , Medula Óssea/efeitos dos fármacos , Medula Óssea/patologia , Esquema de Medicação , Feminino , Humanos , Leucemia Mieloide Aguda/mortalidade , Leucemia Mieloide Aguda/patologia , Masculino , Pessoa de Meia-Idade , Indução de Remissão , Estudos Retrospectivos , Análise de Sobrevida , Vidarabina/uso terapêuticoAssuntos
Leucemia Mielogênica Crônica BCR-ABL Positiva/complicações , Policitemia/complicações , Idoso , Antineoplásicos/uso terapêutico , Proteínas de Fusão bcr-abl/genética , Humanos , Mesilato de Imatinib/uso terapêutico , Leucemia Mielogênica Crônica BCR-ABL Positiva/sangue , Leucemia Mielogênica Crônica BCR-ABL Positiva/tratamento farmacológico , Leucemia Mielogênica Crônica BCR-ABL Positiva/genética , Masculino , MutaçãoRESUMO
PATIENT: Male, 64 FINAL DIAGNOSIS: Acute myeloid leukemia (AML) Symptoms: - MEDICATION: - Clinical Procedure: - Specialty: - OBJECTIVE: Unusual clinical course. BACKGROUND: Central nervous system (CNS) involvement is a sporadic presenting finding in patients with acute myeloid leukemia (AML) both at diagnosis and at relapse. Moreover patients with CNS localization are often asymptomatic, while sometimes show meningeal signs and symptoms or, extremely rarely, signs of cranial nerve impairment. CASE REPORT: Here we report on a patient with refractory AML who suddenly developed strabismus and diplopia. Both neurological and ophtalmologic examinations were suggestive of a bilateral VI cranial nerve palsy. Noteworthy, both a cranial CT and MRI were substantially normal, while a rachicentesis was performed and cerebrospinal fluid examination was clearly suggestive of a meningeal involvement by AML. CONCLUSIONS: This is to our knowledge the first reported case in which the clinical picture of meningeal localization in an AML patient was dominated by an isolated abducens cranial nerve impairment. Moreover it highlights as unexplained strabismus and diplopia can be considered as a potential sign of CNS involvement, even if conventional imaging is negative.
Assuntos
Anticoagulantes/química , Ácido Edético/química , Púrpura Trombocitopênica Idiopática/tratamento farmacológico , Receptores Fc/uso terapêutico , Proteínas Recombinantes de Fusão/uso terapêutico , Trombocitopenia/diagnóstico , Trombopoetina/uso terapêutico , Idoso , Erros de Diagnóstico , Feminino , Humanos , Agregação Plaquetária , Contagem de Plaquetas , Púrpura Trombocitopênica Idiopática/sangueRESUMO
Regulatory T cells (T(reg)) have often been ascribed a role in the pathophysiology of several neoplastic diseases considering their potential ability to suppress anti-tumor immunity. This is particularly the case in myelodysplastic syndromes (MDS), which are clonal hematologic disorders characterized by marked immune dysregulation. We analyzed T(reg) frequencies in a cohort of 36 patients with early-stage MDS using a flow-cytometric approach based on the concomitant expression of CD25 and CD127. MDS patients showed a higher frequency of CD4+CD25(high)+CD127(low) T(reg) than healthy controls (1.51 vs. 1.14%), with no specific effect of patient- and disease-related factors. Our data point to impaired anti-tumor immunity in patients with MDS, even in the early stage, which has already been noted in other clonal disorders.