[Photopheresis: new immunomodulatory therapy for T-lymphocite mediated diseases]. / Fotoféresis: nueva terapia inmunomoduladora para enfermedades mediadas por linfocitos T.

The photopheresis (ECP) is a therapeutic approach based on the biological effect of psoralen and ultraviolet light A on mononuclear cells collected by apheresis, and reinfused into the patient. In 1988, the treatment was the first FDA-approved selective immunotherapy for any type of cancer. Convincing data taken from over 160 centers in Europe and the U.S.A. over the past few years have documented that ECP is associated with a very low side-effect profile. Evidence shows that this therapy prolongs the mean survival, and also induces 50-75% response rates in patients with advanced cutaneous T-cell lymphoma. In addition, more and more reports indicate that photopheresis is a potent agent in the therapy of solid organ transplant rejection, graft versus host disease, scleroderma, and other autoimmune diseases resistant to conventional therapy. The mechanism of this treatment is likely due to the induction of cell-mediated anticlonotypic immune response against pathogenic clones of T lymphocytes.

[Primary thrombocytopenic purpura in infants under 3 months of age]. / Púrpura trombocitopénica primaria en el lactante menor de 3 meses.

The analysis concerns 14 cases of idiopathic thrombocytopenic purpura among infants from 1 to 3 months old, studied at the Servicio de Pediatría del Hospital San Juan de Dios (Santiago), between 1971 and the first trimester of 1978. In none of them an apparent cause of thrombocytopenia has been found, reason why we called them primary. The very good evolution, the laboratory findings and the history of catarrhal symptoms very recently or developing when illness started leads us to assume that they would suffer from a pathogen similar to the acute ITP. The existence of some clinical differences with acute ITP, as major incidence of anemia, the splenomegaly and the purpura characteristics, could be explained by the age of our patients, but not because they present different disease. The existence of some clinical differences with acute ITP, as major incidence of anemia, the splenomegaly and the purpura characteristics, could be explained by the age of our patients, but not because they present different disease. The increase of the incidence of ITP amongst infants, specially during the first trimester of life, is being emphasized. We suggest that this fact could be due to the presence of new strains of virus.