RESUMO
Very high-dose chemotherapy with autologous blood stem cell (BSC) rescue becomes more and more widely performed. In order to simplify the technique, a large volume apheresis programme combined with an uncontrolled rate cryopreservation at -80 degrees C was developed. Twenty-six patients suffering from multiple myeloma (n = 8), non-Hodgkin's lymphoma (n = 7), dysgerminoma (n = 4), breast cancer (n = 3), Hodgkin's disease (n = 2), acute lymphoblastic leukaemia (n = 1) and acute myelocytic leukaemia (n = 1) were autografted after a classical high-dose chemotherapy regimen. A single large volume apheresis was sufficient to obtain the threshold value of CD34+ BSC in 24/26 transplantations. The haematological recovery was favourably comparable with the previously published data obtained with controlled rate frozen BSC: median time to granulocytes > 1000/microL and to a self-supporting platelet count > 20,000/microL, respectively, 10.5 and 12 d. The treatment-related mortality was confined to 1/26 BSCT. These results indicate that this easy and cost-saving policy of BSCT is efficacious and safe: sustained long-term haematopoiesis, reduced morbidity and mortality were observed.
Assuntos
Transplante de Células-Tronco Hematopoéticas/métodos , Neoplasias/terapia , Adulto , Antineoplásicos/uso terapêutico , Remoção de Componentes Sanguíneos/métodos , Neoplasias da Mama/terapia , Terapia Combinada , Criopreservação/métodos , Intervalo Livre de Doença , Disgerminoma/terapia , Feminino , Células-Tronco Hematopoéticas , Humanos , Leucemia/terapia , Linfoma/terapia , Masculino , Pessoa de Meia-Idade , Mieloma Múltiplo/terapia , Neoplasias/mortalidade , Taxa de Sobrevida , Transplante AutólogoAssuntos
Tamponamento Cardíaco/etiologia , Linfoma Relacionado a AIDS/diagnóstico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Fator Estimulador de Colônias de Granulócitos/uso terapêutico , Humanos , Linfoma Relacionado a AIDS/complicações , Linfoma Relacionado a AIDS/tratamento farmacológico , Masculino , Pessoa de Meia-IdadeRESUMO
Primary gastrointestinal lymphoma (Maltoma) represent between 1 to 4% of all gastrointestinal malignancies. Disseminated cases are hard to differentiate with advanced stages of peripheral non-Hodgkin's lymphoma. The discovery of specific adhesion molecules could resolve this physiopathological problem. The prevalence of small bowel lymphoma is higher in Middle-East and South Africa (50% vs 30%) than in West Europe because of the occurrence of the immunoproliferative small intestinal disease (IPSID). Multicenter locations and disseminated forms of small bowel lymphoma yield curative surgery uneasiness. An algorithm of treatment, including surgery, mono or polychemotherapy, colony-stimulating factors, and interferon, taking into account histological and clinical stages is proposed. Because of the rarity of the disease, treatment must be improved by activation of international multicenter randomized trials.
Assuntos
Neoplasias Gastrointestinais/terapia , Linfoma/terapia , Algoritmos , Terapia Combinada , Diagnóstico Diferencial , Neoplasias Gastrointestinais/classificação , Neoplasias Gastrointestinais/patologia , Humanos , Linfoma/classificação , Linfoma/patologia , Linfoma não Hodgkin/diagnósticoRESUMO
The peripheral lymphocytes of 50 cases of human immunodeficiency virus (HIV) infection (13 of acquired immune deficiency syndrome (AIDS), 17 of AIDS related complex (ARC), and 20 healthy carriers) were studied immunoultrastructurally. The prevalence of "tubuloreticular structures" and "tubular confronting cisternae" increased with the progression of the disease. Numerous tubular confronting cisternae were noted in patients presenting with a high serum acid labile alpha-interferon values. The patients with depressed natural killer cell activity were characterised by circulating immature natural killer cells with abundant multivesicular bodies that were devoid of "parallel tubular arrays". With an immunogold staining technique the location of HIV antigen was detected ultrastructurally, both at the surface of "hand-mirror" natural killer cell lymphocytes and inside vacuolised cells, probably corresponding to infected T4 lymphocytes. These findings indicate the usefulness of electron microscopic techniques in evaluating the pathology and the pathogenetic outcome of AIDS.
Assuntos
Síndrome da Imunodeficiência Adquirida/patologia , Linfócitos/ultraestrutura , Complexo Relacionado com a AIDS/patologia , Síndrome da Imunodeficiência Adquirida/sangue , Humanos , Interferon Tipo I/sangue , Células Matadoras Naturais/ultraestrutura , Microscopia Eletrônica , Microtúbulos/ultraestrutura , Plasmócitos/ultraestrutura , Vacúolos/ultraestruturaAssuntos
Amilases/sangue , Neoplasias da Mama/enzimologia , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
The peripheral lymphocytes of a patient with prodromal acquired immune deficiency syndrome contained giant multivesicular bodies. These were specifically stained by immuno-gold labelled polyclonal antibodies against the major core protein p24 of bovine leukaemia virus and human T cell leukaemia virus I. Moreover, the patient's serum was positive for bovine leukaemia virus by the ELISA method.
Assuntos
Síndrome da Imunodeficiência Adquirida/imunologia , Antígenos Virais/análise , Retroviridae/imunologia , Anticorpos Antivirais , Especificidade de Anticorpos , Deltaretrovirus/imunologia , Feminino , Ouro , Humanos , Vírus da Leucemia Bovina/imunologia , Linfócitos/imunologia , Microscopia Eletrônica , Pessoa de Meia-Idade , Coloração e RotulagemAssuntos
Linfoma de Burkitt/patologia , Leucemia Linfoide/patologia , Antígenos de Neoplasias/análise , Linfoma de Burkitt/imunologia , Feminino , Humanos , Leucemia Linfoide/imunologia , Linfócitos/imunologia , Linfócitos/patologia , Linfócitos Nulos/imunologia , Linfócitos Nulos/patologia , Pessoa de Meia-IdadeRESUMO
A rare case of congenital non-spherocytic hemolytic anemia due to pyruvate kinase deficiency is reported. Of particular interest is the never before in the literature mentioned complication of migratory phlebitis and acute thrombosis of the left lower limb associated with trophic changes of the foot. Arteriography disclosed thrombosis of all three calf arteries. The patient was treated by lumbar sympathectomy combined with streptokinase fibrinolysis and resulted in healing of the trophic changes. The distal location of the vascular lesions made direct vascular reconstruction illusory. Fogarty thrombectomy is not indicated either due to the thrombotic nature of the lesions in association with thrombocytosis.
Assuntos
Anemia Hemolítica Congênita não Esferocítica/complicações , Anemia Hemolítica Congênita/complicações , Piruvato Quinase/deficiência , Tromboflebite/etiologia , Trombose/etiologia , Adulto , Anemia Hemolítica Congênita não Esferocítica/etiologia , Humanos , Masculino , Estreptoquinase/uso terapêutico , Simpatectomia , Trombose/terapiaRESUMO
One case of a syndrome simulating a systemic disease is reported. An HLA-B, patient presented with apparent toxoplasmosis, retinal vein occlusion, autoantibodies against cephalin, contact factors and lipoproteins, immune complexes, rheumatoid factor, and cryoprecipitate. A representation of the immunological mechanisms involved is proposed.
Assuntos
Temperatura Baixa , Veia Retiniana , Toxoplasmose Ocular/imunologia , Complexo Antígeno-Anticorpo/imunologia , Autoanticorpos/análise , Precipitação Química , Constrição Patológica , Feminino , Antígenos HLA/análise , Humanos , Lipoproteínas/imunologia , Pessoa de Meia-Idade , Fator Reumatoide/análise , Síndrome , Doenças Vasculares/imunologiaAssuntos
Leucemia Monocítica Aguda/enzimologia , Muramidase/metabolismo , Ribossomos/ultraestrutura , Medula Óssea/ultraestrutura , Feminino , Humanos , Leucemia Monocítica Aguda/sangue , Leucemia Monocítica Aguda/patologia , Leucemia Monocítica Aguda/urina , Microscopia Eletrônica , Pessoa de Meia-IdadeRESUMO
Endoplasmic reticulum-associated crystals were seen in 1-10% of the bone-marrow lymphocytes and in the lymphocytes of the peripheral blood in three cases of immunocytoma. Their crystalline nature and their location in the cisternae of the rough endoplasmic reticulum was proved by ultrastructural study. IgM lambda in the crystals was demonstrated by fluorescent and peroxidase-labelled antibody methods. The crystals did not stain with the PAS reaction, suggesting that the immunoglobulin was not bound to a carbohydrate group. A defect in glucosyltransferase activity with failure to modify the immunoglobulins could explain the absence of the PAS reaction and the accumulation of immunoglobulin in crystalline before reaching the Golgi region.
Assuntos
Citoplasma/imunologia , Cadeias Leves de Imunoglobulina/análise , Imunoglobulina M/análise , Cadeias lambda de Imunoglobulina/análise , Linfoma/imunologia , Plasmocitoma/imunologia , Idoso , Feminino , Imunofluorescência , Humanos , Técnicas Imunoenzimáticas , Linfócitos/imunologia , Linfócitos/ultraestrutura , Linfoma/ultraestrutura , Masculino , Microscopia Eletrônica , Pessoa de Meia-Idade , Plasmocitoma/ultraestruturaRESUMO
Six patients, two with acute lymphoblastic leukaemia (A.L.L.) and four with lymphosarcoma with early transformation into A.L.L., have been studied. All blast-cells demonstrated with cytological, cytochemical and ultrastructural features of Burkitt's tumour. The clinical evolution was fulminant and there was no remission of long duration despite intensive chemotherapy. The cytoplasm of the blast-cells displayed a great number of lipid droplets. The level of the anticapsid Epstein-Barr virus antibodies was high in the case investigated.