RESUMO
Thirty four patients with mucormycosis in 10 hospitals of St. Petersburg were observed in 2004-2013. The most frequent underlying diseases of mucormycosis were acute leukoses (64%). In 100% of the patients mucormycosis developed as a nosocomial infection. The risk factors, etiology, basic clinical signs and strategy in the treatment of mucormycosis were analyzed.
Assuntos
Antifúngicos/uso terapêutico , Infecção Hospitalar/microbiologia , Leucemia Linfocítica Crônica de Células B/microbiologia , Leucemia Mieloide Aguda/microbiologia , Mucormicose/microbiologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Infecção Hospitalar/complicações , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/mortalidade , Feminino , Humanos , Leucemia Linfocítica Crônica de Células B/complicações , Leucemia Linfocítica Crônica de Células B/tratamento farmacológico , Leucemia Linfocítica Crônica de Células B/mortalidade , Leucemia Mieloide Aguda/complicações , Leucemia Mieloide Aguda/tratamento farmacológico , Leucemia Mieloide Aguda/mortalidade , Masculino , Pessoa de Meia-Idade , Mucormicose/complicações , Mucormicose/tratamento farmacológico , Mucormicose/mortalidade , Estudos Prospectivos , Rhizopus/efeitos dos fármacos , Rhizopus/crescimento & desenvolvimento , Rhizopus/isolamento & purificação , Fatores de Risco , Federação Russa , Análise de SobrevidaRESUMO
AIM: To review results of 2-year experience in execution of the protocol on the treatment of adult acute Ph-negative lymphoblastic leukemia ALL-2009. MATERIAL AND METHODS: Of 111 patients registered in the study from November 2008 to December 2010 the analysis covered 96 patients from 23 hematological centers in 18 towns of the RF. RESULTS: Treatment according to the Protocol ALL-2009 resulted in achievement of a complete remission in 91.2% patients with low early lethality of 5.5%. Postremission lethality fell to 3.7% versus previous studies (22%). Overall 2-year survival and recurrence-free survival reached 77.6 and 78.4%, respectively. Detection of any chromosomic aberrations significantly affected recurrence-free survival: 74 vs 100% in patients with normal karyotype. CONCLUSION: Protocol All-2009 demonstrates high efficacy in moderate toxicity and good reproducibility in any hematologic center.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Adolescente , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Intervalo Livre de Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cromossomo Filadélfia , Projetos Piloto , Leucemia-Linfoma Linfoblástico de Células Precursoras/diagnóstico , Leucemia-Linfoma Linfoblástico de Células Precursoras/mortalidade , Recidiva , Indução de Remissão , Adulto JovemRESUMO
AIM: Detection of associations between carrying some HLA-antigens class I in patients with multiple myeloma (MM) and activity of the malignant process. MATERIALS AND METHODS: 76 MM patients received polychemotherapy. Its efficacy was assessed after one, three, six and twelve courses by reduced blood and/or urine levels of monoclonal protein, signs of bone healing, reestablishment of normal number of plasma cells in the bone marrow. Identification of HLA-antigens was made in two-stage lymphocytotoxic complement-mediated test using the standard panel of the anti-HLA sera. Data on HLA-typing of 865 blood donors served control. The findings were statistically processed. RESULTS: All the patients were divided into 3 groups: with indolent (n = 18), active (n = 25) and aggressive (n = 37) MM course. In patients with aggressive MM course high chi-square values were estimated for three HLA specificities: HLA-B13, HLA-B40, HLA-B5. Only HLA-B13 proved significant. No significant differences in carrying HLA-antigens were revealed for patients with active MM course. CONCLUSION: The survival of MM patients depends on the degree of the malignant process activity. Patients with aggressive MM course significantly more frequently carry HLA-B13, therefore it can be considered a genetic marker of MM. Its detection can serve a criterion for determination of adequate polychemotherapy.
Assuntos
Antígenos HLA-A/sangue , Antígenos HLA-B/sangue , Mieloma Múltiplo/imunologia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Distribuição de Qui-Quadrado , Progressão da Doença , Marcadores Genéticos/imunologia , Teste de Histocompatibilidade/estatística & dados numéricos , Humanos , Mieloma Múltiplo/tratamento farmacológico , Mieloma Múltiplo/mortalidade , Prognóstico , Estudos Prospectivos , Estudos Retrospectivos , Fatores de TempoRESUMO
Serum levels of beta 2-microglobulin (beta 2-M) have been assayed in 50 patients with multiple myeloma (MM) (stage 1-8, stage II-25. stage III - II and remission - 6). Smoldering MM was registered in 11 cases, active - 22 and aggressive - 17. Said level was significantly higher in MM patients than in healthy donors (p < 0,01) and correlated with stage and course in most cases: blood concentration of beta 2-M at stage I and in remission was found to be significantly lower than at stage II and III (p < 0,05, p < 0,05) while at stage III - higher than at stage II (p < 0,01). Serum level of beta 2-M was significantly higher in smoldering course than in healthy donors (p < 0,05) and lower than in active (p < 0,05) and aggressive MM (p < 0.01). Said concentration in blood proved significantly higher in aggressive course than in active MM (p < 0,05). Since some cases of active and aggressive MM revealed a low level of serum beta 2-M, reliance on this index as a sole prognostic test seems doubtful.
Assuntos
Mieloma Múltiplo/sangue , Microglobulina beta-2/metabolismo , Humanos , Mieloma Múltiplo/patologia , Estadiamento de Neoplasias , Valor Preditivo dos Testes , PrognósticoRESUMO
The morphology of Paramecium bursaria cells, both originally possessing 2 micronuclei (MI), or one MI, has been studied after a local UV irradiation of the germ nuclei. Elimination of one of the MI in bimicronuclear cells usually did not lead to general cytological damage in the UV progeny. Irradiation of MI in the unimicronuclear cells resulted in the following: producing of amicronuclear (MI-) UV subclones, 86% of which appeared to be non-viable. The MI- cells are characterized by the appearance of somatic deciliation and the loss of mobility, disorganization structures of the oral apparatus, the feeding process and the cell division. It is remarkable that the macronucleus (MA) of cells from those cultures displays fragmentation and aberrant division. The structure of MA was changed. Dimensions of the MI- ciliates decreased (by 1.7--1.8 times in average); sometimes these cells had 3--5 contractile vacuoles with one pore. These data suggest that the MI has important role during the vegetative phase of the cell life. Possible asexual cellular functions of the MI and the role of the break of nuclear interactions in the appearance of the morphological damage are discussed.
Assuntos
Medula Óssea/patologia , Transformação Celular Neoplásica/patologia , DNA de Neoplasias/análise , Leucemia/patologia , Doença Aguda , Adolescente , Adulto , Idoso , Autorradiografia , Medula Óssea/efeitos dos fármacos , Transformação Celular Neoplásica/análise , Transformação Celular Neoplásica/efeitos dos fármacos , Células Cultivadas , Humanos , Cinética , Leucemia/análise , Leucemia/tratamento farmacológico , Pessoa de Meia-Idade , Fotometria , Timidina/metabolismo , TrítioRESUMO
The 3H-thymidine incorporation capacity and DNA contents were studied in the same bone marrow blasts in 4 patients suffering from acute leucaemia. The blast populations were both proliferating and non-proliferating. Actively proliferating cells were blasts of large and medium diameters. Mitotically inactive cells were blasts of medium and small diameters. Cells that stopped dividing were established as being in period G1 of the cell cycle. A high variation in DNA contents was noted in blasts unlabeled with 3H-thymidine, a possible reason of the above phenomenon being discussed.