RESUMO
Data of literature on the frequency of the nervous system lesions in different variants of leucosis are analyzed. A case of a man with petechial skin rash and bruises on the body, gingival hemorrhage and general sickness is described in details. The hematologic tests revealed acute myeloblast leucosis. A lumbar puncture revealed blood in the cerebrospinal fluid and MRI showed an epidural hematoma in lumbar segments 3 and 4. At this level, the hematoma compressed the dural bag and roots of the horse tail with accompanying vessels (the radicular medullar artery and large radicular veins). A paracentetic removal of the hematoma with the decompression of spinal roots was carried out. The blasts in the cerebrospinal fluid and symptoms of the left facial nerve lesion allowed to diagnose neuroleucosis. This case presented the mixed pathogenesis of myeloischemia. The epidural hematoma compressed not only the roots of the horse tail but the accompanying vessels (arteries and veins). The venous outflow obstruction along radicular veins worsened the microcirculation in the cross-sectional area of the spinal cord. Complex polychemotherapy in the combination with neuroprotectors (cortexin, gliatiline), antiaggregants and vitamins is recommended.
Assuntos
Leucemia Mieloide Aguda/complicações , Medula Espinal/irrigação sanguínea , Acidente Vascular Cerebral/etiologia , Adulto , Idoso , Diagnóstico Diferencial , Humanos , Imageamento por Ressonância Magnética , Masculino , Punção Espinal , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/fisiopatologiaRESUMO
AIM: To study efficacy of maintenance therapy of patients with acute promyelocytic leukemia (APL) in the APL treatment Russian multicenter trial. MATERIAL AND METHODS: The trial was made with participation of 18 hematological departments of clinics in Russia. A total of 68 APL patients entered the trial. The maintenance therapy consisted of 5-day courses of cytostatic drugs which alternated or did not alternate with 5-day courses of ATRA. Cytogenetic tests were made in 31 patients, t(15;17) was detected in 26 of them. Molecular examination conducted in 28 patients discovered chimeric transcript PML/RARa in 26 of them. Of 20 patients examined in Hematological Research Center, 7 (35%) had a bcr 1/2 variant of the transcript PML/RARa, 13 (65%)--bcr 3 variant. RESULTS: 65 patients were eligible for assessment. A complete remission was achieved in 90% cases. No resistance was observed. In follow-up within 30 months the recurrence rate was similar on both treatments. The results of the induction therapy and survival in patients with different variants of the transcripts were also similar. Overall 2.5 year survival for all the patients was 77%, recurrence-free--80%. The survival analysis in patients with leukocytosis higher and lower 10 x 10(9)/l found no statistical differences by the survival. Patients with hyperleukocytosis had higher early lethality than patients with leukocytes under 10 x 10(9)/l (25% vs 5.3%, p = 0.03). CONCLUSION: The APL 06.01 protocol showed high efficacy of the relevant maintenance which provides a complete molecular remission in the majority of patients with probable recurrence-free 2.5 year survival 80%.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biomarcadores Tumorais/genética , Leucemia Promielocítica Aguda/tratamento farmacológico , Adolescente , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Citarabina/administração & dosagem , Citarabina/uso terapêutico , Daunorrubicina/administração & dosagem , Daunorrubicina/uso terapêutico , Intervalo Livre de Doença , Esquema de Medicação , Feminino , Humanos , Leucemia Promielocítica Aguda/genética , Leucemia Promielocítica Aguda/mortalidade , Masculino , Pessoa de Meia-Idade , Proteínas de Neoplasias/genética , Proteínas de Fusão Oncogênica/genética , Proteínas Tirosina Quinases/genética , Proteínas Proto-Oncogênicas/genética , Proteínas Proto-Oncogênicas c-bcr , Indução de Remissão , Transcrição Gênica , Tretinoína/administração & dosagem , Tretinoína/uso terapêuticoRESUMO
We compared efficacy of conventional myelosuppressive chemotherapy with myelosan, hydrealitalir and interferon-alpha (Ifn-a) therapy in 52 patients with chronic myeloid leukemia (CML). The latter treatment (Ifn-a was given in different doses) was conducted in 23 patients. Significant differences (p = 0.007) were found in medians of survival of patients on conventional myelosuppressive chemotherapy (40 months) and on Ifn-a therapy (61 months). Toxicity of treatment with Ifn-a (domestic reaferon, in particular) was mild. Thus, Ifn-a treatment was more effective than conventional myelosuppressive therapy against CML in a chronic phase.
Assuntos
Bussulfano/uso terapêutico , Imunossupressores/uso terapêutico , Interferon-alfa/uso terapêutico , Leucemia Mielogênica Crônica BCR-ABL Positiva/tratamento farmacológico , Adulto , Idoso , Quimioterapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
In etiolated coleoptiles and initial leaf of developing wheat shoots the DNA synthesis is periodical and synchronous. In the initial leaf each step of DNA synthesis results in a stepwise increase of DNA content and is doubled at the first three steps. During the leaf plane formation the synthesis of nuclear DNA (nDNA) is decreased, while that of mitochondrial DNA (mitDNA) continues in synchronous cycles. This is the cause of relative stabilization of DNA content per unit of leaf plane length. The DNA increase in this organ occurs due to synchronous synthesis of nDNA and mitDNA in intercalary meristem cells. In coleoptiles a marked replication of nDNA is observed at the first three steps of the synthesis; in each cycle nDNA synthesis precedes that of mitDNA. With completion of coleoptile formation the nDNA synthesis in it practically ceases, whereas that of mitDNA continues in synchronous cycles. MitDNA is non-methylated and its composition (56 mol.% GC) differs significantly from that of the newly synthesized nDNA (44 mol.% GC; 100 X m5C/(C + m5C) = 16-17%). It may be concluded that in various organs of wheat shoots the composition and methylation of newly synthesized DNA depend on the age of the shoot and on the ratio of nDNA/mitDNA syntheses.
Assuntos
Núcleo Celular/metabolismo , Replicação do DNA , DNA Mitocondrial/genética , DNA/genética , Mitocôndrias/metabolismo , Desenvolvimento Vegetal , Envelhecimento , Escuridão , Cinética , Luz , Triticum/crescimento & desenvolvimentoRESUMO
In mature ageing coleoptiles as well as in cut-off etiolated wheat shoots exhausted by incubation in H2O nuclear DNA (nDNA) synthesis does not occur. However, the synthesis of another DNA is continued under these conditions. The parameters of this DNA (e. g. buoyant density, rho = 1.716 g/cm3, and composition - 56 mol.% GC) differs from those of nDNA (rho = 1.700 g/cm3, 44 mol.% GC). The newly synthesized DNA is non-methylated and metabolically stable. It is not sensitive to cycloheximide (20 micrograms/ml) but is markedly inhibited by ethidium bromide (2-10 micrograms/ml). The synthesis of this DNA is localized in the mitochondria, thus indicating that in ageing coleoptiles and exhausted wheat shoots all the newly synthesized DNA is of mitochondrial origin.
Assuntos
Replicação do DNA , DNA Mitocondrial/genética , Mitocôndrias/metabolismo , Desenvolvimento Vegetal , Envelhecimento , Núcleo Celular/metabolismo , DNA/genética , Cinética , Plantas/metabolismo , Plantas/ultraestrutura , Triticum/crescimento & desenvolvimento , Triticum/metabolismoRESUMO
The base composition (45 divided by 56 mol.% GC) and methylation level (100 . m5C/(m5C + C) = = 20% divided by 0.4%) of pulse-labelled newly formed DNA in etiolated wheat seedlings and their individual organs are markedly changed with age. The base composition of total leaf and coleoptile DNA (45 mol.% GC) remains unchanged; the changes in the methylation level are not significant (1). In the course of development of the plant organs (e. g. leaf) the level of synthesis of DNA whose composition is identical to that of nuclear DNA, is decreased and the incorporation of labelled precursors into the GC-rich (56 mol.% GC) practically unmethylated DNA is increased. In ageing coleoptiles only the synthesis of unmethylated DNA of the GC-type takes place. It is assumed that this DNA may correspond to mitochondrial DNA.