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1.
Pediatr Hematol Oncol ; 26(5): 345-55, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19579081

RESUMO

INTRODUCTION: Experience with the use of allogeneic hemopoietic stem transplantation (AHSCT) in pediatric myelodisplastic syndrome (MDS) in Spain is reviewed. METHODS AND PATIENTS: Twenty-four children with MDS were analyzed retrospectively. Median age of the patients was 10 years. Twenty patients received a bone marrow graft and 4 an unrelated cord blood (UCB) transplant; 12 bone marrow grafts were from a matched related donor (MRD) and 8 from a matched unrelated donor (MUD). Conditioning regimen consisted of chemotherapy alone in 17 patients (busulfan and cyclophosphamide +/- melfalan) Seven patients received TBI and cyclophosphamide. RESULTS: Ten patients died from transplant-related toxicity and 4 had relapse or disease progression post-AHSCT. Nine patients are alive and event-free with a median follow-up of 120 months. EFS rate in the MRD group was 0.48 (SE 0.13) versus 0.25 (SE 0.12) in the MUD/UCB group (p = .07). Lansky score in survivors is >or=90%. CONCLUSIONS: In this historical series of children with MDS, in spite of severe transplant-related toxicity, encouraging EFS outcomes have been achieved after AHSCT with good quality of life.


Assuntos
Doença Enxerto-Hospedeiro/prevenção & controle , Transplante de Células-Tronco Hematopoéticas , Síndromes Mielodisplásicas/cirurgia , Condicionamento Pré-Transplante , Transplante Homólogo/imunologia , Adolescente , Criança , Pré-Escolar , Quimioterapia Combinada , Feminino , Doença Enxerto-Hospedeiro/imunologia , Humanos , Masculino , Síndromes Mielodisplásicas/imunologia , Síndromes Mielodisplásicas/mortalidade , Qualidade de Vida , Estudos Retrospectivos , Resultado do Tratamento
2.
Clin Transl Oncol ; 11(6): 387-92, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19531454

RESUMO

INTRODUCTION: The long-term results of the Spanish Study Protocol SEOP-SO-95 for treatment of localised osteosarcoma of the extremities in children were evaluated. PATIENTS AND METHODS: One hundred consecutive patients under 18 years of age from 22 institutions were enrolled from January 1995 to December 2000. Immunohistochemical expression of p53, HER/erbB-2 and P-glycoprotein were retrospectively studied in 27 patients. Treatment consisted of: preoperative chemotherapy with doxorubicin, cisplatin, high-dose methotrexate with leucovorin rescue and ifosfamide for 14 weeks; surgery of primary tumour in week 16; postoperative chemotherapy with the above-mentioned drugs for 25 weeks. RESULTS: With a median follow-up of 124 months (range 84-158 months), 69 patients (69%) were continuously event-free survivors; the 10-year probability of event-free survival (EFS) was 62%. Conservative surgery was performed in 85% of patients. Twenty-six patients had local recurrence or distant relapse. The median time to recurrence/ relapse was 27 months (range 17-93 months). The local recurrence rate was 7% (7 of the 100 patients); 4 had wide surgical margins, 2 marginal and 1 intralesional. Four patients died as a result of chemotherapy-related toxicity and 1 developed a second neoplasia (acute myeloid leukaemia). p53 expression and HER2/erbB-2 expression showed no effect on survival or EFS. CONCLUSIONS: This therapeutic protocol achieved good oncologic and orthopaedic results. We observed a significant treatment-related toxicity.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Ósseas/tratamento farmacológico , Osteossarcoma/tratamento farmacológico , Adolescente , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Neoplasias Ósseas/genética , Neoplasias Ósseas/mortalidade , Neoplasias Ósseas/cirurgia , Quimioterapia Adjuvante , Criança , Pré-Escolar , Terapia Combinada , Intervalo Livre de Doença , Extremidades , Feminino , Seguimentos , Genes MDR , Genes erbB-2 , Genes p53 , Humanos , Estimativa de Kaplan-Meier , Masculino , Terapia Neoadjuvante , Recidiva Local de Neoplasia/epidemiologia , Segunda Neoplasia Primária/epidemiologia , Osteossarcoma/genética , Osteossarcoma/mortalidade , Osteossarcoma/cirurgia , Complicações Pós-Operatórias/induzido quimicamente , Complicações Pós-Operatórias/mortalidade , Espanha/epidemiologia
3.
Intensive Care Med ; 29(1): 91-6, 2003 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-12528028

RESUMO

OBJECTIVE: To determine prognostic factors in child recipients of hematopoietic stem cell transplantation from blood or bone marrow (BMT) requiring critical care. DESIGN: Retrospective study of a cohort of patients. SETTING: Pediatric Intensive Care Unit (PICU) in a university tertiary care center. PATIENTS AND PARTICIPANTS: Child recipients of BMT requiring PICU admission. MEASUREMENTS AND RESULTS: Of the 151 children receiving transplants in our institution, 44 (29.1%) had 49 admissions to the PICU. Mechanical ventilation (MV) was required in 34 patients (69.4% of all admissions). Overall mortality was 31/44 (70.4%). Mortality in patients requiring MV and not requiring MV was 26/34 (76.5%) and 5/10 (50%), respectively. The following variables were significantly associated with mortality in the univariate analysis: male gender (P=0.02), older age (P=0.03), acute graft versus host disease (aGVHD) grades III or IV (P=0.01), severe hemorrhagic cystitis (P=0.01), the diagnosis of lung injury (P=0.04), the need for MV (P=0.03) or for renal replacement therapy (P=0.02), the presence of respiratory (P=0.003), cardiovascular (P=0.009) or gastrointestinal (P=0.01) failures, and the failure of > or =3 organs (P=0.01). In the multivariate analysis, the presence of aGVHD grades III or IV, male gender, severe hemorrhagic cystitis, and the failure of > or =3 organs were found to be independent predictors of mortality. CONCLUSIONS: The need for intensive care is common among child recipients of a BMT. These patients have a high mortality rate but some complications are reversible with critical care support. Certain clinical parameters are useful to establish a realistic prognosis and to optimize the use of the available resources.


Assuntos
Transplante de Células-Tronco Hematopoéticas , Complicações Pós-Operatórias/diagnóstico , Adolescente , Criança , Pré-Escolar , Feminino , Transplante de Células-Tronco Hematopoéticas/mortalidade , Humanos , Lactente , Unidades de Terapia Intensiva Pediátrica , Modelos Logísticos , Masculino , Análise Multivariada , Complicações Pós-Operatórias/mortalidade , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Espanha/epidemiologia , Estatísticas não Paramétricas
4.
Quito; s.n; mayo 2000. 40 p. tab.
Tese em Espanhol | LILACS | ID: lil-296990

RESUMO

El trabajo de parto pretérmino es una entidad frecuente en las Salas de Obstetricia de todos los hospitales, a nivel mundial. Uno de los retos para el médico especialista, es buscar en forma inmediata detener el proceso, con la finalidad inmediata de evitar un recién nacido prematuro. La búsqueda de la droga ideal, con menores efectos indeseables, pero efectiva, es continua. En nuestro estudio, nos planteamos evaluar los efectos farmacológicos tocolíticos del Trinitrato de Gliceron transdérmico, en comparación con una droga ampliamente utilizada con esta finalidad: el fenoterol. Para ello, en un estudio transversal, de muestra incidental, comparativo, administramos a 26 pacientes de cada grupo, en forma aleatoria fenoterol...


Assuntos
Fenoterol/administração & dosagem , Nitroglicerina/administração & dosagem , Parto , Equador , Maternidades
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