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1.
J Nanosci Nanotechnol ; 14(9): 6614-23, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25924307

RESUMO

Iron oxide nanostructured (ION) electrodes were assembled layer-by-layer onto ITO-coated glass substrates and their structure, morphology, and electrochemical properties were investigated, the latter aiming at the development of a chemical sensor for Cu2+. The electrodes were built by immersing the substrate alternately into an aqueous colloidal suspension of positively charged magnetite nanoparticles (np-Fe3O4, 8 nm) and an aqueous solution of anionic sodium sulfonated polystyrene (PSS). The adsorbed amount of both materials was monitored ex-situ by UV-vis spectroscopy and it was found to increase linearly with the number of deposition cycles. The resulting films feature a densely-packed structure of magnetite nanoparticles, as suggested by AFM and Raman spectroscopy, respectively. Cyclic voltammograms of electrodes immersed in acetate buffer (pH 4.6) displayed three electrochemical events that were tentatively ascribed to the reduction of Fe(III) oxy-hydroxide to magnetite, reduction of maghemite to magnetite, and finally oxidation of magnetite to maghemite. The effect of np-Fe3O4/PSS bilayers on the ION electrode performance was to increase the anodic and cathodic currents produced during electrochemical oxidation-reduction of the Fe(CN)(3-/4-) redox couple. With more bilayers, the ION electrode provided higher anodic/cathodic currents. Moreover, the redox couple exhibited a quasi-reversible behavior at the ION electrode as already observed with other working electrode systems. Fitting of voltammetry data provided the apparent electron transfer constants, which were found to be higher in ION electrodes for both redox couples (Fe(CN)(3-/4-) and Cu(2+/0)). By means of differential pulsed anodic stripping voltammetry, the ION electrodes were found to respond linearly to the presence of Cu2+ in aqueous samples in the range between 1.0 and 8.0 x 10(-6) mol x L(-1) and displayed a limit of detection of 0.3 x 10(-8) mol x L(-1). The sensitivity was - 0.6µA/µmol x L(-1). In standard addition and recovery experiments performed with tap water the recovery was about 102%-119%. In similar experiments conducted with ground and instant coffee samples the recovery was 92.5% and 103%, respectively. Furthermore, the ION electrodes were almost insensitive to the presence of common interfering ions, such as Zn2+, Mn2+, Ni2+, and Fe3+, even at concentrations ten times higher than that of Cu2+.


Assuntos
Cobre/análise , Técnicas Eletroquímicas/métodos , Nanopartículas de Magnetita/química , Eletrodos
2.
Clin Lab Haematol ; 28(3): 202-7, 2006 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-16706938

RESUMO

Cord blood (CB) has become a real alternative source of haematopoietic stem cells for bone marrow reconstitution in a variety of malignant disorders. As a response to this increasing activity, CB banks have been developed to guarantee the quality of processed CB units. Volume reduction of CB units maximizes storage space and also has other advantages. The aim of this study was to develop a program for the volume reduction of CB in the Compomat G4 device. We also compared two different top and bottom systems for CB fractionation (Compomat G4 and Optipress II). We empirically designed three different programs for volume reduction of CB with Compomat G4: two for final BC volume of 41 ml (CB1 and CB2) and the other one for buffy coat (BC) volume of 25 ml (CB3). Significantly worse recoveries were achieved for CB processed with program CB3. A RBC depletion of >or=50%, >or=60% and >or=70% were achieved for 67%, 39% and 9% of all units respectively. When comparing Compomat G4 and Optipress II, total nucleated cell recovery was similar for both methods, while lymphocytes recovery was significantly better for Optipress II.


Assuntos
Separação Celular/instrumentação , Sangue Fetal/citologia , Células-Tronco/citologia , Antígenos CD34/análise , Armazenamento de Sangue/métodos , Separação Celular/métodos , Criopreservação/métodos , Citometria de Fluxo , Humanos , Avaliação de Programas e Projetos de Saúde , Estatísticas não Paramétricas
3.
Clin Lab Haematol ; 26(6): 413-8, 2004 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-15596000

RESUMO

Many cord blood (CB) banks have been established worldwide as a response to the increasing number of CB transplantations. In this study, we describe a quality control program in which the utility of an integral bag segment and cryovial containing aliquots of cryopreserved product as haematopoietic content control and HLA typing confirmation for CB units has been evaluated. For this purpose, every month one stored CB unit and its satellite cryovials were thawed and washed. Nucleated cell counts, viability and clonogenic assays were performed from the bag and cryovial before washing. After washing, total nucleated cell, CD34+ counts, viability, and clonogenic assays were performed from the bag. In order to assure the ability of bag segments to confirm hematopoietic potential of CB units, clonogenic assays and viability were performed from attached segments of 10 CB units and the results were compared with those from bags and cryovials. When comparing all variables between thawed bag and cryovial samples, they showed similar results. Mean colony-forming unit (CFU) content of segment samples was 118.8 +/- 93.72 x 10(4) that resulted similar to bags and cryovials haematopoietic content. In conclusion, the quality control system described in this paper demonstrates that CB units are processed preserving the quantity and quality of the progenitor cells. The contiguous segment haematopoietic content is representative of the final product.


Assuntos
Bancos de Sangue , Criopreservação , Sangue Fetal/citologia , Células-Tronco Hematopoéticas/citologia , Teste de Histocompatibilidade/normas , Feminino , Teste de Histocompatibilidade/métodos , Humanos , Recém-Nascido , Gravidez , Controle de Qualidade
4.
Acta Obstet Gynecol Scand ; 82(5): 439-42, 2003 May.
Artigo em Inglês | MEDLINE | ID: mdl-12752074

RESUMO

BACKGROUND AND OBJECTIVES: Collection strategy is the first step for collecting good quality cord blood (CB) units. There are two principal different techniques to collect CB from the umbilical vein: in the delivery room while the placenta is still in the uterus by midwives and obstetricians or in an adjacent room after placental delivery by CB-bank trained personnel. In this study, the benefits and disadvantages between two different CB collection strategies were evaluated in order to improve CB bank methodology. DESIGN AND METHODS: Valencia CB bank maintains the two different collection strategies aforementioned. Before processing CB units, volume was calculated and samples were drawn for cell counts. After processing and before cryopreservation, samples for cell counts, CD34 analysis, viability, clonogenic assays and microbiology were drawn directly from the bags. We compared the efficiency of the two collection techniques. RESULTS: Obstetric date and umbilical CB was obtained from 848 vaginal (484 collected in uterus and 364 collected ex uterus). The proportion of excluded CB units before processing was 33% for ex uterus and 25% for in uterus. The difference was statistically significant. A larger volume and a higher number of total nucleated cells, CD34+ cells and CFUs were harvested in the in uterus collection group. INTERPRETATION AND CONCLUSIONS: Based on our findings, we conclude that the mode of collection influences the hematopoietic content of CB donations. Collection before placental delivery is the best approach to CB collection and allows optimizing CB bank methodology.


Assuntos
Coleta de Amostras Sanguíneas/métodos , Criopreservação/métodos , Parto Obstétrico , Sangue Fetal/citologia , Antígenos CD34/análise , Parto Obstétrico/métodos , Feminino , Transplante de Células-Tronco Hematopoéticas , Células-Tronco Hematopoéticas/imunologia , Humanos , Placenta/irrigação sanguínea , Gravidez , Espanha , Estatísticas não Paramétricas
5.
Bone Marrow Transplant ; 31(4): 269-73, 2003 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-12621461

RESUMO

The use of cord blood (CB) for transplantation has increased greatly in recent years. The collection strategy is the first step in collecting good-quality CB units. There are two main techniques for collecting CB from the umbilical vein: in the delivery room while the placenta is still in the uterus by midwives and obstetricians or in an adjacent room after placental delivery by CB bank trained personnel. In this study, the benefits and disadvantages between the two different CB collection strategies were evaluated, in order to improve CB bank methodology. Valencia CB bank maintains the two different collection strategies. CB was obtained from 569 vaginal and 70 caesarean deliveries and obstetrical and clinical charts were reviewed. Before processing CB units, volume was calculated and samples were drawn for cell counts. After processing and before cryopreservation samples were drawn for cell counts, CD34+cell analysis, viability, clonogenic assays and microbiology were drawn directly from the bags. We compared the efficiency of the two collection techniques. Obstetric data and umbilical CB were obtained from 569 vaginal (264 collected in utero and 305 collected ex utero) and 70 caesarean deliveries. The proportion of excluded CB units before processing was 33% for vaginal ex utero, 25% for vaginal in utero and 46% for caesarean deliveries. Differences were statistically significant. For vaginal deliveries a larger volume and a higher number of nucleated cells, percentage of CD34+ cells and colony-forming units (CFUs) were harvested in the in utero collection group. There was no statistical difference between CB collected after placental expulsion from vaginal and caesarean deliveries. Comparison between all vaginal and caesarean deliveries did not show any difference. We conclude that the mode of collection influences the haematopoietic content of CB donations. Collection before placental delivery is the best approach to CB collection and allows optimisation of CB bank methodology. Caesarean deliveries seem to contain similar progenitor content to vaginal deliveries.


Assuntos
Sangue Fetal/citologia , Células-Tronco Hematopoéticas/citologia , Adulto , Peso ao Nascer , Separação Celular/métodos , Ensaio de Unidades Formadoras de Colônias , Criopreservação , Parto Obstétrico , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Idade Materna , Placenta , Gravidez , Preservação de Tecido/métodos , Veias Umbilicais
6.
Leuk Res ; 27(1): 5-12, 2003 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-12479846

RESUMO

Factors influencing the collection of autologous peripheral blood stem cells (PBSCs) were studied in 182 mobilization procedures performed on 145 consecutive patients with acute myeloblastic leukemia (AML; n=67) and with various non-myeloid malignancies (NMM; n=78). PBSC were collected following mobilization with chemotherapy, treatment with granulocyte colony-stimulating factor (G-CSF) or chemotherapy plus G-CSF. Fewer colony-forming unit granulocyte-macrophages (CFU-GMs) were collected from patients with AML than from patients with NMM (P<0.0001), although there were no differences in the numbers of CD34+ cells collected between both groups. Multiple regression analysis showed that chemotherapy alone was predictive of a low CD34+ yield in patients with NMM (regression coefficient (RC)=-2.1; P=0.003). In addition, the interactions "diagnosis mutliple myeloma (MM)xmobilization with chemotherapy" (RC=2.9; P=0.004) and "diagnosis MMxmobilization with chemotherapy plus G-CSF" (RC=2.1; P=0.04) also remained in the model, both showing a favorable influence. In AML, mobilization with chemotherapy plus G-CSF was associated with higher CD34+ yields (P=0.003). In this subgroup of patients, multiple regression analysis identified the number of cycles of previous chemotherapy (< or =2 cycles; RC=1.3; P=0.03) and peripheral blood counts (WBC > or =1.5 x 10(9)/l and monocytes >20%; RC=0.8; P=0.02) as the factors most predictive of CD34+ cell yield. These findings emphasize the need to optimize harvesting technique to enhance safety and minimize morbidity and costs of this valuable procedure.


Assuntos
Antineoplásicos/farmacologia , Fator Estimulador de Colônias de Granulócitos/farmacologia , Mobilização de Células-Tronco Hematopoéticas , Leucemia Mieloide/sangue , Neoplasias/sangue , Transplante de Células-Tronco de Sangue Periférico , Doença Aguda , Adolescente , Adulto , Idoso , Contagem de Células Sanguíneas , Medula Óssea/efeitos dos fármacos , Medula Óssea/efeitos da radiação , Ensaio de Unidades Formadoras de Colônias , Sinergismo Farmacológico , Feminino , Mobilização de Células-Tronco Hematopoéticas/métodos , Humanos , Leucaférese/instrumentação , Leucaférese/métodos , Leucemia Mieloide/terapia , Masculino , Pessoa de Meia-Idade , Neoplasias/terapia , Radioterapia/efeitos adversos , Análise de Regressão , Estudos Retrospectivos , Segurança , Resultado do Tratamento
7.
Bone Marrow Transplant ; 29(10): 825-32, 2002 May.
Artigo em Inglês | MEDLINE | ID: mdl-12058232

RESUMO

Factors influencing hematopoietic recovery (HR) after autologous blood stem cell transplantation (ABSCT) were analyzed in 73 patients with various non-myeloid malignancies (NMM), and in 58 patients with acute myeloblastic leukemia (AML). Peripheral blood stem cells were collected following mobilization with chemotherapy, granulocyte colony-stimulating factor (G-CSF), or chemotherapy plus G-CSF. The conditioning regimen used consisted of either chemotherapy alone (112 cases) or chemotherapy plus total body irradiation (19 cases). The median number of colony-forming units granulocyte-macrophage (CFU-GM) was similar in both groups of patients, with the median number of CD34(+) cells infused being higher in the AML group (5.4 vs 4 x 10(6)/kg; P = 0.03). Median time neutrophils >0.5 x 10(9)/l was 13 days in both groups, and median time to a platelet count >20 x 10(9)/l was longer in AML patients (14 vs 12 days; P = 0.01). In multivariate analysis, the only factors affecting neutrophil recovery in the NMM group were the CD34+ cell number (continuous model) and the CFU-GM dose (categorized model) infused, whereas for platelet recovery, previous chemotherapy also remained significant. In the AML group, the only factors significantly affecting the speed of neutrophil recovery were dose of CD34+ cells administered and the patient's age. As for platelet recovery, only the progenitor dose administered remained significant. In the NMM group, the most discriminating cut-off values for a rapid neutrophil and platelet recovery were 1.5 x 10(6) and 2.5 x 10(6) CD34+ cells/kg, respectively, and for AML patients these figures were 1.5 x 10(6) and 4 x 10(6) CD34+ cells/kg, respectively. Our results confirm the slower HR after ABSCT in AML, and highlight the importance of progenitor cell dose in accelerating HR after ABSCT.


Assuntos
Hematopoese , Transplante de Células-Tronco Hematopoéticas , Leucemia Mieloide Aguda/terapia , Neoplasias/terapia , Adolescente , Adulto , Idoso , Neoplasias da Mama/patologia , Neoplasias da Mama/terapia , Ensaio de Unidades Formadoras de Colônias , Feminino , Doença de Hodgkin/patologia , Doença de Hodgkin/terapia , Humanos , Leucemia Mieloide Aguda/patologia , Linfoma não Hodgkin/patologia , Linfoma não Hodgkin/terapia , Masculino , Pessoa de Meia-Idade , Mieloma Múltiplo/patologia , Mieloma Múltiplo/terapia , Neoplasias/patologia , Transplante Autólogo
8.
Blood ; 98(8): 2332-8, 2001 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-11588027

RESUMO

The potential role of unrelated donor cord blood transplantation (UD-CBT) in adults remains unclear. This study reports the results of UD-CBT in 22 adults with hematologic malignancies following conditioning with thiotepa, busulfan, cyclophosphamide, and antithymocyte globulin in 21, with thiotepa, fludarabine, and antithymocyte globulin in 1, and graft-versus-host disease (GVHD) prophylaxis with cyclosporine and prednisone. Median age was 29 years (range, 18-46 years), and median weight was 69.5 kg (range, 41-85 kg). HLA match was 6 of 6 in 1 case, 5 of 6 in 13 cases, and 4 of 6 in 8 cases. Median number of nucleated cells infused was 1.71 x 10(7)/kg (range, 1.01 x 10(7)/kg to 4.96 x 10(7)/kg). All 20 patients surviving more than 30 days had myeloid engraftment, and only 1, who received the lowest cell dose, developed secondary graft failure. Median time to reach an absolute neutrophil count of at least 0.5 x 10(9)/L was 22 days (range, 13-52 days). Median time to platelets numbered at least 20 x 10(9)/L was 69 days (range, 49-153 days). Seven patients (32%) developed acute GVHD above grade II, and 9 of 10 patients at risk developed chronic GVHD, which became extensive in 4 patients. Twelve patients remained alive and disease-free 3 to 45 months after transplantation. Disease-free survival (DFS) at 1 year was 53%. Age strongly influenced DFS (P =.01). For patients aged 30 years or younger, the DFS at 1 year was 73%. These preliminary results suggest that UD-CBT should be considered a reasonable alternative in young adults with hematologic malignancy and no appropriate bone marrow donor.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Hematológicas/terapia , Transplante de Células-Tronco Hematopoéticas , Adulto , Soro Antilinfocitário/uso terapêutico , Ciclofosfamida/uso terapêutico , Feminino , Sangue Fetal , Doença Enxerto-Hospedeiro/prevenção & controle , Neoplasias Hematológicas/tratamento farmacológico , Neoplasias Hematológicas/mortalidade , Teste de Histocompatibilidade , Humanos , Imunossupressores/uso terapêutico , Recém-Nascido , Leucemia/tratamento farmacológico , Leucemia/mortalidade , Leucemia/terapia , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Síndromes Mielodisplásicas/tratamento farmacológico , Síndromes Mielodisplásicas/mortalidade , Síndromes Mielodisplásicas/terapia , Contagem de Plaquetas , Taxa de Sobrevida , Tiotepa/uso terapêutico , Falha de Tratamento
9.
Bone Marrow Transplant ; 27(7): 693-701, 2001 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-11360108

RESUMO

The potential role of unrelated donor cord blood transplantation (UD-CBT) in adults is not well established. We report the results of UD-CBT in nine adult patients with chronic myeloid leukemia (CML). The median age was 27 years (range, 19-41 years), and the median weight was 62 kg (range, 45-78 kg). At transplant, six patients were in chronic phase (five in first, and one in second), two in blast crisis, and one in accelerated phase. Eight had received intensive chemotherapy, and three had undergone autologous peripheral blood hematopoietic stem cell transplantation. Four had received interferon with no cytogenetic response, and only three underwent UD-CBT within 1 year of diagnosis. After serological typing for class I antigens, and high-resolution DNA typing for DRB1, the degree of HLA match between patients and cord blood (CB) units was 4/6 in six cases and 5/6 in three cases. The median number of nucleated cells infused was 1.7 x 10(7)/kg (range, 1.2 to 4.9 x 10(7)/kg), and was above 2 x 10(7)/kg in only two cases. All patients received thiotepa, busulfan, cyclophosphamide and anti-thymocyte globulin as conditioning; cyclosporine and prednisone for graft-versus-host disease (GVHD) prophylaxis; and G-CSF from day +7 until engraftment. All seven evaluable cases engrafted. The median time to reach an absolute neutrophil count > or =0.5 x 10(9)/l and > or =1 x 10(9)/l was 22 days (range, 19-52 days) and 28 days (range, 23-64 days), respectively. In the four patients evaluable for platelet recovery time to levels of > or =20 x 10(9) platelets/l, > or =50 x 10(9) platelets/l, and > or =100 x 10(9) platelets/l, these ranged from 50 to 128 days, 60 to 139 days, and 105 to 167 days, respectively. Three patients developed acute GVHD above grade II, and three of the five patients at risk developed extensive chronic GVHD. Four patients, all transplanted in chronic phase, remain alive in molecular remission more than 18, 19, 24 and 42 months after transplantation. These preliminary results suggest that UD-CBT may be considered a reasonable alternative in adults with CML who lack an appropriate bone marrow donor.


Assuntos
Doadores de Sangue , Sangue Fetal/citologia , Transplante de Células-Tronco Hematopoéticas/normas , Leucemia Mielogênica Crônica BCR-ABL Positiva/terapia , Doença Aguda , Adulto , Doença Crônica , Intervalo Livre de Doença , Doença Enxerto-Hospedeiro/etiologia , Doença Enxerto-Hospedeiro/imunologia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Histocompatibilidade , Teste de Histocompatibilidade , Humanos , Leucemia Mielogênica Crônica BCR-ABL Positiva/complicações , Projetos Piloto , Taxa de Sobrevida , Resultado do Tratamento
11.
Am J Hematol ; 65(3): 260-2, 2000 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-11074546

RESUMO

We report here a case of nonhepatosplenic gammadelta T-cell lymphoma with undescribed initial localization in testis, without hepatosplenomegaly or adenopathies, and subsequent development in the maxillary sinus. The maxillar mass biopsy revealed a T-cell infiltration, and its immunologic characterization by flow cytometry showed a gammadelta T-cell phenotype (CD45+, CD3+, CD2+, TCR gammadelta+), without expression of CD7, CD5, CD1a, TdT, CD4, CD8, TCR alphabeta, or NK antigens (CD16, CD56, and CD57). Clonal gamma-chain gene rearrangement by polymerase chain reaction (PCR) was detected in testicular and maxillar biopsies. Epstein-Barr virus type 1 (EBV) sequences were detected by molecular biology in the biopsy material, suggesting that this oncogenic virus may play a role in the genesis of the clonal expansion of gammadelta T-cells. The patient was initially treated with standard chemotherapeutic protocols, with poor response and aggressive course.


Assuntos
Neoplasias Hepáticas/patologia , Linfoma de Células T/patologia , Neoplasias Esplênicas/patologia , Neoplasias Testiculares/patologia , Humanos , Masculino , Neoplasias do Seio Maxilar/patologia , Pessoa de Meia-Idade , Receptores de Antígenos de Linfócitos T gama-delta/análise
12.
An Otorrinolaringol Ibero Am ; 26(6): 583-93, 1999.
Artigo em Espanhol | MEDLINE | ID: mdl-10645017

RESUMO

It is classically been though that radical sinus surgery implies a difficulty for ulterior image diagnosis. The reason is postoperative fibrosis of soft tissue may be shown at TC scan as an occupation of paranasal sinuses. We realized that it does not usually happen. The aim of our study is to find out the appearance of sinuses after radical surgery performed to treat chronic sinusitis, mucocele and sinusal cysts. For so doing we have reviewed symptoms and radiological signs before and after surgery.


Assuntos
Sinusite/diagnóstico por imagem , Sinusite/cirurgia , Adolescente , Adulto , Idoso , Criança , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X
13.
Bone Marrow Transplant ; 18(6): 1167-73, 1996 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-8971390

RESUMO

Leukemic relapse remains the most frequent reason for treatment failure in patients with acute myeloblastic leukemia (AML) treated with autologous blood stem cell transplantation (ABSCT). The aim of this study was to evaluate the possible role of autologous bone marrow transplant (ABMT) in patients with AML who relapse after ABSCT. Eighteen consecutive patients were enrolled in the study. At ABMT, 17 patients were in untreated relapse and one was in third complete remission (CR). The preparative regimen was BAVC, and consisted of BCNU 800 mg/m2 on day -6, M-AMSA 150 mg/m2/day on days -5 to -3, VP-16 150 mg/m2/day on days -5 to -3 and Ara-C 300 mg/m2/day on days -5 to -3. There were two regimen-related deaths (11%). Thirteen out of 17 patients in untreated relapse before ABMT achieved CR (76%). The cumulative risk of relapse was 58 +/- 13% at 3 years. Seven patients are in CR between 7+ and 53+ months, with a disease-free survival (DFS) probability of 36 +/- 12% at 3 years. The probability of DFS after ABMT was clearly higher in those patients relapsing later than 7 months after the first autograft (52%) than in patients relapsing earlier (20%)(P = 0.02). In a significant proportion of patients, remission duration was clearly longer after ABMT than ABSCT. We conclude that BAVC conditioning followed by ABMT is associated with a low treatment-related toxicity and results in prolonged DFS in a substantial number of AML patients who relapse after ABSCT. Until better therapeutic options become available, ABMT in untreated relapse is a useful alternative in this group of very poor-risk patients.


Assuntos
Transplante de Medula Óssea , Transplante de Células-Tronco Hematopoéticas , Leucemia Mieloide/terapia , Doença Aguda , Adulto , Amsacrina/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Transplante de Medula Óssea/efeitos adversos , Carmustina/administração & dosagem , Terapia Combinada , Citarabina/administração & dosagem , Intervalo Livre de Doença , Etoposídeo/administração & dosagem , Feminino , Humanos , Leucemia Mieloide/tratamento farmacológico , Leucemia Mieloide/mortalidade , Leucemia Mieloide/patologia , Tábuas de Vida , Masculino , Pessoa de Meia-Idade , Recidiva , Risco , Terapia de Salvação , Condicionamento Pré-Transplante/efeitos adversos , Transplante Autólogo , Resultado do Tratamento
14.
J Clin Oncol ; 11(9): 1661-7, 1993 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-8102640

RESUMO

PURPOSE: To determine if peripheral-blood stem cells (PBSC) collected during the recovery of standard induction and consolidation chemotherapy in acute myeloblastic leukemia (AML) can be used as a safe tool for autologous transplantation, and to study aspects of the autologous blood stem-cell transplantation (ABSCT) procedure and their results in AML patients in first remission. PATIENTS AND METHODS: Twenty-four AML patients in first remission received busulfan (BU; 16 mg/kg) and cyclophosphamide (CY; 200 mg/kg) followed by ABSCT. PBSC were collected by continuous-flow leukaphereses after induction and consolidation courses. RESULTS: The median numbers of mononuclear cells (MNCs) and colony-forming unit granulocyte-macrophage (CFU-GM) administered were 6 x 10(8)/kg and 11 x 10(4)/kg, respectively. ABSCT induced engraftment in 22 patients and there were two graft failures. The median times to reach a polymorphonuclear (PMN) leukocyte count of 0.5 x 10(9)/L and a platelet count of 50 x 10(9)/L were 13 and 19 days, respectively. Fatal hepatic veno-occlusive disease (VOD) was observed in two cases. Other toxicities were mild and uncommon. Twelve patients relapsed between 1 and 9 months posttreatment. Actuarial disease-free survival (DFS) and actuarial risk of relapse at 30 months were 35% (95% confidence interval [CI], 25% to 45%) and 60% (95% CI, 50% to 72%), respectively. CONCLUSION: These preliminary results show the fast hematopoietic recovery and the low infectious and hemorrhagic morbidity associated with the procedure and strongly suggest that ABSCT may be as effective as autologous bone marrow transplantation (ABMT) in AML. However, further strategies for reducing leukemic relapse must still be investigated.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Transplante de Células-Tronco Hematopoéticas , Leucemia Mieloide Aguda/tratamento farmacológico , Leucemia Mieloide Aguda/cirurgia , Análise Atuarial , Adolescente , Adulto , Bussulfano/administração & dosagem , Terapia Combinada , Criopreservação , Ciclofosfamida/administração & dosagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Indução de Remissão , Análise de Sobrevida , Transplante Autólogo
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