RESUMO
Adjuvant transfusion of donor lymphocytes (aDLT) may reduce the risk of relapse after allogeneic stem cell transplantation in high-risk AML. We performed a retrospective analysis on the safety and efficacy of aDLT in a cohort of 46 patients. To be eligible for aDLT, patients had to be in CR for at least 120 days from transplantation, off immunosuppression for ⩾30 days and free of GvHD. Thirty-four patients with similar disease characteristics and fulfilling the same selection criteria served as controls. Median follow-up among aDLT recipients was 7.2 years. Ten patients (22%) relapsed inspite of aDLT, as compared with 53% in the control group. Induction of GvHD was the main complication. However, non-relapse mortality was low with patients dying from infection (n=2), severe chronic GvHD (n=1) and secondary malignancy (n=2). At the time of analysis, 31/46 aDLT recipients were alive in CR at a median of 5.7 years after first aDLT. Overall survival at 7 years after transplant was 67% as compared with 31% in the control group (P<0.001). In conclusion, aDLT is safe, when given in escalating doses to a well predefined group of patients. Long-term survival can be achieved.
Assuntos
Leucemia Mieloide Aguda/terapia , Transfusão de Linfócitos/métodos , Transplante de Células-Tronco/métodos , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Intervalo Livre de Doença , Feminino , Seguimentos , Doença Enxerto-Hospedeiro , Humanos , Infecções , Leucemia Mieloide Aguda/complicações , Leucemia Mieloide Aguda/mortalidade , Masculino , Pessoa de Meia-Idade , Segunda Neoplasia Primária , Recidiva , Estudos Retrospectivos , Transplante de Células-Tronco/efeitos adversos , Transplante de Células-Tronco/mortalidade , Adulto JovemRESUMO
A total of 161 arthropod specimens were collected from 55 sites in a health care facility during July and September 1990. Of the 116 bacterial isolates obtained from their body surfaces 6% were from parasites (mosquitoes), 59% from eusynanthropic arthropods (Tenebrionid beetles, flies, German cockroaches, wasps), 16% from hemisynanthropic arthropods (ants, spiders) and 19% from occasionally encountered insects (non-biting midges, moths, beetles). Most (88%) of the isolated bacteria were Gram-negative rods of the species E. coli, Enterobacter, Klebsiella, Citrobacter, Proteus, Serratia, Pseudomonas and Acinetobacter. Gram-positive cocci accounted for 13% of isolates and were primarily represented by coagulase-negative staphylococci. The highest isolation rates were from body surfaces of flies, German cockroaches, non-biting midges (Chironomids) and Tenebrionid beetles. About one third of all isolates were resistant to more than three antimicrobials using a standard disc diffusion assay. The presence of multiple resistance to antibiotics was observed in two thirds of Enterobacter isolates, namely those of Enterobacter cloacae from the body surface of Germany cockroaches, in 13% of Citrobacter spp and in 8% of Klebsiella spp as well as Acinetobacter calcoaceticus strains. Strains of Morganella and Hafnia species were very infrequent but all of them shared resistance to the antibiotics tested. In contrast, strains of Serratia spp were relatively antibiotic-sensitive. The group of isolated Gram-positive organisms was represented by two strains of Staphylococcus hominis and one strain of Enterococcus sp, all of them were multiply-resistant to antimicrobials.
Assuntos
Aracnídeos/microbiologia , Bactérias Gram-Negativas/isolamento & purificação , Bactérias Gram-Positivas/isolamento & purificação , Insetos/microbiologia , Animais , Aracnídeos/classificação , Tchecoslováquia , Vetores de Doenças , Resistência Microbiana a Medicamentos , Fungos/isolamento & purificação , Hospitais de Ensino , Humanos , Insetos/classificação , Testes de Sensibilidade MicrobianaRESUMO
Certain leukemias have a high relapse risk even after allo-SCT, and GVHD prophylaxis with calcineurin inhibitors (CNIs) may interfere with a possible GVL effect. Therefore, we replaced CYA by sirolimus in patients with high relapse risk. In contrast to CNIs, sirolimus promotes the generation of regulatory T-cells and has potent antineoplastic activity. Sirolimus has been used in combination with CNI for GVHD prophylaxis in hematopoietic SCT. However, no CNI-free prophylactic regimen with sirolimus has been evaluated so far. Within the FLAMSA-RIC protocol, 15 patients received GVHD prophylaxis with sirolimus and mycophenolate mofetil (MMF). The underlying diagnoses were relapsed or refractory T-ALL (n=3), AML with FMS-like tyrosine kinase 3-internal tandem duplication (FLT3-ITD) or mixed-lineage leukemia-partial tandem duplication (MLL-PTD; n=10; 5 with refractory disease) and CML in refractory myeloid blast crisis (n=2). All evaluable patients (n=14) were engrafted. Grades II-IV acute GVHD occurred in 21% and chronic GVHD in 30% of patients. Non-relapse mortality rate was 14%. No thrombotic microangiopathy or sinusoidal obstruction syndrome was observed. Three patients with FLT3-ITD+ AML relapsed after a median of 112 days. At a median follow-up of 10 months after transplantation, 10 patients are alive and in complete remission. In conclusion, sirolimus-based GVHD prophylactic regimens deserve further investigation.
Assuntos
Doença Enxerto-Hospedeiro/prevenção & controle , Transplante de Células-Tronco Hematopoéticas/métodos , Leucemia/terapia , Ácido Micofenólico/análogos & derivados , Sirolimo/administração & dosagem , Adulto , Inibidores de Calcineurina , Estudos de Coortes , Feminino , Doença Enxerto-Hospedeiro/tratamento farmacológico , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Humanos , Imunossupressores/administração & dosagem , Leucemia/complicações , Leucemia/mortalidade , Masculino , Pessoa de Meia-Idade , Ácido Micofenólico/administração & dosagem , Pré-Medicação/métodos , Terapia de Salvação/métodos , Taxa de Sobrevida , Transplante Homólogo , Adulto JovemRESUMO
A population of 200 Y. enterocolitica strains of the serotype 03 and 100 strains belonging to other serotypes mostly, however, to the biotype 1 were examined for their sensitivity to chemotherapeutics. The serotype 03 strains were obtained from human material of diarrhoeal cases, the origin of other serotypes was various. They originated from human extraintestinal material, animals, water and foods. To summarize their results, the authors elaborated an antibiogram presented in graphs.
Assuntos
Antibacterianos/farmacologia , Yersinia/efeitos dos fármacos , Indóis/metabolismo , Testes de Sensibilidade Microbiana , Sorotipagem , Yersinia/metabolismoRESUMO
Effects of a new antimicrobial agent sisomicin on microorganisms isolated from pathologic material (Pseudomonas aeruginosa, Staphylococcus aureus, Serratia marcescens, Klebsiella pneumoniae, Salmonella spp., Streptococcus pyogenes-B, Citrobacter Freundii) were studied. The results obtained were compared with another two aminoglycoside antibiotics - gentamicin and tobramycin. All three antibiotics were found to be very effective in vitro; their effect was enhanced by addition of an antibiotic of the penicillin group (carbenicillin, suncillin) or an antibiotic of the tetracyklin series (oxytetracyklin, doxycyklin). All three preparations were tested on 26 Mycobacterium tuberculosis strains. Tobramycin inhibited growth of 22 strains and thus presented the highest level of efficiency among these deoxystreptamin preparations.
Assuntos
Antibacterianos/farmacologia , Bactérias/efeitos dos fármacos , Sisomicina/farmacologia , Carbenicilina/análogos & derivados , Carbenicilina/farmacologia , Doxiciclina/farmacologia , Sinergismo Farmacológico , Gentamicinas/farmacologia , Klebsiella pneumoniae/efeitos dos fármacos , Mycobacterium tuberculosis/efeitos dos fármacos , Oxitetraciclina/farmacologia , Resistência às Penicilinas , Pseudomonas aeruginosa/efeitos dos fármacos , Salmonella/efeitos dos fármacos , Serratia marcescens/efeitos dos fármacos , Staphylococcus aureus/efeitos dos fármacos , Tobramicina/farmacologiaRESUMO
The authors studied the sensitivity of some rather recent products--flucloxacillin, doxycyclin, clindamycin and cotrimoxazol--in correlation with classical penicillin. If therapy by means of classical penicillins is unsuitable, clindamycin and the semi-synthetic penicillin flucloxacillin appear to be a further alternative and the most suitable chemotherapeutic in streptococcal infections.
Assuntos
Antibacterianos/farmacologia , Penicilinas/farmacologia , Streptococcus/efeitos dos fármacos , Antibacterianos/uso terapêutico , Clindamicina/farmacologia , Relação Dose-Resposta a Droga , Doxiciclina/farmacologia , Floxacilina/farmacologia , Testes de Sensibilidade Microbiana , Especificidade da Espécie , Infecções Estreptocócicas/tratamento farmacológico , Streptococcus agalactiae/efeitos dos fármacos , Streptococcus pyogenes/efeitos dos fármacos , Sulfametoxazol/farmacologia , Sulfametoxazol/uso terapêutico , Trimetoprima/uso terapêuticoRESUMO
The antifungal activity of jaritin and haloprogin against Candida albicans is similar. In vitro they had less activity than clotrimazole and miconazole, but the activity was independent of inoculum size.
Assuntos
Candida albicans/efeitos dos fármacos , Clotrimazol/farmacologia , Imidazóis/farmacologia , Miconazol/farmacologia , Éteres Fenílicos/farmacologia , Testes de Sensibilidade Microbiana , PirimidinasRESUMO
Ps. aeruginosa strains--a frequement resuet of an irresponsible antibiotic therapy--represent a common agent of nosocomial infektions. At the same time, gravity of Pseudomonas diseases is also increasing. Lysogeny, bacteriocinogeny and frequent occurrence of autoplaques are the lytic manifestations of Pseudomonas aeruginosa strains which play a great role in the complexity of solving diagnostic, epidemiological end therapeutical problems connected with infections induced by these microbes. A survey is presented of the importance and utilization of the lytic properties of bacterial strains of Pseudomonas aeruginosa during the differentiation, epidemiological typing and further expansion of therapeutical possibilities in infections caused by Pseudomonas aeruginosa bacteria.
Assuntos
Pseudomonas aeruginosa/isolamento & purificação , Tipagem de Bacteriófagos , Infecção Hospitalar/diagnóstico , Lisogenia , Infecções por Pseudomonas/diagnósticoRESUMO
Main antibacterially active agents obtained from plants-Cajeput essential oil--1,8 cineol, linalool, alpha-terpineol and terpinen-4-ol, for example from Melalleuce leucadendron (Myrtaceae) as well as essential oil from Ocimum gratissimum (Labiatae) were combined in tests in vitro with selected antibiotics. Above mentioned plant products were found to be effective medicaments for local application in modern medical practice. Combinations with antibiotics potentiated their therapeutical action. On the basis of tests in vitro the synergistic action of these two kinds of medicaments, i.e., preparations traditionally used for a few last decades--antibiotics--might be well applied for therapeutical needs.
Assuntos
Pseudomonas aeruginosa/efeitos dos fármacos , Staphylococcus aureus/efeitos dos fármacos , Antibacterianos , Sinergismo Farmacológico , Quimioterapia Combinada/farmacologia , Testes de Sensibilidade Microbiana , Óleos de Plantas/farmacologia , Terpenos/farmacologia , Leveduras/efeitos dos fármacosRESUMO
The strains of Acinetobacter calcoaceticus, var. anitratus (A. c. a.) were isolated in the nosocomial environment as an opportune pathogen. The therapy of choice may be determined after in vitro tests. Our results show following therapeutical possibilities: beta-lactam antibiotics--cephalosporins of IIIrd generation (cefotaxime), also combinations of antimicrobials have shown good results: amoxycillin or ticarcillin with clavulanic acid. Best synergistic effect was found in combination ticarcillin-amikacin.