Association between chronic lymphocytic leukemia and sarcoidosis: clinical value of bronchoalveolar lavage.

We report a case of sarcoidosis, occurred in a patient with chronic lymphocytic leukemia (CLL) shortly following the completion of initial chemotherapy, who relapsed shortly after a second course. Since bronchoalveolar lavage (BAL) demonstrated a predominance of CD4+ lymphocytes, it largely excluded spread of the malignant disorder to the lung, and strongly suggested that sarcoidosis was the cause of the pulmonary infiltrates. This diagnosis was confirmed by the finding of non-caseating granuloma on transbronchial lung biopsy.

Acute intravascular haemolysis with massive microspherocytosis in a 75-year-old woman.

Acute intravascular haemolysis (AIH) sometimes occurs in patients with sepsis or bacteraemia, mainly due to clostridia or Salmonella sp., and may be a life-threatening condition. We describe a case of AIH in a 75-yr-old woman with chronic cholelithiasis. Blood and stool cultures were repeatedly negative, but the massive microspherocytosis, typically observed in clostridia infections, oriented our diagnosis. The patient was treated with antibiotics and for a rapid worsening of her conditions, which could have led to the onset of a multi-organ dysfunction syndrome (MODS), with plasma exchange and, subsequently, haemodialysis, with satisfactory results.

Treatment of advanced pancreatic carcinoma with the somatostatin analogue BIM 23014. Preliminary results of a pilot study.

Treatment of advanced pancreatic cancer has not improved substantially in recent years. The search for new agents or new therapeutic modalities may be critical for further development in the therapy of this disease. Experimental and clinical findings suggest that it might be possible to develop a new hormonal therapy for exocrine cancer of the pancreas based on new somatostatin analogues. Preliminary results indicate clinical activity and increased survival in some patients. In this study, 19 patients with advanced exocrine pancreatic carcinoma were given the somatostatin analogue BIM 23014 using a range of doses from 250 micrograms/day to 1 mg/day. One patient had a partial response, 6 patients had stable disease, and 11 had progressive disease. Six patients showed a sharp improvement in pain and performance status. Side effects were mild. Plasma levels of growth hormone were evaluated in ten patients and remained unchanged. The clinical activity observed, even if limited, warrants further investigation using more appropriate schedules and administration techniques.

Satisfactory recovery and viability of stem cells cryopreserved at high cell concentration.

Peripheral Blood Stem Cells (PBSC) are being extensively used in both oncology-haematology and in solid tumor therapy schedules. The latest generation of cell separators allow the collection of greater numbers of nucleated cells (NC) than is usually obtained in bone marrow transplantation (BMT) settings. Thus, larger volumes of components would be stored if the same NC concentration employed in BMT is to be used. In order to reduce large volume DMSO-infusion related side effects and to avoid storage problems, we froze components from 23 PBSC collections at higher NC concentrations, from 40-200 x 10(6)/mL. After 2-12 months of storage, we thawed the samples and determined if the high NC concentration had a detrimental effect on NC viability and on stem cell clonogenicity. No statistically significant differences emerged in regard to CFU-GM, CFU-GEMM and BFU-E percent recovery even at 200 x 10(6)/mL NC concentration.

Detection and identification of monoclonal components: immunoelectrophoresis on agarose gel and immunofixation on cellulose acetate compared.

Immunofixation on cellulose acetate has been compared with immunoelectrophoresis on agarose gel. We studied 90 sera containing monoclonal components and 10 containing polyclonal immunoglobulins according to agarose gel screening electrophoresis. Results by the two methods agreed about 80% of the time for monoclonal components in concentrations exceeding 1-2 g/L. Immunofixation appeared more sensitive, but it is more susceptible to technical artifacts. Immunofixation may be adopted as a first-step method for easier cases, but it should be supported by immunoelectrophoresis for difficult cases, such as when there is an uncertain presence of monoclonal components at screening electrophoresis or presence of more and (or) small bands of monoclonal components.