Assuntos
Carcinoma Broncogênico/tratamento farmacológico , Carcinoma Broncogênico/enzimologia , Fluoruracila/uso terapêutico , L-Lactato Desidrogenase/sangue , Triaziquona/uso terapêutico , Vimblastina/uso terapêutico , Carcinoma Broncogênico/sangue , Carcinoma de Células Escamosas/enzimologia , Humanos , Isoenzimas , Metástase NeoplásicaRESUMO
The cloning of hematopoietic growth factors has allowed their application in clinical medicine. This review deals with clinical studies on GM-CSF and G-CSF in bone marrow insufficiency (primary or secondary to chemotherapy), myelodysplastic syndromes, AIDS and bone marrow transplantation.
Assuntos
Doenças da Medula Óssea/terapia , Fatores Estimuladores de Colônias/uso terapêutico , Substâncias de Crescimento/uso terapêutico , Doenças Hematológicas/terapia , Fator Estimulador de Colônias de Granulócitos , Fator Estimulador de Colônias de Granulócitos e Macrófagos , Granulócitos , Hematopoese/efeitos dos fármacos , Humanos , Infecções/terapia , Proteínas Recombinantes/uso terapêuticoRESUMO
BACKGROUND: In the medical community, little is known regarding bone marrow necrosis (BMN) as a clinicopathologic entity, although to the authors' knowledge it was described for the first time more than 50 years ago. To identify the rate of prevalence, the symptoms and signs, the underlying disease associations, and the usefulness of diagnostic procedures, an extensive literature search was made. METHODS: Only cases identified as extensive necrosis and diagnosed during life were selected. Two hundred forty cases met these criteria. RESULTS: Bone pain (75%) and fever (68.5%) were the most important symptoms, whereas anemia (91%) and thrombocytopenia (78%), associated with a leukoerythroblastic picture (51%), were the most frequent hematologic abnormalities. Nearly 50% of patients showed elevated lactate dehydrogenase and alkaline phosphatase levels. In 90% of the patients an underlying malignancy was identified. CONCLUSIONS: Bone marrow necrosis is caused by hypoxemia after failure of the microcirculation. Given the high rate of malignancy as an underlying disease association, an extensive search for neoplastic disease is justified whenever BMN is diagnosed. Pancytopenia and embolic processes are major complications that should be managed with supportive measures until effective treatment of the underlying disease has been administered. When necrosis resolves, repopulation of the bone marrow cavity with normal hematopoiesis is observed.
Assuntos
Neoplasias/complicações , Osteonecrose/fisiopatologia , Anemia/etiologia , Diagnóstico Diferencial , Febre/etiologia , Hematopoese , Humanos , L-Lactato Desidrogenase/análise , Neoplasias/diagnóstico , Osteonecrose/etiologia , Dor/etiologia , Trombocitopenia/etiologiaRESUMO
A novel alkaline phosphatase (AP) isozyme has been observed in the serum of 4 patients suffering from acute non-lymphocytic leukemia (ANLL). It resembled the AP of liver/bone origin in most physico-chemical characteristics, but particular electrophoretic characteristics in agar and starch gel and a distinct molecular weight gave this novel AP isozyme its unique character. Its leukemic origin has been demonstrated by isolation from peripheral blood and bone and bone marrow blasts. The appearance of the novel AP isozyme in the patients' sera appeared to be an ominous sign as, in all four, it shortly preceded death. In patients it may have contributed to the observed resistance towards thioguanine therapy.