ABSTRACT
Three hundred and seventy-one children below 16 years, with newly diagnosed acute myeloid leukaemia, were included in six consecutive GATLA/GLATHEM protocols, from November 1967 to December 1987. The study was divided in three periods: 1967 to 1975, 1976 to 1982, and 1983 to 1987. Three induction schedules were used during the first two periods, and different maintenance schemes alternating with monthly consolidations were explored; the value of immunotherapy with C. Parvum and androgen therapy with stanozolol was also tested. Protocol 3-AML-83, representing the third period, included a four-week induction phase with vincristine, adriamycin, cytosine-arabinoside, prednisone and 6-mercaptopurine, followed by a consolidation phase with cyclophosphamide, cytosine-arabinoside and 6-mercaptopurine for four weeks. Maintenance phase included daily, oral 6-mercaptopurine, and monthly cytosine-arabinoside, both during two years, and adriamycin every eighth week, for one year. Complete remission rates for the first two periods of therapy were 40% and 55%, whereas that of the last period was 74%. The overall results of the period 1967-1982, showed actuarial duration rates of complete remission, event-free survival and survival, at 60 months, between 2% and 6%, their median duration being of 9, 8 and 10 months respectively. No significant difference was observed between the first two periods or protocols. Protocol 3-AML-83, activated in March 1983, achieved actuarial rates of continuous complete remission, event-free survival, and survival of 51%, 37% and 39% respectively, at 48 months. The difference between the first two periods and the last one was highly significant (P less than 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Leukemia, Myeloid, Acute/drug therapy , Adolescent , Child , Child, Preschool , Clinical Trials as Topic , Cyclophosphamide/administration & dosage , Cytarabine/administration & dosage , Daunorubicin/administration & dosage , Doxorubicin/administration & dosage , Evaluation Studies as Topic , Humans , Infant , Methotrexate/administration & dosage , Prednisolone/administration & dosage , Prednisone/administration & dosage , Thioguanine/administration & dosage , Vincristine/administration & dosageSubject(s)
Acquired Immunodeficiency Syndrome , Referral and Consultation , Adolescent , Adult , Ambulatory Care , Argentina , Child , Female , HIV Seropositivity , Homosexuality , Humans , Male , Middle Aged , Risk Factors , Substance-Related DisordersSubject(s)
Acquired Immunodeficiency Syndrome/immunology , Antibodies, Viral/analysis , Cytomegalovirus/immunology , HIV/immunology , Herpesvirus 4, Human/immunology , Adult , Animals , Antibodies, Protozoan/analysis , Argentina , Homosexuality , Humans , Lymphocyte Depletion , Male , Toxoplasma/immunologyABSTRACT
Serologic reactivity against EBV-infected lines was assayed in patients with AIDS (n = 4) or the AIDS related complex (AIDS-RC) (n = 46) residing in Argentina. Anti-VCA serology was comparable to that of controls. However sera from AIDS and AIDS-RC could induce antibody dependent cell mediated cytotoxicity (ADCC) to EBV-infected cell lines (P3HRIK and Raji). ADCC activity could be recovered in the high molecular weight fractions of AIDS and AIDS-RC sera. ADCC was observed in sera with high levels of PEG precipitable material (PEG-pp) but was unrelated to the presence of complement-fixing immune complexes (Clq-F) or to anti-VCA titers. Fc receptor (FcR) bridging between target cells FcR and effector cells FcR may play a role in the outcome of total ADCC.
Subject(s)
AIDS-Related Complex/immunology , Acquired Immunodeficiency Syndrome/immunology , Antibody-Dependent Cell Cytotoxicity , Capsid Proteins , Herpesvirus 4, Human/immunology , AIDS-Related Complex/blood , Acquired Immunodeficiency Syndrome/blood , Antibodies, Viral/immunology , Antigen-Antibody Complex/analysis , Antigens, Viral/immunology , Burkitt Lymphoma/pathology , Cell Line , Complement Activating Enzymes/analysis , Complement C1/analysis , Complement C1q , Humans , Male , Receptors, Fc/immunology , Tumor Cells, CulturedABSTRACT
En el suero de pacientes con síndrome de inmunodeficiencia adquirida (SIDA) y sujetos de alto riesgo de SIDA (SAR), se estudió la relación entre la actividad de anticuerpos anti-VCA, la presencia de complejos inmunes circulantes (CIC) y la capacidad de inducir la citotoxicidad dependiente de anticuerpo (CDA) de linfocitos normales contra líneas celulares infectadas con EBV. Se observó que los sueros de estos pacientes indujeron la CDA de linfocitos mononucleares (LM) normales contra células linfoblastoideas infectadas con EBV (P3HRIK y Raji). El título de anti-VCA en los pacientes con SIDA y SAR no difirió del grupo control normal. El contenido de IgG sérica y el nivel de CIC precipitable con PEG-PEG-pp) fue superior al normal. No se encontró relación entre PEG-pp y el nivel de CIC determinado por fijación de C1q (C1q-F). La CDA está favorecida por la presencia de CIC que actúan como puente entre receptores Fc (RFc) de las células P3HRIK y Raji y los LM efectores. De esta manera factores presentes en el suero de pacientes con SIDA y SAR pueden cooperar con LM normales no sensibilizados en la destrucción de células infectadas por EBV a través de la CDA clásica y la CDA mediada por los puentes RFc-RFc
Subject(s)
Humans , Acquired Immunodeficiency Syndrome/immunology , Antibodies, Viral/immunology , Herpesvirus 4, Human/immunology , Cytotoxicity, ImmunologicABSTRACT
Serologic reactivity against EBV-infected lines was assayed in patients with AIDS (n = 4) or the AIDS related complex (AIDS-RC) (n = 46) residing in Argentina. Anti-VCA serology was comparable to that of controls. However sera from AIDS and AIDS-RC could induce antibody dependent cell mediated cytotoxicity (ADCC) to EBV-infected cell lines (P3HRIK and Raji). ADCC activity could be recovered in the high molecular weight fractions of AIDS and AIDS-RC sera. ADCC was observed in sera with high levels of PEG precipitable material (PEG-pp) but was unrelated to the presence of complement-fixing immune complexes (Clq-F) or to anti-VCA titers. Fc receptor (FcR) bridging between target cells FcR and effector cells FcR may play a role in the outcome of total ADCC.
ABSTRACT
En el suero de pacientes con síndrome de inmunodeficiencia adquirida (SIDA) y sujetos de alto riesgo de SIDA (SAR), se estudió la relación entre la actividad de anticuerpos anti-VCA, la presencia de complejos inmunes circulantes (CIC) y la capacidad de inducir la citotoxicidad dependiente de anticuerpo (CDA) de linfocitos normales contra líneas celulares infectadas con EBV. Se observó que los sueros de estos pacientes indujeron la CDA de linfocitos mononucleares (LM) normales contra células linfoblastoideas infectadas con EBV (P3HRIK y Raji). El título de anti-VCA en los pacientes con SIDA y SAR no difirió del grupo control normal. El contenido de IgG sérica y el nivel de CIC precipitable con PEG-PEG-pp) fue superior al normal. No se encontró relación entre PEG-pp y el nivel de CIC determinado por fijación de C1q (C1q-F). La CDA está favorecida por la presencia de CIC que actúan como puente entre receptores Fc (RFc) de las células P3HRIK y Raji y los LM efectores. De esta manera factores presentes en el suero de pacientes con SIDA y SAR pueden cooperar con LM normales no sensibilizados en la destrucción de células infectadas por EBV a través de la CDA clásica y la CDA mediada por los puentes RFc-RFc (AU)