Asunto(s)
Anemia Hemolítica Autoinmune/tratamiento farmacológico , Infecciones por Citomegalovirus/virología , Citomegalovirus/efectos de los fármacos , Inmunosupresores/uso terapéutico , Activación Viral/efectos de los fármacos , Anciano , Anemia Hemolítica Autoinmune/virología , Citomegalovirus/fisiología , Infecciones por Citomegalovirus/inducido químicamente , Femenino , Humanos , Inmunosupresores/efectos adversos , Masculino , Persona de Mediana EdadRESUMEN
Our case highlights the possible coexistence of essential thrombocythemia (ET) and idiopathic thrombocytopenic purpura (ITP), two pathological entities with opposite clinical and laboratory manifestations. It also underlines how an autoimmune attack has been temporarily able to overcome a neoplastic clone.
Asunto(s)
Leucemia-Linfoma Linfoblástico de Células T Precursoras/patología , Neoplasias del Recto/diagnóstico , Neoplasias del Recto/secundario , Adulto , Biomarcadores , Biopsia , Colonoscopía , Humanos , Inmunofenotipificación , Imagen por Resonancia Magnética , Masculino , Tomografía Computarizada por Tomografía de Emisión de Positrones , Leucemia-Linfoma Linfoblástico de Células T Precursoras/metabolismoAsunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Citarabina/uso terapéutico , Quimioterapia de Inducción/métodos , Leucemia Mieloide Aguda/tratamiento farmacológico , Vidarabina/análogos & derivados , Anciano , Médula Ósea/efectos de los fármacos , Médula Ósea/patología , Esquema de Medicación , Femenino , Humanos , Leucemia Mieloide Aguda/mortalidad , Leucemia Mieloide Aguda/patología , Masculino , Persona de Mediana Edad , Inducción de Remisión , Estudios Retrospectivos , Análisis de Supervivencia , Vidarabina/uso terapéuticoAsunto(s)
Leucemia Mielógena Crónica BCR-ABL Positiva/complicaciones , Policitemia/complicaciones , Anciano , Antineoplásicos/uso terapéutico , Proteínas de Fusión bcr-abl/genética , Humanos , Mesilato de Imatinib/uso terapéutico , Leucemia Mielógena Crónica BCR-ABL Positiva/sangre , Leucemia Mielógena Crónica BCR-ABL Positiva/tratamiento farmacológico , Leucemia Mielógena Crónica BCR-ABL Positiva/genética , Masculino , MutaciónRESUMEN
PATIENT: Male, 64 FINAL DIAGNOSIS: Acute myeloid leukemia (AML) Symptoms: - MEDICATION: - Clinical Procedure: - Specialty: - OBJECTIVE: Unusual clinical course. BACKGROUND: Central nervous system (CNS) involvement is a sporadic presenting finding in patients with acute myeloid leukemia (AML) both at diagnosis and at relapse. Moreover patients with CNS localization are often asymptomatic, while sometimes show meningeal signs and symptoms or, extremely rarely, signs of cranial nerve impairment. CASE REPORT: Here we report on a patient with refractory AML who suddenly developed strabismus and diplopia. Both neurological and ophtalmologic examinations were suggestive of a bilateral VI cranial nerve palsy. Noteworthy, both a cranial CT and MRI were substantially normal, while a rachicentesis was performed and cerebrospinal fluid examination was clearly suggestive of a meningeal involvement by AML. CONCLUSIONS: This is to our knowledge the first reported case in which the clinical picture of meningeal localization in an AML patient was dominated by an isolated abducens cranial nerve impairment. Moreover it highlights as unexplained strabismus and diplopia can be considered as a potential sign of CNS involvement, even if conventional imaging is negative.
Asunto(s)
Anticoagulantes/química , Ácido Edético/química , Púrpura Trombocitopénica Idiopática/tratamiento farmacológico , Receptores Fc/uso terapéutico , Proteínas Recombinantes de Fusión/uso terapéutico , Trombocitopenia/diagnóstico , Trombopoyetina/uso terapéutico , Anciano , Errores Diagnósticos , Femenino , Humanos , Agregación Plaquetaria , Recuento de Plaquetas , Púrpura Trombocitopénica Idiopática/sangreRESUMEN
Regulatory T cells (T(reg)) have often been ascribed a role in the pathophysiology of several neoplastic diseases considering their potential ability to suppress anti-tumor immunity. This is particularly the case in myelodysplastic syndromes (MDS), which are clonal hematologic disorders characterized by marked immune dysregulation. We analyzed T(reg) frequencies in a cohort of 36 patients with early-stage MDS using a flow-cytometric approach based on the concomitant expression of CD25 and CD127. MDS patients showed a higher frequency of CD4+CD25(high)+CD127(low) T(reg) than healthy controls (1.51 vs. 1.14%), with no specific effect of patient- and disease-related factors. Our data point to impaired anti-tumor immunity in patients with MDS, even in the early stage, which has already been noted in other clonal disorders.
