Aplasia medular secundaria a la infección por el virus del dengue / Medullary aplastic anemia secondary to dengue virus infections

La aplasia medular es una enfermedad hematológica caracterizada por citopenia periférica y una marcada hipocelularidad medular. Esta es una rara complicación de infecciones como la fiebre hemorrágica del dengue. Se presentan 2 pacientes en edad pediátrica que fueron atendidas en el servicio de Pediatría del Instituto de Hematología e Inmunología con el diagnóstico de aplasia medular en el transcurso de una infección por dengue (IgM+). Ambos casos tuvieron diagnóstico histológico de aplasia medular muy grave con una evolución tórpida(AU)

Aplastic anemia is a blood disorder characterized by peripheral cytopenia and marked marrow hypocellularity. This is a rare complication of infections, such as dengue hemorrhagic fever. Two pediatric patients were referred to our center with the diagnosis of aplastic anemia in the course of infection by dengue (IgM +), both with severe pancytopenia(AU)

The availability of full match sibling donors and feasibility of allogeneic bone marrow transplantation in Brazil.

The feasibility of allogeneic bone marrow transplantation (alloBMT) in a developing country has not yet been demonstrated. Many adverse factors including social and economic limitations may reduce the overall results of this complex and expensive procedure. Our objective was to characterize the most important clinical, social and economic features of candidates for transplantation and their potential donors as well as the influence of these factors on overall survival in a retrospective and exploratory analysis at a university hospital. From July 1993 to July 2001, candidates for BMT were referred to the Bone Marrow Transplantation Unit by Hematology and Oncology Centers from several regions of Brazil. A total of 1138 patients were referred to us as candidates for alloBMT. Median age was 25 years (range: 2 months-60 years), 684 (60.1%) were males and 454 (39.9%) were females. The clinical indications were severe aplastic anemia and hematological malignancies. From the total of 1138 patients, 923 had HLA-typing; 497/923 (53.8%) candidates had full match donors; 352/1138 (30.8%) were eligible for alloBMT. Only 235 of 352 (66.7%) were transplanted. Schooling was 1st to 8th grade for 123/235 (52.3%); monthly family income ranged from US$60 (7%) to more than US$400 (36%). Overall survival for patients with chronic myeloid leukemia, severe aplastic anemia and acute myeloid leukemia was 58, 60 and 30%, respectively. Thus, overall survival rates for the most frequent hematological diseases were similar to those reported in the International Registry, except for acute myeloid leukemia. This descriptive and exploratory analysis suggests the feasibility of alloBMT in a developing country like Brazil.

[Hodgkin's disease treated with chemotherapy at reduced dosage]. / Enfermedad de Hodgkin tratada con quimioterapia a dosis reducidas.

Fifty-six patients with Hodgkin's disease in advanced stages (III-IV) were entered in a study aimed to compare standard doses (28 cases) with low doses (28 cases) ABVD regimen. Both groups had similar clinico-pathological features. The group receiving standard doses chemotherapy achieved complete remission rate of 89% versus 85% for the low-doses group. The number of relapses was, respectively, 8 and 9, and the duration of remission was 66 and 57 months, respectively. Presently, 24 patients have died, 11 of the standard doses group and 13 of the reduced doses group. Toxicity was notably higher in the group receiving standard dosage, where fatal myelosuppression was present in two instances. Those data appear to suggest that chemotherapy with reduced doses for Hodgkin's disease can attain similar response rate and survival than those achieved with standard treatment, with the advantages of a lower toxicity.

Causes of death in Jamaica, 1953 to 1964: an analysis of post-mortem diagnosis at the University of the West Indies

During the period 1953 to 1964, post-mortem examinations were performed on 4,115 cases at the University Hospital of the West Indies. The diagnosed made in these cases have been reviewed and are presented in this paper. 48 per cent of the cases were less than seventeen years of age, of which 18.5 per cent were in the perinatal age group. The number of deaths from malnutrition and infection in children aged under three years has declined during the period of study. In the adult group neoplastic disease was the major cause of death followed closely by cardiovascular lesions, amongst which hypertensive heart disease was a common entity. Chronic bronchitis and emphysema was common amongst the respiratory causes of death.(AU)