Risk factors for outcomes after unrelated cord blood transplantation for adults with acute lymphoblastic leukemia: a report on behalf of Eurocord and the Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation.

We performed a retrospective analysis on 421 adult patients who underwent unrelated cord blood transplantation (UCBT) for ALL. Median age was 32 years; 46% were in first CR (CR1), 32% in CR2 and 22% had advanced disease. Double UCBT was performed in 173 patients (41%). Myeloablative conditioning (MAC) was given to 314 patients (75%). Cumulative incidence (CI) of 60-day neutrophil recovery was 78%. CI of acute and chronic GVHD was 33 and 26%, respectively. Non-relapse mortality (NRM) at 2 years was 42%. Age⩾35 years (P<0.0001), advanced disease at UCBT (P<0.0001) and use of MAC (P<0.0001) were associated with increased NRM. Relapse incidence (RI) at 2 years was 28%; use of reduced intensity conditioning (RIC) (P=0.0002) was associated with increased RI. Two-year leukemia-free survival (LFS) was 39% for patients in CR1, 31% for CR2 and 8% for advanced disease. In multivariate analysis, factors associated with decreased LFS rate were: age ⩾35 years (P=0.034), use of MAC (P=0.032) and advanced disease (P<0.0001). These results show that UCBT is a valuable option to treat high-risk adult ALL when in remission. Strategies to decrease toxicity and relapse are needed to improve final outcomes.

[Ileal loop perforation caused by tuberculosis in patients with the acquired immunodeficiency syndrome]. / Perfuração de alça ileal por tuberculose em portadores da síndrome da imunodeficiência adquirida.

UNLABELLED: This clinical and surgical study was performed in a Public Government Hospital with the purpose of investigating the etiology and treatment of acute perforative abdomen in AIDS patients, particularly in the case of intestinal tuberculosis. The authors describe the cases of two young male AIDS patients with acute abdomen in which surgery revealed intestinal ileal perforation due to tuberculosis. One of the patients did not survive due to his poor post-operative condition. The other case had a better evolution and was submitted to outpatient care. The immediate surgery with occlusion of the perforation and biopsy of the lesion permitted to arrive at the etiology and contributed to the good evolution of the second patient. CONCLUSION: Literature indicates cytomegalovirus as the main cause of intestinal perforation in AIDS patients. In this study, etiology was tuberculous and this is probably an important cause of acute perforative abdomen in our AIDS patients due to the general prevalence of tuberculosis in AIDS patients in Brazil and in other developing countries.