RESUMO
OBJECTIVES: The objective of this study is to evaluate the toxicity of autologous transplantation of non-frozen peripheral blood stem cells in Moroccan patients with multiple myeloma. MATERIAL AND METHODS: This was a bicentric retrospective study conducted in the Clinical Haematology Department of Mohammed V Military Teaching Hospital and at the Al Madina Clinic in Casablanca. The study period was from January 2015 to June 2019. All patients with multiple myeloma who had undergone an autologous peripheral stem cell transplant without freezing were included. Mobilisation was performed with lenograstim alone and the collected stem cells were stored for 24-48hours in a blood bank refrigerator at a temperature of 4°C. After standard conditioning with high-dose melphalan, the peripheral blood stem cells were reinjected 24 h following conditioning. RESULTS: Over the study period, 55 patients received an autologous transplant using non-frozen peripheral blood stem cells. The median richness of the CD34 cells collected was 4.5×106 CD34/kg (range: 2-12.2). The time required for neutrophil recovery was 12 days (range: 7-19). The time required for platelet recovery was 14 days (range: 9-32). The mortality rate within 100 days post-transplant was 3.6%. We did not observe any cases of graft failure. CONCLUSION: Our study finds good feasibility and low toxicity of autologous peripheral stem cell transplantation without freezing in patients with multiple myeloma.
Assuntos
Preservação de Sangue , Mieloma Múltiplo/terapia , Transplante de Células-Tronco de Sangue Periférico/métodos , Adulto , Idoso , Contagem de Células Sanguíneas , Preservação de Sangue/métodos , Feminino , Sobrevivência de Enxerto , Mobilização de Células-Tronco Hematopoéticas , Humanos , Lenograstim/farmacologia , Masculino , Melfalan/farmacologia , Pessoa de Meia-Idade , Marrocos , Mieloma Múltiplo/sangue , Transplante de Células-Tronco de Sangue Periférico/efeitos adversos , Estudos Retrospectivos , Condicionamento Pré-Transplante/efeitos adversos , Transplante AutólogoAssuntos
Antibióticos Antineoplásicos/efeitos adversos , Bleomicina/efeitos adversos , Doenças Pulmonares Intersticiais/induzido quimicamente , Enfisema Mediastínico/induzido quimicamente , Pneumotórax/induzido quimicamente , Antibióticos Antineoplásicos/uso terapêutico , Bleomicina/uso terapêutico , Evolução Fatal , Doença de Hodgkin/tratamento farmacológico , Humanos , Pulmão/patologia , Doenças Pulmonares Intersticiais/complicações , Masculino , Enfisema Mediastínico/complicações , Pessoa de Meia-Idade , Pneumotórax/complicações , Tomografia Computadorizada por Raios XAssuntos
Dor Aguda/etiologia , Transfusão de Plaquetas/efeitos adversos , Reação Transfusional/etiologia , Anemia Aplástica/terapia , Transplante de Medula Óssea , Dispneia/etiologia , Humanos , Hipotensão/etiologia , Masculino , Pessoa de Meia-Idade , Plaquetoferese/instrumentação , Taquicardia/etiologia , Trombocitopenia/etiologia , Trombocitopenia/terapiaAssuntos
Candidíase Invasiva/diagnóstico por imagem , Radioisótopos de Flúor , Fluordesoxiglucose F18 , Hepatite/diagnóstico por imagem , Imagem Multimodal , Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos , Esplenopatias/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Anfotericina B/uso terapêutico , Antifúngicos/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Candidíase Invasiva/tratamento farmacológico , Candidíase Invasiva/etiologia , Neutropenia Febril Induzida por Quimioterapia/complicações , Citarabina/administração & dosagem , Citarabina/efeitos adversos , Daunorrubicina/administração & dosagem , Daunorrubicina/efeitos adversos , Hepatite/tratamento farmacológico , Hepatite/etiologia , Humanos , Hospedeiro Imunocomprometido , Leucemia Mieloide Aguda/complicações , Leucemia Mieloide Aguda/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Esplenopatias/tratamento farmacológico , Esplenopatias/etiologiaRESUMO
Introduction. We report the case of a Bing and Neel syndrome revealed by an isolated left ptosis. Case Report. a 57-year-old man was followed up since October 2003 for a typical Waldenström's macroglobulinemia. A first complete remission was obtained with chlorambucil. In August 2004, he relapsed. A second complete remission was obtained with RFC chemotherapy regimen (rituximab, fludarabine, and cyclophosphamide). In October 2009, the patient presented with an isolated left ptosis revealing a Bing and Neel syndrome. The diagnosis was suspected on MRI and confirmed by the detection in the CSF of a monoclonal IgM similar to the one found in the plasma. A quite good partial remission has been obtained after one course of RDHAP (rituximab, dexamethasone, cytarabine, and cisplatin) and 3 courses of RDHOx (rituximab, dexamethasone, cytarabine, and oxaliplatin), in addition to ten intrahectal chemotherapy injections. The treatment was followed by intensification and autologous stem cell transplantation. At D58, the patient died due to a septic shock. Conclusion. BNS is a rare and potentially treatable complication of WM. It should be considered in patients with neurologic symptoms and a history of WM.
RESUMO
Seventy-nine strains of Acinetobacter baumannii isolated from pathologic products obtained mainly from surgical and intensive care units at the Rabta Hospital in Tunisia were studied. The sensitivity of these bacteria to the antibiotics used singly or in combination was tested in order to determine the most effective agents. Sensitivity to the disinfectants routinely used in our hospital was also studied using the "dilution-neutralisation" method according to "AFNOR" norms in order to identify the product with the most powerful preventive effect for Acinetobacter baumannii infection. The bacteria tested were resistant to all antibiotics except imipernem, colistin, and some aminoglycosides. A combination of imipenem-amikacin was effective against all strains. Best disinfection was obtained after 5 minutes of bacterial contact with aldehyde, phenol and amphotere.