Multidrug-resistant tuberculosis in bone marrow transplant recipient.

Multidrug-resistant tuberculosis (TB) is an increasing problem worldwide, however only three cases have been previously described in transplant recipients, especially involving lung and heart transplant. We describe a case of multidrug-resistant TB in an allogenic bone marrow transplant recipient with good response to second-line therapy.

[Autotransplantation of hematopoietic progenitor cells in multiple sclerosis]. / Autotrasplante de células progenitoras hematopoyéticas en esclerosis múltiple.

Multiple sclerosis (MS) is an autoimmune demyelinating disease exhibiting great clinical variability. For control of its primary and secondary progressive variants, treatment has met with limited success. In recent years, increasing experience has been gained with the administration of high dose chemotherapy supported by the autologous infusion of hematopoietic progenitor cells (HPC), in some instances depleted of T cells. The European and International Registry of Hematopoietic Cell Transplantation for Autoimmune Diseases include 43 MS patients. BEAM was the most frequently used conditioning therapy. Treatment related mortality was 7%. The actuarial disease free survival and the overall projected survival at 38 months were 85% and 90% respectively. The inclusion of an increasing number of MS patients into these treatment programs and the growing submission of cases to the Registries will provide useful information to determine if the initial enthusiasm generated by this approach for the control of primary and secondary progressive forms of MS is justified.

Autotrasplante de células progenitoras hematopoyéticas en esclerosis múltiple. / [Autotransplantation of hematopoietic progenitor cells in multiple sclerosis]

Multiple sclerosis (MS) is an autoimmune demyelinating disease exhibiting great clinical variability. For control of its primary and secondary progressive variants, treatment has met with limited success. In recent years, increasing experience has been gained with the administration of high dose chemotherapy supported by the autologous infusion of hematopoietic progenitor cells (HPC), in some instances depleted of T cells. The European and International Registry of Hematopoietic Cell Transplantation for Autoimmune Diseases include 43 MS patients. BEAM was the most frequently used conditioning therapy. Treatment related mortality was 7

. The actuarial disease free survival and the overall projected survival at 38 months were 85

and 90

respectively. The inclusion of an increasing number of MS patients into these treatment programs and the growing submission of cases to the Registries will provide useful information to determine if the initial enthusiasm generated by this approach for the control of primary and secondary progressive forms of MS is justified.

Combination salvage chemotherapy with MIZE (ifosfamide-mesna, idarubicin and etoposide) for relapsing or refractory lymphoma.

In this study, 54 patients with relapsed or refractory non-Hodgkin's lymphoma (NHL) were treated in a phase II, multicentric trial with ifosfamide-mesna 1500 mg/m2 IV days 1-3, idarubicin 12 mg/m2 IV day 1 and etoposide 100 mg/m2 IV day 1-3 (MIZE). Overall response was 72%; complete response (CR) and partial response (PR) were 46% and 26% respectively. In Stage I-II pts CR was 59% and in Stage III-IV pts CR was 40.5%. Patients who relapsed from an initial CR had a 64% CR rate when treated with MIZE, in contrast to refractory disease's patients who only had 19% CR (p = 0.004). The group of pts that had an objective response (CR + PR) to front line therapy had a 2 year survival rate of 55% compared with none for refractory disease (p = 0.029) after salvage therapy. Median survival for the entire group was 17.5 months. Better survival was seen in pts who were asymptomatic with low levels of LDH, previous CR, non high-grade histology, and limited disease stage at relapse. Toxicity was mainly hematologic: 91.5% had neutropenia, (56.5% grade III-IV), and 9.5% died from infectious complications. Other clinical toxicities including cardiac toxicity were negligible. MIZE chemotherapy was effective in patients with relapsed and refractory lymphoma and showed limited clinical and cardiac toxicity. Myelosupression was the most frequent single toxicity.

Virus y linfoma: leucemia / Virus and lymphoma: leukemia

El virus HTLV-I fue encontrado promotor de la Leucemia T del adulto y de la paraparesia espástica tropical. No es el único virus inculpado con la producción de neoplasias en el hombre. Se trata de un virus muy similar al HTLV-II o HIV, que se propaga en forma muy similar a éste. Tiene como diferencia fundamental, al producción de atipías linfoides y su muy largo período de incubación. Se lo encuentra en casi todo el mundo, pero su origen es el sur del Japón, si bien es endémico en la costa Americana del Pacífico, donde produce el cuadro neurológico mencionado anteriormente

Virus y linfoma: leucemia / Virus and lymphoma: leukemia

El virus HTLV-I fue encontrado promotor de la Leucemia T del adulto y de la paraparesia espástica tropical. No es el único virus inculpado con la producción de neoplasias en el hombre. Se trata de un virus muy similar al HTLV-II o HIV, que se propaga en forma muy similar a éste. Tiene como diferencia fundamental, al producción de atipías linfoides y su muy largo período de incubación. Se lo encuentra en casi todo el mundo, pero su origen es el sur del Japón, si bien es endémico en la costa Americana del Pacífico, donde produce el cuadro neurológico mencionado anteriormente (AU)