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2.
Rev Med Brux ; 36(4): 237-47, 2015 Sep.
Artigo em Francês | MEDLINE | ID: mdl-26591307

RESUMO

Malignant lymphoma and other lymphoproliferative disorders represent a group of malignant hemopathies where immunotherapy has allowed spectacular progresses over the last ten years. The recent W.H.O. classification, based upon tumor immunology, and cytogenetical anomalies, allows a better identification of each lymphoma and the comparison of homogeneous populations within various clinical studies. The increase in the incidence of non-Hodgkin lymphoma is related to the aging of the population as well as to other factors that are still to be analysed - a real challenge for the future. We have tried to offer an overview of the latest therapeutical advances while focusing on the major role of general practitioner. The most frequency askeed questions will be discussed.


Assuntos
Drogas em Investigação/uso terapêutico , Clínicos Gerais , Linfoma/terapia , Papel do Médico , Humanos , Linfoma/patologia , Padrões de Prática Médica , Terapias em Estudo/métodos
3.
Rev Med Brux ; 36(5): 436-8, 2015.
Artigo em Francês | MEDLINE | ID: mdl-26749635

RESUMO

A 53-years-old man has a dysentery since two weeks. The blood test shows Coombs-positive hemolytic anemia and inflammation. Autoimmune hemolytic anemia (AIHA) is treated with corticosteroid. A colonoscopy reveals an ulcerative colitis. The evolution of the patient is complicated by a spontaneous digestive perforation treated by total proctocolectomy. After this intervention, there is a resolution of the AIHA and the patient is gradually weaned from corticosteroids. AIHA is a rare extra-intestinal manifestation of inflammatory bowel disease essentially ulcerative colitis. Identification of this cause of secondary AIHA is important for the therapeutic strategy. However treatment is nonspecific and based on low levels of evidence.


Assuntos
Anemia Hemolítica Autoimune/etiologia , Colite Ulcerativa/complicações , Colite Ulcerativa/diagnóstico , Disenteria/complicações , Humanos , Masculino , Pessoa de Meia-Idade
4.
Rev Med Brux ; 35(4): 361-7, 2014 Sep.
Artigo em Francês | MEDLINE | ID: mdl-25675644

RESUMO

Anaemia is a problem that affects almost 10% over 65 years and 20% over 85 years. There is no physiological anaemia in the elderly. Any anaemia expresses the existence of a pathological process, regardless of its severity. Anaemia in the elderly is always associated with a poor prognosis that is in terms of mortality, morbidity and risk of fragility. The diagnostic approach to anemia in the elderly is the same as in younger individual. There are many causes of anaemia; anaemia balance is a complex diagnostic process. Most anaemias are due to a deficiency, chronic inflammation or comorbidity. However, in the elderly, the etiology of anaemia is often multifactorial. In a number of cases remain unexplained anaemia. In a number of cases, anemia remain unexplained. Treatment of anaemia is the treatment of the cause, but specific therapeutic aspects to the elderly should be considered, as among other martial substitution or use of erythropoietin (EPO).


Assuntos
Envelhecimento/fisiologia , Anemia/diagnóstico , Anemia/terapia , Idoso , Idoso de 80 Anos ou mais , Anemia/complicações , Anemia/fisiopatologia , Humanos
5.
Genom Data ; 1: 7-10, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26484051

RESUMO

Validated biomarkers predictive of response/resistance to anthracyclines in breast cancer are currently lacking. The neoadjuvant Trial of Principle (TOP) study, in which patients with estrogen receptor (ER)-negative tumors were treated with anthracycline (epirubicin) monotherapy, was specifically designed to evaluate the predictive value of topoisomerase II-alpha (TOP2A) and develop a gene expression signature to identify those patients who do not benefit from anthracyclines. Here we describe in details the contents and quality controls for the gene expression and clinical data associated with the study published by Desmedt and colleagues in the Journal of Clinical Oncology in 2011 (Desmedt et al., 2011). We also provide R code to easily access the data and perform the quality controls and basic analyses relevant to this dataset.

6.
Leukemia ; 19(1): 77-82, 2005 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-15510210

RESUMO

Although reciprocal chromosomal translocations are not typical for B-cell chronic lymphocytic leukemia (B-CLL), we identified the novel t(1;6)(p35.3;p25.2) in eight patients with this disorder. Interestingly, all cases showed lack of somatically mutated IgV(H). Clinical, morphological, immunologic, and genetic features of these patients are described. Briefly, the age ranged from 33 to 81 years (median: 62.5 years) and the sex ratio was 6M:2F. Most of the patients (6/8) presented with advanced clinical stage. Therapy was required in seven cases. After a median follow-up of 28 months, five patients are alive and three died from disease evolution. Three cases developed transformation into diffuse large B-cell lymphoma. Translocation t(1;6) was found as the primary karyotypic abnormality in three patients. Additional chromosomal aberrations included changes frequently found in unmutated B-CLL, that is, del(11)(q), trisomy 12 and 17p aberrations. Fluorescence in situ hybridization analysis performed in seven cases allowed us to map the t(1;6) breakpoints to the 1p35.3 and 6p25.2 chromosomal bands, respectively. The latter breakpoint was located in the genomic region coding for MUM1/IRF4, one of the key regulators of lymphocyte development and proliferation, suggesting involvement of this gene in the t(1;6). Molecular characterization of the t(1;6)(p35.3;p25.2), exclusively found in unmutated subtype of B-CLL, is in progress.


Assuntos
Cromossomos Humanos Par 1 , Cromossomos Humanos Par 6 , Leucemia Linfocítica Crônica de Células B/genética , Translocação Genética , Humanos , Hibridização in Situ Fluorescente , Cariotipagem
7.
Leukemia ; 18(4): 734-42, 2004 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-14973504

RESUMO

Detection of the FIP1L1-PDGFRA fusion gene or the corresponding cryptic 4q12 deletion supports the diagnosis of chronic eosinophilic leukemia (CEL) in patients with chronic hypereosinophilia. We retrospectively characterized 17 patients fulfilling WHO criteria for idiopathic hypereosinophilic syndrome (IHES) or CEL, using nested RT-PCR and interphase fluorescence in situ hybridization (FISH). Eight had FIP1L1-PDGFRA (+) CEL, three had FIP1L1-PDGFRA (-) CEL and six had IHES. FIP1L1-PDGFRA (+) CEL responded poorly to steroids, hydroxyurea or interferon-alpha, and had a high probability of eosinophilic endomyocarditis (n=4) and disease-related death (n=4). In FIP1L1-PDGFRA (+) CEL, palpable splenomegaly was present in 5/8 cases, serum vitamin B(12) was always markedly increased, and marrow biopsies revealed a distinctively myeloproliferative aspect. Imatinib induced rapid complete hematological responses in 4/4 treated FIP1L1-PDGFRA (+) cases, including one female, and complete molecular remission in 2/3 evaluable cases. In the female patient, 1 log reduction of FIP1L1-PDGFRA copy number was reached as by real-time quantitative PCR (RQ-PCR). Thus, correlating IHES/CEL genotype with phenotype, FIP1L1-PDGFRA (+) CEL emerges as a homogeneous clinicobiological entity, where imatinib can induce molecular remission. While RT-PCR and interphase FISH are equally valid diagnostic tools, the role of marrow biopsy in diagnosis and of RQ-PCR in disease and therapy monitoring needs further evaluation.


Assuntos
Síndrome Hipereosinofílica/diagnóstico , Síndrome Hipereosinofílica/genética , Receptor alfa de Fator de Crescimento Derivado de Plaquetas/genética , Fatores de Poliadenilação e Clivagem de mRNA/genética , Adulto , Benzamidas , Cromossomos Humanos Par 4 , Células Clonais/patologia , Feminino , Humanos , Síndrome Hipereosinofílica/complicações , Síndrome Hipereosinofílica/tratamento farmacológico , Mesilato de Imatinib , Hibridização in Situ Fluorescente , Masculino , Pessoa de Meia-Idade , Proteínas de Fusão Oncogênica , Fenótipo , Piperazinas/uso terapêutico , Pirimidinas/uso terapêutico , RNA Mensageiro/análise , Receptor alfa de Fator de Crescimento Derivado de Plaquetas/análise , Estudos Retrospectivos , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Taxa de Sobrevida , Fatores de Poliadenilação e Clivagem de mRNA/análise
8.
Leuk Lymphoma ; 30(3-4): 325-52, 1998 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-9713964

RESUMO

We studied myeloid and lymphoid recovery during a period of 12 months following HLA matched allogeneic bone marrow transplantation (BMT) in 15 patients. Patients were divided into three groups. Each group contained 5 patients according to the source of hematopoietic stem cell transplantation (HST): 1) related bone marrow transplantation (BMT), 2) allogeneic peripheral blood stem cell transplantation (PBSCT) and 3) matched unrelated donor transplantation (MUD). The rate and pattern of recovery of granulocytes, lymphocytes (T-cell subsets, B-cells, NK cells, subsets of CD45) were studied by cell counting and flow cytometry. Our results suggest faster recovery of PMN after PBSCT. Higher CD4 cell counts observed in the PBSCT group may have an impact on a lower incidence of opportunistic infections. Chronic GvHD mediated GvL effect seems to be more important in blood stem cell transplanted patients and this may have an influence on disease free survival.


Assuntos
Transplante de Medula Óssea/imunologia , Medula Óssea/imunologia , Transplante de Células-Tronco Hematopoéticas , Subpopulações de Linfócitos/imunologia , Neoplasias/terapia , Adulto , Antígenos CD/biossíntese , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/imunologia , Condicionamento Pré-Transplante , Transplante Homólogo
9.
Leuk Lymphoma ; 21(5-6): 519-20, 1996 May.
Artigo em Inglês | MEDLINE | ID: mdl-9172821

RESUMO

Impairment in marrow function often characterizes the evolution of myelodysplastic syndrome. As a differentiating agent, interferon alpha 2a (INF alpha) has been shown to be active in the correction of cytopenias related to myelodysplastic syndromes (MDS). We report the clinical course of 9 patients with MDS treated with low-dose subcutaneous INF alpha (1 x 10(6), 3 times per week). A significant effect on anemia was only demonstrated in one patient (11%). In the other, eight, therapy was totally ineffective and four of them could not receive the complete treatment due to worsening cytopenias or leukemic transformation. In conclusion, in our study, INF alpha had only limited activity in the treatment of myelodysplastic syndrome.


Assuntos
Fatores Imunológicos/uso terapêutico , Interferon-alfa/uso terapêutico , Síndromes Mielodisplásicas/terapia , Avaliação de Medicamentos , Feminino , Humanos , Interferon alfa-2 , Masculino , Pessoa de Meia-Idade , Síndromes Mielodisplásicas/mortalidade , Proteínas Recombinantes , Falha de Tratamento
10.
Leukemia ; 9(6): 1102-3, 1995 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-7596177

RESUMO

Partial tumoral responses have been described after cyclosporin A treatment in refractory B-chronic lymphocytic leukemia patients. We report the effect of this therapy in five patients prospectively treated with oral conventional dose of cyclosporin A. Antitumoral efficiency was marginal (one sustained partial response among five patients) which, added to a potential worsening of natural and therapy-related immunodepression, limits its use in this instance.


Assuntos
Antineoplásicos/uso terapêutico , Ciclosporina/uso terapêutico , Leucemia Linfocítica Crônica de Células B/tratamento farmacológico , Adulto , Idoso , Antineoplásicos/efeitos adversos , Ciclosporina/efeitos adversos , Feminino , Humanos , Leucemia Linfocítica Crônica de Células B/sangue , Contagem de Leucócitos/efeitos dos fármacos , Masculino , Pessoa de Meia-Idade , Contagem de Plaquetas/efeitos dos fármacos
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