RESUMO
In an attempt to evaluate the immune competence of urologic cancer patients, antibody-dependent cell-mediated cytotoxicity (ADCC) were performed in thirty-four patients and same numbers of age and sex matched normal controls. Also we compared of the level of ADCC before and after the operation. Concomittantly the values of ADCC were examined by histological grading and clinical staging. We used 51Cr-labelled chicken erythrocytes sensitized with 7s rabbit anti-chicken erythrocytes antibody as target cells and patient peripheral mononuclear cells as effector cells. 1. Effector cells of the patients with the urologic cancer showed significantly lower ADCC than those of normal controls. 1) All urologic cancer. Controls 41.4+/-6.0% (n=34) Preoperation 22.1+/-6.8% (n=34) 2) Transitional cell carcinoma of the renal pelvis and the bladder. Controls 41.7+/-6.1% (n=28) Preoperation 22.5+/-6.3% (n=28) 3)Non-transitional cell carcinoma(renal cell Ca. prostate ca. penis ca. seminoma). Controls 40.2+/-5.9% (n=6) Preoperation 20.6+/-4.6% (n=6) 2. In the patients with the transitional cell carcinoma of the bladder and the renal pelvis, highly graded patients had tendency to have lower response of ADCC. Grade I 27.3+/-4.0% (n=14) Grade II 19.9+/-4.l% (n=7) Grade III 15.5+/-3.2% (n=7) 3. In the patients with bladder carcinoma highly staged patients had tendency have lower response of ADDC. Stage T
Assuntos
Humanos , Masculino , Citotoxicidade Celular Dependente de Anticorpos , Carcinoma de Células de Transição , Galinhas , Eritrócitos , Imunocompetência , Pelve Renal , Competência Mental , Pênis , Próstata , Carga Tumoral , Bexiga Urinária , Neoplasias UrológicasRESUMO
BACKGROUND: Serologic test for syphilis(STS) is an old traditional donor screening test for preventing transfusion-transmitted syphilis. By conducting STS, history taking for donors and refrigeration of blood, transfusion associated syphilis is very rare at present. This study evaluated the usefulness of the STS as a surrogate marker for preventing the transfusion of human immunodeficiency virus(HIV) via the transfusion of infectious window-period blood in Korean blood donors. METHODS: Demographic and laboratory information on blood donations made between January 1997 and December 1998 in 16 Korean Red Cross Blood Centers was analyzed. STS positive rate of 239 HIV-infected people and blood donors in 1999 were investigated. RESULTS: Of 4,808,297 donations over 2-year period, 3,956 (0.08%) were positive in STS and 40 (0.0008%) were anti-HIV confirmed positive. Of those, two were simultaneously positive for STS and anti-HIV. Among donations, Anti-HIV positive donations were 64 times more likely to be STS positive(odds ratio=63.9) and positive predictive value (PPV) of STS for anti-HIV was 0.05%. Fourteen of 239 HIV-infected people were STS positive. CONCLUSION: STS positivity was higher in anti-HIV positive donors, but the PPV of STS for anti-HIV was low. STS as a donor screening test is considered as a poor marker for preventing post-screening HIV infections and the usefulness of STS must be evaluated in its own value.
Assuntos
Humanos , Biomarcadores , Doadores de Sangue , Seleção do Doador , Infecções por HIV , HIV , Cruz Vermelha , Refrigeração , Testes Sorológicos , Sífilis , Doadores de TecidosRESUMO
BACKGROUND: As the number of malaria patients has increased in Korea, the number of blood donors who are diagnosed as malaria after donation has also increased. And during 1997~2001, ten cases of transfusion-transmitted malaria were reported. We investigated the transfusion safety of blood that was donated by malaria patients before diagnosis. METHODS: For a total of 2,552 malaria patients diagnosed in 2001, blood donation history of past one year before diagnosis was inquired at the beginning of 2002. Then we inquired informations about recipients of the hospitals through the regional Red Cross blood centers. we also inquired development of malaria after transfusion for the recipients in the August of 2002. Malaria antibody test results of donated blood were also analyzed to determine the status of immunity of donors in Seoul, Gyeonggi and Gangwon area. RESULTS: Among 2,552 malaria patients, 162 (6.3%) patients had donated within one year before diagnosis and they were all man. Their blood was processed into 292 units of blood components and supplied to 90 hospitals, where it was transfused 286 patients. Among these 286 patients, no one was diagnosed as malaria until time of database retrieving. Among 162 malaria patient, enzyme immunoassay malaria antibody test results of 107 (66.0%) patients were available, and all were negative. CONCLUSION: No one has developed malaria among the recipients transfused with blood that was donated by malaria patients before diagnosis. Therefore, the infectivity of blood donated before malaria diagnosis is thought to be very low. As antibody to malaria was not produced in some of malaria patients before diagnosis, this finding could be useful for the study of immunology of malaria infection.
Assuntos
Humanos , Alergia e Imunologia , Doadores de Sangue , Diagnóstico , Técnicas Imunoenzimáticas , Coreia (Geográfico) , Malária , Cruz Vermelha , Seul , Doadores de TecidosRESUMO
BACKGROUND: In Korean Red Cross, recombinant immunoblot assay (RIBA) has been used for the confirmatory test of HCV positive units since 1995. To certify the HCV infection in blood donors who showed the 'indeterminate result on the RIBA test, this study was performed. METHODS: Three enzyme immunoassay (EIA) kits (LG HCD 3.0, DONG-A HCV 3.0, and ORTHO HCV 3.0)and RNA detection method were employed to evaluate infection state of 135 samples of the 'indeterminate in the RIBA test. RESULTS: The 52.6% of the samples showed the same test results with three EIA kits. Fifteen samples (11.1%) were HCV RNA positive with RT-PCR-hybridization technique. Among 15 samples of HCV RNA positive, 13 (86.7%), 13 (86.7%), and 14(93.3%) of samples were positive in LG HCD 3.0, Ortho HCV 3.0 and Dong-A HCV 3.0 EIA, respectively. In the analysis of RIBA band reaction, HCV RNA positivity were correlated with core14, core518, and 897 antigen. However, among 64 samples which react with core antigen only, five samples (7.8%) were HCV RNA positive. CONCLUSION: Based on the results of the present study, it is recommend that the HCV RNA test be used as a method of confirmatory test in order to notify exact HCV positivity status to blood donor who showed indeterminate RIBA result.
Assuntos
Humanos , Doadores de Sangue , Técnicas Imunoenzimáticas , Cruz Vermelha , RNA , Doadores de TecidosRESUMO
Total body irradiation has been applied to treat acute leukemia and chronic granulocytic leukemia. 20 patients with acute leukemia or chronic granulocytic leukemia were treated with total body irradiation using 6 MV linear accelerator before bone marrow transplantation at the Division of Therapeutic Radiology, department of Radiology, St. Mary's Hospital, catholic University Medical College from August 1987 to September 1988. Among 20 patients, 8 patients received 6 fractions of 200 cgy (total 1200 cgy), 10 patients received a single 850 cgy radiation, 1 patient received 4 fractions totaling 850 cgy (200, 200, 200, 250), and 1 patient received 1100 cgy in 2 fractions (850, 250). 17 patients received allogenic grafts, 2 patients received autologous grafts, and only one patients received one locus mismatched graft. 13 patients are still alive and 7 patients died. The complications induced by total body irradiation were nausea and vomiting, diarrhea, skin eruption, mucositis, and pneumonitis.
Assuntos
Humanos , Transplante de Medula Óssea , Diarreia , Leucemia , Leucemia Mielogênica Crônica BCR-ABL Positiva , Mucosite , Náusea , Aceleradores de Partículas , Pneumonia , Radioterapia (Especialidade) , Pele , Transplantes , Vômito , Irradiação Corporal TotalRESUMO
Hepatic graft-versus-host disease (GVHD) occurs in nearly one-third of recipients of HLA-identical sibling bone marrow transplantation (BMT), and is a major cause of morbidity and mortality following BMT. Hepatic dysfunction after BMT may result from a number of causes such as pretransplant chemoradiation, drugs for GVHD prophylaxis, venoocclusive disease, various infections, GVHD, and infiltration of recurrent malignancy. The clinical distinction of these causes may be difficult and the treatment of each causes is quite different. Therefore the early diagnosis of GVHD is very important. Hepatic GVHD is recognized to immunologic disorder such as primary biliary cirrhosis, and is characterized by cholestasis due to extensive bile duct damage and mild hepatocellular necrosis. In Korea, the occurrence of GVHD is about 20-45%. We report three cases of severe hepatic GVHD after allogeneic BMT, which were proven by laparoscopic liver biopsy in 1996. There were differences in primary illness, associated condition and disease progression.
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Humanos , Ductos Biliares , Biópsia , Transplante de Medula Óssea , Colestase , Progressão da Doença , Diagnóstico Precoce , Doença Enxerto-Hospedeiro , Coreia (Geográfico) , Laparoscopia , Cirrose Hepática Biliar , Fígado , Mortalidade , Necrose , IrmãosRESUMO
Radiation therapy was the treatment of choice for CML in the past, in the form of Sl or radioactive phosphorus. Its use has been replaced to a large extent by various chemotherapeutic agents. Recently Sl in CML has been used, both to relieve painful splenomegaly and to take advantage of an indirect effect of Sl on unirradiated bone marrow. We have treated 15 CML cases who had a huge spleen during chemotherapy or even after chemotherapy by 6 MV linear accelerator during the past two years at the Division of Radiation Therapy, Kang Nam St. Mar's Hospital, Catholic College. Response to Sl has been rated according to the scoring system of Roger W. Byhardt, et al. which evaluated the splenic and hematologic response as well as the response of disease-elated systems. According to this scoring system, most patients demonstrated a significant relief of splenomegaly along with improvement of hemogram. And we observed the change of Karnofsky Performance Status after Sl, and survival after a confirmative diagnosis and Sl.
Assuntos
Humanos , Medula Óssea , Diagnóstico , Tratamento Farmacológico , Avaliação de Estado de Karnofsky , Leucemia Mielogênica Crônica BCR-ABL Positiva , Aceleradores de Partículas , Fósforo , Baço , EsplenomegaliaRESUMO
Between August 1987 and July 1991, 22 patients with acute nonlymphocytic leukemia have received allogeneic bone Marrow transplantation (BMT) with non-T-Iymphocyte-depleted marrow obtained from matched sibling donors. Of these patients, 12 patients were in first complete remission(CR) and 10 patients in second CR or greater or in relapse. All patients were treated with a preparative regimen consisting of cyclophosphamide (CTX, 60 mg/kg) or combined drags, and 850 cGy single-dose or 150~200 cGy fractionated total body irradiation (TBI) administered twice daily for a total dose of 1200~1320 cGy. Survivors have been followed from 8 to 54.5 months (median, 24 months). The overall 2 year survival rate, relapse rate and incidence of radiation pneumonitis and graft versus host disease(GVHD) have been evaluated by age, phase of disease, initial WBC count, modality of TBI or conditioning chemotherapy. Overall 2 year survival was 58%. The median survival was 31 months and mean survival was 23.2 months. Overall survival have significant impact in patients of age > 19 years old (p=0.008), patients in first CR (p=0.09). Two years survival rate is significantly correlated with age (>19 vs 19, 79.4% vs 14.3%, p=0.0008), regimen of chemotherapy (CTX vs combined drag, 76.9% vs 33.3%, p=0.04), phase of disease (1st CR vs 2nd CR or relapse, 83.3% vs 30%, p=0.01) and method of TBI (fractionated vs single dose, 70.7% vs 37.5%, p=0.05). The influence of French-American-British (FAB) subtypes on relapse rate is not significant, but initial WBC count > 20000/mm3 is associated with increased relapse rate. There is difference in the rate of radiation pneumonitis (14.3% vs 25%1, GVHD (14.3% vs 50%) and relapse (21.4% vs 50%) according to fractionated versus single-dose TBI. As mentioned above, fractionated TBI is compatible for the preparative regimen combined with chemotherapy in allogeneic BMT of first CR patients under 41 years of age with suitable donor. Those results from a retrospective, non-randomized study clearly need additional clinical data, ideally from a randomized study.
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Humanos , Adulto Jovem , Transplante de Medula Óssea , Medula Óssea , Ciclofosfamida , Tratamento Farmacológico , Incidência , Leucemia Mieloide Aguda , Pneumonite por Radiação , Recidiva , Estudos Retrospectivos , Irmãos , Taxa de Sobrevida , Sobreviventes , Doadores de Tecidos , Transplantes , Irradiação Corporal TotalRESUMO
No abstract available.
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Humanos , Transplante de Medula Óssea , Medula Óssea , Diarreia , SomatostatinaRESUMO
Between July 1987 and December 1992, we treated 22 patients with chromic myelogenous leukemia; 14 in the chronic phase and 8 with more advanced disease. All were received with allogeneic bone marrow transplantation from HLA-identical sibling donors after a total body irradiation (TBI) cyclophosphamide conditioning regimen. Patients were non-randomly assigned to either 1200 cGy/6fractions/3days (6 patients) or 1320 cGy/8 fractions/4days (16 patients) by dose of TBI. Of the 22 patients, 8 were prepared with cyclophosphamide alone, 14 were conditioned with additional adriamycin or daunorubicin. To prevent graft versus host disease, cyclosporine was given either alone or in conjunction with methotrexate. The actuarial survival and leukemic-free survival at four years were 58.5% and 41.2%, respectively, and the relapse rate was 36% among 22 patients. There was a statistically significant difference in survival between the patients in chronic phase and more advanced phase (76% vs 33%, p=0.05). The relapse rate of patients receiving splenectomy was higher than that of patients receiving splenic irradiation (50% vs 0%, p=0.04). We conclude that the probability of cure is highest if transplantation is performed while the patient remains in the chronic phase.
Assuntos
Humanos , Transplante de Medula Óssea , Medula Óssea , Ciclofosfamida , Ciclosporina , Daunorrubicina , Doxorrubicina , Doença Enxerto-Hospedeiro , Leucemia Mielogênica Crônica BCR-ABL Positiva , Leucemia Mieloide , Metotrexato , Recidiva , Irmãos , Esplenectomia , Doadores de Tecidos , Irradiação Corporal TotalRESUMO
No abstract available.
Assuntos
Tratamento Farmacológico , Leucemia Mieloide Aguda , Náusea , VômitoRESUMO
PURPOSE: We assessed the three-alkylator combination of busulfan, melphalan and thiotepa or TBI, melphalan and thiotepa conditioning for allogeneic stem cell transplantation in 7 adult patients with refractory or relapsed acute leukemias. MATERIALS AND METHODS: Six patients were transplanted for acute myeloid leukemia, one for acute lymphoblastic leukemia and included 5 of relapsed refractory, 2 of relapsed after first-BMT. All but 1 cases received G-CSF stimulated CD34+ allogeneic peripheral blood progenitor cells (PBPCs) in addition to stimulated allogeneic marrow. RESULTS: All patients except one engrafted (median time to ANC >0.5 10 (9)/L=11days, to platelets >30 X 10 (9)/L=14 days) successfully and complete remission was obtained in 6 patients. Grade I-II acute GVHD and controllable regimen-related toxicity especially oral mucositis (grade II-III) developed in all cases, but 2 patients including one second- allogeneic BMT patient expired early by transplant-related toxicity of hepatic or multiorgan failure along the course of sepsis. CONCLUSION: Although the observation period on these cases are limited, the data presented show that the combination of busulfan, melphalan and thiotepa is tolerable as a preparative regimen for allogeneic marrow transplantation in high-risk leukemic patients. We think that these encouraging results need to be confirmed in prospective studies in the future.