摘要:

Abstract: In this report we have reviewed studies on the clinical effect of the interferon (IFN) treatment of 304 patients suffering from cutaneous T‐cell lymphoma (CTCL). Intramuscular, subcutaneous or intralesional administration of recombinant IFN has been used as monotherapy or as part of combination therapy. In general, IFN has proved to be a relatively effective agent in the treatment of CTCL, and the best responses have been achieved in the early stages of the disease. In CTCL the overall response rate to IFN including complete, partial and minor responses is 70%. Neither the doses nor the routes of administration in these studies has any statistically significant influence on the clinical response to IFN treatment. Continuous low‐dose IFN therapy, presumably in combination with psoralen and UVA light (PUVA), is recommended. This review concludes that the clinical stage of disease before treatment is the only known predictive parameter concerning the clinical response to IFN treatment in patients with

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1993.tb01595.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract: Secretion of the potentially antileukaemic cytokines IFN‐γ and TNF‐α was investigated for CD4+and CD8+TCRαβ+T‐cell clones derived from 4 leukaemia patients 3–6 weeks after allogeneic BMT. We investigated cytokine secretion in response to the activation signal accessory cells + phytohaemagglutinin + Interleukin 2. All clones derived after BMT were capable of IFN‐γ and TNF‐α secretion, and both for CD4+(n = 96) and CD8+(n = 8) T cells quantities of IFN‐γ and TNF‐α were significantly correlated with one another. When comparing the overall results for posttransplant and normal T‐cell clones derived from 2 bone marrow donors (n = 65), both CD4+and CD8+TCRαβ+T‐cell clones showed increased IFN‐γ production, and CD4+but not CD8+clones showed a decreased TNF‐α secretion. The results suggest that noncytotoxic T cells derived after allogeneic BMT can produce IFN‐γ and TNF‐α and may thus be

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1993.tb01596.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract: One‐hundred‐and‐fifty‐one patients with previously untreated multiple myeloma were allocated to treatment with either NOP regimen (mitoxantrone 16 mg/m2and vincristine 2 mg day 1 and prednisolone 250 mg day 1–4 and 17–20) or M + P regimen (melphalan 0.25 mg/kg and prednisolone 100–200 mg/day day 1–4). Both regimens were repeated every 4 weeks and were scheduled for 1 year. Seventy‐seven patients were treated with NOP and 74 patients with M + P. No major clinical differences were recorded between the groups before treatment. Sixty percent of the patients responded (CR + PR) to NOP versus 64% to M + P (NS). The time to progression was 16 months (95% C.L. 14–51) in the NOP group versus 21 months (95% C.L. 15–27) in the M + P group (NS). The median survival was 14 months (7–21) in the NOP group and 31 months (21–43) in the M + P group (p = 0.02). NOP was significantly more toxic than M + P. Seven patients treated with NOP died due to infection and neutropenia and 1 patient died of cardiac toxicity, in contrast to 1 death due to infection and neutropenia in the M + P group. Gastrointestinal toxicity was acceptable in both groups. In conclusion, NOP was inferior to M + P as primary tr

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1993.tb01597.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract: Chronic exposure of adult rats to dietary untake of cadmium (15 mg CdCl2/day/kg for 30 days) leads to development of anemia and thrombocytosis. Anemia is characterized by significant reticulocytosis (13.1 ± 1.0%), anysocytosis, poikilocytosis, iron deficiency and marked alterations of antioxidant and metabolic status of red blood cells. Activities of SOD, catalase, GPx and GR were significantly increased in red blood cells of cadmium‐treated rats. In treated animals cadmium induced an increase of red cell reduced and oxidized glutathione with no changes of GSSG/GSH ratio. However, significant reduction of lipid peroxidation was found. Plasma levels of tocopherol and ascorbate, as well as activity of glutathione‐S‐transferase, were all significantly increased in cadmium‐treated rats. The energy metabolism of red blood cells was deeply altered in cadmium‐treated rats. The levels of ATP, ADP, AMP and TAN were significantly increased while ATP/ADP ratio and adenylate energy charge (AEC) were significantly reduced. The level of 2,3‐BPG was somewhat lower, but 2,3‐BPG/Hb ratio was considerably higher, in red blood cells of cadm

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1993.tb01598.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract: In this study, we evaluated the efficacy of fludarabine (FLU), an adenine nucleoside analogue, in 35 previously treated patients with advanced and progressed B‐cell chronic lymphocytic leukemia (B‐CLL) and in 6 at diagnosis. All patients were treated at a dose of 25 mg/m2per day for 5 consecutive days (mean number of courses was 5, with a range from 4 to 6). The majority of patients experienced a beneficial effect on hematological parameters. In particular, a remarkable reduction of lymphocyte count together with an increase of neutrophils and platelets was observed. The overall response rate was 42% with 1 complete response and 16 partial responses. Ten patients achieved minor responses and the remaining 14 showed no benefit from treatment. An increased response rate was achieved in 6 untreated patients who showed an overall response rate of 67% (4/6). The major complications observed were neutropenia (66%) and febrile episodes (44%) that were generally infection‐related and were fatal in 3 cases. Because we were dealing with patients whose disease was advanced and/or resistant to treatment, the overall results may be considered encouraging with acceptable toxic reactions not superior to those frequently observed with polychemo

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1993.tb01599.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract: In a randomised multicentre trial a combination of methylprednisolone, vincristine, lomustine, cyclophosphamide and melphalan (MOCCA) was compared with the same regimen omitting methylprednisolone after the first course (COLA) in previously untreated patients with multiple myeloma. The MOCCA arm showed a response rate of 72% among 79 patients and the COLA arm a response rate of 60% among 59 patients. This difference was not statistically significant. The median survival time was 56 months in the MOCCA arm and 61 months in the COLA arm. There was a slight increase of early deaths (within the first 6 months) in the MOCCA arm as compared with the COLA arm. We conclude that, in multidrug therapies, the continuation of corticosteroid at conventional dosage beyond the first course does not improve response rate or survival time in multiple myelom

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1993.tb01600.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract: The hospital files of 410 patients with hematological malignancy treated at our clinic between 1977 and 1990 were reviewed to determine the importance of infections as a cause of death. The total number of infections was 203 (49.5%). A microbiologically documented infection was detected in 27.3%, a clinically documented infection in 9.5% and a possible infection in 12.7% of the patients. Gram‐positive bacteria were responsible for 25.9%, gram‐negative bacteria for 31.3%, anaerobic baeteria for 2.7%, viruses for 4.5% and fungi for 25.9% of the microbiologically documented infections. Of 29 systemic fungal infections only 2 were diagnosed before the patients died. The remaining diagnoses rested on autopsy findings. Empiric antifungal therapy was introduced in 1983; still, 74.2% of systemic fungal infections in 1977–1990 were detected after 1982. Patients with a verified infection had statistically significantly higher CRP concentrations than patients who died of other causes (152 mg/lvs.117.5 mg/l, p = 0.018). We conclude that infection is a significant cause of death in patients with these diseases. The number of systemic fungal infections is increasing, despite the widespread use of antifungal medication and thus better diagnostic methods and more effective treatment are n

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1993.tb01601.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract: The proliferative capacity of precursor cells in bone marrow and peripheral blood of 19 patients with acute lymphoblastic leukaemia (ALL) at diagnosis was studied and results were compared with the immunophenotype of the leukaemic population. Bone marrow proliferative capacity in these patients was strongly diminished, low or absent, independent of the immunophenotype, compared with control values (p<0.0002). In contrast, the growth pattern in peripheral blood cultures from the same patients varied widely according to the subtype of ALL: whereas in patients with undifferentiated ALL [TdT+, HLA‐DR+, CD19+or−, CD10−, (n=4) or CD7+, CD5+, CD1−, CD4−and CD8−(n=1)] PB had strongly reduced proliferative capacity compared with control (p<0.05), there was excess growth of normal neutrophil and erythroid colonies in BP cultures from patients with a more mature immunophenotype of either B‐[CD10+, (n=11)] or T [CD1+, CD4+and/or CD8+, (n=3)] phenotype. This phenomenon was only seen in patients who had circulating lymphoblasts: If their number was low, growth was so prolific that single colonies could not be identified. In the presence of a high blast count, colony growth was less prolific ‐ probably due to a “dilution” effect ‐ but still higher than normal (p<0.05). We conclude that, in relatively mature ALL of the B‐ and the T‐cell line, the presence of circulating lymphoblasts is associated with increase

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1993.tb01602.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract: L‐selectin is a glycoprotein which is one of three members in a family of cell adhesion molecules called selectins. L‐selectin is present in distinct forms on both neutrophil granulocytes and lymphocytes, and it appears to play an important role in the early stages of leukocyte‐endothelial cell interaction. Activation of leukocytes leads to shedding of the extracellular part of L‐selectin which thus forms a soluble adhesion molecule, sL‐selectin, which retains functional capacity and can be detected in serum. In the present study we have developed a specific, sensitive sandwich ELISA to measure the serum level of sL‐selectin in patients with hematological and infectious disorders. Three patients with acute myeloid leukemia in remission and 1 patient with chronic myeloid leukemia in chronic phase were followed during bone marrow transplantation and the level of sL‐selectin was found to correlate closely to the leukocyte counts with no detectable sL‐selectin during periods of severe leukopenia. In 11 patients with chronic phase chronic myeloid leukemia and 13 patients with chronic lymphocytic leukemia the sL‐selectin level was also found to correlate closely to the leukocyte count (R = 0.98; p = 0.001 and R = 0.83; p = 0.004 respectively). One CML patient with a leukocytosis of 385 times 109/1 was found to have an sL‐selectin concentration 625 times above normal. Ten patients with acute pneumonia were evaluated at diagnosis and at the time of follow‐up 4–8 weeks later. In all patients the initial sL‐selectin level was higher than at follow‐up. However, no close correlation between sL‐selectin and leukocyte count or CRP (C‐reactive protein) at the time of diagnosis was found. In summary, we have found that the sL‐selectin level in human serum closely correlates to the leukocyte count in both CML and CLL and d

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1993.tb01603.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1993.tb01604.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY