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Biomedical subjects

A Devergie

Publications and source records attributed to A Devergie.

At least 145 records · Page 8Linked to original sources
PubMed1983

Oral acyclovir prophylactic treatment of herpes simplex infection after bone marrow transplantation.

In a double-blind controlled study, oral acyclovir has been compared to a placebo in a series of 39 consecutive patients undergoing bone marrow transplantation. A dose of 200 mg was given every 6 h from day 8 to day 35 after transplantation. Pharmacokinetic studies have shown the good absorption of the drug despite intestinal damage related to chemoradiotherapy or gut graft-versus-host disease (GVHD); there was no sign of toxicity. The protection against herpes simplex virus (HSV) infection was complete in the treated group when compared to the control group even in patients with high anti-HSV antibody titres. The same protection was observed against cytomegalovirus (CMV) infection. The incidence of HSV and CMV was the same in both groups after treatment ended. This study confirms the efficacy of acyclovir against HSV infection and possibly against CMV infection when it is given prophylactically after bone marrow transplantation.

Acyclovir↗
PubMed1983

Radiosensitivity in Fanconi anaemia: application to the conditioning regimen for bone marrow transplantation.

Fanconi anaemia, an autosomal recessive constitutional aplastic anaemia, seems to be related to a DNA repair mechanism defect. Bone marrow transplantation is sthe only treatment which can cure these patients. Previous attempts at BMT have shown an increased sensitivity to Cyclophosphamide used for the conditioning. Such a sensitivity has also been observed in vitro when Fanconi anaemia cells were incubated with alkylating agents. We have tested the in vivo radiosensitivity and cell repair after skin contact radiotherapy to calculate the irradiation dose which could be tolerated by FA patients. Eight patients have been tested and the results confirmed the suspected increased radiosensitivity in the majority of patients. Following these results, four patients were conditioned with low dose Cyclophosphamide (20 mg/kg) associated with 5 Grays thoraco-abdominal irradiation. All had a take and no major complication of the conditioning regimen. All are alive in good condition from day 51 to day 330 after transplant. Oesophagitis was one major unexpected complication. This study confirms the possibility of curing FA patients with BMT when the conditioning regimen is modified according to the pathophysiology of the disease.

Adolescent↗
PubMed1982

[Constitutional aplastic pancytopenia in children (author's transl)].

Constitutional aplasia of the bone marrow is a general term which designates familial aplastic pancytopenias with recessive autosomal transmission. They are rare and often associated with malformations which are of great diagnostic value. The Fanconi syndrome is a well individualized form in which aplasia of the bone marrow is combined with various malformations which are of great diagnostic value. The Fanconi syndrome is a well individualized form in which aplasia of the bone marrow is combined with various malformations, particularly skeletal, cutaneous and renal. Cytogenic lymphocyte analysis shows an abnormal tendency to chromosomal breakage which is increased after incubation with alkylating agents. Bone marrow transplantation is the only available therapy for these constitutional aplasias.

Anemia, Aplastic↗
PubMed1982

Monocytotoxic antibodies after bone marrow transplantation in aplastic anemia.

Pre- and post transplant sera from 51 cases of bone marrow transplants performed for severe aplastic anemia were tested on monocytes (M) and corresponding B cells (B) from a panel of unrelated donors. One-third of the sera were cytotoxic for B and M either from different or from the same individuals, while 45% reacted only to M and appeared to recognize non-HLA M-associated antigens. No significant reaction to endothelial cells was obtained from these sera. The subsequent clinical course was not associated with any reaction pattern of pre-transplant sera. There was a significant relationship between rejection and the development of M antibodies after grafting, but since these were also found in many other patients without rejection, their occurrence has no predictive value for an individual patient.

Anemia, Aplastic↗
PubMed1982

Results of immunosuppression in 170 cases of severe aplastic anaemia. Report of the European Group of Bone Marrow Transplant (EGBMT).

This is a report of the European Group of Bone Marrow Transplant (EGBMT) on the influence of immunosuppression (IS) on survival of patients with severe aplastic anaemia (SAA). Fourteen teams participated in this survey involving 170 cases treated from 1974 to December 1980. The 1 year survival was 62.7%. Three types of treatment were used: (1) anti-thymocyte globulin (ATG) alone, (2) anti-thymocyte globulin and haplo-identical related bone marrow infusion, and (3) high dose bolus-6-methyl-prednisolone (b-6 MePr). There was no statistical difference in survival between these three groups. Androgens did not modify survival. Blood counts before treatment had a significant prognostic value. Patients with less than 0.2 X 10(9)/l granulocytes and less than 10 X 10(9)/l reticulocytes had 40% 1 year survival; the others had more than 70% 1 year survival. Patients with complete or partial reconstitution had the same good prognosis. In contrast, patients with no improvement after IS had a 27% 1 year survival. Several successive courses of IS improved the prognosis of non-responding patients. This survey confirms that IS improves the survival of patients with SAA. A prospective study will be performed to define the best and safest form of IS and to correlate clinical results with in vitro tests.

Adolescent↗
PubMed1982

Inhibitory effects of peripheral blood cells on in vitro colony formation by autologous bone marrow in aplastic anaemia: relation with response to immunosuppressive therapy.

The inhibitory activity of peripheral blood lymphocytes on autologous bone marrow was studied in 27 patients with aplastic anaemia after treatment with androgen. Inhibitory activity was hard to assess in 10 patients studied during the first year of treatment. The colony count was too low to be certain of differences between the samples incubated with or without lymphocytes. Among the 17 patients who had more than 10 colonies per 2 x 10(5) mononuclear bone marrow cells, nine showed inhibitory activity by peripheral blood lymphocytes. After 12 months of androgen therapy each of these patients showing inhibitory activity of bone marrow colony forming cells by peripheral lymphocytes responded to antithymocyte globulin. None of nine patients with few colony forming cells or no inhibitory activity of lymphocytes responded to immunosuppression.

Adolescent↗
PubMed1981

Natural killer cell activity in human bone marrow recipients: early reappearance of peripheral natural killer activity in graft-versus-host disease.

Natural killer (NK) cell activity toward K562 target cells and antibody-dependent cell-mediated cytotoxicity (ADCC) toward L1210 cell sensitized with anti-L1210 antisera were sequentially tested in peripheral blood lymphocytes (PBLs) from 24 human bone marrow (BM) recipients. Although consistently decreased before the transplant, NK cell activity was restored in all of the patients tested that argues for a bone marrow origin of NK progenitors in humans. In patients without graft-versus-host disease (GVHD), peripheral NK cell activity remained low during the 1st month after the transplant, then rapidly increased and reached normal values usually between days 30 and 50. By contrast, peripheral ADCC appeared earlier restored (since day 13), suggesting that NK and ADCC are two distinct effector mechanisms. When restored, peripheral NK cell activity remained within normal range, except in seven cases with a drastic fall in NK cell values contemporary with a severe viral infection, mainly with cytomegalovirus (CMV). NK cells are thus suggested to play an important role in the control of viral infections in these deeply immunodepressed patients. In patients with acute GVHD, strikingly high NK values were observed early after the transplant, and during the 1st month a strong correlation did exist between high NK values and acute GVHD occurrence. These results suggest that cells involved in GVHD mechanism are able to exert NK cell activity at some stages of their maturation. The assessment of NK cell activity could be an attractive routine procedure for monitoring the prophylaxis of GVHD in human BM recipients.

Antibody-Dependent Cell Cytotoxicity↗
PubMed1981

Bone marrow transplantation in severe aplastic anaemia: a survey of the European Group for Bone Marrow Transplantation (E.G.B.M.T.).

A survey of the results of bone marrow transplantation for severe aplastic anaemia in 13 European teams is reported. 159 questionnaires were analysed by univariate and multivariate analysis. The overall 1 year survival was 41.2%. The chance of survival was decreased by the presence of infection before grafting and by the use of female donors. The conditioning regimen did not influence survival. Graft rejection was influenced by the conditioning regimen and the sex of the donor. Graft-versus-host disease was influenced by the conditioning regimen, and the age and the sex of the recipient. This study defines prognostic indices which may be helpful in determining the likelihood of success after marrow transplantation for severe aplastic anaemia.

Adolescent↗
PubMed1981

Granulocyte progenitor compartments after allogeneic bone marrow grafts.

Bone marrow granulocyte colony forming cells (CFU-C) were measured in HLA compatible sibling donor-recipient pairs. The regeneration of granulocytes and CFU-C compartments were also studied in order to evaluate haemopoietic recovery. The number of nucleated bone marrow cells in the donation was 23 +/- 4 X 10 cells, which recipients received (3.5 +/- 0.4) X 10(8) nucleated cells/kg and (1.19 +/- 0.32) X 10(5) CFU-C/kg. This produced a bone marrow reconstitution of (67 +/- 26) X 10(5) CFU-C/kg by day 30. There was a significant correlation between CFU-C/kg and (1) granulocyte count on day 30 (P equal less than 0.05) and (2) the first day of reappearance of neutrophils in the blood (P equal less than 0.05). These results indicate that the speed and completeness of granulocyte regeneration can be predicted by measurement of the size of the CFU-C inoculant in the bone marrow graft.

Adolescent↗
PubMed1981

Bone marrow transplantation in 65 patients with severe aplastic anemia.

This articles summarizes the experience of the Hospital Saint-Louis Bone Marrow Transplantation Team of bone marrow transplantation in severe aplastic anemia. Sixty-five consecutive patients have been transplanted with an HLA identical sibling marrow. Various conditioning regimen have been used. Conditioning regimen using high dose Cyclophosphamide alone or associated with Procarbazine and anti-thymocyte globulin gave a high number of bone marrow graft rejection. Therefore, a conditioning regimen using Cyclophosphamide and total body irradiation with lung shielding has been used for the last three years. This regimen suppressed bone marrow graft rejection. The main problems remain graft versus host disease and intercurrent infections. Despite these complications, 50 per cent of the patients become long term survivors and are apparently cured of their initial disease.

Adolescent↗
PubMed1981

[Cutaneous manifestations of graft versus host disease (author's transl)].

Skin is a target organ for Graft v Host Reaction (GvHR). Cutaneous changes sometimes are the first symptoms for GvHR. They offer the opportunity for its early recognition. They include: -- A primarily acute phase, as red maculopapular rash, on face, palms and soles, which can spread over large areas, resembling scarlatiniform rash. Some courses have resulted in severe epidermal necrolysis similar to Lyell syndrome. -- A chronic phase, described with a variable time of onset after the acute episode. Two stages have been recognised: -- the early chronic phase has a clinical and histological picture similar to Lichen Planus, a frequent dermatosis which is thought to be the result of a chronic immune injury against epidermis. As early phase is fading, an atrophic aspect of the skin may develop, whose severe type is described as Poïkiloderma. -- The late chronic phase, in which densification of dermal collagen is become the essential features. In some patients, sclerotic changes develop, which are resembling to scleroderma ones. The cutaneous manifestations of GvH Disease can be responsible for considerable morbidity, mortality and sequelles. They may serve as a biological model for several skin diseases.

Acute Disease↗