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Biomedical subjects

A Indovina

Publications and source records attributed to A Indovina.

At least 55 records · Page 3Linked to original sources
PubMed1979

[Use of angiopneumography with Tc-99M in 2 cases of pneumopathy caused by anatomical defect].

A parallel study, using traditional angiopneumographic technique with iodate contrast medium and the radioisotopic technique employing 99MTc has been carried out in some cases of bronchopulmonary malformations due to anatomic defect. The purpose of this is to assess the angiographic performance at pulmonary circulation level of an extremely simple radioisotopic technique. Analysis of the two cases presented suggests that although radioisotopic angiopneumography presents lower resolution capacity for viewing small and medium lumen branches of the pulmonary artery, it has the advantage of associating the results of traditional angiopneumography with statis pulmonary scintigraphy in a single exploration. It is considered that this investigation can be used particularly in those patients with severe cardiorespiratory insufficiency, for whom the invasive technique presents some by no means inconsiderable risks.

Bronchi↗
PubMedDate not supplied

The use of three different therapeutic protocols according to the immunologic pathology present in three women with recurrent spontaneous abortion and fetal death for immunologic reasons: flucortolone and salicylates; high-dose intravenous gammaglobulins; subcutaneous heparin.

The authors report three cases of immunologic spontaneous abortions and fetal death. In the first patient there was lupus-like anticoagulant activity with a diagnosis of sub-clinical autoimmune disease; the second showed inadequate blocking factor activity, while the third subject presented excessive lymphocytotoxicity. In these cases three different therapeutic protocols were successfully used: flucortolone and salicylates, high-dose intravenous gammaglobulins and subcutaneous heparin.

Abortion, Habitual↗
PubMedDate not supplied

Collection of PBSC with Fenwal CS-3000 for autografting.

The peripheral blood represents an alternative source of haemopoietic progenitors and permits autografting in patients who have contraindications for a bone marrow harvest but who are otherwise candidates for autologous bone marrow transplantation. Circulating stem cells can be harvested performing several leucaphereses during the overshoot after a mobilization chemotherapy. The use of Fenwal CS-3000 cell separator allows reproducibility from donor to donor and makes the procedure very efficient. We collected peripheral blood stem cells (PBSC) in four patients, 2 with Hodgkin's lymphoma, 1 with high-grade non-Hodgkin's lymphoma and 1 with secondary FAB unclassifiable ANLL: the procedures of collection and cell harvests obtained are reported.

Adult↗
PubMedDate not supplied

Circulating stem cell autograft in malignant lymphomas.

Autologous peripheral blood stem cells (PBSC) collected after an intensive course of chemotherapy were employed for hematological reconstitution in 3 patients (age 24-44 years), 2 with Hodgkin's and 1 with high-grade non-Hodgkin's lymphoma, in 2nd complete or partial remission. PBSC collections were performed with a Fenwal CS-3000 cell separator (programs "3" and "1-modified"). After collection and partial RBC removal, cells were cryopreserved and stocked in liquid nitrogen. In all patients the CVB combination was employed as myeloablative transplant regimen. Patients received respectively 28.0, 33.1 and 12.3 x 10(4)/Kg peripheral blood CFU.GM. Hematologic recovery was prompt and complete in 2 patients, while a patient with Hodgkin's lymphoma who had previously been treated with combined modality, is still moderately thrombocytopenic and granulocytopenic 148 days post graft. Patients are currently alive and disease-free 148-301 days post graft.

Adult↗
PubMedDate not supplied

Autologous blood stem cell transplantation in hematologic malignancies.

Circulating stem cells (CSC) are well documented in animals and humans. Though their function in normal conditions remains obscure, autologous CSC seem capable of restoring hemopoiesis after myeloablative treatment. With cell separators CSC may be harvested in adequate number, and collection may be further improved giving chemotherapy and/or GM-CSF that mobilize stem cells into the circulation. Due to the high number of progenitor cells infused, hematologic reconstitution is more rapid with CSC than with marrow cells. Autologous blood stem cell transplantation (ABSCT) is increasingly employed in a variety of hematologic malignancies and in some solid tumors. CSC allow transplantation in patients previously irradiated on the sites of harvest or with marrow tumor involvement, and probably decrease the risk of infection by shortening the duration of post-graft aplasia. Their use is also encouraged by a belief that, along with CSC, a large number of immunocompetent cells are infused that may exert an anti-tumor effect. A lower tumor contamination of CSC as compared to marrow is an attractive matter, but remains to be demonstrated. Standardization of cell cloning assays, identification of monoclonal antibodies to recognize the surface antigens expressed on progenitor cells, and definition of advantages of ABSCT are items of future work.

Animals↗
PubMedDate not supplied

Immunological problems in the recurrent abortion syndrome.

The recurrent abortion syndrome has been considered a serious obstetrical problem, since it was not possible to diagnose the causes in over 40% of the cases. Great progress has now been made with the knowledge of the immunological mechanisms involved in the maintenance of pregnancy. The disorders of such immunological mechanisms, both due to auto- or alloimmune problems, are demonstrated in about 40% of the cases of recurrent abortions. The Authors have studied a group of 56 patients with recurrent abortion syndrome in a complex diagnostic work-up involving: 1) The research of an autoimmune cause; 2) The research of the presence of the Blocking-factors by means of one-way mixed lymphocyte cultures; 3) The research of an altered antipaternal lymphocytotoxic activity or of an excessive HLA-sharing. According to the results of the investigations, several forms of therapeutic management have been used: 1) Steroids-aspirin-calcic heparin for Autoimmune cases. 2) Active immunotherapy for the cases due to the lack of blocking factors. 3) Calcic heparin for the altered antipaternal lymphocytotoxic activity. At the moment it is difficult to evaluate the results of pregnancy rate with this type of therapeutic management because of the too short follow-up.

Abortion, Habitual↗
PubMedDate not supplied

Mobilization of circulating progenitor cells in multiple myeloma during VCAD therapy with or without rhG-CSF.

BACKGROUND: Circulating progenitor cells (CPC), when infused in large numbers, rapidly repopulate the marrow after myeloablation with high-dose therapy. In multiple myeloma (MM), as in other disorders, different chemotherapy regimens, including single-as well as multiple-agent chemotherapy, with or without hemopoietic growth factors, have been proposed to mobilize these progenitor cells into the blood. Here we report our experience with a drug combination called VCAD and compare the results to those obtained by adding rhG-CSF to the same combination. METHODS: Fourteen MM patients were given one course of VCAD, a chemotherapy association of vincristine 2 mg, cyclophosphamide 4 x 0.5 g/m2, adriamycin 2 x 50 mg/m2 and dexamethasone 4 x 40 mg, before undergoing apheresis to collect CPC for autografting. Seven also received rhG-CSF (filgrastim) 5 mcg/kg/day over the period of apheresis. These latter were allocated to rhG-CSF treatment sequentially from the time the drug became available for clinical use. RESULTS: Following VCAD-induced pancytopenia, CFU-GM peaked at a median of 853/mL (range 96-4352; 7.6 times basal level). RhG-CSF administration increased CFU-GM levels but not significantly. With rhG-CSF the CFU-GM peak was reached sooner, toxicity was reduced and granulocytopenia less protracted. Fewer aphereses were run in the rhG-CSF group, there were higher yields per single run, and patients began and completed their collection program more quickly. CONCLUSIONS: The VCAD association is able to mobilize CPC in patients with MM, and rhG-CSF is recommended as a fundamental part of the priming schedule.

Adult↗
PubMedDate not supplied

Treatment of normal donors with rhG-CSF 16 micrograms/kg for mobilization of peripheral blood stem cells and their apheretic collection for allogeneic transplantation.

BACKGROUND: Utilization of peripheral blood stem cells (PBSC) in allogeneic transplantation requires a method for their mobilization and collection that is not inconvenient for the donor. METHODS: We administered rhG-CSF (filgrastim) 16 micrograms/kg subcutaneously for 4 days in five normal subjects (age 18-31, M = 3, F = 2), previously selected as HLA-identical donors of siblings with leukemia. All the donors gave written informed consent. On days 4 and 5 (in one donor on day 6 too), 10:l leukapheretic collection was performed with a CS-3000 (Baxter) or an AS-104 (Fresenius) cell separator through the antecubital vein. RESULTS: The WBC count reached a median peak of 57.0 x 10(9)/L on day 5. The peripheral blood CFU-GM peaked to a median level of 8908/mL on day 5 with a median increase over baseline values of 39.1 times. The CD34+ cells peaked to (median) 147.0 x 10(6)/L on day 4 with a median increase of 65.3 times. A lesser enrichment was recorded for BFU-E (median increase 12.7 times) and CFU-GEMM (median increase 15.2 times). Even CD3+ and CD56+CD3- cells increased (median 1.7 and 1.5 times, respectively). A median of 771 x 10(8) MNC (range 672-1378), 116.4 x 10(6) CFU-GM (range 47.7-145.1) and 754 x 10(6) CD34+ cells (range 477-2599) were apheretically collected. Concerning side effects, mild to moderate back pain and general minor discomfort were reported by all donors. The platelet level regularly but transiently decreased after completion of the apheretic procedures with a median nadir of 69 x 10(9)/L (range 43-126) on (median) day 7, but in no case did thrombocytopenia cause bleeding. The thrombocytopenia was more pronounced with the CS-3000 than the AS-104 apparatus. CONCLUSIONS: rhG-CSF 16 micrograms/kg x 4 days is an efficient schedule for PBSC mobilization in healthy donors, but lower doses and even a single apheresis procedure might prove similarly adequate.

Adolescent↗
PubMedDate not supplied

Engraftment kinetics and long-term stability of hematopoiesis following autografting of peripheral blood stem cells.

BACKGROUND: We analyzed short-term and sustained hematopoietic reconstitution after high-dose therapy with peripheral blood stem cell (PBSC) support in patients with various malignant disorders. METHODS: Fifty-six patients, all with malignant hematologic disorders, were autografted between 1989 and 1994 using PBSC (47 pts) or PBSC + bone marrow (BM) cells (9 pts). PBSC were collected after mobilization with chemotherapy +/- hematopoietic growth factors (GF). RESULTS: All patients engrafted > 0.5 x 10(9)/L polymorphonuclear cells (PMN) and > 50.0 x 10(9)/L Plt at a median of 12 (8-32) and 13 (9-365) days, respectively. Thirty-nine patients were evaluable for long-term graft performance, and their hematologic values at 30 and 100 days, at 6 months and at 1, 2, 3, 4 and 5 years were retrospectively analyzed. Steady counts were recorded over the years. None of the patients had late graft failure. CONCLUSIONS: PBSC given after high-dose chemotherapy ensure a fast hematologic recovery with stable graft performance up to five years after autograft. Though this is not definitive proof of the presence of uncommitted stem cells in the PBSC population, it gives further support to the idea that PBSC are as safe as bone marrow for long-term engraftment. A delayed or incomplete recovery of platelets may occur with low PBSC counts or when disease relapse occurs rapidly after autograft.

Adolescent↗