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Biomedical subjects

C Rozman

Publications and source records attributed to C Rozman.

At least 253 records · Page 14Linked to original sources
PubMed1989

[Effect of treatment with recombinant interferon alfa on natural killer activity in patients with chronic type B lymphatic leukemia].

The role played by alpha interferon (alpha-IFN) in the treatment of B-type chronic lymphocytic leukaemia (B-CLL) has been studied by different authors. Despite the inconclusiveness of the results, alpha-IFN seems to be more effective in those patients with low tumour burden (early stages) who have been previously untreated. Although the mechanism of action of alpha-IFN is not wholly understood, it is known that this agent is a strong stimulant of the natural killer lymphocytes (NK). NK activity has been found decreased in B-CLL. In the present work the effect of alpha-IFN on NK activity was studied in 9 previously untreated B-CLL patients in stage A, who received chlorambucil (CLB) followed by alpha-IFN for at least 4 months. The disease stage did not change in most of the patients during alkylating or IFN therapy. CLB failed to increase NK activity, although it diminished the lymphocyte count. Although the lymphocyte count of the patients treated with alpha-IFN was not reduced beyond the values attained by CLB, NK activity reached normal values in 5 of the 7 patients in whom this was low, and kept within normal ranges in the two patients with normal NK activity. The number of CD57+ lymphocytes (this being the antigen present in NK cells) increased after alpha-IFN treatment, without any changes in the remaining T-lymphocyte (CD2, CD4 and CD8) and NK (CD16 and CD11b) subpopulations. These results show that alpha-IFN enhances NK activity in vivo.

Adult↗
PubMed1989

Graft failure following bone marrow transplantation for severe aplastic anemia: risk factors and treatment results.

Graft failure was analyzed in 625 patients receiving allogeneic bone marrow transplants from HLA-identical sibling donors as treatment for severe aplastic anemia. Sixty-eight (11%) had no or only transient engraftment. Second bone marrow transplants were successful in achieving extended survival in 16 of 27 patients with transient initial engraftment but in none of ten patients with no sign of engraftment after the first transplant. The major factors associated with a reduced risk of graft failure were use of radiation for pretransplant immunosuppression and use of cyclosporine rather than methotrexate or T-cell depletion of the donor bone marrow for prophylaxis against graft-v-host disease (GVHD). Among 266 patients prepared for transplantation with cyclophosphamide alone, the risk of graft failure was increased in patients who received previous transfusions and reduced in those who received corticosteroids for previous therapy. Neither cell dose nor administration of donor buffy coat cells affected the probability of engraftment. Although use of radiation in conditioning reduced graft failure, survival was not improved. Posttransplant treatment with cyclosporine and avoidance of pretransplant blood transfusions were associated with improved survival.

Actuarial Analysis↗
PubMed1989

[Plasma cell leukemia. Study of 10 cases].

Ten patients with plasma cell leukaemia (PCL), out of 259 cases of multiple myeloma diagnosed in the Haematology Service of the University Hospital of Barcelona in the last 18 years, are presented. Of the 10 PCL cases, 5 were primary and 5 were secondary. Anaemia and thrombocytopenia, along with massive plasma cell infiltration of the bone marrow, were the most striking findings. Osteolytic lesions were present in 9 of the cases and liver involvement in two. Chemotherapy including vincristine and prednisone was administered to eight patients, associated to alkylating agents (melphalan and/or cyclophosphamide) in six of them. Four of these patients received also adriamycin and BCNU. Two objective responses were achieved, lasting for 10 and 3 months, the remaining six patients failed to respond. The median survival for all the PCL patients was less than one month (ranging between 0.2 and 14 months). None of the secondary PCL patients survived for 2 months after diagnosis. Infection (3 cases of septicaemia and 3 of pneumonia), renal failure (2 cases) and liver insufficiency (1 case) were the causes of death in the nine deceased patients. The therapeutic possibilities for this severe haemopathy are discussed.

Adult↗
PubMed1989

Lung function in allogeneic bone marrow transplantation recipients.

In order to investigate the incidence of pulmonary function complications following bone marrow transplantation (BMT), 17 patients with leukaemia and 8 with aplastic anaemia were sequentially assessed over a one year period. Before BMT, all the patients were free of respiratory symptoms and had both normal chest X-ray and routine lung function tests. However, 5 patients disclosed airway hyperreactivity. Aplastic anaemia patients had significantly lower haemoglobin-adjusted diffusing capacity for carbon monoxide (DLCO) than those with leukaemia, a finding significantly related to the lower haemoglobin values shown in the former individuals. Following BMT there were transient mild to moderate reductions in DLCO and static lung volumes; moreover, patients with leukaemia had lower DLCO than those with aplastic anaemia. Fourteen of the 25 patients had ventilatory defects, including 10 individuals with bronchial hyperresponsiveness. Post-BMT lung function changes were transiently accompanied by mild to moderate symptoms of respiratory disease in most of the patients.

Adult↗
PubMed1989

Temporal relationships between the major complications of bone marrow transplantation for leukemia.

Data from 3113 patients receiving HLA-identical sibling bone marrow transplants for leukemia were analysed to determine the time course of the major causes of treatment failure. The median interval from transplant to onset of acute graft-versus-host disease (GVHD) was 17 days, interstitial pneumonitis 63 days, and chronic GVHD 111 days. The median interval from transplant to relapse was 3.3 months for patients transplanted in relapse of acute leukemia or blast phase of chronic myelogenous leukemia (CML), 6.4 months when transplants were performed in second or subsequent remission of acute leukemia or accelerated phase of CML, and 7.8 months for patients transplanted during first remission of acute leukemia or while in the first chronic phase of CML. Shorter intervals from transplant to onset of interstitial pneumonitis or chronic GVHD were associated with a significantly lower probability of 2-year survival. The temporal relationships between these complications are displayed graphically and demonstrate the overlapping and competing causes of death following allogeneic bone marrow transplantation.

Adolescent↗
PubMed1989

Hypertriglyceridemia in bone marrow transplant recipients: another side effect of cyclosporine A.

The incidence and duration of hypertriglyceridemia (HTG) associated with allogeneic HLA-identical bone marrow transplantation (BMT) were investigated in 38 patients with normal triglyceride levels (TG) before BMT and without any evidence of prior liver disorder. Twenty-two (58%) patients developed HTG. The median of TG peak values was 350 mg/dl (range 215-908) and the median actuarial time for HTG appearance was 7 weeks (range 1-12). Among several variables analysed (age, sex, hyperglycemia, total parenteral nutrition, treatment with methylprednisolone, estrogens or cyclosporine A) only cyclosporine A administration was significantly associated with HTG development.

Adolescent↗
PubMed1989

[Extramedullary blast crisis in chronic myeloid leukemia].

Out of 113 cases of blastic crisis (BC) of Ph'-positive chronic myeloid leukaemia (CML), 13 had extramedullary involvement, this being the first BC manifestation in 5 instances. The median interval between extramedullary BC and bone marrow BC in these last was 2 months. Lymph nodes were the commonest extramedullary site of BC (8 cases), followed by osteoperiosteal and central nervous system (CNS). Lymph node BC occurred as generalised lymphadenopathy in most cases. Osteoperiosteal BC was seen as severe bone pain on osteolytic areas, whereas CNS blast crisis occurred as meningeal leukaemia in one case and chloroma in another. Lymphoid phenotype of blast cells was found in only 2 instances. The median survival of the patients after the onset of extramedullary involvement was 3 months.

Adult↗
PubMed1989

[Chronic myelomonocytic leukemia and solid neoplasms: is it a causal or a fortuitous association?].

Out of a series of 36 patients with chronic myelomonocytic leukaemia (CMML), five cases are reported with the association of this hemopathy to solid neoplasms. In two patients this last was a cutaneous tumour, while the remainders had, respectively, papilloma of the bladder, carcinoma of the sigma, and cutaneous T-cell lymphoma. These neoplasms were diagnosed in all cases prior to the discovery of CMML. When applying the "patient/year" method, significantly higher frequency of solid tumours was found for CMML patients, which would support the hypothesis that this myelodysplasia could be regarded as a paraneoplastic condition.

Aged↗
PubMed1989

[Erythroblastopenia associated with chronic myelomonocytic leukemia].

A patient is presented in whom the diagnoses of chronic myelomonocytic leukaemia (CMML) and erythroblastopenia were simultaneously established. Besides the conventional criteria for both haemopathies, the culture of bone-marrow precursor cells showed lack of growth of the erythroid stem cells. 6-Mercaptopurine given as therapy for CMML failed to induce any favourable changes in erythroblastopenia, which in turn improved with prednisone. Nevertheless, the patients died five months after diagnosis due to acute transformation of the CMML.

Aged↗
PubMed1989

Age-related variations of fat tissue fraction in normal human bone marrow depend both on size and number of adipocytes: a stereological study.

Studies dealing with the number or size of individual adipose cells in human bone marrow are lacking. To ascertain whether the age-related variations in fat tissue fraction depend on the size of individual adipocytes or their number or both, a stereological study of 20 normal human bone marrow specimens was performed. A total number of 17,039 adipose cell profiles was measured and two stereological parameters were obtained in each specimen: mean diameter and number of cells per mm3 of bone marrow. With increasing age, an increasing fat tissue fraction was observed (r = 0.61; p = 0.004). The fat tissue fraction correlated positively with the size (r = 0.81; p less than 0.001) and the number/volume (r = 0.59; p = 0.006) of adipocytes. The significance of both adipocyte size and adipocyte number/volume was confirmed by stepwise multiple regression, in which the size alone explained 66.2% of fat tissue fraction and both size and number/volume explained 97.2% of fat tissue fraction. These results are discussed from a pathophysiological point of view.

Adipose Tissue↗
PubMed1988

Serum immunoglobulins in B-chronic lymphocytic leukemia. Natural history and prognostic significance.

To investigate the prognostic significance of gammaglobulin and immunoglobulin levels in chronic lymphocytic leukemia (CLL), survival studies were performed in a series of patients with that disorder. The survival probability of patients with initial levels of gammaglobulin of less than 700 mg/dl was significantly lower (P = 0.03) than in patients with initial levels of 700 mg/dl or more. Decreased initial levels of IgG and IgA also were associated with reduced survival probability (P = 0.027 and P = 0.014, respectively), whereas hypo-IgM did not show any influence on survival. When the influence on survival of gammaglobulin and immunoglobulin concentration was analyzed by Cox's multivariate model, the only variable which entered the regression at significant level was IgA (P = 0.006). As shown by the same type of analysis, the prognostic value of hypo-IgA is independent from the clinical staging. The natural history of hypogammaglobulinemia and hypoimmunoglobulinemia was investigated by sequential analysis in a series of untreated patients. The appearance of decreased levels of these globulins was found to be a continuous process developing spontaneously during the untreated course of the disease. Among factors associated with the appearance of hypogammaglobulinemia during the evolution of CLL, initial lower levels of IgG and IgA, but not IgM, were found in a multivariate analysis.

Agammaglobulinemia↗
PubMed1988

Combined assay of adenosine deaminase, purine nucleoside phosphorylase, and lactate dehydrogenase in the early clinical evaluation of B-chronic lymphocytic leukemia.

The levels of adenosine deaminase (ADA), purine nucleoside phosphorylase (PNP), lactic dehydrogenase (LDH), and LDH isoenzyme patterns (LD1 to LD5) have been measured in lymphocyte extract from 28 patients with B-chronic lymphocytic leukemia (B-CLL). The activities of ADA, PNP, and LDH have been correlated with two morphological groups of B-CLL classified according to the percentage of large, nongranular, atypical lymphocytes (AL) in peripheral blood: "typical" B-CLL (less than 10% of AL, 21 cases) and "atypical" B-CLL (10-25% of AL, seven cases). Patients with atypical B-CLL had significantly (P less than 0.001) higher activities of ADA (0.46 +/- 0.17 U/10(9) cells), PNP (1.74 +/- 1.0 U/10(9) cells), and LDH (48.3 +/- 9.7 U/10(9) cells) than patients with typical B-CLL (ADA, 0.29 +/- 0.1 U/10(9) cells; PNP, 0.58 +/- 0.23 U/10(9) cells; and LDH, 29 +/- 10 U/10(9) cells). In addition, the "treatment-free period" was also significantly (P less than 0.025) shorter in the group of atypical B-CLL compared with the typical B-CLL group. No clear-cut statistical differences in lymphocyte surface markers or in several other prognostic factors between the two subgroups of B-CLL were found. The present study supports the idea that in B-CLL the simultaneous determination of ADA, PNP, and LDH might be helpful in better understanding the pathophysiology, prognosis, and natural history of the disease.

Adenosine Deaminase↗
PubMed1988

Chronic neutrophilic leukemia with marked myelodysplasia terminating in blast crisis.

A case of chronic neutrophilic leukemia (CNL) is reported. The patient had a history of bleeding, and showed sustained mature neutrophilic leukocytosis, hepatosplenomegaly, a high leukocyte-alkaline phosphatase score, elevated serum vitamin B12 and uric acid, and the presence of Döhle bodies in the neutrophils. In addition to the above typical features, marked myelodysplastic changes in the erythroid and megakaryocytic series were observed in the bone marrow. Three months after the diagnosis of CNL had been established, the hematological picture evolved into a blast crisis of monocytic type. Such findings give support to the statement of CNL as a distinct entity belonging to the spectrum of the myeloproliferative disorders.

Blast Crisis↗