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Biomedical subjects

C Rozman

Publications and source records attributed to C Rozman.

At least 271 records · Page 15Linked to original sources

Characterization of mononuclear exudates in idiopathic inflammatory myopathies.

Percentages of B-cells, T-cells and subsets Th, Ts, T activated, and macrophages were analyzed by using monoclonal antibodies in a series of 24 patients [19 dermatomyosis (DM) and 5 polymyositis (PM)]. Specific site of deposition of these cells was also identified (endomysial, perimysial and perivascular). We were able to find a greater number of endomysial T-cells in PM than in DM. However, B-cells were more frequent at perivascular sites in DM than in PM. These findings support the previous reported hypothesis that humorally-mediated immune damage in both vascular and muscle cells predominates in DM while cellular cytotoxic mediated damage is more marked in PM patients.

Adult↗

Bone marrow lymphoid nodules in myeloproliferative disorders: association with the nonmyelosclerotic phases of idiopathic myelofibrosis and immunological significance.

The presence of lymphoid nodules in bone marrow biopsy was investigated at diagnosis in 200 patients with chronic myeloproliferative disorders (MPD). Twelve out of 51 patients with idiopathic myelofibrosis (IM) showed such a feature (23.5%), versus two out of 100 with Ph1-positive chronic myeloid leukaemia, two of 32 with polycythaemia vera, and one of 17 with essential thrombocythaemia, the difference between IM and the remaining MPD being statistically significant (P less than 0.0001). When IM patients were compared for their initial characteristics according to the presence or not of bone marrow lymphoid nodules, patients with such a histological finding showed significantly lower values for either WBC counts, number of primitive cells in the blood, and serum lactic dehydrogenase levels. Moreover, it was observed that virtually all patients with lymphoid nodules were in the nonmyelosclerotic phases of IM. Finally, among the 14 of 32 IM patients (44%) investigated for circulating immune complexes who gave a positive test, a significant association between this immunological abnormality and bone marrow lymphoid nodules was found. The above results reinforce the immunological significance of the finding of bone marrow lymphoid nodules in IM and give support to the hypothesis of an immune component in the pathogenesis of the disorder.

Adult↗

Liver involvement at diagnosis of primary myelofibrosis: a clinicopathological study of twenty-two cases.

Liver biopsies were carried out at diagnosis in 22 patients with primary myelofibrosis. Pathological changes were semiquantitatively evaluated and correlated with either liver function tests, peripheral blood features, bone marrow biopsy changes or patient survival. Hepatic myeloid metaplasia (HMM), primarily consisting of the presence of morphologically abnormal megakaryocytes, was found in all cases. Other remarkable pathological changes included increased reticulin network, sinusoidal widening not related to the intensity of HMM, and iron overload in the absence of previous blood transfusions. High serum alkaline phosphatase was the most frequent biochemical abnormality, and reflected rather the presence of sinusoidal widening than the degree of HMM. The number of immature myeloid cells was the only peripheral blood parameter positively correlated with the degree of HMM. No relationship could be established between bone marrow changes and the degree of HMM. Finally, patients with mild HMM survived longer than those showing marked HMM.

Adolescent↗

Hypocholesterolemia in acute myelogenous leukemia.

Plasma-cholesterol concentrations were determined in 85 acute myelogenous leukemia patients. Measurements were repeated in 28 cases during remission. Mean plasma-cholesterol concentration (+/- SD) at diagnosis was 3.95 mmol/l (+/- 1.29). 47 patients (55.3%) had hypocholesterolemia (less than 3.87 mmol/l). Among the main clinical, hematologic and biochemical parameters, only high leukocyte counts were correlated with hypocholesterolemia. As far the FAB subtypes are concerned, the lowest cholesterol levels were observed in leukemias with monocytic component. However, although the same FAB subtypes showed significantly higher leucocytes counts than the other subtypes, both parameters were independently related to low cholesterol levels. Remission was associated with a significant increase in cholesterol levels in those patients with low cholesterol concentrations or high leukocyte counts at diagnosis. These results support the idea that initial hypocholesterolemia in acute myelogenous leukemia is related to the tumoral mass present at diagnosis.

Adult↗

Y-body study in bone marrow precursors, peripheral blood cells and alveolar macrophages for demonstration of haemopoietic engraftment in allogeneic bone marrow transplantation.

The value of Y-body study for assessment of haemopoietic engraftment was analyzed in 50 consecutive patients submitted to allogeneic bone marrow transplantation (BMT) (sex-matched in 28 cases, sex-mismatched in 22). The study was performed weekly on bone marrow and peripheral blood smears in all cases, and alveolar macrophages were also studied in 15 patients in whom bronchoalveolar lavage was carried out because of concurrent respiratory disturbances. The analysis was performed blindly by 2 independent observers. In both sex-matched and sex-mismatched cases there was an absolute concordance between recipient and donor Y-body results, as well as with the simultaneous cytogenetic study. The engraftment of erythroid and granulopoietic lines was documented at day +14 in all cases of sex-mismatched BMT, whereas megakaryocyte and lymphocyte take was demonstrated at d +21. On the other hand, the results from alveolar macrophages were in accordance with those obtained in the simultaneous study of bone marrow precursors after BMT. The above results indicate that Y-body analysis is a simple and useful tool for the demonstration of bone marrow take in sex-mismatched BMT.

Blood Cells↗

Longitudinal study of serum ferritin concentrations in chronic granulocytic leukaemia.

In 60 patients with Ph1-positive chronic granulocytic leukaemia (CGL) the serum ferritin concentration was measured as a part of the initial evaluation of the disease. The mean value (+SD) was 285 +/- 368.6 ng/ml, normal or slightly increased values being obtained in most cases. In 38 patients serum ferritin was again determined in clinical remission following busulphan treatment. Although the levels generally remained within the normal range, a significant decrease was observed with respect to the initial values (p = 0.0000004), suggesting that serum ferritin at presentation of CGL may be partially influenced by the disease activity. Finally, a further determination of serum ferritin concentration was made in a subgroup of 21 patients when they were diagnosed as being in the accelerated or blastic phases of CGL. Although no substantial increase was found with respect to the values obtained at presentation, a significant increase (p = 0.0008) was observed when accelerated-blastic phase ferritin levels were compared with those obtained in clinical remission. Although in patients in blast crisis no correlation was found between blast cell mass and serum ferritin, the differences observed between the different phases could indicate that in CGL serum ferritin concentrations roughly parallel the disease activity.

Adolescent↗

Intestinal lymphoma in a patient with chronic lymphocytic leukemia of atypical phenotype: Richter's syndrome of unusual presentation.

A patient who developed an intestinal large-cell pleomorphic lymphoma during the course of untreated chronic lymphocytic leukemia (CLL) with an atypical phenotype (SIgG kappa) is reported. This is an unusual presentation of Richter's syndrome since RS with primary gastrointestinal involvement has only been described in two patients. In our case, immunological studies disclosed the same immunoglobulin (IgG kappa) in the large-cell pleomorphic lymphoma and on the surface of CLL cells, suggesting that both had arisen from the same clonal proliferation.

Aged↗

Influence of different indwelling lines on the measurement of blood cyclosporin A levels.

We studied in vivo and in vitro the possible influence of the indwelling line on the measurement of cyclosporin A (CSA) levels. CSA levels measured in samples taken from the catheter lumen used for CSA administration were significantly higher than those taken either from a second lumen or from a peripheral vein. Reversible fixation of the drug to the catheter walls might explain this alteration. The degree of fixation varies for different types of plastic material.

Bone Marrow Transplantation↗

Bone marrow biopsy in chronic lymphocytic leukemia.

In chronic lymphocytic leukaemia (CLL), bone marrow biopsy (BM) sections show different infiltration patterns (nodular, interstitial, mixed diffuse) with a fairly homogeneous distribution when bilateral biopsies are examined. Sequential studies demonstrate that these patterns represent a dynamic process reflecting the degree of lymphocytic burden. Moreover, BM histopathology (diffuse vs non-diffuse) is a highly significant prognostic parameter. Although partly related to clinical stages, BM patterns have prognostic value on their own. A combined clinicopathologic staging system (integrating clinical stages and bone marrow histology) predicts the outcome of CLL patients more accurately than clinical stages alone.

Biopsy, Needle↗

Critical factors in new therapeutic approaches in chronic lymphocytic leukaemia (CLL).

Three critical questions in new therapeutic approaches for CLL are analyzed: balance between risks and benefits; impact of therapy on survival; and can CLL be cured? New treatments should take into account a balance between risks and benefits. Relatively risky therapies can be tried only in those subsets of patients in whom the survival is shortened as compared to the control population. The impact of new therapies on survival is best demonstrated by prospective randomized trials. Two errors are common when the response to treatment is analyzed. Frequently unsuitable statistical methods, biased in favour of responders, are employed. In addition, it is often incorrectly implied that response causes longer survival. To investigate whether CLL can be cured, more research should be directed to the characteristics of complete clonal remissions. The use of non-risky biologic response modifiers in early stages may contribute to these efforts.

Humans↗

Prognostic significance of additional cytogenetic abnormalities at diagnosis of Philadelphia chromosome-positive chronic granulocytic leukemia.

Of 661 patients with Philadelphia chromosome (Ph)-positive, nonblastic chronic granulocytic leukemia, 58 had cytogenetic abnormalities in addition to the Ph at the time of diagnosis. Twenty patients had reduplication of the Ph in one or more metaphases. Twenty-one patients with a single Ph exhibited hyperdiploidy in one or more metaphases. Eleven patients had two or more hypodiploid metaphases as their only numerical abnormality. The remaining six patients had a variety of abnormalities. Many patients had more than one type of abnormality. Survival of patients in the different subgroups was similar, but these 58 patients had a shorter course than the 603 patients without additional cytogenetic abnormalities (P less than .02). Survival curves for the two populations did not diverge until the 2-year point, after which the annual death rate among patients with additional cytogenetic abnormalities was approximately 40% higher than that of patients without such abnormalities. The two populations had similar relative risk values according to a hazard ratio formula previously described by the International CGL Prognosis Study Group. Thus, they would have been expected to have essentially identical survival curves. We conclude that the presence of additional cytogenetic abnormalities at the time of diagnosis constitutes an independently significant prognostic feature with an unusually delayed influence on survival.

Adolescent↗

Natural history of chronic lymphocytic leukemia: on the progression and progression and prognosis of early clinical stages.

In chronic lymphocytic leukemia (CLL) clinical staging systems provide useful tools for establishing the prognosis and to plan therapy. Clinical staging systems, however, do not give information regarding disease progression. In this study the progression and survival of CLL in early clinical stages is analyzed. Among 261 patients with CLL, 134 (51%) were in stage A (M 60/F 74; mean age 64.2 years; DS = 11), and 87 (33%) in stage 0. Progression was analyzed as far as patients remained untreated (median: 11 months; range: 3-114). Thirty-three (24.6%) out of 134 patients in stage A progressed to more advanced stages (17 to B, 16 to C) with an actuarial cumulative risk for progression of 31% at 3 years. Variables at diagnosis predictive of a more likely progression were: number of lymph nodes involved (p less than 0.001), rapid lymphocyte doubling time (p = 0.0025), and markedly increased lymphocyte count (p = 0.02). Twenty-eight (32%) out of 87 patients in stage 0 progressed (8 to I, 12 to II, 7 to III), the actuarial cumulative risk being of 28% at 3 years. The only variable predictive of progression was a lower normal Hb level (p = 0.015). Although the survival probability of patients in stage A (0) was not statistically different from those in stage A (I, II), their median survivals were of 125.7 and 91 months, respectively. Concerning survival, the following poor prognostic variables were identified: stage A: advanced age (p = 0.01), and rapid lymphocyte doubling time (p = 0.0045). Stage 0: higher lymphocyte count (p = 0.005), and lower normal Hb level (p = 0.015).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗