Cyclosporin A and graft-vs.-host disease.
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Biomedical subjects
Publications and source records attributed to C Rozman.
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In 100 untreated patients with chronic lymphocytic leukaemia (CLL) lymphocyte doubling time (LDT) has been investigated in relationship with clinical stages, bone marrow histological patterns, treatment-free period and survival. Although partially correlated with clinical stages and bone marrow patterns, LDT has a clear prognostic significance by itself: whereas a LDT of 12 or less months identifies a population of patients with poor prognosis, a LDT higher than 12 months is indicative of good prognosis as substantiated by a long treatment-free period and survival. This simple parameter can be useful in the clinical management of CLL patients.
Immune thrombocytopenic purpura (ITP) has been observed infrequently in untreated Hodgkin's disease. A patient with an ITP associated with an inapparent Hodgkin's disease, who presented a life threatening CNS haemorrhage as first clinical manifestation, is described.
Damage of skeletal muscle in association with graft-versus-host disease (GvHD) has been referenced exceptionally. Eighteen months after bone marrow transplantation, a 22-year-old man developed polymyositis associated with manifestations of chronic GvHD, such as peripheral eosinophilia and localized morphea. Diagnosis of polymyositis was established by clinical, electromyographic, and histopathologic findings. His clinical condition improved with immunosuppressive therapy. At electronmicroscopy, some close and broad contacts between lymphocytes with activated appearance and degenerated muscle fibers were observed, suggesting a lymphocytotoxic mechanism. The findings support the idea that polymyositis can be considered a manifestation of chronic GvHD.
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Fifteen patients with Hodgkin's disease resistant to the chemotherapy combinations of cyclophosphamide, vinblastine, procarbazine and prednisone and doxorubicin, bleomycin, vinblastine, and dacarbazine were treated with lomustine, etoposide, and prednimustine. Four of them achieved complete remission and two achieved partial remission (overall response rate, 40%). The median duration of response was 5.5 months, with two complete responders relapsing at 4 and 17 months and the other two remaining disease-free at 7 and 18 months, whereas disease progression was observed at 2.5 and 6 months in the partial responders. Extrahematological toxicity was scarce. Severe myelosuppression was observed in only three patients. These results indicate that lomustine, etoposide, and prednimustine can play a role in the treatment of advanced resistant Hodgkin's disease.
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