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C Rozman

Publications and source records attributed to C Rozman.

At least 559 records · Page 31Linked to original sources
PubMedDate not supplied

Compensated cirrhosis: natural history and prognostic factors.

To investigate the natural history of compensated cirrhosis, 293 consecutive patients without previous major complications (ascites, jaundice, encephalopathy or gastrointestinal hemorrhage) were studied in terms of morbidity (probability of developing decompensated cirrhosis during follow-up) and survival. Patients were diagnosed by liver histology between 1968 and 1980. Median follow-up was 63 months. Decompensation of cirrhosis was considered when a patient first developed one of the major complications of the disease. Ten years after diagnosis, the probability of developing decompensated cirrhosis and the survival probability rate were 58 and 47%, respectively. A multivariate survival analysis (Cox's regression model) using clinical, biochemical and histological data obtained at diagnosis disclosed seven factors that predicted prognosis: serum bilirubin; serum gamma-globulin concentration; hepatic stigmata; prothrombin time; sex; age, and alkaline phosphatase. According to the contribution of each one of these factors to the final model, a prognostic index was constructed that allows calculation of the estimated survival probability. The predicting value of this index was validated by a split sample testing technique.

Adult↗
PubMedDate not supplied

Non-Hodgkin's lymphoma of unfavourable histology: a multivariate analysis of factors predicting the response to CHOP.

Forty-eight patients with de novo non-Hodgkin's lymphoma (NHL) of unfavourable biology received CHOP as first-line chemotherapy. A complete remission (CR) was achieved in 64.5 per cent patients. Overall 4-year projected survival was 48 per cent with a median follow-up of 40.5 months. Two pretreatment characteristics, high LDH serum levels and bulky abdominal disease, were negatively associated with survival at the proportional hazards regression model and were used to calculate each patient's relative-risk. Such analysis allowed to identify two prognostic subgroups according to their outcome to CHOP. Firstly, a high-risk subgroup that showed an 8 per cent CR rate, most patients dying within the first year after diagnosis. Secondly, a low-risk subgroup that showed an 83.5 per cent CR rate and a 4-year project survival of 66 per cent. From the above results two major conclusions can be drawn: (1) the CHOP combination is an effective treatment for unfavourable NHL patients with a low relative-risk and (2) new therapeutic approaches should be explored for NHL patients with a high relative-risk at diagnosis.

Adult↗
PubMedDate not supplied

Specific cutaneous involvement in Hodgkin's disease.

In Hodgkin's disease (HD) specific cutaneous involvement is rare. When it occurs, retrograde lymphatic spread, direct extension from the underlying lymph nodes, and hematogenous dissemination are the mechanisms usually implicated. Among 349 patients with HD diagnosed and followed-up at our institution from 1969 to 1990, three (0.85 per cent) presented specific cutaneous involvement. In two cases with mixed cellularity subtype, skin lesions displayed histologic features similar to those found in the lymph node. Treatment with combination chemotherapy resulted in rapid disappearance of the lesions in two patients but was ineffective in the third. Previous reports of cutaneous involvement in HD, its differential diagnosis, prognostic significance, and treatment are briefly reviewed.

Adult↗
PubMedDate not supplied

Mitoxantrone and intermediate-dose cytosine arabinoside for poor-risk acute leukemias: response to treatment and factors influencing outcome.

Mitoxantrone (MIT, 12 mg/m2, i.v. 5 days) and intermediate-dose cytosine arabinoside (IDAC 1 g/m2/12 h, i.v. 3 days) was given to 43 patients with poor-risk acute leukemias (AL). Moderate or severe toxicity was infrequent. The proportion of complete remissions (CR) in the main patient categories was as follows: 15/18 (85 per cent) in acute myeloid leukemia (AML) in the first relapse, 2/6 in ALL in the first relapse, 0/2 in AML in relapse after bone marrow transplantation (BMT), 2/7 in AML refractory to first-line treatment (REF-AL), and 1/6 in postmyelodysplastic (PMD-AL) plus secondary AL (S-AL). The mortality rate during induction was 23 per cent. Median duration of CR was 24 weeks. The multivariate prognostic factor analysis on CR obtention showed that data concerning treatment for the first relapse and platelet count higher than the median of the series were favourable. On the contrary, PMD-AL, S-AL and REF-AL were unfavourable situations. A percentage of marrow erythroblasts superior to the median was a favourable prognostic factor for survival. Finally, the duration of CR after MIT-IDAC was directly related to the duration of previous CR. In conclusion, MIT-IDAC was highly effective to attain CR in AML in the first relapse. However, due to the poor long-term results in these patients, additional measures are recommended after CR.

Adolescent↗
PubMedDate not supplied

5th International Workshop on Chronic Lymphocytic Leukemia.

In the past few years important advances have been made in our understanding of the biology and natural history of CLL; also, new strategies and agents offer promise in the treatment of this form of leukemia. Now, patients can be treated on a more rationale basis and with real prospects for a sustained control of their disease, and improved quality of life. Hopefully, progresses in CLL will continue to accumulate in the coming years.

Animals↗
PubMedDate not supplied

Comparative morphology of granulocytes collected by three methods of leukapheresis. A light microscopy and transmission electron microscopy study.

The morphology of granulocytes collected by continuous-flow centrifugation (CFC), discontinuous-flow centrifugation (DFC), and continuous-flow filtration (CFF) was investigated in 18 healthy donors by means of light microscopy and transmission electron microscopy. Light microscopy study of semithin sections of granulocytes collected by CFC and DFC showed minimal morphologic abnormalities, compared to granulocytes procured by CFF. Ultrastructural study of granulocytes procured by CFF showed more conspicuous qualitative and quantitative abnormalities (the most prominent being "microvilli," degranulation, and bazarre chromatin) than in granulocytes obtained by the other two methods. Controls showed that the bulk of CFF-cell abnormalities was due to the "tapping" of the filters. Factors such as the mechanical compression (plasma extractor) used in DFC method, donor pretreatment with anticoagulants and steroids, hydroxyethyl starch, and duration of leukapheresis scarcely influenced granulocyte morphology.

Adult↗
PubMedDate not supplied

[Non-Hodgkin's lymphomas: current aspects].

OBJECTIVE: We wish to briefly review current knowledge of non-Hodgkin lymphomas (NHL) with special emphasis on aspects of interest in ophthalmology, otorhinolaryngology and neurology. DEVELOPMENT: We analyze the historical evolution of the classification of the NHL and refer to that recently devised by the World Health Organization. Amongst the numerous conditions forming part of this group of disorders we refer to the main data (clinical, immunophenotype, cytogenetics and of molecular biology) relative to the five most important types: 1. Follicular lymphoma; 2. Diffuse large cell lymphoma; 3. 'Mantle' cell lymphoma; 4. MALT lymphoma (mucosa associated lymphoid tissue), and 5. Peripheral T lymphoma. Then we describe the types and clinical forms of NHL in ophthalmology, otorhinolaryngology and neurology. Finally we consider the recent advances in prognosis (international index, biological markers) and treatment (new types of polychemotherapy, eradication of Helicobacter pylori, transplant of hemopoietic progenitors, monoclonal antibodies and anti-sense treatment of these conditions. CONCLUSIONS: The NHL form a group of conditions in which the annual increase in recent years has been over 4%. With considerable frequency these tumors are found from the beginning or during their course in otorhinological and ophthalmic tissues, or in the nervous system; in the latter case, apart from direct tumour expression they may also cause paraneoplastic manifestations.

Antibodies, Monoclonal↗
PubMedDate not supplied

Estimation of bone marrow cellularity by means of vertebral magnetic resonance.

BACKGROUND AND OBJECTIVE: A magnetic resonance (MR) signal shows an inverse correlation with bone marrow cellularity. In this study, we investigated the possibility of estimating the degree of bone marrow cellularity by means of this non-invasive technique. METHODS: In 25 patients with different hematological disorders and homogeneous bone marrow distribution, the percentage of bone marrow cellularity was compared to the MR signal of four middorsal vertebrae in T1 sequence. As internal control, the MR signal of the mid-dorsal spinal cord region was used. The results were expressed as the MR signal ratio (great mean MR signal of four vertebrae/MR signal of the spinal cord). RESULTS: The correlation coefficient (r) between both parameters was -0.93 (p < 0.0001). All observed values fell within the 90% limits of predicted values. The mean difference between observed and predicted bone marrow cellularity was 5.6 (SD 4.0)%. INTERPRETATION AND CONCLUSIONS: The measurement of the MR signal is not easy to standardize since it depends to a large degree on the control employed. The spinal cord proved to be a satisfactory internal control of the MR signal. Within defined conditions, MR can be useful for a rough estimate of bone marrow cellularity in several clinical situations, such as analysis of tumor burden for prognosis of some leukemias and the evaluation of response to therapy in both proliferative and hypoplastic disorders.

Adolescent↗
PubMedDate not supplied

High incidence of chronic graft versus host disease after allogeneic peripheral blood progenitor cell transplantation. The Spanish Group of Allo-PBPCT.

BACKGROUND AND OBJECTIVE: The incidence of acute GVHD (aGVHD) in allogeneic peripheral blood progenitor cell transplantation (allo-PBPCT) seems to be similar to that seen in allogeneic bone marrow transplantation (allo-BMT). In contrast, some preliminary results suggest that the incidence of chronic GVHD (cGVHD) might be higher. The aim of the present study was to analyze the actuarial probability of developing cGVHD in allo-PBPCT, its clinical manifestations and response to treatment. METHODS: We have retrospectively analyzed clinical results from 21 allo-PBPCT recipients that had been transplanted at least 18 months before this study and that fulfilled the following criteria: HLA identical sibling donor, non T-cell depleted apheresis and more than 90 days of survival with sustained engraftment. The median follow-up was 12 months (range 4.5-22). RESULTS: Twelve out of the 21 (57%) patients presented cGVHD, 1 limited and 11 extensive. The actuarial probability of cGVHD was 72.7% (95% CI, 49-96%). The median interval from transplant to onset was 180 days (range 95-270). Nine of the 12 cases (75%) presented combined skin and liver involvement. Of the other three, the liver was involved in one case; skin, mouth, and nail cGVHD was observed in another case; and skin and mouth involvement together with an obstructive pulmonary disease was observed in the remaining case. Under therapy, a complete resolution of cGVHD manifestations was achieved in five cases, and a partial improvement was attained in three other cases. In two responsive patients, cGVHD reappeared after stopping treatment. Four patients were refractory to the treatment. INTERPRETATION AND CONCLUSIONS: It would appear from this retrospective and multicenter study that, after a median follow-up of 12 months, cGVHD after allo-PBPCT could be more frequent than after allo-BMT. A randomized trial with a large number of patients and a sufficient follow-up will be necessary to answer this question definitively.

Adolescent↗