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Biomedical subjects

D Donadio

Publications and source records attributed to D Donadio.

At least 37 records · Page 2Linked to original sources
PubMed1990

Doxorubicin and doxorubicinol: intra- and inter-individual variations of pharmacokinetic parameters.

Doxorubicin was given by short i.v. infusion (dose range 25-72 mg/m2) to 18 patients who underwent three to seven successive courses of chemotherapy (total, 57 courses). Plasma levels of doxorubicin and its major metabolite doxorubicinol were determined by high-performance liquid chromatography over a 48-h period after the infusion. Pharmacokinetic parameters for the parent drug and its metabolite were calculated for each course of treatment. The results show considerable inter- and intraindividual variations for most parameters. The coefficients of variation (CV) ranged from 37% to 93% (inter-individual) and from 6% to 59% (intra-individual). Nevertheless, we observed a good stability over successive courses for terminal half-life in six patients (CV, 6%-25%) and for clearance and AUC in four subjects (CV, 10%-22%). The ratio of the AUCs for doxorubicinol: doxorubicin averaged 0.514. The pharmacokinetic pattern of doxorubicinol was biphasic in plasma of the majority of patients. We propose a model for curve-fitting of these metabolite plasma concentrations that is based on two successive releases of the compound in the plasma compartment, separated by a lag time.

Adult↗
PubMed1990

[Cutaneous lesions in POEMS syndrome. Apropos of 3 case reports and a review of the literature].

We present three new cases of POEMS syndrome with the most common cutaneous signs of this entity. The syndrome is a multivisceral complex, mostly described in Japanese patients, which includes polyneuropathy, organomegaly, endocrine disorders, monoclonal gammopathy and skin changes. The latter are constant but sometimes reduced to one type of lesion. The most frequent are hyperpigmentation sparing the mucosae, hypertrichosis, scleroderma-like skin thickening and capillary angiomas. The other signs are much less common, as shown in table I. Histological findings are seldom reported and usually have little specificity. None of these abnormalities is pathognomonic, but their predominance at the extremities may be suggestive and leads to a search for other elements of the syndrome, notably gammopathy. The main differential diagnostic problem is with scleroderma, sometimes circumscribed and often systemic. Some cases are very ambiguous. The relationship between the two diseases would suggest the existence of one or several common pathogenic factors. The overall physiopathology of POEMS syndrome is obscure. The role of endocrine disorders in the genesis of the cutaneous signs is subject to discussion: hyperoestrogenism may explain some of these signs, but hypertrichosis is incompatible with the frequent finding of low androgen secretion. The role of one or several "toxic" substances secreted by plasmocytes is highly hypothetical. In some cases, the skin abnormalities have regressed after treatment of gammopathy, and in rare patients the recurrence of gammopathy was followed by that of skin lesions. In a few cases, a "paraneoplastic" character may be suspected.

Adult↗
PubMed1989

Interest of simultaneous ultrastructural characterization of morphology, cytochemistry and immune phenotype in a case of putative hybrid acute leukaemia.

A case of acute leukaemia is reported in which blast cells expressed some B-related antigens (namely the CALLA antigen) and no peroxidase activity at the optical level; however, some mature granular cells contained Auer rods. Simultaneous characterization of ultrastructural morphology, cytochemistry and immune phenotype was performed. There was an apparent mutual exclusion in the expression of myeloperoxidase activity and the CALLA antigen, and a heterogeneity in the CALLA expression among the blastic population. These results disagree with the hypothesis of a true biphenotypic leukaemia and demonstrate a complete heterogeneity between the lymphoblastoid cells and the myeloid ones. The interest of such a simple combined method in a case of putative hybrid acute leukaemia is emphasized.

Acute Disease↗
PubMed1989

Acute monocytic leukemia with B cell markers expression following B chronic lymphocytic leukemia.

A case of chronic lymphocytic leukemia (CLL) treated with chlorambucil, followed by the development of an acute monoblastic leukemia, is described. Cytofluorometric quantitative immunophenotype was determined during the blastic phase. Whereas small lymphocytes displayed a CD19+; CD24+; CD37+; CD5+ phenotype, the blastic population exhibited, besides CD13, CD14 and CD15 positivity, which is usually noted in such a monoblastic leukemia, definite CD9, CD10, CD22, CD24, CD37, CD5 and CD4 staining. Such results argue against a complete independence between the two clones, although their similarity could not be demonstrated.

Aged↗
PubMed1989

Inaugural intra-atrial neoplastic thrombosis in stage II Hodgkin's disease.

We report the first case of intra-atrial neoplastic thrombosis discovered in the initial stage of Hodgkin's disease. Considering the course of the case and the recurrence after 18 months we emphasize the necessity of screening cardiac cavities by CT Scan with a bolus, and of treating such a case as an initial stage IV Hodgkin's disease.

Adult↗
PubMed1988

[Chronic diarrhea caused by Campylobacter jejuni in a patient with AIDS].

We report a case of C. jejuni chronic diarrhea in a homosexual man with AIDS. The antibiotic susceptibility of the bacteria was about normal for the species. Investigating specific immunity, we observed the presence of anti-C. jejuni IgG and the absence of anti-C. jejuni IgA. These findings concord with the hypothesis that specific IgA are necessary for C. jejuni clearance from the digestive tract.

Acquired Immunodeficiency Syndrome↗
PubMed1988

[Does plasma exchange have a place in the treatment of necrotizing angiodermatitis?].

Necrotizing angiodermatitis is of characteristic clinical expression and is often difficult to treat. It is associated with microcirculatory disorders of hypertensive or diabetic origin. A particularly long course (m = 8 months) in 8 patients with necrotic angiodermatitis (of hypertensive origin in 6 cases and diabetes in 2) resulted in treatment by plasma exchange, two other patients with immunological angiodermatitis being treated similarly because of very similar symptomatology. The 10 patients (3 men, 7 women age range 55 to 80 years) received between 4 and 18 small volume plasma exchanges over 2 to 12 weeks. Results were evaluated from pain and duration of healing, absence of pain being reported by 7 patients and a beneficial effect on healing by 6 patients. No correlation existed between ESR and hematocrit values during treatment and the clinical course. The question arises as to whether the mode of action of plasma exchange in angiodermatitis is related to the purifying of serum factors or a rheological role.

Aged↗
PubMed1988

[The role of surgery in primary gastric non-Hodgkin's malignant lymphoma].

A total of 15 cases of primary gastric non-Hodgkin's malignant lymphoma (PGML) seen between 1974 and 1985 were reviewed, and data obtained combined with reports in the literature, to define the place of surgery in this affection becoming the monopoly of chemotherapists. The indication for surgery is indisputable when the diagnosis is in doubt, and justified for ulcerated and preperforating forms and in extirpable tumoral forms of loco malignancy. It should be avoided in high grade PGML unless the operation does not delay chemotherapy. Total gastrectomy should not be performed by principle but by necessity. Abdominal exploration should include lymph node and liver biopsies. An effective total care of these patients requires close cooperation between medical and surgical teams.

Adult↗
PubMed1987

Erythrocyte mean corpuscular volume during cytotoxic therapy is a predictive parameter of secondary leukemia in Hodgkin's disease.

Mean corpuscular volume (MCV) evolution during cytotoxic therapy was studied in 32 patients with Hodgkin's disease (HD) who developed therapy-related acute nonlymphocytic leukemia (t-ANLL) and in 64 HD controls matched for age, therapy duration, and MOPP (mechlorethamine, vincristine, procarbazine, and prednisone) administration. Maximum MCV during therapy reached 108.3 +/- 8.2 fl in t-ANLL patients and 103.4 +/- 9.1 fl in the controls (P = 0.001). Maximum MCV increase was 26.7 +/- 8.3 fl in t-ANLL patients and 16.6 +/- 8.3 fl in the controls (P = 10(-9). The greatest 3-month increase observed during therapy was 14.8 +/- 6 fl in the t-ANLL patients and 10.1 +/- 4.8 fl in the controls (P = 0.0001). During initial MOPP therapy, the greatest 3-month increase reached 14.1 +/- 5.3 fl in t-ANLL patients and 9.8 +/- 4.5 fl in the controls (P = 0.01). The relative risk of developing t-ANLL was 9 for a MCV maximum increase over 24 fl during therapy, which was observed in 71% of the patients with t-ANLL and in only 22% of the controls. For the greatest 3-month MCV increase over 15 fl observed in 57% of the t-ANLL patients and in 17% of the controls, the relative risk reached 15. This suggests that there is at least one factor, independent from therapy, which predisposes to t-ANLL. MCV evolution during therapy appears useful in determining which HD patients have a high risk of developing t-ANLL.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

Preleukemic changes in cases of nonlymphocytic leukemia secondary to cytotoxic therapy. Analysis of 105 cases.

Peripheral blood changes preceding therapy-related leukemia were studied in 105 patients who had received cytotoxic therapy, 53 for Hodgkin's disease and 52 for other cancers. Preleukemic anomalies were observed in 74.3% of the cases, appearing after a mean interval of 68.7 months after diagnosis of the initial cancer. This interval was only 57.5 months in patients aged 50 years or older and only 42.3 months in patients with Hodgkin's disease having received cytotoxic therapy for 6 months or less. The first changes most frequently observed were pancytopenia (24.8%) and isolated erythrocyte abnormalities such as anemia or macrocytosis (18.1%). Involvement of two cell lines, isolated thrombocytopenia or leukopenia, circulating immature cells, monocytosis, leukocytosis, or thrombocytosis were also observed. Therapy-related myelodysplastic syndrome was recognized in 19 patients and myelofibrosis in 3. Median duration of the preleukemic phase was 6 months; 9 months in cases of isolated erythrocyte involvement and 5 months in the other cases. Myelomonocytic or monoblastic leukemia appeared less frequently when the first sign involved erythrocytes only. Hematological surveillance thus appears necessary in all patients having received cytotoxic therapy. Bone marrow study with cytogenetic examination should be performed in cases of persistent peripheral blood abnormalities.

Adolescent↗
PubMed1986

Acute leukemia after treatment for ovarian cancer. Report of four cases and review of the literature.

Four cases of acute nonlymphocytic leukemia (ANLL) following ovarian cancer are reported. All patients received alkylating agents and had a preleukemic phase. Seventy-nine additional cases of ANLL following therapy found in the literature are also reviewed. All but 2 patients received alkylating or alkylating-related agents alone or in combination. Mean duration of chemotherapy was 31.4 +/- 19.4 months. Eighty-eight percent of the patients presented with preleukemia with a mean duration of 10 +/- 10 months. Mean interval between cancer and ANLL was 57.3 +/- 26 months. Cytogenetic abnormalities were found in 71% among patients who had a karyotype. Long-term alkylating agent therapy seems to have a significant role in the development of ANLL and should be avoided in ovarian cancer.

Aged↗
PubMed1986

Long term plasma exchange therapy in bullous pemphigoid.

Long term plasma exchanges associated with corticosteroids (11 patients) were compared with corticotherapy alone (10 patients) for the treatment of bullous pemphigoid. The patients having long term plasma exchanges showed a lower rate of relapses at six months and needed less corticosteroids.

Aged↗
PubMed1985

[Treatment of malignant hemopathies with aracytine in low doses. Analysis of 159 cases].

Based on the in vitro experiments which showed the capacity of Aracytine (AraC) to induce differentiation of leukemic cells, low dose AraC treatment of patients with acute myeloid leukaemia (AML) or myelodysplastic syndromes (MDS) has been available since 1980. Many studies involving only small numbers of patients have demonstrated contradictory results regarding the efficacy or the mechanism of action of this regimen. A retrospective clinical study is presented, including 159 patients treated in 11 French institutions and 1 German institution (AML: 99 patients; MDS: 38 patients). The study confirms the efficacy of low dose AraC, especially in elderly patients with hypoplastic AML. Although, less severe than with high dose chemotherapy, toxicity needs regular monitoring. The mechanism of action cannot be ascertained by this clinical study, however half of the complete remissions were obtained with no bone marrow aplasia. Studies with low dose AraC and/or other in vitro differentiating agents need to be continued.

Aged↗
PubMed1985

[Enterolithiasis and digestive duplication. Apropos of a pediatric case].

This is the case report of a 13 years old white young girl in whom numerous moving abdominal calcifications are discovered during investigation for chronic anemia. Because of the existence of a severe vascular malformation of the face, a digestive arteriography is performed with no evidence of a calcified angiomatosis of the intestine tract. Preoperative diagnosis was intestinal duplication with enterolithiasis. Exploratory laparotomy confirmed that it was a huge communicating ileal duplication with numerous intestinal calculi and alimentary fragments. Surgical excision was easy and post-operative course, uneventful. This is a standard association but never reported in the pediatric literature. The authors stress on the different diagnosis of calcifications encountered in abdominal X rays in children and on chronic intestinal stasis which is the main factor in enteroliths formation.

Adolescent↗