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Biomedical subjects

D Russo

Publications and source records attributed to D Russo.

At least 271 records · Page 15Linked to original sources
PubMedDate not supplied

Sequential treatment of Ph-positive chronic myeloid leukemia with interferon gamma and interferon alpha.

Several clinical observations have shown that alpha-IFN is presently the most interesting investigational agent for the treatment of Ph+ chronic myeloid leukemia (CML). Gamma-IFN is also effective, and experimental data as well as preliminary clinical observations suggest that the combination of the two IFNs is worth investigating. No comparative data are available on the effects of the two IFNs, given alone, in the same patients. In this study 11 patients with PH+ CML were first treated with gamma-IFN, up to a maximum period of 35 weeks, and after a short rest period were retreated with alpha-IFN. Both IFNs were ineffective in 3 patients in accelerated or instable chronic phase. Both IFNs were equally effective in 8 patients in stable chronic phase, but none of these patients achieved a karyotypic conversion with either IFN. This study did not show any measurable differences in the therapeutic response to gamma-IFN and alpha-IFN given consecutively to the same patients.

Adolescent↗
PubMedDate not supplied

Serum lactate dehydrogenase is an important risk determinant in acute lymphocytic leukemia.

Pretreatment serum total lactate dehydrogenase (LDH) activity was measured in 341 adult patients (greater than 15 years old) with acute lymphocytic leukemia (ALL) in order to assess its prognostic value. Failure, death during induction and remission were not related to LDH. In contrast, a negative and continuous relationship was found between LDH and relapse-free survival. Though LDH activity was significantly higher in cases with already established risk factors such as high WBC count, FAB L3 cytotype, mature B-cell phenotype, and central nervous system involvement, LDH was confirmed to be the strongest predictor of remission duration by multivariate analysis. This study provides a definitive confirmation of the negative prognostic value of LDH in adult ALL.

Adolescent↗
PubMedDate not supplied

Human immunodeficiency virus testing in acute leukemia patients transfused between 1978 and 1985: a retrospective study on 91 cases.

Human immunodeficiency virus (HIV-1) can be transmitted by blood transfusions. A recent report focused on the relativey high risk of HIV-1 infection in American patients treated for leukemia and multiply transfused as a consequence of therapy. We therefore conducted a retrospective study on the presence of HIV-1 antibodies among 91 acute leukemia patients diagnosed between 1978 and 1985, before the onset of routine tests for HIV-1 contamination of blood products. The transfusion requirement (platelet units, red blood cell concentrates) involved almost 7,000 donors. We did not find any case of seropositivity in patients transfused with units from the donor pool. The only case of HIV-1 seropositivity was due to a bone marrow transplant donor, retrospectively found to be HIV-1 seropositive. These results differ from the American data previously cited. This is probably due both to differences in diffusion of the HIV-1 infection in the two countries and to differences in the selection of the two donor populations. We conclude that the risk of contracting HIV-1 infections before 1985 through multiple transfusions from registered donors in our Italian area was very low, if not absent, not only for leukemia patients but reasonably for other categories of heavily transfused groups.

Acute Disease↗
PubMedDate not supplied

Intensive polychemotherapy experience in chronic myeloid leukaemia.

A pilot study, testing two different chemotherapeutic schedules in CML patients, was carried out in order to verify the possibility of Ph1 clone disappearance. Both therapeutic regimens, though able to induce severe marrow aplasia, determined only a reduction of Ph1 positive metaphases in two patients, while in one case no response could be detected. Therefore we believe that chemotherapy alone is probably not sufficient to eradicate the Ph1 malignant clone.

Adult↗
PubMedDate not supplied

Phase II study of bisantrene in relapsed/refractory acute non lymphoid leukemias (ANLL).

The antileukemic activity of Bisantrene, a new anthracene derivative, has been evaluated in a phase II clinical study in 10 patients affected by refractory or primary relapsed ANLL. The patients received an induction course consisting of 250 mg/m2/day for 7 days followed, in case of CR, by 250 mg/m2/day for 3 days (consolidation treatment). In case of partial response a reinduction course (250 mg/m2/day for 3 days) was administered. Four out of the 10 patients obtained CR (3 of them after a single induction course). No significant toxic effect was noticed, apart from fever (due to myelosuppression) and hypotension in one patient who soon recovered without residual effects. These preliminary results could suggest further evaluation of Bisantrene in association with other drugs in both relapsed patients and those at onset of the disease.

Adult↗
PubMedDate not supplied

Spinal cord compression by extramedullary hematopoietic tissue in a thalassemic patient: prompt effect of radiotherapy.

As described in the literature, spinal cord compression by extramedullary hematopoietic tissue rarely occurs in thalassemic patients. Laminectomy and/or radiotherapy are the main approaches. We report on a patient with thalassemia intermedia who developed paralysis of both lower extremities due to the compression of the spinal cord by extramedullary hematopoietic tissue.

Adult↗
PubMedDate not supplied

Laparoscopic splenectomy in the management of hematological diseases.

The indications for splenectomy in hematological diseases are well known. In particular, they include idiopathic thrombocytopenic purpura (ITP), hereditary spherocytosis (HS) and Hodgkin's disease (HD) (as a part of subdiaphragmatic staging). We present here our initial experience of 10 cases (6 ITP, 2 HS and 2 HD) managed with a laparoscopic approach as opposed to the traditional laparotomy. Advantages over the open operation include decrease of post-operative pain, pulmonary sequelae and infections, cosmetic advantages, faster recovery and reduced hospitalization.

Adult↗
PubMedDate not supplied

Development of autoimmune thyroid diseases during long-term treatment of hematological malignancies with alpha-interferons.

In recent years recombinant alpha-interferons (alpha-IFNs) have been widely used in the treatment of several hematological malignancies. Prolonged courses of IFN have been shown to induce autoantibodies and to support the exacerbation or even the development of autoimmune diseases. In this report we describe the development of symptomatic autoimmune thyroid diseases in 4 (7.4%) out of 54 patients in chronic treatment with recombinant alpha-IFNs in our department. Two patients developed a disease resembling Hashimoto's thyroiditis after 17 and 49 months of continuous IFN treatment, while the other two developed a typical Graves' disease after 41 and 52 months of therapy. The mechanism by which IFN induces autoimmune thyroid diseases, the choice of searching for anti-thyroid autoantibodies before starting long-term IFN treatment, the option of discontinuing IFN therapy in the presence of overt thyroid diseases, and the management of these diseases are discussed.

Autoimmune Diseases↗
PubMedDate not supplied

p170-dependent multidrug resistance. Restoring full sensitivity to idarubicin with verapamil and cyclosporin A derivatives.

BACKGROUND: Cell sensitivity to anthracyclines and other drugs depends on several factors, including overexpression of a 170Kd transmembrane glycoprotein (P170) that enhances drug efflux from the cells. Since the result of treatment is negatively related to the expression of P170 in leukemia, malignant lymphoma and other tumors, it is important to investigate drugs and methods that can modify multidrug resistance (MDR). MATERIALS AND METHODS: Using an MTT-microcultured tetrazolium colorimetric method, we assayed sensitivity to daunorubicin (DNR) and to its 4-demethoxy derivative idarubicin (IDA) in two MDR cell lines (CEM VLB and LOVO DX) and in their respective non-MDR parental lines (CEM and LOVO 109), with and without three MDR modifiers, namely the D-isomer of verapamil (DVRP), cyclosporin A (CyA) and the new CyA derivative SDZ PSC 833. RESULTS: We showed that down-modulation of resistance with MDR modifiers was greater for DNR than for IDA in MDR cells. However, we also demonstrated that restoration of full sensitivity could only be achieved for IDA, not for DNR. DVRP and CyA in combination were more effective than either compound alone and could abolish P170-related resistance to IDA at concentrations of 1-2 microM and 1.6 microM, respectively. SDZ PSC 833 alone was even more effective and set MDR to zero at a concentration ranging between 0.8 and 1.6 microM. CONCLUSIONS: These data suggest that combinations of IDA and MDR modifiers may improve the results of cancer and leukemia treatment and that they are worth investigating in vivo, with attention to possible effects on drug pharmacokinetics and on normal tissue damage.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMedDate not supplied

Overexpression of MDR-related p170 glycoprotein in chronic myeloid leukemia.

BACKGROUND AND METHODS: Philadelphia (Ph) positive chronic myeloid leukemia (CML) cannot be induced into a true remission with conventional chemotherapy. Blast cells and precursors obtained from 51 Ph+ CML cases were assayed for expression of the multidrug resistance (MDR)-associated glycoprotein (p170) by immunocytochemistry (APAAP) with the MRK-16 monoclonal antibody. RESULTS AND CONCLUSIONS: Positive cells were found in 11/17 cases in chronic phase (65%), in 4/8 cases in accelerated phase, and in 23/26 cases in blastic phase (89%). The proportion of positive cells, which ranged between less than 1% and 95%, was higher in blastic phase (mean 32 +/- 29.9) than in chronic phase (mean 3 +/- 5.3) (p = 0.006). These findings show that p170 overexpression is common in Ph+ CML, especially after progression to blastic phase, and suggest that p170-related MDR may contribute significantly to treatment failure.

ATP Binding Cassette Transporter, Subfamily B, Mem↗