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E Montserrat

Publications and source records attributed to E Montserrat.

At least 271 records · Page 15Linked to original sources
PubMed1988

Serum immunoglobulins in B-chronic lymphocytic leukemia. Natural history and prognostic significance.

To investigate the prognostic significance of gammaglobulin and immunoglobulin levels in chronic lymphocytic leukemia (CLL), survival studies were performed in a series of patients with that disorder. The survival probability of patients with initial levels of gammaglobulin of less than 700 mg/dl was significantly lower (P = 0.03) than in patients with initial levels of 700 mg/dl or more. Decreased initial levels of IgG and IgA also were associated with reduced survival probability (P = 0.027 and P = 0.014, respectively), whereas hypo-IgM did not show any influence on survival. When the influence on survival of gammaglobulin and immunoglobulin concentration was analyzed by Cox's multivariate model, the only variable which entered the regression at significant level was IgA (P = 0.006). As shown by the same type of analysis, the prognostic value of hypo-IgA is independent from the clinical staging. The natural history of hypogammaglobulinemia and hypoimmunoglobulinemia was investigated by sequential analysis in a series of untreated patients. The appearance of decreased levels of these globulins was found to be a continuous process developing spontaneously during the untreated course of the disease. Among factors associated with the appearance of hypogammaglobulinemia during the evolution of CLL, initial lower levels of IgG and IgA, but not IgM, were found in a multivariate analysis.

Agammaglobulinemia↗
PubMed1988

Combined assay of adenosine deaminase, purine nucleoside phosphorylase, and lactate dehydrogenase in the early clinical evaluation of B-chronic lymphocytic leukemia.

The levels of adenosine deaminase (ADA), purine nucleoside phosphorylase (PNP), lactic dehydrogenase (LDH), and LDH isoenzyme patterns (LD1 to LD5) have been measured in lymphocyte extract from 28 patients with B-chronic lymphocytic leukemia (B-CLL). The activities of ADA, PNP, and LDH have been correlated with two morphological groups of B-CLL classified according to the percentage of large, nongranular, atypical lymphocytes (AL) in peripheral blood: "typical" B-CLL (less than 10% of AL, 21 cases) and "atypical" B-CLL (10-25% of AL, seven cases). Patients with atypical B-CLL had significantly (P less than 0.001) higher activities of ADA (0.46 +/- 0.17 U/10(9) cells), PNP (1.74 +/- 1.0 U/10(9) cells), and LDH (48.3 +/- 9.7 U/10(9) cells) than patients with typical B-CLL (ADA, 0.29 +/- 0.1 U/10(9) cells; PNP, 0.58 +/- 0.23 U/10(9) cells; and LDH, 29 +/- 10 U/10(9) cells). In addition, the "treatment-free period" was also significantly (P less than 0.025) shorter in the group of atypical B-CLL compared with the typical B-CLL group. No clear-cut statistical differences in lymphocyte surface markers or in several other prognostic factors between the two subgroups of B-CLL were found. The present study supports the idea that in B-CLL the simultaneous determination of ADA, PNP, and LDH might be helpful in better understanding the pathophysiology, prognosis, and natural history of the disease.

Adenosine Deaminase↗
PubMed1988

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↗
PubMed1988

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↗
PubMed1988

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↗
PubMed1988

A randomized trial comparing chlorambucil plus prednisone vs cyclophosphamide, melphalan, and prednisone in the treatment of chronic lymphocytic leukemia stages B and C.

Ninety-six previously untreated patients (67 males/29 females; mean age: 63 years; range: 46-84) with CLL in stage B (62 cases) or C (34 cases) were randomized to be treated with either chlorambucil (0.4 mg/kg orally days 5 and 6) plus prednisone (60 mg/m2 orally days 1 to 4) (CL + PDN) every 2 weeks or cyclophosphamide (160 mg/m2 orally days 1 to 4), melphalan (6 mg/m2 orally days 1 to 4), and prednisone (60 mg/m2 orally days 1 to 4) (CMP) every 3 weeks for 10 months. Forty-eight patients were treated with CLR + PDN, and the remaining 48 with CMP. The following types of response were considered: complete response (CR): total disappearance of symptoms and signs related to the disease. Partial response (PR): shift of the disease to a less advanced stage. Stable disease (SD) no change in the stage after treatment. Progressive disease (PD): progression of the disease to a more advanced stage. Thirty-six (75%) responses (27% CR) with CLR + PDN and 26 (54.5%, 12.5% CR) with CMP were observed (p = 0.054). Although more responses were achieved in stage B (69%, 24% CR) than in stage C (54%, 12% CR) this difference did not achieve statistical significance. Survival was statistically not different for those patients treated with LCR + PDN as compared to those receiving CMP.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1988

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↗
PubMed1988

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↗
PubMed1988

Recombinant alpha 2-interferon in the treatment of B chronic lymphocytic leukemia in early stages.

Ten previously untreated patients with early B cell chronic lymphocytic leukemia (B-CLL) (seven in Rai's stage 0, three in stage I) were given recombinant alpha 2-interferon (alpha 2IF) (2 X 10(6) U/m2 intramuscularly three times a week for a minimum of 14 weeks) to assess its effectiveness. All patients were evaluable for response to therapy and toxicity. No complete response was achieved. In all cases a definite, although transient reduction in the absolute number of peripheral blood lymphocytes was observed. In eight patients an increase in the absolute number of granulocytes was detected. None of the patients experienced severe hematologic toxicity. Fatigue, malaise, and fever were the more common side effects, but all patients were able to finish their treatment as planned. The results of this pilot study suggest that low doses of recombinant alpha 2-IF have some activity in early and previously untreated B-CLL and that further studies of IF effectiveness in B-CLL seem warranted.

Adult↗
PubMed1988

Immunohistochemical study of bone marrow sections in CLL.

T lymphocytes and dendritic reticulum cells (DRC) were studied in frozen-cut bone marrow sections of 35 patients with chronic lymphocytic leukemia (CLL) (infiltration patterns: interstitial 8, nodular 6, mixed 9, diffuse 12) and 13 cases of low grade non Hodgkin's lymphoma (NHL) (centroblastic/centrocytic 7, centrocytic 3, lymphoplasmacytoid 3) with bone marrow involvement. In contrast to the usual findings in normal bone marrow, in CLL and low grade NHL CD4 positive cells were more numerous than CD8 positive cells. Whereas in NHL CDR were large and occupied all the nodule, in CLL were small and located in the center of the nodule. These findings can be of interest in the study and differential diagnosis of lymphoproliferative disorders.

Antigens, Differentiation, T-Lymphocyte↗
PubMed1988

Advances in therapy of chronic lymphocytic leukaemia.

Chronic lymphocytic leukaemia (CLL) is a lymphoproliferative disorder characterized by the progressive accumulation of clonal small mature-looking lymphocytes, usually of B cell origin. In addition to a better understanding of many biological features, during the last 10-15 years a great progress has been made in the prognostic characterization of the disease. The therapeutic achievements, however, have been less impressive. The possibility to identify patients with different prognosis has renewed interest in the treatment of this disorder. A considerable number of controlled trials have been performed or are in course, and new perspectives for CLL treatment are emerging. Basically four different kinds of measures are used: 1) chemotherapy, 2) radiotherapy, 3) adjuvant measures and 4) new modalities.

Combined Modality Therapy↗