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Biomedical subjects

E Orlandi

Publications and source records attributed to E Orlandi.

At least 73 records · Page 4Linked to original sources
PubMed1988

Hematologic and clinical features of patients with chromosome 5 monosomy or deletion (5q).

This paper analyzes the hematologic features and outcome of 13 patients with chromosome 5 abnormalities (monosomy 5 or deletion of 5q), either isolated or with additional anomalies. Among four patients with isolated del (5q), two had a stable refractory macrocytic anemia with thrombocytosis (5q-syndrome). All nine patients with complex karyotypes had acute leukemia or refractory anemia with excess of blasts in acute transformation; two cases were TdT-positive, with a lymphoid or a mixed phenotype. In seven patients, preleukemia preceded overt leukemia, and in six, a prior therapeutic, or occupational exposure to mutagens/carcinogens had occurred. Additional chromosome 7 abnormalities were seen in four cases. The median survival of patients with complex karyotypes was 19 months from the time of diagnosis of the hematologic disorder and 5 months from the time of identification of the chromosome 5 abnormality. Pathogenetic implications of the chromosome 5 monosomy or del (5q) through a proto-oncogene activation and the putative hemopoietic stem cell involvement in a clonal disease are discussed.

Adult↗
PubMed1988

Adult leukemia developing after aplastic anemia: report of 8 cases.

481 cases of adult leukemia (115 acute lymphoblastic leukemia, ALL, and 366 acute nonlymphoid leukemia, ANLL) diagnosed at the Hematology Division of Pavia between 1976 and 1985 were reviewed to evaluate how many patients had an aplastic presentation. In 8 cases (1.6%) typical marrow hypoplasia preceded overt leukemia. At the leukemic transformation, the morphological and immunological findings were diagnostic for non-T non-B ALL in 2 cases, for ANLL in 5 cases (2 M1, 2 M2, 1 M5) and for Ph'-negative chronic granulocytic leukemia in 1 case. Median survival from the onset of leukemia was 5 months. In a certain proportion of cases aplastic anemia may be considered as a preleukemic state with a low propensity to develop into acute leukemia.

Acute Disease↗
PubMed1986

Systemic high-dose ara-C for the treatment of meningeal leukemia in adult acute lymphoblastic leukemia and non-Hodgkin's lymphoma.

Considering the good penetration of systemic high-dose ara-C (HDara-C) into the CNS, we used this approach for treating overt meningeal leukemia, either isolated or with concurrent extraneurologic disease, in 15 adults with high-risk acute lymphoblastic leukemia (ALL), one adult with lymphoid blast crisis of chronic granulocytic leukemia (LBC-CGL), and four adults with poor-prognosis non-Hodgkin's lymphoma (NHL). Treatment consisted of ara-C, 3 g/m2 every 12 hours by three-hour infusion for eight doses followed by a second course of four doses on day 21. Remitters received consolidation with monthly courses of HDara-C for four doses. Additional systemic multi-drug reinduction therapy and direct CNS treatment with intrathecal methotrexate (IT MTX) and cranial irradiation (CRT) was administered to the three remitters last treated. Thirteen of 20 patients (65%) achieved complete remission (CR): seven of seven patients with isolated meningeal leukemia and six of 13 patients with concurrent CNS and bone marrow disease. Of the remaining seven patients, five had a complete CSF clearing with persistent marrow disease. In all cases there was prompt resolution of neurologic signs and symptoms. The median duration of CR was 5 months (range 2 to 8 months). The most significant toxicity seen was myelosuppression, which was predictable and manageable. Nonhematologic toxicity was generally acceptable and included moderate nausea and vomiting, diarrhea, drug fever, transient liver dysfunction, and dermatitis. No cases of CNS toxicity occurred. There were no treatment-related deaths. Disease-free survival was limited by marrow relapse, either isolated or with concurrent CNS disease. No instances of isolated meningeal relapse occurred. These results obtained in a poor-risk subset of patients indicate that HDara-C is an effective treatment for the induction of remission in ALL and NHL with meningeal leukemia. Therefore, HDara-C should be considered for inclusion in multiagent consolidation programs for patients at high risk for CNS disease.

Acute Disease↗
PubMed1986

[Emergencies in carcinoma of the esophagus].

The authors reviewed their experience in the emergency treatment of complications of esophageal cancer. They have treated 5 cases of acute obstruction, bleeding (4 cases), perforations or rupture (5 cases), feeding and neoplastic obstruction of esophageal endoprostheses (30 cases), dislocations and migrations of endoprostheses (15 cases), damage of endoprostheses (1 case) and, finally, acute complications after laser treatment.

Emergencies↗
PubMed1986

[Early gastric cancer (case contribution)].

Early gastric cancer (e.g.c.) was detected in 23 patients (7.8%) from a total of 293 gastric cancers observed from 1970 to 1985. Clinical and pathological aspects are discussed. In 19 cases the surgical treatment was subtotal gastrectomy for lesions of the middle and lower third, in 4 cases total gastrectomy for tumors of the upper third and of the greater curvature.

Gastrectomy↗
PubMed1986

[Endobrachyesophagus as a sequel of esophagitis due to caustics].

Caustic ingestions show, nevertheless medical progress, many clinical and therapeutical problems; particularly risk factors of stenotic and neoplastic evolutions as well as of functional outcome are little known. A case of Barrett's esophagus after acid sulphuric ingestion is the starting point of some personal considerations, after revision of literature.

Burns, Chemical↗
PubMed1986

[Injuries caused by traffic accidents: passive safety and restraint systems in automobiles].

In this article are considered the multiple instruments today employed in cars, in order to prevent or ameliorate the lesions caused to the occupants in case of road accident. The acquisitions in the differentiated structure of the car, in the windshield, in the components of the passenger cell are described, and the peculiar importance of the restraint systems is evidenced.

Accidents, Traffic↗
PubMed1986

[Injuries caused by seat belts].

The effectiveness of seat belts is largely proved. Nevertheless, this safety device produces typical lesions, for very violent accidents, or if it is malpositioned. The pathogenetic criterium of these lesions ("seat belt syndrome") is described, while a complete revision of literature is presented. The importance of emergency care in the identification and treatment of these lesions is emphasized.

Abdominal Injuries↗
PubMed1985

Low-dose arabinosyl cytosine in acute leukemia after a myelodysplastic syndrome and in elderly leukemia.

Low-dose arabinosyl cytosine (ARA-C) was tested in 15 patients with acute leukemia after a myelodysplastic syndrome (MDS) and in six elderly patients with acute nonlymphoid leukemia (ANLL). The drug was given subcutaneously at 10 mg/m2, every 12 hr for 2 weeks, every 28 days. The overall response rate was 19% (one complete remission, three partial responses), and the median duration of response was 4 months. No particular features at diagnosis were predictive of response. Pancytopenia and marrow hypoplasia occurred after 44 (78%) of 56 courses of therapy and were more severe in nonresponders. Four patients died during the aplasia following ARA-C therapy. Subcutaneous low-dose ARA-C was of limited benefit and bore a noticeable hematologic toxicity.

Acute Disease↗
PubMed1982

Adult acute lymphoblastic leukemia. Response to therapy according to presenting features in 62 patients.

Sixty-two adult patients with acute lymphoblastic leukemia (ALL) were treated with an induction regimen including vincristine, daunorubicin and prednisone (VDP) followed by CNS prophylaxis. Forty-five patients (72.5%) achieved complete remission (CR). The CR were maintained with daily 6-MP and weekly MTX. Monthly reinduction cycles with vincristine and prednisone (plus daunorubicin every three courses) were also given. Median duration of CR was 10.4 months. Overall survival was 17.4 months. The remission rate and length of CR were studied in relation to the clinical and hematological features present at diagnosis. CR rate was adversely influenced by age only over 40 and by tumoral presentation. The length of remission was negatively influenced by tumoral presentation, CNS involvement, high circulating blast count, L2 and L3 cytology, and T or B immunological phenotype. Multiple regression analysis confirmed the weight of FAB morphology in determining the length of remission. Among L2 adult patients, tumoral presentation appears to be the major unfavourable prognostic factor.

Adolescent↗
PubMed1982

Quantitative evaluation of erythropoietic activity in dysmyelopoietic syndromes.

Based on the morphological appearances of the bone marrow and peripheral blood, 43 patients with dysmyelopoietic syndromes were categorized into four types: refractory anaemia with excess of blasts, chronic myelomonocytic leukaemia, primary acquired sideroblastic anaemia and refractory anaemia with cellular marrow, without excess of blasts and/or ring sideroblasts. Ferrokinetics allowed three distinct groups of patients to be defined. All cases of refractory anaemia with excess of blasts and chronic myelomonocytic leukaemia were classified in the same group. They were characterized by relative marrow failure and had a high likelihood of developing acute leukaemia. At the other end of the spectrum, individuals with primary acquired sideroblastic anaemia had high erythropoietic activity which was largely ineffective. They had a benign clinical course without evidence of leukaemic transformation. In the middle group, in terms of erythropoietic activity, lay patients with refractory anaemia with cellular marrow and a few individuals with primary acquired sideroblastic anaemia. Their clinical course and risk of developing acute leukaemia were intermediate between the other two groups. These findings indicate that separate entities may exist within the spectrum of dysmyelopoietic syndromes. In clinical practice, they may be recognized by morphological studies and other simple laboratory means.

Adolescent↗
PubMed1982

Erythropoiesis in hairy cell leukaemia: a true erythroid failure.

A quantitative evaluation of erythropoiesis was carried out in 12 patients with hairy cell leukaemia (HCL). The results were compared with those obtained in eight patients with aplastic anaemia (AA) in order to define the characteristics of erythroid failure in HCL. Discriminant analysis was applied to both haematological and erythrokinetic parameters of the two disease groups. Plasma iron concentration and MCV were significantly higher in AA, and allowed a perfect separation of the patients. As regards erythrokinetics, values of ineffective erythropoiesis and peripheral haemolysis were able to separate completely the two disease groups, being significantly lower in HCL than in AA. A true erythroid failure was the peculiar erythrokinetic pattern of HCL. This conclusion allows one to speculate on the nature of the stem cell damage in this disease.

Adult↗