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Biomedical subjects

E Pogliani

Publications and source records attributed to E Pogliani.

At least 55 records · Page 3Linked to original sources

Idarubicin in sequential combination with cytosine arabinoside in the treatment of relapsed and refractory patients with acute non-lymphoblastic leukemia.

Sixteen adult patients with refractory acute non-lymphoblastic leukemia (ANLL) underwent reinduction therapy with idarubicin (12 mg/m2) i.v. on days 1-3) followed by cytosine arabinoside (120 mg/m2 every 12 h on days 4-10). Patients achieving complete remission (CR) received consolidation and early intensification courses which included idarubicin at lower dosage. CR was reached after a single course in 70% of the patients treated at first relapse, and two of the five subjects previously resistant to daunorubicin-containing regimens responded to the idarubicin protocol. The median duration of CR was 11 months. Gastrointestinal side-effects were not important; mild and reversible ECG changes were noted whereas delayed cardiac toxicity was not observed despite previous treatment with daunorubicin. These encouraging results confirm the efficacy of idarubicin in treating acute leukemia and suggest it may have a major role in the treatment of relapsed and refractory patients with ANLL.

Acute Disease↗

Oral idarubicin in adult acute leukemia: a preliminary experience.

Twelve patients affected by different types of acute leukemia received idarubicin (4-demethoxy-daunorubicin) by oral route at the total dosage of 45, 60 or 90 mg/m2 distributed over three consecutive days. Drug response was assessed by the decrease in blast cells in peripheral blood and showed some variations between the different types of leukemia. Acute myelogenous leukemia patients and those with blastic crisis of chronic myeloid leukemia appeared to be the more responsive groups; however, the lower dose schedule could explain the less satisfactory results obtained in lymphatic leukemia patients. Data suggest that idarubicin is absorbed rapidly after oral ingestion, in spite of nausea and vomiting, which appeared 3-4 h later and were easily controlled by antiemetic therapy. The purpose of fractionating the drug dosage over three consecutive days is to prolong in the blood an elevated concentration of the main idarubicin metabolite (13-dihydro-derivative), which presents in experimental models an antileukemic potency similar to the parent compound. This study confirms that idarubicin is effective in acute leukemia also by oral route. This formulation could offer some advantages for subjects who cannot tolerate parenteral chemotherapy and it could be proposed in maintenance leukemia protocols.

Acute Disease↗

Complete remission in prolymphocytic leukemia with 4-demethoxydaunorubicin and arabinosyl cytosine.

Prolymphocytic leukemia (PL) is a morphologically distinct disease generally characterized by unsatisfactory therapeutic response and brief survival. Aggressive chemotherapy protocols including doxorubicin (DX) have been successfully used as alternatives to treatments usually effective in chronic lymphocytic leukemia (CLL). A patient with typical PL, resistant to regimens containing DX, was treated with 4-demethoxydaunorubicin (4-dm DNR), a new anthracycline analog derived from daunorubicin (DNR). The therapeutic response was rapid and impressive; furthermore 4-dm DNR combined with arabinosyl cytosine (Ara-C) produced a complete remission which is unusual in PL.

Antineoplastic Combined Chemotherapy Protocols↗

Value of CT scanning in the diagnosis of CNS mycotic involvement: report of 3 cases.

Fungal infections of the CNS are becoming an increasingly serious problem in immunosuppressed patients. We describe three patients with malignant blood disease who in the course of systemic fungal infection presented cerebral involvement. The nature, site and extent of the cerebral involvement were defined by computed tomography (CT). Further, in one patient it was possible to follow the course of the lesion and assess the effectiveness of antimycotic therapy by CT because of its noninvasiveness and repeatability.

Adult↗

Response to vincristine treatment in a case of idiopathic hypereosinophilic syndrome with multiple clinical manifestations.

A case is reported of idiopathic hypereosinophilic syndrome involving many organs and systems and with a wide range of clinical findings: hematologic, cardiovascular, skin, pulmonary, spleen, liver, and gastrointestinal. Mortality in such patients is very high, but aggressive medical treatment (vincristine 2 mg/week for 5 weeks) produced a significant clinical benefit and considerably improved our patient's prognosis.

Aspirin↗

Unusual bone marrow hyperplasia in a case of thalassemia intermedia.

A case of beta thalassemia intermedia is described. Beside the typical hematologic picture and extramedullary erythropoiesis in the liver always present in such a clinical form, atypical masses due to foci of erythropoiesis were found at paravertebral, parasternal and subcostal sites. The size of these masses caused problems in differential diagnosis; they have been solved by computerized axial tomography.

Adult↗

Therapeutic activity of 4-demethoxydauno-rubicin (idarubicin) in adult acute leukemia.

Twenty-six patients affected by acute leukemia were treated with 4-demethoxydaunorubicin (idarubicin), a new anthracycline compound which in experimental leukemias showed an antitumoral activity superior to daunorubicin (DNR) and doxorubicin (DX), with a higher ratio of active to cardiotoxic doses. A group of 16 patients in relapse received idarubicin at a dosage of 5-6 mg/m2/day for 3 consecutive days; a second group of 6 relapsing and 4 previously untreated cases was treated with a sequential combination of idarubicin and arabinosyl cytosine. In all patients, a significant fall of bone marrow and peripheral blast cells was obtained. These preliminary results suggest that idarubicin has a therapeutic activity against human acute leukemias usually responsive to DNR or DX. The duration of myelosuppression varied from 7 to 50 days, leading in some cases to a high risk of infections. As regards other toxic effects (gastrointestinal, hepatic and acute cardiac toxicity, alopecia), idarubicin appears to be, in our experience, a well-tolerated drug; however, it is too early to comment on delayed cardiac effects.

Acute Disease↗

Reduction of plasma levels of betathromboglobulin and platelet factor 4 during hemodialysis: a possible role for a short acting inhibitor of platelet aggregation.

Plasma levels of the platelet markers betathromboglobulin and platelet factor 4 are elevated in patients with chronic renal failure, and their levels in hemodialysis patients increase further during exposure to the dialysis membrane. The effectiveness of a short acting inhibitor of platelet aggregation in reducing the blood levels of betathromboglobulin and platelet factor 4 was assessed by means of a double blind cross over study. A statistically significant reduction of betathromboglobulin and platelet factor 4 levels was observed during treatment with the platelet inhibitor.

Adult↗

Pharmacokinetic, bioavailability and pharmacodynamic study of indobufen (K 3920), an inhibitor of platelet aggregation, after a single dose in man.

Six healthy volunteers received single iv and oral doses of 2-[p-(1-oxo-2-isoindolinyl)phenyl] butyric acid 100 mg (indobufen; K 3920), an inhibitor of platelet aggregation. Plasma levels and urinary excretion of the drug were determined by GLC. Collagen-induced platelet aggregation was assessed turbidimetrically at various intervals after administration. The plasma half-life of the drug was 7--8 h and more than 70% of the administered dose was recovered within 48 h in urine, as unchanged drug and as the glucuronide of indobufen. After oral administration of tablets of two different formulations, the drug was completely absorbed, but one formulation showed faster absorption. The maximal inhibitory effect on platelet aggregation was observed 1 to 4 h after iv administration, and it had decreased by 8h. After tablets, peak effect and the time of the peak were similar, but activity was significantly prolonged, in accordance with the higher plasma levels found at 8 h. The data suggest that the effect of indobufen on platelets is reversible, and that for this drug platelets behave as a compartment that slowly equilibrates with plasma.

Administration, Oral↗

[Interaction between anti-aggregating and anticoagulant agents. A double blind study on the concomitant administration of nicergoline and acenocoumarols].

A double blind study was carried out comparing 10-methoxy-1,6-dimethyl-ergoline-8 beta-methanol-(5-bromonicotinate) (nicergoline, Sermion) and placebo in 60 thromboembolic patients on long-term controlled acenocoumarol treatment. Aim of the trial was to assess the hypothesis of an interaction on both the coagulatory parameters and the clinical findings. No significant variations of the acenocoumarol daily dose were required in nicergoline treated group and no interaction was demonstrated in coagulatory parameters. Prothrombin activity and thrombo-test evaluated fortnightly were not statistically different in nicergoline and placebo groups while the platelet antiaggregating activity of nicergoline was confirmed after a three months' treatment. Bleeding time was unaffected. Minor differences in clinical findings were observed in the two groups.

Acenocoumarol↗