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Biomedical subjects

F Mandelli

Publications and source records attributed to F Mandelli.

At least 415 records · Page 23Linked to original sources
PubMed1983

Severe deficiency of natural killer activity in the peripheral blood of patients with hairy cell leukemia.

Natural killer (NK) activity against K-562 tumor cells was evaluated in peripheral blood leukocytes (PBL) obtained from untreated patients affected by hairy cell leukemia (HCL). NK activity present in PBL from 10 HCL patients was at least six-fold lower (p less than 0.01) than that present in PBL from 15 healthy donors. Decreased NK activity in HCL PBL was not due to dilution of the NK effector cells by the neoplastic cells; in fact, NK activity of PBL from 4 HCL patients with less than 5% circulating neoplastic cells was still five-fold lower (p less than 0.01) than that present in normal PBL. Partial characterization of the NK defect in HCL patients indicated that: (A) defective cytotoxicity was not dependent on the duration of the assay; (B) HCL PBL added to normal PBL during the assay did not exert suppressor activity; (C) the NK activity of HCL PBL could be potentiated in vitro by interferon; and (D) low levels of NK activity were associated with reduced numbers of circulating monocytes (p less than 0.01) and of large granular lymphocytes (LGL) (p less than 0.01). In conclusion, our results indicate that the low levels of NK activity present in the peripheral blood of HCL patients may be related to reduced numbers of circulating effector cells.

Adult↗
PubMed1983

Transfused and pharmacological iron: relationship of overload to HLA antigens.

Forty-eight haemodialysis patients were divided in two groups according to presence or absence of haemochromatosis alleles (HA). Serum ferritin concentrations were determined and analysed according to blood transfusion history. Furthermore 20 patients were given iron saccarate and post treatment ferritin concentrations were determined at 15 and 30 days. Following blood transfusion, only HA+ patients increased ferritin concentrations, while intravenous iron administration produced increased ferritin both in HA+ and HA- patients. Therefore it is advisable to minimise transfusions in HA+ patients, while intravenous iron administration should be avoided regardless of HA status.

Adolescent↗
PubMed1982

Treatment by splenic irradiation in 22 chronic lymphocytic leukemia patients.

Twenty-two patients with chronic lymphocytic leukemia, score 2 according to Rai et al. (10), who received only a course of splenic irradiation are reviewed. Splenic doses ranged from 420 to 1080 rad. Response to splenic irradiation was rated by evaluating peripheral lymphocytosis, hepatosplenomegaly, adenomegaly and disease-related symptoms. Following splenic irradiation, 8 patients showed a significant reduction in splenomegaly; 7 patients showed a significant reduction in peripheral lymphocytosis (less than 10,000/mm3), which has lasted from 15-42 months without any other treatment. In 14 patients, response to splenic irradiation was partial, and it has successively been necessary to treat 12 patients with chemotherapy. Methods of splenic irradiation, survival, clinical and hematologic behavior are discussed in detail.

Adult↗
PubMed1982

B-cell acute lymphoid leukemia (ALL) with lymphoblasts expressing surface immunoglobulins only at relapse.

Morphological, cytogenetic and immunological studies were performed on lymphoblasts of two patients with acute lymphoid leukemia at onset and at relapse. At onset and before any treatment lymphoblasts had L3-FAB morphology, a 14q+ chromosome abnormality due to a 8;14 translocation in the absence of expression of specific immunologic markers (E-rosette, C3-receptor, surface immunoglobulins). The clinical behaviour of the two patients was characterized by a very short first complete remission and by a short survival. At relapse SIg was expressed by lymphoblasts of both patients. This evolution in immunological phenotype of the dominant blast populations from onset to relapse provides evidence that in vivo, during the course of the leukemic disease, phenotype changes take place that seem to be cell differentiation.

Adolescent↗
PubMed1982

Vindesine in the treatment of refractory hematologic malignancies: a phase II study.

A phase II evaluation of vindesine (VDS) was carried out in 46 patients with hematologic malignancies refractory to conventional chemotherapy. Two VDS schedules were employed (at random): (A) a weekly bolus (5 mg/m2 i.v. X 4); (B) fractionated daily injections (0.5 mg/m2 i.v. q.12 h X 10, course to be repeated after 10-15 days). Complete and partial remissions were observed in acute lymphocytic leukemia (3/14 patients), acute non-lymphocytic leukemia (2/12 patients), chronic myelocytic leukemia in blastic crisis (4/12 patients) and non-Hodgkin's lymphoma (4/8 patients). Responses were seen with higher frequency in patients treated with the weekly bolus (42.8 vs 16%). Myelosuppression was the most relevant side effect in both schedules. Neurotoxicity occurred infrequently and was generally mild in degree. Further trials with VDS in combination with other drugs are recommended in hematologic malignancies.

Acute Disease↗
PubMed1982

Chromosomal, morphological and clinical correlations in blastic crisis of chronic myeloid leukaemia: a study of 69 cases.

The karyotypic pattern in 69 patients with Ph1-positive chronic myeloid leukaemia (CML) was investigated during the blastic phase (BC) and correlated with survival and certain parameters of potential prognostic significance, including blast morphology, basophilia and thrombocytopenia. There was no difference in median survival in BC between patients with and without aberrations in addition to the Ph1. Nor were there any differences in this respect among patients with the specific aberrations +Ph1, +8, iso(17q), or other abnormalities. There was no correlation between the incidence of thrombocytopenia and any particular karyotypic change. However, the incidence of basophilia was a characteristic feature for patients with an iso(17q). The survival time in BC was considerably longer in patients with a lymphoid morphology of the blastic cells compared to the myeloid varieties, and within the myeloid varieties the survival in BC was longer in patients with granular differentiated blasts than in those with granular atypical blast cells. No obvious correlation was apparent between blast morphology and karyotypic pattern. However, a pattern was discernible regarding survival and certain chromosomal changes within some morphologic groups: in patients with granular differentiated and lymphoid morphology, the median survival in BC was considerably longer when the bone marrow cells had a Ph1 as the sle abnormality compared to patients who had additional aberrations.

Acute Disease↗
PubMed1982

Adolescent and adult acute lymphoblastic leukemia: prognostic features and outcome of therapy. A study of 293 patients.

The case histories of 293 adolescent and adult patients with acute lymphoblastic leukemia (ALL) first seen and treated between 1969 and 1979 are reviewed. A complete remission (CR) was achieved in 79% of cases. Male sex, advanced age (greater than or equal to 30 yr old), and early CNS involvement were the major determinants of remission failure. Median duration of first CR was 16 mo, with 23 patients (actuarial proportion 25%) alive and relapse-free at 5 yr. The major determinant of first CR length was white blood cell (WBC) count (best cut-off value at 35 X 10(9)/liter). First CR length was also negatively affected by early CNS involvement, morphological FAB L3 subtype, and B-cell (Smlg+) leukemia, but these features were significantly associated with a high WBC count. First CR length in patients 11-15 yr old did not differ significantly from that of patients 16-59 yr old. The negative prognostic value of T-cell (E+) leukemia was not confirmed in this adult series. CNS prophylaxis provided an effective protection against CNS relapse. Maintenance chemotherapy was apparently more effective when 4 or more than 4 drugs were employed. "Low risk" patients (WBC count less than 35 X 10(9)/liter still relapsed rather frequently (32% at 1 yr, 49% at 2 yr), with 33% of them alive and relapse-free at 5 yr. "High risk" patients (WBC count greater than or equal to 35 X 10(9)/liter +/- early CNS involvement +/- morphological L3 subtype +/- B-cell leukemia) relapsed very quickly (50% at 6 mo. 70% at 1 yr), with only 6% of them relapse-free at 5 yr.

Actuarial Analysis↗
PubMed1981

Long-term survival in childhood acute lymphocytic leukemia in Italy.

Among 727 children with acute lymphocytic leukemia (ALL) observed at eight pediatric clinics in Italy in the years 1967-1974, 200 (27.5%) survived for more than five years after diagnosis. The proportion of long-term survivors rose significantly during the years 1970-1974 when aggressive therapeutic programs with curative intent were uniformly adopted in Italy (19.8% vs. 29.4%; P less than 0.05). Clinical and laboratory data at diagnosis of the 200 long-term survivors were analyzed and compared with that of the 527 nonsurvivors. We found that, besides a leukocyte count greater than 50,000 cells/mm3, other factors such as early central nervous system CNS leukemia and the presence of mediastinal mass were predictive of a poorer prognosis for long-term survival. Life-table analysis revealed that the chance of long-term survival was significantly higher in those children who have survived for five years without relapse (82.9% vs. 24.1%; P less than 0.01). Although late initial relapse is always possible, if a child with ALL remains in continuous complete remission for at least nine years, it is likely that the patient is cured.

Adolescent↗
PubMed1981

Acute lymphocytic and myelomonocytic leukemia associated with low platelet counts and a 21q- marker chromosome.

A terminal deletion of the long arm of one chromosome 21 at band q21 was found in two patients with acute leukemia and a low platelet count: one case of acute myelomonocytic leukemia and one case of acute lymphocytic leukemia. The segment deleted from chromosome 21 could not be found translocated to any other chromosome of the complement. The results indicate that the 21q- marker chromosome may be due to a true deletion and that the marker is no specific for primary thrombocythemia or other myeloproliferative disorders associated with thrombocytosis.

Chromosome Deletion↗