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G Marinone

Publications and source records attributed to G Marinone.

At least 19 recordsLinked to original sources
PubMed1995

Cardiac and pleuropulmonary AL amyloid imaging with technetium-99m labelled aprotinin.

Antiproteases are known to be present in amyloid deposits. We evaluated the possibility of using an anti-serine protease (aprotinin) labelled with technetium-99m (TcA), usually employed as a cortical renal tracer, for the imaging of amyloid deposits. Because of the known high uptake of TcA by the kidneys, we limited our analysis to extra-abdominal amyloid localizations. We report the scintigraphic findings observed in 24 patients with light chain amyloidosis (AL) and one with a hereditary form who were known or suspected to have extra-abdominal involvement. Planar scans obtained 100min after i.v. TcA administration showed myocardial accumulation in 11 patients, pleuropulmonary accumulation in nine, pericardial accumulation in two and localization in the neck region (thyroid, salivary glands and tongue) in eight. TcA scintigraphy was negative in five patients without clinical or laboratory evidence of extra-abdominal involvement, as well as in 12 control group patients with cardiac and renal diseases. These preliminary results indicate TcA to be a low-cost, readily available radiopharmaceutical for imaging of extra-abdominal involvement in AL type amyloidosis.

Adult↗
PubMed1995

Cardiac immunocyte-derived (AL) amyloidosis: an endomyocardial biopsy study in 11 patients.

The objective of this study was to investigate the spectrum of morphologic features in myocardial biopsy specimens from patients with cardiac immunocyte-derived (AL) amyloidosis. Cardiac involvement is the most important predictor of survival in AL amyloidosis. Myocardial biopsy remains the method of choice for diagnosing cardiac amyloidosis when noninvasive studies give equivocal results. Histologic, immunohistochemical, ultrastructural, and morphometric studies were made on myocardial biopsy specimens from 11 patients in whom the diagnosis of AL amyloidosis was based on the demonstration of a monoclonal immunoglobulinopathy and of amyloid deposits in tissues. Histopathologic study showed amyloid in 10 of the 11 biopsies. In one biopsy (Congo red negative), the diagnosis was made by ultrastructural identification of amyloid fibrils. In all patients, the deposits formed perimyocytic layers that measured up to 18 microns in thickness. These layers formed along the basement membranes, which were partially preserved in 5 patients and unrecognizable in 6. Interstitial nodular deposits were also present in 5 patients. Immunohistochemical studies for the characterization of the proteins in the amyloid deposits were diagnostic in 1 patient and confirmatory in 10. Nodular deposits, thick perimyocytic layers of amyloid and small myocyte diameters were associated with shorter survival of the patients. Small-vessel involvement and myofilament loss occurred in all patients. In conclusion, myocardial biopsy serves to (1) establish the diagnosis of cardiac amyloidosis; (2) characterize immunohistochemically the proteins in the amyloid fibrils and (3) assess the degree of myocyte damage and atrophy.

Adult↗
PubMed1993

Acute phase proteins and prognosis in multiple myeloma.

Serum IL-6 levels have been shown to correlate with disease severity and prognosis in patients with plasma cell dyscrasias. Among its pleiotropic actions, IL-6 is also the major regulator of the acute phase response in humans. The possible impact on survival of the major serum acute phase proteins (s.APP) [C-reactive protein (s.CRP), alpha-1-antitrypsin (s.AAT), haptoglobin, acid alpha-1-glycoprotein and alpha-2-macroglobulin (used as control)] was assessed on a population of 103 consecutive, previously untreated myeloma patients. Univariate analysis showed that among the acute phase proteins only s.AAT (P = 0.015) and s.CRP (P = 0.027) were significantly correlated with survival. The multivariate Cox proportional hazard model applied to s.APP and other common parameters showed that s.beta-2-microglobulin (s.b2M), s.calcium, s.creatinine, BM plasma cell percentage, age and s.AAT correlated significantly with survival. Combining s.b2M and s.AAT allowed stratification of myeloma patients: those with low levels of s.b2M (< or = 3 mg/l) and of s.AAT (< or = 3 g/l) presented an excellent prognosis (median survival exceeding 10 years) while those presenting higher values of the two parameters presented a median survival of 2.5 years (P = 0.002).

Acute-Phase Proteins↗
PubMed1993

Application of monoclonal anti-idiotypes in the study of AL amyloidosis: therapeutic implications.

A monoclonal anti-idiotyped antibody (IgG1k MAb 3B11D4) has been raised against the lambda-chain dimers isolated from the urine of a patient (DEP) with AL amyloidosis. This antibody binds a conformational idiotope present on the monoclonal DEP IgA, but does not recognize the reduced and alkylated lambda-chain monomers, nor the 15- to 17-kDa light chain fragments obtained from the amyloid fibrils, which have the same N-terminal sequence as the urinary light chains. The nonreactivity of this MAb with amyloid fibrils was confirmed by immunohistochemical examination of cryostatic sections of an amyloidoma surgically removed from the patient's subcutaneous tissue. Our data demonstrate that the deletion of about 70 amino acid residues of the C-terminus of the lambda chain prevents the formation of the self-limiting dimer and may facilitate the deposition of fragments into amyloid fibrils. With regard to the amyloidogenic clone, MAb 3B11D4 recognizes the plasma cell clone in bone marrow and 9% of circulating B lymphocytes. Panning and cytotoxicity experiments demonstrate that this antibody has the capability of selectively eliminating the idiotype-positive cells from peripheral blood. Antibodies with these properties could find application in a new therapeutic strategy which provides high-dose chemotherapy, total body irradiation, and rescue with circulating stem cells. These antibodies could be used in two distinct phases: first, in the purging of the stem cells to be infused from the amyloidogenic clone and, secondly, in an attempt to eliminate residual disease by intravenous infusion.

Amyloid↗
PubMed1992

Use of an anti-idiotypic monoclonal antibody in studying amyloidogenic light chains in cells, urine and fibrils: pathophysiology and clinical implications.

A monoclonal anti-idiotype antibody (IgG1k MoAb 3B11D4) raised against the amyloidogenic DEP lambda chain dimer binds a conformational idiotope also present on the monoclonal DEP IgA immunoglobulin. MoAb 3B11D4 does not recognize the reduced and alkylated lambda chain monomers, nor the 15-17-kDa fibrillar light chain fragments which have the same N-terminal sequence of the urinary light chains. The lack of about 70 amino acid residues of the C terminal of the protein prevents the formation of the self-limiting dimer and may facilitate the deposition of the fragments into amyloid fibrils. MoAb 3B11D4 recognizes the plasma cell clone in bone marrow and 9% of circulating B lymphocytes. Panning experiments demonstrate that this antibody has the capability to selectively eliminate the idiotype positive cells from peripheral blood. Antibodies with these characteristics could become a useful tool for better understanding the pathogenesis of the disease and for new therapeutic options.

Amino Acid Sequence↗
PubMed1990

Prevalence, clinical, and laboratory features of thrombocytopenia among HIV-infected individuals.

Prevalence and clinical features of human immunodeficiency virus (HIV)-related thrombocytopenia have been investigated among a random population of 657 anti-HIV-positive individuals. A platelet count below 100 X 10(9)/liter was detected in 72 patients (10.9%). Compared with anti-HIV-positive controls with normal platelets, a significantly higher prevalence of males (p less than 0.02) and of intravenous drug abusers (p less than 0.02) as well as a higher frequency of patients with advanced HIV-related disease (p less than 0.001) were detected among thrombocytopenic patients. Those patients whose thrombocytopenia was associated with neutropenia and/or anemia (14 cases, 2.1%) clearly differed from patients with isolated thrombocytopenia (IT) (58 cases, 8.8%) since they belonged to the more advanced groups of the CDC classification of HIV-related disorders, had lower CD4-positive lymphocyte counts, a higher frequency of cutaneous anergy, and less persistent thrombocytopenia. In the cohort of patients with persistent IT (47 cases), no single epidemiological or clinical data proved to correlate with the severity of thrombocytopenia. They did not differ significantly from anti-HIV-positive controls in their distribution among CDC groups, but the total lymphocyte and the CD4-positive lymphocyte counts were significantly lower in IT patients belonging to CDC group II (p less than 0.05 and p less than 0.02, respectively) and III (p less than 0.01 and p less than 0.005, respectively) compared with CDC group-matched controls; after a median followup of one year, the two cohorts showed similar rates of progression to CDC Group IV.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Estrogen and progesterone receptor guideline for tamoxifen therapy in chronic lymphocytic leukemia: a pilot study.

We studied estrogen and progesterone receptors (ER, PR) in 23 patients with chronic lymphocytic leukemia (CLL) and evaluated the results of this determination with other clinical and laboratory parameters. ER and PR activity was found respectively in 12 out of 23 (52%) and 6 out of 23 (26%) of the patients with a range between 2 and 23 fmol/mg protein (mean 10.3 fmol/mg) for ER and 18 and 92 fmol/mg (mean 41.8 fmol/mg) for PR. No correlations between ER/PR status and other parameters such as age, sex, stage, androgen and glucorticoid receptors (AR, GR), lymphocytic count or plasma estradiol and progesterone levels were noted. Seventeen consecutive patients out of 23 with a known receptor status and 1 with an unknown receptor status had been treated with tamoxifen 30 mg/day for 3 months. No objective response was achieved, despite some occasional reports of the literature.

Aged↗
PubMed1985

Decrease of granulocyte-macrophage colony-forming units during high dose medroxyprogesterone acetate treatment in advanced breast cancer.

We treated 18 post-menopausal women with advanced breast cancer with medroxyprogesterone-acetate 1000 mg p.o. daily. The study of granulocyte-macrophage colony forming units (GM-CFU) performed monthly, and peripheral white blood cell count showed an increase of granulocytes not statistically significant and a progressive decrease of GM-CFU that could protect marrow from chemotherapeutic agents or interfere with the myelosuppression of cytotoxic drugs.

Breast Neoplasms↗
PubMed1984

Remission continuation therapy for adult acute lymphoblastic leukemia. Preliminary results with a multidrug treatment protocol.

Twenty-four adolescent and adult patients with newly diagnosed acute lymphoblastic leukemia (ALL) were treated with the multidrug therapeutic program called IGG-74(9). Seventeen patients (71%) obtained a complete remission (CR) after induction therapy. They subsequently underwent a consolidation course with cytosine arabinoside and a seven drug maintenance regimen, lasting three years, with cyclophosphamide, 6 mercaptopurine, methotrexate, BCNU, adriamycin, vincristine and prednisone. The remission continuation treatment was well tolerated and produced an actuarial three-year disease-free survival rate of 57% and an overall median survival of 19 months. The efficacy of multidrug programs for the prevention of relapse in adults with ALL is discussed.

Adolescent↗
PubMed1983

Eosinophilic blast crisis in a case of chronic myeloid leukaemia.

A case of typical chronic myeloid leukaemia (CML) is described, of which the terminal blast crisis was characterized by an impressive proliferation of atypical eosinophils and by the simultaneous complete deficiency of neutrophilic myeloperoxidase. Since eosinophilic cells preserved a strong peroxidase positivity, a high number of immature non-granular eosinophilic precursors could be recognized among the leukaemic blast cells, thus supporting the diagnosis of eosinophilic blast crisis of CML.

Eosinophilia↗
PubMed1983

Detection of circulating immune complexes in acute non-lymphatic leukaemia: is it reliable?

The in vivo and in vitro phagocytic ability of leukaemic cells and the serum levels of circulating immune complexes (CIC) have been evaluated in 11 patients affected by acute non-lymphatic leukaemia (ANLL). High levels of serum CIC were detected in 17% of the cases showing phagocytic ability and in 80% of the cases lacking phagocytic ability (p less than 0.05). In 3 patients serum CIC determinations were negative while immunoglobulins with complement-fixing ability were detected in the cytoplasm of leukaemic cells indicating in vivo phagocytosis of CIC. These results suggest that leukaemic cells may sometimes interfere through their phagocytic ability on the detection of CIC in the serum. Therefore, the clinical and prognostic value of serum CIC in ANLL seems questionable.

Antigen-Antibody Complex↗
PubMed1981

Circulating immune complexes in human acute leukaemia.

Circulating immune complexes (CIC) in the sera of 60 newly diagnosed leukaemic patients were investigated by two methods, 125I-C1q binding test (C1q-BA) and conglutinin binding assay (KgB-SP). Positivity percentages were respectively 20.0% (C1q-BA) and 28.3% (KgB-SP). The small overlap between the results of the two methods suggests the occurrence of different types of CIC. The presence of CIC was found to be related only to clinical haemorrhage and thrombocytopenia; it did not prove to affect the prognosis and the survival of leukaemic patient.

Acute Disease↗