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J M Castrillo

Publications and source records attributed to J M Castrillo.

At least 19 recordsLinked to original sources
PubMed1999

Other cancers in patients with gastric MALT lymphoma.

Patients with Hodgkin's disease and nodal non-Hodgkin's lymphomas seem to have an excess risk for other cancers. A high incidence of other cancers has also been found in some series of patients with gastric MALT lymphomas. In a series of 136 patients with gastric MALT lymphomas the occurrence and features of other cancers have been described. In order to evaluate their occurrence statistically (excluding skin cancers) standard incidence ratios (SRI) have been calculated, using the incidence rates of a Cancer Registry in Spain as a reference. A Cox's multivariate proportional hazard model was fitted in order to evaluate the influence of age, sex, histological grade and treatment with chemotherapy or chemotherapy plus radiotherapy in the development of other non-skin cancers occurring after the diagnosis of MALT lymphoma. Other cancers were detected in 16 of the 136 patients (11.7%); the other cancer was detected prior to MALT gastric lymphoma in 6 patients (4.41%), concomitantly in 4 (2.9%) and after diagnosis of the lymphoma in 6 (4.41%). Other cancers occurred in 14.4% of the male and in 8.3% of the female patients; in 12% of the patients with low grade and in 11% of the patients with high grade lymphomas. Of the 6 cancers that occurred after diagnosis of the gastric lymphoma, 3 did in the 80 patients (3.7%) that had been treated with chemotherapy, 1 in the 3 cases (33%) treated with chemotherapy and radiotherapy and 2 in the 53 patients (3.7%) who had not received chemotherapy or radiotherapy. The most frequent other cancers were lymphoid neoplasms and gastric carcinoma. There was not an excess of other cancers in the whole cohort or in the sex or histological grade strata. There was an excess close to significance (SIR =2.59; 95% CI:0.98-6.88) in the patients under 50 years of age. In the Cox's analysis, age, sex, histological grade and treatment did not influence the occurrence of other cancers after the diagnosis of lymphoma. In conclusion, in patients with gastric MALT lymphoma other cancers also occur. An excess incidence was not demonstrated, although it may exist in patients under 50 years. Of special importance is the occurrence of gastric cancer that appears concomitantly or after gastric lymphoma.

Adenocarcinoma↗
PubMed1998

Peripheral T-cell lymphomas: initial features, natural history, and prognostic factors in a series of 174 patients diagnosed according to the R.E.A.L. Classification.

BACKGROUND: Peripheral T-cell lymphomas (PTCL) account for about 10% of all lymphomas in Western countries. The aim of the present study is to analyze the initial characteristics and prognostic factors in a large series of PTCL patients. PATIENTS AND METHODS: 174 patients (105 male/69 female; median age 61 years) were diagnosed with PTCL according to the R.E.A.L. Classification in nine Spanish institutions between 1985 and 1996. Cutaneous lymphomas and T-cell chronic lymphocytic/prolymphocytic leukemia were excluded from the study. Univariate and multivariate analyses were used to assess the prognostic value of the main initial variables. RESULTS: The distribution according to histology subgroup was: PTCL unspecified, 95 cases (54.4%); anaplastic large-cell Ki-l-positive (ALCL), 30 cases (17%); angioimmunoblastic T cell, 22 cases (13%); angiocentric, 14 cases (8%); intestinal T cell, 12 cases (7%), and hepatosplenic gamma delta T cell, one case (0.6%). As compared to the other types, ALCL presented more frequently in ambulatory performance status, without extranodal involvement, in early stage, normal serum beta 2-microglobulin (B2M) level and low-risk international prognostic index (IPI). Most patients were treated with adriamycin-containing regimens. The overall CR rate was 49% (69% for ALCL vs. 45% for other PTCL; P < 0.02). The risk of relapse was 48% at four years. Median survival of the series was 22 months (65 months for ALCL vs. 20 months for other PTCL; P = 0.03), with a four-year probability of survival of 38% (95% confidence intervals (95% CI): 28-48). In the univariate analysis, in addition to the histology, older age, poor performance status, presence of B-symptoms, extranodal involvement, bone marrow infiltration, advanced Ann Arbor stage, high serum LDH, high serum B2M, and intermediate- or high-risk IPI were related to poor survival. In the multivariate analysis the histologic subgroup (ALCL vs. other PTCL) (P = 0.02; response rate (RR): 4.3), the presence of B-symptoms (P = 0.02, RR: 2.2), and the IPI (low vs. high) (P = 0.04, RR: 2) maintained independent predictive value. When the analysis was restricted to the unspecified subtype, only IPI had independent prognostic value (P = 0.003; RR: 3.5). CONCLUSIONS: PTCL have adverse prognostic features at diagnosis, respond poorly to therapy and have short survival, with no sustained remission. ALCL constitutes a subgroup which responds better to therapy and has a longer survival.

Adolescent↗
PubMed1996

Evaluation of the international index in the prognosis of high grade gastric malt lymphoma.

The International Prognostic Index identifies four risk groups with different survival rates in aggressive non-Hodgkin's lymphoma. We have studied whether a slight modification of this index has prognostic significance in high grade gastric B-cell MALT lymphoma. In 53 patients with high grade gastric B-cell MALT lymphoma the following survival factors were investigated: age over or under 60 years, sex, B symptoms, more than one extranodal site of involvement other than the stomach, serum LDH levels, performance status, stage I/IIE1/IIE2 v.s. stage III/IV, treatment with surgery, chemotherapy or both modalities together and the four risk groups as defined by the Modified International Prognostic Index (MIPI). A multivariate Cox's test was used to evaluate the independent prognostic significance on survival of all the above variables. Advanced stage (III/IV) and involvement of more than one extranodal site not including stomach were the only variables influencing survival. The MIPI was not sufficient to separate groups with significant differences in survival or to stratify prognostic groups. In this series, the MIPI did not show prognostic significance in high grade gastric B-cell MALT lymphoma.

Adolescent↗
PubMed1995

Gastric B-cell mucosa-associated lymphoid tissue (MALT) lymphoma. Clinicopathological study and evaluation of the prognostic factors in 143 patients.

BACKGROUND: Gastric MALT lymphoma can be histologically classified into two groups, low-grade (LG) and high-grade (HG); however, their natural history is poorly understood. We have studied a large retrospective series aiming to confirm whether the histological groups confer different clinical features and behavior and to analyze the prognostic factors in these patients. PATIENTS AND METHODS: A series of 143 gastric B-cell MALT lymphomas is reported. Eighty-four were low-grade lymphomas (LG) and 59 were high-grade lymphomas (HG). Median follow-up was 36 months. The clinical and analytical parameters of the 84 LG patients were compared with those of the 59 HG patients. In the patients who had been operated on, the pathological features (macroscopical patterns, tumor size, involvement of resection margins, degree of parietal invasion and involvement of abdominal lymph nodes and adjacent viscera) of the LG patients were compared with those of the HG patients. The sites of relapses were studied. In the 132 treated and followed-up patients the influence of the treatment and that of clinical, analytical and pathological features on survival were investigated with the Kaplan and Meier and log-rank tests. To identify the factors with independent influence on survival, a Cox model was fitted for the whole series and separately for 53 HG patients. RESULTS: HG group differed from the LG group by a significantly higher frequency of weight loss at presentation, palpable abdominal mass, hepatomegaly, peripheral lymphadenopathy, elevated serum LDH, higher incidence of stage III-IV and tumor/mass patterns in the endoscopy and in the gastrectomy specimen. The tumor was significantly larger in the HG group than in the LG and the deeper invasion of the gastric wall, the higher frequency of infiltration of the abdominal lymph nodes and the visceral extension were also significant in the HG group. Complete remission (CR) was achieved in 91% of the patients of the LG group, but was significantly lower, 70%, in the HG group. Relapses occurred in the stomach and also in non-MALT sites. In 132 treated and followed-up patients, elevated serum LDH, absence of CR, HG group and stage III-IV were associated with a worse survival. In the Cox multivariate model, stage was the only variable influencing survival, although stage was related to the histological grade. In the HG group, stage was also an independent significant risk factor, whereas treatment with surgery, chemotherapy or both was not. In the 103 patients treated with surgery, a worse survival was associated with the involvement of the resection borders, depth of the infiltration of the gastric wall, dissemination to distant abdominal nodes and adjacent organs, but not with the addition of chemotherapy. CONCLUSIONS: Histological classification into LG and HG separates distinctive groups of gastric MALT lymphoma that show striking clinical and prognostic differences. Besides histological grade, stage is the most important prognostic feature.

Aged↗
PubMed1994

B-cell follicular lymphomas: clinical and biological characteristics.

Seventy cases of follicular B-cell lymphomas were studied: 37 cases derived from the follicular centre [27 centroblastic-centrocytic (CB-CC) and 10 centroblastic (CB)] and 33 from the mantle zone [mantle-cell lymphoma (ML)]. Presenting features as well as response to therapy, time free of symptoms and survival were reviewed. All the cases were diagnosed and classified with routine and immunohistochemistry methods. In 61 cases tumors were studied with specific markers in a CAS-200 Image Analyser. Flow cytometry (FCM) was also done and correlated with proliferative-values and survival. A minor aggressive course of CB-CC and ML was demonstrated, with ML being the most benign form (lower proliferation rate and longest survival). Ploidy did not correlate with histological subtypes, survival or response to therapy. These results confirm the utility of biodynamic studies in lymphoid neoplasias.

Adult↗
PubMed1993

[Follicular mantle lymphoma: clinicopathologic and cell proliferation of 11 cases].

BACKGROUND: The aim of the present was to study the biologic behavior of the lymphomas of the follicular mantle by analysis of different indexes of neoplastic cell proliferation and their relation with the clinical symptoms, prognosis and survival of the patients. METHODS: Light microscope, ultrastructural, and frozen and paraffin immunohistochemical studies were performed including the proliferative markers Ki-67 and PC10, flow cytometry and analysis of cell cycle in biopsy samples. Clinical data of 11 patients were collected in addition to therapeutic response and survival. RESULTS: Lymphoma of the follicular mantle is constituted by small sized cell elements with a variable pattern of tumoral growth in the lymph nodes. In normal lymphocytes of the follicular mantle the immunophenotype shows expression of IgM + IgD and a light chain in the cell surface. From a clinical point of view, massive splenomegaly and disseminated stage are the most outstanding characteristics. One third of the cases analyzed presented an aneuploid neoplastic population. According to the PC10 marker, the proliferative index ranged from 2.9 to 14.7% of neoplastic cellularity (mean 7.0). The percentage of cells in the phases S, G2 and M of the cell cycle by flow cytometry varied from 14 to 35 (mean 23%). Neither the cell ploidy nor the tumoral proliferative index were related with the survival of the patients (53 +/- 51 months). CONCLUSIONS: Lymphoma of the follicular mantle is a clinical pathological entity of low biologic aggressivity. Cell aneuploidy or ploidy and the tumoral proliferative index did not establish differences in prognosis or survival in this series.

Adult↗
PubMed1993

Visceral leishmaniasis in patients with AIDS: report of three cases treated with pentavalent antimony and interferon-gamma.

The optimal therapy for visceral leishmaniasis in patients with AIDS is unknown. We describe herein three patients with advanced AIDS and disseminated leishmaniasis who were treated with meglumine antimoniate plus interferon-gamma. The conditions of the three patients rapidly improved, and the therapeutic combination drastically reduced the parasite burden; after administration of antiprotozoal therapy for 4 weeks, cultures of bone marrow were negative for two of the three patients. Interferon-gamma was well tolerated. Because the patients died of other AIDS-related diseases in the months following therapy, the efficacy of the combination of meglumine antimoniate and interferon-gamma for preventing relapses remains unknown.

AIDS-Related Opportunistic Infections↗
PubMed1993

Peripheral T-cell lymphoma: a clinicopathological study of 41 cases and evaluation of the prognostic significance of the updated Kiel classification.

A total of 41 non-cutaneous peripheral T-cell lymphomas were classified following the updated Kiel classification. Of these, 20 cases belonged to the low-grade group (T-cell chronic lymphocytic leukaemia, 3; lymphoepithelioid, 5; angioimmunoblastic, 4; pleomorphic small cell, 8) and 21 to the high grade group (pleomorphic medium and large cell, 11; immunoblastic, 3; large-cell anaplastic Ki-1 positive, 7). Seventy per cent showed a CD4+/CD8-phenotype, 39% a defective phenotype and 88% an activation phenotype. Eighty per cent had B-symptoms, 63% hepatomegaly, 48% splenomegaly and 26% had involvement of more than three lymphoid areas. Bone marrow was infiltrated in 34%, central nervous system in 4%, lung in 12% and skin in 14.6%. Seventeen per cent presented with extranodal disease and 82.8% had stage III/IV disease. Hypergammaglobulinaemia was found in 29%, hypercalcaemia in 7%, raised LDH serum levels in 58% and HTLV-I antibodies in only one case. Of the 37 treated patients 18 (48%) achieved a complete remission, but 33% relapsed. Mortality was 59% and actuarial overall survival at 38 months was 0.32. In the comparison of the clinical, analytical and immunophenotypic variables and outcome between low and high grade groups, only the average of bone marrow infiltration in the low grade and stage I-II, presence of defective phenotypes and higher Ki-67 positivity in the high grade group were significantly different.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMed1992

Gastric B-cell mucosa associated lymphoid tissue lymphoma: a clinicopathological study in 56 patients.

Clinico-pathological features of 56 patients with primary gastric lymphoma were evaluated retrospectively. All cases were regraded according to a classification of Isaacson et al into high grade and low grade B-cell mucosa associated lymphoid tissue lymphoma. A third group of mixed grade was recognised in 11 patients with low grade who also had occasional areas of high grade. Low grade and mixed grade patients had a 100% actuarial survival at 156 months, which was significantly better (p < 0.01) than that of 52% for patients with high grade disease. Different treatment methods--surgery, chemotherapy, or a combination of both--did not significantly affect survival. Low grade tumours occurred mainly in men with a history of several years, and who presented with non-specific gastric symptoms without remarkable exploratory or laboratory findings: most patients were in stage IE-IIE and achieved remission and cure. High grade can have a shorter history, systemic symptoms, abnormal exploratory and laboratory findings, gastric tumour masses, stage IV disease, and a worse outcome. The only significant prognostic factors for survival were the type of lymphoma and stage IV disease. These findings support the Isaacson classification system which separates two extreme groups of gastric lymphomas with different morphology, behaviour, and outcome. The presence of limited areas of high grade in a specimen showing low grade does not change the outcome but suggests that primary gastric lymphoma forms a continuum between these extreme types.

Adult↗
PubMed1990

Severe haemolytic anaemia due to cold anti-'i' antibodies associated with cytomegalovirus infection.

A 66 year old patient with multiple myeloma and monoclonal cryoglobulinaemia who developed a severe haemolytic anaemia following a cytomegalovirus infection is reported. The presence of a high titre of anti-'i' cold antibody of IgM subclass is demonstrated. Anti-'i' antibody disappeared when complement-fixation antibody titres against cytomegalovirus decreased. Various pathogenetic mechanisms involved in the development of haemolytic anaemia associated with cytomegalovirus infection are discussed. To our knowledge, this is the first case described in the English language publications associating severe haemolytic anaemia with an anti-'i' antibody after a cytomegalovirus infection in an immunocompromised patient.

Aged↗
PubMed1990

[Cranial sarcoidosis with an unusual location in the orbital vertex].

Bone sarcoidosis preferentially localizes in skull bones with long lasting skin lesions, (its manifestation in skull are rare and there are only 12 or 13 published cases) and the bone involvement of the cranial basis has been referred, until now, as extensive lesions of granulomas localized in neighbouring structures. We present a case of cranial basis granulomatosis, in a patient diagnosed of multiple sarcoidosis by repetitive biopsies of lymph nodes, liver, and skin with chronic skin lesions, the rare localization of which in the orbital vertex with an original bone procedence, is discussed in the neuroradiologic findings. Such rareness has been found in a carrier of a form of common variable immunodeficiency, a disease which is also rare.

Adult↗
PubMed1990

[Gastroenteritis with eosinophilia caused by Giardia lamblia].

A case of gastroenteritis due to Giardia lamblia with severe dehydration and complicated with arterial thrombosis, accompanied by eosinophilia and increased serum IgE levels, is presented. The relationship between Giardia and eosinophilia and allergic manifestations is discussed as well as its pathogenesis.

Acute Kidney Injury↗