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J Marín

Publications and source records attributed to J Marín.

At least 19 recordsLinked to original sources
PubMed2007

The results of consolidation with autologous stem-cell transplantation in patients with peripheral T-cell lymphoma (PTCL) in first complete remission: the Spanish Lymphoma and Autologous Transplantation Group experience.

BACKGROUND: Peripheral T-cell lymphoma (PTCL) is a heterogeneous group of aggressive lymphomas associated with poor prognosis with standard chemotherapy. Consolidation with autologous stem-cell transplantation (ASCT) may improve survival. We present 74 patients transplanted in first complete response (CR) from the Spanish Lymphoma and Autologous Transplantation Group cooperative group. PATIENTS AND METHODS: Median age was 46 years. Eighty-eight percent presented advanced (III-IV) Ann Arbor stage; 53% had B symptoms; 52% had high lactate dehydrogenase; 65% had two or three risk factors of the adjusted-International Prognostic Index; 58% presented a high Tumor score and in 14% more than two adverse factors of the Prognostic Index for peripheral T-cell lymphoma (PIT) were observed. RESULTS: With a median follow-up of 67 months from diagnosis, the 5-year overall survival (OS) was 68% and progression-free survival (PFS) reached 63%. The multivariate analysis showed that the only factor associated with a shorter OS and PFS was the presence of more than two risk factors from the PIT risk system. CONCLUSIONS: In a retrospective study with a prolonged follow-up, consolidation with ASCT in CR patients who had presented unfavorable prognostic factors at diagnosis substantially increased the OS and PFS when compared with conventional chemotherapy. The PIT risk system identified 14% of patients without benefit from ASCT consolidation. Thus, other innovative therapies are still necessary in certain cases.

Adolescent↗
PubMed2006

Soluble HLA-G in heart transplantation: their relationship to rejection episodes and immunosuppressive therapy.

The aims of this study were to quantify the level of soluble HLA-G in heart transplant patients, to determine the relationship between the sHLA-G levels and the appearance of acute rejection episodes, and to identify the influence of immunosuppressive therapy on sHLA-G levels. Analysis of sHLA-G, measured by enzyme-linked immunosorbent assay in the transplant patients, revealed the existence of two similarly sized groups of patients. One group displayed a significant increase (p < 0.001) in sHLA-G during the first month after transplantation while the other group maintained low levels of the molecule (0-30 ng/ml) throughout the study. The latter group displayed a high incidence of recurrent severe rejection. A significant increase (p < 0.01) in sHLA-G 2 hours after administration of immunosuppressive treatment (mycophenolate mofetil, cyclosporine A/FK506, corticoids) was found. These results suggest that sHLA-G participates in the induction of certain levels of immunological tolerance in these recipients.

Adolescent↗
PubMed2005

Stir bar sorptive extraction for the determination of volatile compounds in oak-aged wines.

Stir bar sorptive extraction (SBSE) followed by a thermal desorption-gas chromatography-mass spectrometry analysis has been optimized for the determination of 13 of the most important oak volatiles in wine samples, all in a single run. The stir bar sorptive extraction method was optimized in terms of temperature, time, pH and NaCl addition, and the best results were obtained after stirring the wine sample with the polydimethylsiloxane stir bar during 90min at room temperature. The addition of sodium chloride did not enhance the volatile extraction. The method proposed showed good linearity over the concentration range tested, with correlation coefficients ranging from 0.92 to 0.99 for all the analytes. The reproducibility and repeatability of the method was estimated between 0.11 and 5.45%. The detection and quantification limits of all analytes were lower than their respective olfactory threshold values, and, most importantly, no artifacts have been observed during the analysis as described in most extractions using other current methodologies.

Flavoring Agents↗
PubMed2005

Prognostic factors affecting long-term outcome after stem cell transplantation in Hodgkin's lymphoma autografted after a first relapse.

PURPOSE: To analyse outcome and prognostic factors for overall survival (OS) and time to treatment failure (TTF) in 357 patients with Hodgkin's lymphoma (HL) undergoing an autologous stem cell transplantation (ASCT) after a first relapse and reported to the The Grupo Espanol de Linfomas/Trasplante Autologo de Medula Osea (GEL/TAMO) Cooperative Group. METHODS: Two hundred and twenty males and 137 females with a median age of 29 years were autografted in second remission (n=181), first sensitive relapse (n=148) and first resistant relapse (n=28). RESULTS: Five-year actuarial TTF and OS were of 49% +/- 3% and 57% +/- 3%. Advanced stage at diagnosis, complementary radiotherapy before ASCT, a short first complete response (CR) and detectable disease at ASCT adversely influenced TTF. Year of transplant < or =1995, bulky disease at diagnosis, a short first CR, detectable disease at ASCT and > or =1 extranodal areas involved at ASCT were adverse factors for OS. CONCLUSIONS: ASCT constitutes a therapeutic option for HL patients after a first relapse. Promising results are observed in patients with low tumour burden at diagnosis, autografted after a long CR and without detectable disease at ASCT. Innovative approaches should be pursued for patients with risk factors at relapse.

Adolescent↗
PubMed2005

[Tuberculosis epidemiology in area 15 of the Spanish autonomous community of Valencia: evolution from 1987 through 2001].

OBJECTIVES: To describe the evolution of tuberculosis epidemiology in Area 15 of the Autonomous Community of Valencia. MATERIAL AND METHODS: Cases of tuberculosis were identified by active case finding in Area 15 from January 1987 through December 2001. Clinical and epidemiological data were extracted from case records and a patient interview. RESULTS: Four hundred seventy-six diagnosed cases of mycobacterial infection were identified (459 tuberculosis, 16 atypical, and 1 mixed); 423 tuberculosis patients were residents of Area 15. The mean annual incidence rate was 24.6/100 000 population, representing a rate decrease of 41.5% from 1990. The most frequent risk factors were smoking (38%), alcoholism (20%), human immunodeficiency virus (HIV) infection (18%), and contact with a tuberculosis patient (14%). The site of tuberculosis involvement was the lung in 61% (49% bacillus positive, with a nonsignificant trend to decrease over time), nonpulmonary in 26%, and mixed in 13%. The radiographic pattern observed most often was pulmonary infiltrates (67%), and lower lobe involvement tended to increase over time. Diagnosis was by acid-fact bacillus stain for 77%, clinical picture for 16%, and histological for 7%. Isoniazid resistance was detected in 1.5% and rifampicin resistance in 0.3%. Patients were hospitalized during diagnosis in 79% of cases; the mean stay was 18 days. CONCLUSIONS: The incidence of tuberculosis has decreased in spite of the HIV pandemic. Risk factors have not changed, bacteriological diagnosis has improved, and the location of pulmonary infiltrates has changed. No influence of immigration on the incidence rate of tuberculosis has been detected to date.

Adolescent↗
PubMed2004

[Risk factors of readmission in acute exacerbation of moderate-to-severe chronic obstructive pulmonary disease].

OBJECTIVES: More effective management of chronic obstructive pulmonary disease (COPD) and improved survival of COPD patients requires a better understanding of the risk factors for exacerbation. The aim of this study was to identify factors related to readmission in patients with moderate-to-severe COPD. PATIENTS AND METHODS: Ninety patients with moderate-to-severe COPD hospitalized consecutively for acute exacerbation were studied prospectively. At discharge, the following potential predictors were assessed: clinical and spirometric variables, arterial blood gases, and respiratory muscle strength determined noninvasively. The patients were followed for a period of 3 months. Readmission for exacerbation and time intervals free of hospitalization were recorded. RESULTS: Univariate analysis showed that the presence of cor pulmonale (P<.05), long-term oxygen therapy (P<.05), hypercapnia (P<.05), and high inspiratory load--mean inspiratory airway pressure measured at the mouth exceeding 0.40 cm H2O and a pressure-time index greater than 0.25 (P<.05 for both variables)--increased the risk of hospitalization for exacerbation. Multivariate analysis showed that only cor pulmonale (P<.05) and a high pressure-time index (>0.25, P<.05) were independently related to risk of readmission. CONCLUSIONS: Cor pulmonale and a high pressure-time index are independent risk factors for hospitalization for exacerbation of moderate-to-severe COPD.

Acute Disease↗
PubMed2003

Non-invasive management of an acute chest infection for a patient with ALS.

We describe a man diagnosed with non-bulbar amyotrophic lateral sclerosis (ALS) who uses 24-h non-invasive ventilator at home, and assisted cough through the use of the mechanical insufflation-exsufflation (MAC) device (CoughAssist, J.H. Emerson). This was essential for the removal of bronchial secretions in order to provide successful non-invasive management (and indeed less suffering for the patient) during an acute respiratory tract infection with hypoxemia and failure of manually assisted cough.

Acute Disease↗
PubMed2003

A simple noninvasive pressure-time index at the mouth to measure respiratory load during acute exacerbation of COPD A comparison with normal volunteers.

We assessed the validity of the pressure-time index (PTI) measured at the mouth as a noninvasive and simplified alternative to conventional tension-time index for assessing respiratory load and inspiratory muscle force reserve. PTI was measured within 48 h of hospital admission and at 24 h before discharge in 37 consecutive patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) using the equation PTI = (P(awo)/MIP)(T(I)/T(T)) 100, where P(awo) is the mean airway pressure measured at the mouth, MIP the maximal inspiratory pressure, and T(I)/T(T) the inspiratory time (T(I)) to total cycle length (T(T)) ratio. Controls were 30 normal volunteers with similar anthropometric features. Mean (+/- SD) PTI values were significantly higher in COPD patients (0.29 +/- 0.10) than in controls (0.11 +/- 0.04) (P < 0.001) primarily because MIP and T(I)/T(T) were significantly lower and P(awo) was higher in the COPD population than in controls. As a result of improvement of the respiratory condition, PTI values were significantly lower at discharge (0.20 +/- 0.10 vs. 0.29 +/- 0.10, P < 0.001) due to a drop in P(awo) and an increase in MIP. The accuracy of different PTI cutpoints was assessed by comparison of the receiver operating characteristics curves. Best cutpoint values for differentiating COPD patients on admission and at hospital discharge from controls were 0.13 (positive predictive value 76%) and 0.17 (positive predictive value 92%) respectively. Noninvasive PTI measured at the mouth provides a valid and easy method for assessing respiratory muscle load and reserve. Changes in PTI values reflect functional improvement following treatment of acute exacerbation of COPD.

Aged↗
PubMed2003

Anaerobic biodegradability of water separated from extracted crude oil.

A study of the anaerobic biodegradability of the three categories of water separated from extracted crude oil (Venezuelan oilfields)--light, medium or heavy crude--was carried out at laboratory scale using UASB reactors working at mesophilic conditions. Chemical oxygen demand (COD) removal in a low loaded UASB reactor fed with water separated from extracted light crude was high, with an average 87% purification efficiency. The remaining COD was made up of the nonbiodegradable and the very slowly biodegradable fractions of the organic matter in the water. During a second period, the hydraulic retention time was reduced in stages, thus increasing the loading rate. In the experimental conditions used, COD concentration at the outlet remained below the Venezuelan standard limit for discharge into the environment (350 mg COD l(-1)) when the hydraulic retention time (HRT) was above 10 hours and the OLR under 3 g COD l(-1) d(-1). For HRT less than 10 hours, or organic loading rate (OLR) greater than 3 g COD l(-1) d(-1), COD at the outlet of the reactor rose as a consequence both of increased volatile fatty acids (VFA) concentrations (indicating an overloading of the methanogenic population) and, also, of the increase in the non-VFA COD (indicating a decrease in the acidification efficiency). On the other hand, results with UASB reactors operated at a low loading rate and fed with water separated from extracted medium and heavy crude oil showed that purification efficiency was low, with only 20% and 37% COD removal respectively. Continuing the operation of the UASB reactor fed with water separated from medium oil over a prolonged period did not bring any improvement, indicating that no adaptation of the sludge occurred.

Bacteria, Anaerobic↗
PubMed2003

High-dose therapy in diffuse large cell lymphoma: results and prognostic factors in 452 patients from the GEL-TAMO Spanish Cooperative Group.

BACKGROUND: The purpose of this study was to analyse the results and prognostic factors influencing overall survival (OS) and disease-free survival (DFS) in 452 patients diagnosed with diffuse large cell lymphomas (DLCL) treated with high-dose therapy (HDT) included in the Grupo Español de Linfomas/Trasplante Autólogo de Médula Osea (GEL-TAMO) Spanish registry. PATIENTS AND METHODS: At transplantation, median age was 42 years (range 15-73), 146 patients (32%) were transplanted in first complete remission (1st CR), 19% in second CR (2nd CR) and 47% had active disease: sensitive disease in 157 (35%) patients [95 were in first partial remission (1st PR) and 62 in second PR (2nd PR)] and refractory disease in 55 (12%) patients. Age-adjusted International Prognostic Index (IPI) was 2 or 3 in 51 patients (12%). Conditioning regimen consisted of BEAM (carmustine, etoposide, cytarabine and melphalan) in 39% of patients, BEAC (carmustine, etoposide, cytarabine and cyclophosphamide) in 33%, CBV (carmustine, etoposide and cyclophosphamide) in 10% and cyclophosphamide plus total body irradiation (TBI) in 12%. RESULTS: Estimated overall survival (OS) and disease-free survival (DFS) at 5 years were 53% and 43%, respectively. The transplant-related mortality was 11% (53 cases). By multivariate analysis three variables significantly influenced OS and DFS: number of protocols to reach 1st CR, disease status at transplant and TBI in the conditioning regimen. Age-adjusted IPI at transplantation also influenced OS. CONCLUSIONS: Prolonged OS and DFS can be achieved in patients with DLCL after HDT and our results suggest that the best line of chemotherapy should be used up-front in patients considered as candidates for HDT in order to obtain an early CR. Resistant patients are not good candidates for HDT and they should be offered newer strategies. Finally, polichemotherapy conditioning regimens offer better results compared with TBI.

Adolescent↗
PubMed2003

High-dose chemotherapy and autologous stem cell transplantation in peripheral T-cell lymphoma: the GEL-TAMO experience.

BACKGROUND: T-cell immunophenotype constitutes an unfavorable prognostic factor in aggressive non-Hodgkin's lymphomas. High-dose chemotherapy with autologous stem-cell rescue (HDC/ASCT) is the best salvage therapy for patients with aggressive B-cell lymphomas. However, results with this therapy in peripheral T-cell lymphoma (PTCL) are not well defined. PATIENTS AND METHODS: From January 1990 to December 1999, 115 patients with PTCL underwent HDC/ASCT inside the Grupo Español de Linfomas/Trasplante Autólogo de Médula Osea (GEL-TAMO) registry. At diagnosis the median age was 41 years and 60% of patients presented with two or three risk factors from the adjusted International Prognostic Index (a-IPI). Thirty-two per cent of patients were transplanted in first complete response (CR), 62% in chemosensitive disease and 5% in refractory disease. RESULTS: Eighty-six per cent of the patients attained a CR and 5% a partial response (PR). With a median follow-up of 37 months (range 1-133), overall survival (OS), time-to-treatment failure (TTF) and disease-free survival (DFS) at 5 years was 56%, 51% and 60%, respectively; for the 37 patients transplanted in first CR, OS and DFS at 5 years were 80% and 79%, respectively. Lactase dehydrogenase (LDH), a-IPI and disease status pre-transplant were associated with outcome. CONCLUSIONS: More than half of patients with chemosensitive disease who were transplanted are expected to be alive at 5 years. We confirm the utility of the pre-transplant IPI system in predicting outcome. Salvage treatment results with HDC/ASCT in PTCL are similar to those found in corresponding aggressive B-cell lymphomas.

Adolescent↗
PubMed2002

Diazepam potentiates the effects of endogenous catecholamines on contractility and cyclic AMP levels in rat ventricular myocardium.

Diazepam has phosphodiesterase (PDE) inhibitory activity and potentiates the effect of some 3',5'-cyclic adenosine monophosphate (cAMP)-dependent positive inotropic agents. The present study was undertaken to determine whether diazepam enhances the contractile responses and cAMP levels induced by endogenous catecholamines in electrically driven rat right ventricular strips, and the effects are compared with that of the PDE inhibitor 3-isobutylmethylxantine (IBMX). Noradrenaline (10 nM(-1) microM), adrenaline (50 nM-500 microM) and tyramine (5-100 microM) produced concentration-dependent positive inotropic effects that were potentiated by the presence of 10 microM diazepam or IBMX. The diazepam-induced potentiation of the contractile effect of the sympathomimetic agents was not mimicked by 100 microM GABA nor was it antagonized by a 5 microM concentration of the blockers of central and peripheral type benzodiazepine receptors, flumazenil and PK 11195. The beta(2)-adrenergic receptor agonist salbutamol (0.1-300 microM) also produced a concentration-dependent positive inotropic effect which was potentiated by the presence of 10 microM diazepam or 10 microM IBMX. However, the contractile effect of salbutamol, either alone or in the presence of diazepam or IBMX, was not affected by 50 nM ICI 118551, an antagonist of beta(2)-adrenergic receptors, but was virtually abolished by a 0.3 microM concentration of CGP 20712A, an antagonist of beta(1)-adrenergic receptors. Diazepam and IBMX also potentiated the increase in cAMP levels caused by these three sympathomimetic agents in this tissue. [(3)H]Noradrenaline release elicited by electrical stimulation or by tyramine was not affected by diazepam. The results demonstrate that diazepam, like the phosphodiesterase inhibitor IBMX, produces an inotropic and biochemical potentiation of the effects of endogenous catecholamines in rat myocardium. This effect is not due to the release of noradrenaline at the presynaptic level nor is it mediated by beta(2)-adrenergic receptors or benzodiazepine receptors of the central or peripheral type. The effect is probably consequential upon the phosphodiesterase inhibitory activity of diazepam.

1-Methyl-3-isobutylxanthine↗
PubMed2001

Angiotensin II increases neurogenic nitric oxide metabolism in mesenteric arteries from hypertensive rats.

We investigated, in mesenteric arteries from hypertensive rats (SHR), the possible changes in neurogenic nitric oxide (NO) release produced by angiotensin II (AII), and the possible mechanisms involved in this process. In deendothelialized segments the NO synthase inhibitor N(G)-nitro-L-arginine (L-NAME, 10 microM) increased the contractions caused by electrical field stimulation (EFS, 200 mA, 0.3 ms, 1-16 Hz, for 30 s). AII (0.1 nM) enhanced the response to EFS, which was unmodified by the subsequent addition of L-NAME. The AII antagonist receptor saralasine (0.1 microM) prevented the effect of AII, and the subsequent addition of L-NAME restored the contractile response. SOD (25 u/ml) decreased the reponse to EFS and the subsequent addition of L-NAME increased this response. AII did not modify the decrease in EFS response induced by SOD, and the addition of L-NAME increased the response. None of these drugs altered the response to exogenous noradrenaline (NA) or basal tone except SOD, which increased the basal tone, an effect blocked by phentolamine (1 microM). In arteries pre-incubated with [3H]-NA, AII did not modify the tritium efflux evoked by EFS, which was diminished by SOD. AII did not alter basal tritium efflux while SOD significantly increased it. These results suggest that EFS of SHR mesenteric arteries releases neurogenic NO, the metabolism of which is increased in the presence of AII by the generation of superoxide anions.

Angiotensin II↗
PubMed2001

Cell volume and ionic transport systems after cold preservation of coronary endothelial cells.

BACKGROUND: Hypothermia-induced changes in cell volume and ionic transport systems of coronary endothelial cells may play a role in the development of coronary artery disease in cardiac transplant recipients. METHODS: Coronary endothelial cells were incubated in University of Wisconsin solution or culture control medium for up to 48 hours at 4 degrees C. Parallel control cultures were incubated at 37 degrees C. Na/K-ATPase and Na/K/Cl cotransport activities were determined as ouabain- and furosemide-sensitive 86Rb+ uptake, respectively. Cell volume changes and cell death were analyzed by a FACScan flow cytometer and the release of lactate dehydrogenase, respectively. RESULTS: Coronary endothelial cells stored in University of Wisconsin solution up to 6 hours showed an increased Na/K-ATPase activity compared to control cells, whereas no changes were observed in Na/K/Cl cotransport activity or cell volume. Long-term preservation (24 and 48 hours) was associated with a partial loss of cell viability, as demonstrated by lactate dehydrogenase release, and dramatic alterations in ionic transport system activities. CONCLUSIONS: University of Wisconsin solution seems to prevent coronary endothelial cells Na/K/Cl cotransport activity changes during cold preservation, which could alter cell volume regulation and cause cell injury.

Cell Size↗
PubMed2001

[Tuberculosis notification from 1987 to 1999 for the public health area of the community of Valencia (Spain)].

OBJECTIVE: Under notification of tuberculosis (TB) is common worldwide but has hardly been studied in Spain. The objective of this study was to determine how many cases of TB are reported in our health care area. MATERIAL AND METHOD: Between 1987 and 1999 we carried out a direct study of the incidence and reporting of TB cases in our area (106,632 inhabitants on the census). Cases were taken from mandatory notification, pathology and bacteriology files and were then reviewed. RESULTS: Of the 410 TB cases diagnosed, 378 were residents of the area (annual incidence: 27/100,000 inhabitants), 223 of whom were reported (54%). Forty-eight patients were under 15 years of age. Sixty-seven percent of the pediatric cases and 53% of the adult cases were reported (n.s.). Of the 78 cases with HIV co-infection, only 32% were reported, in contrast with 60% of HIV-negative cases (p < 0.001). Of the 300 cases with pulmonary involvement, 56% were reported, versus 50% of those with exclusively extrapulmonary involvement (n.s.). For the 149 with positive Ziehl-Neelsen stain, 61% were reported, in contrast with 51% of those who were smear negative (n.s.). Diagnosis was based on clinical signs in 65 cases (16%), 51% of which were reported, versus 55% of those in which diagnosis was based on bacteriology or histology consistent with TB (n.s.). Overall under notification tended to decrease during the study period (r = 0.73, p < 0.005). Under notification also tended to decrease for patients with pulmonary involvement (r = 0.83, p < 0.0001) and for those with positive Ziehl-Neelsen staining of sputum (r = 0.79, p< 0.001). Likewise, under notification also decreased for HIV negative patients (r = 0.74, p < 0.02) but not significantly so for HIV positive patients r = 0.44, n.s.). CONCLUSIONS: Direct quantification of cases revealed a significant degree of under notification that is tending to decrease. Under notification is greatest for HIV-positive patients and is not changing. No differences were seen for smear positive and smear negative patients, by pulmonary or extra-pulmonary involvement, for clinical versus laboratory diagnosis, or for patients who were younger or older than 15 years of age. Reporting should be improved so that measures to decrease the incidence of TB can be taken.

AIDS-Related Opportunistic Infections↗
PubMed2001

University of Wisconsin solution increases hyperpolarizing mechanisms in response to bradykinin.

BACKGROUND: The aim of this study was to determine the effect of University of Wisconsin solution (UWS) incubation on bradykinin-induced vasodilation. METHODS: Porcine coronary arteries were incubated in Krebs-Henseleit solution (KHS) or UWS at 4 degrees C for 20 hours. Endothelium-dependent relaxation to bradykinin and endothelium-independent relaxation to nitric oxide were tested after U46619 or KCl pre-contraction. Nitric oxide synthase activity and protein expression was determined by [3H]-L-citrulline formation and western blot analysis, respectively. RESULTS: The relaxation to bradykinin (0.1 to 300 nmol/liter) after U46619 (30 to 300 nmol/liter) pre-contraction was similar with both KHS and UWS pre-incubation; however, it was reduced after KCl pre-contraction (15 to 20 mmol/liter), this reduction being greater after UWS incubation. The inhibitory effect of N(G)-nitro-L-arginine methylester (0.1 mmol/liter) on bradykinin-induced relaxation was lower in UWS- than KHS-incubated segments after U46619 pre-contraction, but similar after KCl pre-contraction; however, the inhibitory effect of 0.5 mmol/liter ouabain was unaffected. Tetraethylammonium (5 mmol/liter) reduced the response to bradykinin more strongly after UWS pre-incubation. UWS did not modify relaxation to nitric oxide (0.1 to 30 micromol/liter) in pre-incubated UWS or KHS segments. UWS failed to modify both total nitric oxide synthase activity and endothelial nitric oxide synthase expression. CONCLUSIONS: UWS incubation decreased nitric oxide participation and increased the hyperpolarizing mechanisms produced by bradykinin.

Adenosine↗
PubMed2001

Autologous stem cell transplantation for clinically aggressive non-Hodgkin's lymphoma: the role of preparative regimens.

We investigated the impact of the most commonly used preparative regimens on the outcome of 395 patients with diffuse large cell lymphoma (DLCL), consecutively reported to the registry of the Spanish GEL/TAMO. Among them, 139 (35%) were autografted in 1st CR, 86 (22%) in 2nd/3rd CR, 124 (31%) had chemosensitive disease and 46 (12%) had chemoresistant disease. Conditioning consisted of chemotherapy-only in 348 patients (BEAM, 164; BEAC, 145; and CBV, 39) and radiochemotherapy with CY and TBI in 47. Median times to granulocyte, platelet recovery and to discharge were significantly shorter in the chemotherapy-only group. Early transplant-related mortality was significantly higher when using CY-TBI. After a median follow-up of 28 months, overall survival (OS) at 8 years of patients conditioned with BEAM or BEAC (58% (95% CI 50-66%)) was more favorable than with CBV (40% (95% CI 24-56%)), and significantly better than with CY-TBI (31% (95% CI 18-44%)). Multivariate analysis revealed that patients conditioned with chemotherapy-only regimens had improved OS, disease-free (DFS) and relapse-free survival (RFS) when compared to those conditioned with CY-TBI. Status at transplant was also a powerful prognostic indicator. We conclude that preparative regimens consisting of chemotherapy-only seem more efficacious than CY-TBI as conditioning for DLCL, because of faster engraftment and greater anti-lymphoma effect, as indicated by improved OS, DFS and RFS.

Adolescent↗