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Biomedical subjects

L Massimo

Publications and source records attributed to L Massimo.

At least 37 records · Page 2Linked to original sources

Early deaths in acute lymphoblastic leukemia (ALL): results of the Italian Pediatric Cooperative Group for Therapy of Acute Leukemia (AIL-AIEOP).

In this retrospective multicentric study, we report on early deaths (ie, those that occurred during the first month of treatment) in a total of 943 newly diagnosed ALL pediatric patients registered from 1976 to 1981 at 21 centers of the AIL- AIEOP . Objectives of this study were as follows: (1) to verify the incidence and the cause of early death in a wide population of children with ALL and (2) to elucidate factors associated with early death and therefore to identify "high-risk" groups of patients. Out of the 943 ALL patients, 39 (4.1%) early deaths were registered. Main causes were infection, 20 patients (51.3%); hemorrhage, 11 patients (28.3%); uric acid nephropathy, 2 patients (5.1%); cardiac failure, 3 patients (7.6%); syndrome of inappropriate antidiuretic hormone secretion, 1 patient. Two patients died during the first week of unknown cause. Thirteen factors measured at diagnosis and possibly influencing the early death rate were analyzed. Using the chi-square test, only three of these factors (age, mediastinum status, surface markers) appear to have any significant influence on the early death rate. We also tried to determine how therapy influences this process by analyzing variations in the early death rate, other factors being equal. Significant differences in the early death rates were encountered in AIEOP protocols using different induction regimens.

Adolescent

Methisoprinol effect on enriched B and T lymphocyte populations stimulated with phytohemagglutinin.

The Authors investigated the effect of methisoprinol (Inosiplex) on separated B and T lymphocytes from 8 healthy donors. B or T treated cells, recombined with T or B untreated cells, were subsequently mitogen stimulated. Proliferative response resulted significantly increased, in comparison to a control, when T lymphocytes were preincubated with the drug, while treating only B lymphocytes led to a decrement. These data confirm the hypothesis of a direct action of the drug on T lymphocytes, but are also consistent with its influence on B cells too, even though with an opposite effect.

Adult

Methisoprinol effect on enriched B and T lymphocyte populations stimulated with phytohemagglutinin.

The Authors investigated the effect of methisoprinol on separated B and T lymphocytes from 8 healthy donors. B or T treated cells, recombined with T or B untreated cells, were subsequently mitogen stimulated. Proliferative response resulted significantly increased, in comparison to a control, when T lymphocytes were preincubated with the drug, while treating only B lymphocytes led to a decrement. These data confirm the hypothesis of a direct action of the drug on T lymphocytes, but are also consistent with its influence on B cells too, even though with an opposite effect.

Adult

Immunological evaluation of 22 patients with acute lymphoblastic leukemia off-therapy. A longitudinal follow-up.

In 22 patients with ALL in first complete remission, who discontinued therapy after 3 years, longitudinal follow-up of immunological reconstitution was investigated by assessing serum immunoglobulin levels, number and mitogen responsiveness of B and T lymphocytes. Major modifications have been demonstrated for T cells both in terms of number and functionality, while B cells and serum immunoglobulins did not change significantly. Examining the behaviour of the patients one by one, it has been observed that recovery is often characterized by a remarkable rebound occurring from the 15th to the 18th month. Immunosuppression induced by antileukemic treatment appeared to be a transitory phenomenon, mainly limited to the first three months. Reconstitution was achieved, in almost all cases, within one year after treatment was stopped.

B-Lymphocytes

[Diminished in vitro colony forming capacity of bone marrow cells in a case of chromosome 8 trisomy (mosaicism): criteria for "high risk" pre-leukemia syndrome].

A case has been described of Trisomy 8 mosaicism Syndrome. At onset the child presented with hyporegenerative anemia; the study of colony forming capacity in vitro (CFU) by Bone Marrow (B) and Peripheral Blood (PB) showed an abnormal colony formation by myeloid and erythroid progenitor cells. No immunological defects were discovered. The in vitro colony formation appears to have a definite role in the identification of patients who may be at higher risk of developing leukemia. The importance of 8 chromosome for hematopoiesis control is discussed.

Child, Preschool

Lymphoid cell surface markers in acute lymphocytic leukaemia.

Peripheral blood lymphoid cells of 29 patients with acute lymphocytic leukaemia (ALL) at onset were studied for characterization of B and T membrane markers and phytohaemagglutinin responsiveness. 24 cases (83%) were classified as "null" cell ALL and 5 (17%) as T-cell ALL. No relationship could be found between cytological presentation and immunological classification. Moreover, no correlation has been demonstrated between clinical-immunological parameters and prognosis, indicating that in our series of patients, assessment of cell size and surface markers were not a reliable predictor of prognosis.

Antineoplastic Agents

Peptichemio in advanced neuroblastoma.

Peptichemio (PTC) is a mixture of six synthetic peptides of m-L-phenylalanine mustard. It acts with both alkylating and antimetabolic effects, interfering with the synthesis of DNA, RNA, and proteins. PTC was administered iv to 18 previously untreated children with advanced neuroblastoma at a dose of 1-1.5 mg/kg/day for one to three cycles of 5-6 consecutive days each. Eleven of 12 patients (92%) experienced both objective and subjective improvement; complete remission was achieved in two of them. In spite of the high remission rate, the median duration of remission has been short (4 months) and the overall survival (median, 6 months) did not seem to be influenced by the use of PTC. The primary toxic effects were, in order of importance, bone marrow depression, phlebosclerosis, nausea and vomiting, and alopecia. Chronic use of PTC seems limited by two major factors: profound long-lasting thrombocytopenia and severe phlebosclerosis.

Child

Immunological evaluation of 15 children with non-Hodgkin lymphoma.

In the present study, 15 children with non-Hodgkin lymphoma have been immunologically evaluated by the following parameters on peripheral blood (PB) lymphocytes: phytohemagglutinin responsiveness (PHA-r); non-immune rosette formation with sheep red blood cells (RF-L) as T-cell marker; presence of surface immunoglobulins (sIg-L) as B-cell marker; serum immunoglobulins levels (IgA, IgM, IgG). Our patients (pts) have been divided in two groups: the first one includes 10 children without PB involvement; the second one includes 5 pts with bone-marrow and PB invasion. From our data it appears that: 1) the majority of pts of the first group presented normal values of membrane markers; PHA-r was impaired in 4/8 pts; 2) in pts with PB invasion absolute number of B and "null" cells was always abnormal and PHA-r altered; 3) in the second group of pts, a "null" cell origin can be suggested by the high percentage and absolute number of cells without surface markers. In our opinion, the high incidence of "null" cells represents the most relevant question: whether they are cells deprived of specific markers, or endowed with markers not identifiable by our current techniques, remains to be established.

Adolescent