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Biomedical subjects

L Zanesco

Publications and source records attributed to L Zanesco.

At least 73 records · Page 4Linked to original sources
PubMed1987

Phase II trial of methylprednisolone pulse therapy in childhood chronic thrombocytopenia.

Nineteen children with chronic idiopathic thrombocytopenia (ITP) were treated with a single intravenous injection of methylprednisolone (MP), 15 mg/kg/day, for 3 consecutive days. The 3-day pulses gave rise to a positive and fast therapeutic response with increase of the platelet count in about three quarters of the patients. The platelet count remained above 50 X 10(9)/1 for more than 1 month in 10 children. Eight out of them still presented a safe platelet count (greater than 50 X 10(9)/1) 4 months after the onset of the therapy. The MP therapy improved the platelet count more in the older children and possibly in the females. No severe side effects were observed. Our results suggest that this therapeutic approach could be useful in the management of acute bleeding episodes in children with chronic ITP.

Adolescent↗
PubMed1987

Treatment of acute myelogenous leukemia in children: results of the Italian Cooperative Study AIEOP/LAM 8204.

One hundred thirty-three children with acute myelogenous leukemia (AML) entered the multicenter Pediatric Branch of the Italian Association Against Leukemia trial AIEOP/LAM 8204 between July 1982 and May 1986. Induction therapy consisted of two courses of daunomycin (DNM) plus cytosine arabinoside (Ara-C). Those patients who achieved remission were given four courses of consolidation with DNM, 6-thioguanine (6-TG) and escalated doses of Ara-C followed by six courses of sequential continuation therapy using monthly pairs: etoposide (VP-16)/Ara-C, Ara-C/6-TG, and DNM/Ara-C. Periodic intrathecal Ara-C was used for CNS prophylaxis. One hundred seven (80%) children achieved complete remission (CR). Kaplan-Meier estimates of 3-year disease-free survival (DFS) and event-free survival (EFS) are 41% and 33%, respectively. Relapses occurred in 34 patients after 5 to 97 weeks (32 marrow; 2 marrow plus CNS). Overall, 14 patients died of complications during treatment (nine during induction; five during the postremission phase), mostly from infection. Risk factor analysis showed that induction failures occurred predominantly in children with French-American-British (FAB) M5 and in those with elevated leukocyte counts; by step-up Cox analysis, only FAB subtype was predictive of remission success. None of the variables examined was significant for predicting the duration of remission. Hyperleukocytosis was predictive of a significantly worse EFS rate. These results are encouraging and further support the use of intensive chemotherapy programs for childhood AML.

Adolescent↗
PubMed1986

Impairment of polymorphonuclear leucocyte function during therapy with synthetic ACTH in children affected by epileptic encephalopathies.

Therapy with synthetic ACTH (zinc tetracosactide) in children affected by epileptic encephalopathy is often associated with a large number of infectious complications. We studied the phagocytic activity of polymorphonuclear leucocytes (PMN) in 9 children with West or Lennox-Gastaut syndrome, measuring PMN superoxide anion production during the phagocytosis of particles of Zymosan and after phorbol myristate acetate (PMA) stimulation. The test was performed before, during and after therapy with zinc tetracosactide (0.02 mg/kg/day for 15 days). At the same time plasma immunoglobulins, C3, C4, C3 activator and cortisol were determined. During treatment PMN phagocytic function was significantly reduced but returned to normal levels after suspension of therapy. The other hematological parameters considered remained within the normal range. During the follow-up of the patients we observed 15 infectious episodes (3 mucocutaneous candidiasis, 2 enterocolitis, 4 urinary tract infections, 1 otitis media, 3 bronchiolitis, 2 pneumonia). One of the patients died of a bilateral pneumonia. Three children were treated with ACTH on alternating days. In these patients PMN phagocytic activity was less impaired and 2 infectious episodes rapidly resolved. Alternate day ACTH therapy seems to be preferable.

Adrenocorticotropic Hormone↗
PubMed1986

Longitudinal evaluations of psychological distress in parents of children with malignancies.

The authors evaluated the psychological distress in 41 parents of children with acute lymphocytic leukaemia or with Hodgkin's disease using the Symptom Distress Checklist (SCL-90). The subjects were tested three times: within the first few days after the child's admission to hospital and 8 months and 20 months later. The experimental population was compared with a control group of 25 subjects matched for age, sex, marital status and social class. At the first evaluation the experimental group had higher mean scores than the controls for obsession, depression, anxiety and sleep disturbances. Seventy-eight % of the subjects (65.8% excluding the sleep disturbances (SlDi) subscale) scored moderate distress on at least one of the SCL-90 subscales. The 8 month and 20 month follow-ups confirmed the presence of high scores of psychological distress particularly in the sleep disturbances and depression subscales, with 78% (58.4% excluding SlDi) and 82.3% (70% excluding SlDi) of the subjects gaining scores of moderate distress in at least one of the subscales of the SCL-90.

Adolescent↗
PubMed1986

Randomized multicentric Italian study on two treatment regimens for marrow relapse in childhood acute lymphoblastic leukemia.

This paper reports the results of a multicentric randomized clinical trial on the treatment of first hematological relapse in childhood ALL. Induction treatment consisted of vincristine, adriamycin, L-asparaginase, and prednisone. Patients achieving complete remission were randomized to two maintenance regimens (A and B). Regimen A consisted of five different drug associations including VM26 and IDMTX in a sequential schedule; Regimen B was essentially classical Spiers schedule for the first year, followed by a milder treatment. Eighty-four of 102 evaluable patients (82%) achieved second complete remission. The two maintenance regimens were similar as regards duration of second complete remission (median duration A, 32 weeks; B, 37 weeks) and toxicity. Better results were obtained in patients relapsing after 12 months from suspension of treatment in first complete remission than in those relapsing within the first year off therapy (82.8% vs. 31.4%). In group A fewer CNS relapses were reported. The two regimens produced results similar to those reported by other authors. The good prognosis in patients relapsing at least 1 year after treatment suspension in first complete remission must be emphasized.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

Long-term results in childhood rhabdomyosarcoma: a retrospective study in Italy.

This paper reviews a series of 70 consecutive children with rhabdomyosarcoma (RMS) diagnosed during 1971-1978 and treated in five Italian institutions. Thirteen were classified as group I, 12 as group II, 37 as group III, and 8 as group IV according to the Intergroup RMS Study staging system. Survival was influenced by tumor extension at diagnosis, primary site, and response to therapy. The 5-year-survival rate was 92% for group I patients, 67% for group II, 44% for group III, and 0% for group IV. Thirty-four children had all therapy stopped after 12-32 months of complete remission, 7 had late recurrences, and 3 died from disease. Musculoskeletal sequelae were diagnosed in 11 children, short stature in 3, corneal opacity in 2, and cardiac failure in 1.

Adolescent↗
PubMed1986

Greater decrease of fibrinogen as compared to antithrombin III in L-asparaginase treated leukemia patients.

Fibrinogen and Antithrombin III (AT III) were studied sequentially during remission induction with L-asparaginase, prednisone and vincristine in 20 children with acute lymphoblastic leukemia (ALL). The first 2 weeks of therapy were characterized by significant decreases in plasma concentration of fibrinogen (p less than 0.05 or p less than 0.01). AT III (antigen and activity) decreased between the first and second week of therapy, but on an average, they remained a little above the lower limits of normal. However, at the second week, the difference was significant from basic values (p less than 0.05). All parameters gradually returned to normal after completion of L-asparaginase therapy.

Acute Disease↗
PubMed1985

Risk factors in long-term sequelae of central nervous system prophylaxis in successfully treated children with acute lymphocytic leukemia.

Seventy-two successfully treated patients with acute lymphocytic leukemia, all in first complete remission and all off therapy, who had received CNS prophylaxis (radiotherapy, 2,400 rad, plus intrathecal methotrexate), were studied by computed tomography (CT) of the brain, EEGs, and neurologic evaluations 3 to 9 years after the end of prophylaxis. Thirty-five patients showed CT brain scan abnormalities: intracranial calcifications (twelve); widening of the subarachnoid spaces (eight); isolated dilatation of ventricular spaces (three) and with frontal periventricular hypodensity (two); dilatation of ventricular and subarachnoid spaces (nine); and a hypodense area (one). Only 17 patients showed aspecific EEG abnormalities which were never linked to CT scan findings. None of our patients presented major motor deficits at the neurologic examination. A stepwise logistic regression technique showed that age less than 5 years at the time of prophylaxis was the most important risk factor (p = 0.008) of CT brain scan abnormalities followed by neurets (p = 0.037) and sex (p = 0.10). Furthermore, the multivariate analysis pointed out that the interactions between these variables were not significant and the effects were only of the first order.

Acute Disease↗
PubMed1984

Non-T, non-B childhood acute lymphoblastic leukemia. Correlation between cytochemical markers and first complete remission.

The positivity for four cytochemical reactions, acid phosphatase (AcP), alpha-naphtyl acid acetate esterase (ANAE), beta-glucuronidase (BG), and N-acetyl beta-glucosaminidase (NABG) was correlated to first remission duration in 120 children affected with non-T, non-B acute lymphoblastic leukemia (ALL). The percentages of patients remaining in complete remission at 72 months were always higher for children whose blasts lacked these enzymatic reactions; however, a statistical difference was found only between BG+ and BG- ALL. It also appears that more complete enzymatic patterns of leukemic cells are associated with a poorer prognosis. The percentage of patients still in their first remission was 89% for leukemias with no cytochemical markers, 59% when one reaction was present, but less than 39% when two or more enzymes were detected in the blasts. It is noteworthy that the blasts of patients with more severe prognosis demonstrated a simultaneous positivity for AcP-ANAE or BG-NABG cytochemical reactions. The possible usefulness of these cytochemical markers to detect subsets of patients with different prognostic significance among non-T, non-B ALL is discussed.

Acid Phosphatase↗
PubMed1983

The role of surgery in non-localized neuroblastoma. Analysis of 59 cases.

The authors considered 59 stage III and IV neuroblastoma cases, which were observed from January 1967 to June 1979. 13 patients (13/59 = 22%) are surviving in complete remission 3 years after surgery: 9/20 (45%) with stage III and 4/39 (10%) with stage IV disease. The children subjected to complete surgical excision are all alive irregardless of age; the children who were not operated on or subjected to a biopsy, have all died. Of the 33 patients who underwent a reductive excision, 6 (all under 2 years of age) are in complete remission (18%). A better prognosis was found in those patients in whom the site of the primary tumor was at the mediastinal level. These data show the importance of the role of the surgeon in the multidisciplinary treatment of stage III and IV neuroblastomas; our experience is also favorable to the practice of second-look surgery.

Adrenal Gland Neoplasms↗
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

Cytochemical study in human lymphocyte subpopulations as defined by Fc receptors.

Three subpopulations of human T lymphocytes (TG, TM, and Tnon-G/non-M cells) were evaluated by means of six different cytochemical reactions. Elevated staining activity was demonstrated in all the populations when stained for acid phosphatase (AcP), beta-glucuronidase (BG) and N-acetyl beta-glucosaminidase (NABG). While the majority of TM cells displayed an intense acid alpha-naphthyl acetate esterase (ANAE) positivity, only a smaller proportion of the Tnon-G/non-M exhibited a positive reaction and a much lower activity was found in the TG group. TM cells were also alpha-naphthyl acetate esterase (NAE)-and alpha-naphthyl butyrate esterase (NBE)-positive, showing a dot-like pattern. These reactions were present in a lower proportion in the Tnon-G/non-M population and nearly completely absent in the TG cells. The present study identifies different cytochemical phenotypes for the different T-lymphocyte subsets and the analysis of these phenotypes may indicate that the TM is the most cytochemically differentiated subpopulation.

Acetylglucosaminidase↗
PubMed1980

Cytochemical study of thymocytes and T lymphocytes.

Fetal and postnatal thymocytes and circulating T lymphocytes were evaluated for six cytochemical reactions. Acid phosphatase activity was present in a high percentage of cells in all threee groups. Beta-glucoronidase and alpha-naphthyl acetate acid esterase were negative in the most immature fetal thymocytes, but become increasingly positive with T-cell maturation. Only the circulating lymphocytes presented a high percentage of N-acetyl beta glucosaminidase, alpha-naphthyl acetate esterase and alpha-naphthyl butyrate esterase positive cells. This study discusses the presence of these enzymes as proportional to different stages in T-cell maturation, and also of certain cytochemical phenotypes characteristic of these stages.

Acetylglucosaminidase↗