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M Attal

Publications and source records attributed to M Attal.

121 records · Page 7Linked to original sources
PubMed1988

Association of the Philadelphia chromosome and 5q- in secondary blood disorder.

A patient developed a secondary blood disorder 7 years after radiotherapy for a gastric lymphoma. The initial myelodysplastic syndrome evolved to a myeloproliferative phase with transient polycythemia, progressive thrombocythemia, and hyperleukocytosis. Chromosome analysis performed in the terminal phase showed del(5)(q13q31),t(9;22)(q34;q11), and a complex rearrangement involving chromosomes #2 and #3. A correlation between chromosomal abnormalities and hematologic findings could be established. In this case, we have assumed that the Philadelphia translocation is a late event, due to prior mutagen exposure, and its association with a common secondary abnormality (5q-), followed by a progressively developing myeloproliferative phase. Furthermore, the association of Ph and 5q- in a single clone seems to indicate that the same stem cell is affected by these two abnormalities.

Anemia, Refractory, with Excess of Blasts↗
PubMed1988

[Initial antibacterial prophylaxis after bone marrow allograft. Pilot study with systemic vancomycin].

In 22 consecutive patients treated by allogenic bone marrow transplantation, the authors report their experience in complete gastrointestinal decontamination and prophylactic systemic vancomycin. Neither septicemia from the low digestive tract nor with Gram positive is noticed. A child developed septicemia with Capnocytophaga ochracea, resistant to vancomycin. There is no infectious death in this study and no significative toxicity is reported.

Adolescent↗
PubMed1986

t(14;14)(q11;q32) in biphenotypic blastic phase of chronic myeloid leukemia.

A blastic crisis of chronic myeloid leukemia without a detectable chronic phase is reported. At diagnosis, blast cells present t(9;22)(q34;q11),t(14;14)(q11;q32) translocations and early B cell phenotype (DR +, TdT +, B4 +, BA1 +, J5 +). At relapse, the malignant clone evolves to a biphenotypic expression, the initial markers remain unchanged, and two myeloid antigens (My 7, My 9) appear. The wide overlap in percentages of blast cells displaying lymphoid and myeloid markers shows that a single clone bears antigens of both lineages. Simultaneous occurrence of a t(14;14)(q11;q32) translocation, usually found in T cell malignancies, and of a B cell phenotype raises the question of the relationship between chromosomal changes and surface marker expression. The malignant cell is assumed to be a progenitor cell, already committed to lymphoid lineage and retaining the potential to switch to myeloid lineage.

Aged↗
PubMedDate not supplied

Autologous peripheral blood progenitor cell transplantation for multiple myeloma.

Autologous stem cell transplantation (ASCT) is increasingly used in the treatment of cases of multiple myeloma (MM) where there has been no significant improvement in the patient's condition following conventional chemotherapy. Peripheral blood progenitor cells (PBPC) have replaced bone marrow as a source of stem cells and offer easier accessibility and availability, faster haematopoietic recovery and possibly lower tumour contamination. The IFM 90 randomized trial has shown that autologous bone marrow transplantation significantly improves response rate, event-free survival (EFS) and overall survival (OS) in younger patients with MM. For MM, this review discusses the role of ASCT, the use of PBPC for autologous transplantation, and current developments of ASCT.

Age Factors↗
PubMedDate not supplied

Rectal malacoplakia in renal transplantation: MR features.

This report describes the CT and MRI features of rectal malacoplakia in a renal transplant recipient. The lesion appeared strongly hyperdense (105 HU) on unenhanced CT and demonstrated hypointense signal on T1- and T2-weighted MR imaging with slight homogeneous enhancement after gadolinium injection. These characteristics distinguish this lesion from other more common neoplastic, inflammatory rectal lesions that are typically isointense on T1-weighted imaging and enhance variably after gadolinium injection. Characteristic intracytoplasmic siderocalcific spherules in malacoplakia can produce suggestive features on unenhanced CT and MRI.

Colonic Diseases↗
PubMedDate not supplied

Recombinant interleukin-2 (rIL-2) after autologous bone marrow transplantation (BMT): a pilot study in 19 patients.

In vivo use of rIL-2 autologous BMT may be the means of reproducing a kind of "adoptive immunotherapy" from grafted cells after allogeneic BMT. This approach may enhance the spontaneous generation of cytotoxic T-cells and NK cells which are presumably involved in this immunotherapy. Potential risks of such an approach would be to increase the usual toxicity of rIL-2 and to jeopardize the hemopoietic reconstitution. To determine the feasibility of this approach we have treated 19 poor prognosis patients with a succession of autologous BMT followed 78 +/- 12 days later by a continuous infusion of rIL-2. Eighteen million international units (IU) per m2 per day of Proleukine (CETUS, Amsterdam, The Netherlands) were administrated over 6 or 12 days. No patient died of the procedure. Clinical toxicity related to rIL-2 was not increased. Hemopoietic toxicity, significant both for platelets and granulocytes, was transient. Immune stimulation was dramatic for lymphocytes and subpopulations (CD3+ and NK cells) and for cytolytic functions (NK and LAK activity). This trial establishes the feasibility of administration of high doses of rIL-2, 2 months after autologous BMT. In this setting a 6 day period of continuous infusion of 18 million per m2 per day of Proleukine appears to be a regularly tolerable dosage conducting to a major immune activation and invites further studies to determine the clinical impact of such an approach.

Adjuvants, Immunologic↗
PubMedDate not supplied

[Veno-occlusive disease of the liver after bone marrow transplantation. Report of the symposium Autograft in France and the group of study of bone marrow transplantation. France Auto-Greffe et le Groupe d'Etude de la Greffe de Moelle osseuse].

Hepatic veno-occlusive disease is a frequent complication after high-dose chemo- or radiotherapy after bone marrow transplantation and is a major cause of mortality. During the 3 weeks following transplantation, acute major hepatic vascularization is observed together with portal hypertension and weight gain, ascitis and oedema of the lower limbs due to non-thrombotic obstruction of the centrilobular hepatic veins. This report summarizes the observations presented at a French symposium of France Autogreffe and Groupe d'Etude de la Greffe de Moelle osseuse. Different pathogenic processes are implicated including endothelial mechanisms due to toxic factor related to graft preparations and immunosuppressor treatments (methotrexate, cyclosporin), physical factors related to irradiation, immunological factors related to the expression of class II antigens on endothelial cells and viral factors, in particular cytomegalovirus infection. The incidence of veno-occlusive disease varies greatly from one series to another. Two French groups reported 5 and 3 cases among 1991 and 253 autologous grafts respectively (1.2 and 2.3%) while the Seattle group observed 53% among 355 consecutive grafts, although the same clinical criteria were used. Histological criteria include fibrosis around a non-thrombotic occlusion of the centrilobular veins, cytolysis and congestion of the sinuses. Other methods for diagnosis include transjugular biopsy, the suprahepatic pressure and imaging techniques. Prophylactic continuous infusion of low-dose heparin has been associated with a lower incidence. Trials using anti-tumour necrosis drugs and prostaglandin E1 have also been undertaken and show possible effects towards decreasing prevalence.(ABSTRACT TRUNCATED AT 250 WORDS)

Alprostadil↗
PubMedDate not supplied

Comparison of MRI and computed tomography in the various stages of plasma cell disorders: correlations with biological and histological findings. Myélome-Midi-Pyrénées Group.

OBJECTIVE: Our study had a double aim: (i) to evaluate the sensitivity and the specificity of computed tomography (CT) and magnetic resonance imaging (MRI) in the different stages of plasma cell disorders, and (ii) to correlate CT and MRI with the biological, cytological and histomorphometric parameters. METHODS: Twenty-four patients with MGUS according to Kyle, 12 patients with stage 1 and 12 with stage 3 myeloma, and 30 age-matched controls underwent MRI (sagittal views of the spine and coronal views of pelvis and femurs), CT (axial views from T10 to L5, sacrum, iliac crests), a histomorphometric study, determination of plasmocyte infiltration, and measurement of paraprotein, B2-microglobulin, the ca/cr ratio and osteocalcin. RESULTS: Heterogeneous osteopenia with microlacunae seen on CT scan and diffuse decreased signal intensity which remained higher than the signal of the intervertebral disk on T1 weighted sequences (MRI) were not peculiar to myeloma. Lacunae larger than 5 mm with trabecular disruption observed on CT, diffuse decreased signal intensity lower than the disk signal, and a multinodular appearance on MRI, not seen in the controls or in patients with MGUS, were observed in all stage 3 myeloma and in 40% of stage 1 myeloma patients. MGUS and stage 1 myeloma patients with abnormal MRI had a higher monoclonal component, plasma cell percentage and hypercellular bone marrow than those with normal MRI findings. MGUS or stage 1 myeloma patients with abnormal CT had a lower trabecular bone volume than those with normal CT. CONCLUSIONS: CT and MRI both reveal specific lesions in 40% of stage 1 myeloma patients. These methods are thus complementary in bone and bone marrow studies in myeloma.

Aged↗