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Biomedical subjects

M Baccarani

Publications and source records attributed to M Baccarani.

At least 199 records · Page 11Linked to original sources
PubMed1982

Staging of chronic lymphocytic leukemia.

One-hundred and eighty-eight patients with chronic lymphocytic leukemia were analyzed for prognosis based on Rai's staging system. It was found that stages I and II were not homogeneous as to prognosis. Stage II patients presenting with isolated splenomegaly had a long survival and were pooled with stage 0 patients (low risk group, 30% of cases, relative death rate 0.24, median survival greater than 10 yr). Stages I and II patients with a lymphocyte count higher than 40 x 10(9)/liter had a short survival and were pooled with stages III and IV patients (high risk group, 39% of cases, relative death rate 1.91, median survival 3.3 yr). Stages I and II patients with a lymphocyte count lower than 40 x 10(9)/liter made up an intermediate or standard risk group (31% of cases, relative death rate 1.00, median survival 6.2 yr). This modified staging system applied successfully to both old and young patients (more and less than 60 yr old, respectively).

Aged↗
PubMed1981

Staging of chronic myeloid leukaemia.

The prognostic value of nine clinical and haematological features, recorded at diagnosis in chronic myeloid leukaemia (CML), was analysed in two distinct series of patients. One series (116 cases) was collected at a single hospital over a 12-year period. The second series (139 cases) was collected from a multicentre trial over a 20-month period. Six features were associated with a poor prognosis: splenomegaly (more than 15 cm below the costal margin), hepatomegaly (more than 6 cm below the costal margin), thrombocytopenia (< 150 X 10(9)/l) or thrombocytosis (> 500 X 10(9)/l), a leucocyte count above 100 X 10(9)/l, peripheral blood non-granulated precursors (blast cells) above 1%, and peripheral blood granulated precursors (promyelocytes and myelocytes) above 20%. Depending on the number of negative prognostic factors, patients were divided into three categories: group I (0 or 1 factor), group II (2 or 3 factors) and group III (4,5 or 6 factors). Survival was significantly different in the three groups (P < 0.0005), and this was independent of age (below and above 50). The prognostic value of the classification was confirmed in a third series of 153 patients. We suggest that this classification provides a useful tool to identify prognostic categories in CML, and thus allows a proper allocation of patients to different therapies.

Adult↗
PubMed1981

Chronic idiopathic thrombocytopenic purpura (ITP): site of platelet sequestration and results of splenectomy. A study of 197 patients.

51Cr-platelet kinetics study was performed in 197 patients with chronic ITP after corticosteroid therapy had failed to induce a long lasting remission. The incidence of splenic, spleno-hepatic, hepatic and diffuse platelet sequestration site was 58%, 17%, 6% and 19%, respectively. Splenic and spleno-hepatic sequestration sites were more frequent in patients less than 30 years old and in patients with a platelet count lower than 50 x 10(9)/1. 111 patients were splenectomized shortly after the study. Normalization of the platelet count was obtained more frequently in patients with splenic and spleno-hepatic sequestration than in the others. Labelled platelet sequestration site was the best predictor of the outcome of splenectomy. Platelet kinetics is a non-invasive investigation that should be performed early after the diagnosis of chronic ITP in all patients eligible for splenectomy.

Adolescent↗
PubMed1981

In vitro culture and ultrastructure analysis of peripheral blood cells separated by discontinuous albumin density gradient during blast crisis of chronic granulocyte leukemia.

Peripheral blood from 4 patients with chronic granulocytic leukemia during blast crisis has been investigated. One case has been studied before and after treatment with Arabinosyl-Cytosine and 6-Thioguanine. The nucleated blood cells have been separated by a discontinuous density gradient. Cells were obtained from six different gradient fractions (F1-F6: density ranging from 1.052 to 1.078). 0.5 X 10(5) cells from each density fraction have been cultured in agar culture system to evaluate the granulocyte-monocyte committed stem cells (Colony Forming Units-granulocyte monocyte: CFU-GM). Cells recovered from the same density fractions have been studied by electron microscopy to evaluate the number of less differentiated cells. A quantitative correlation between plating efficiency and blast cells number was carried out. The results indicate that the highest recovery of both CFU-GM and blast cells is present in light density fractions (specific density below 1.063). However a discrepancy between blast cell frequency and granulocyte-monocyte colony formation in the same density fractions appears to be evident. In the patient studied before and after treatment it appears that only one out of two light density fractions (F1) responds to the antiblastic treatment.

Blood Cells↗
PubMed1980

Second malignancy in patients treated by Hodgkin's disease.

Six hundred and thirteen consecutive patients with Hodgkin's disease (HD), with a follow-up of two to ten years, were reviewed with the aim of establishing the type and frequency of second malignancies. Acute non-lymphoid leukemia developed in 2 of 152 patients treated by chemotherapy (CHT), and in 5 of 344 patients treated by CHT and radiotherapy (RT). Leukemia developed 12 to 83 months after diagnosis of HD, was always preceded by a preleukemic phase (3 to 25 months), and was always fatal (after 1 to 12 months). The karyotype of leukemic cells was studied in 4 of 7 patients and was always abnormal. Solid tumors developed in 1 of 152 patients treated by CHT, and in 4 of 344 patients treated by CHT and RT. The tumors appeared 10 to 63 months after diagnosis of HD and killed all 5 patients after 10 to 16 months. For patients treated by CHT, the actuarial frequency of leukemia and other tumors seven years after diagnosis of HD was 2.0% and 1.26%, respectively. For patients treated by CHT and RT, the figures were 2.04% and 2.26%, respectively. Second malignancies were not recorded among 117 patients treated by RT alone. These data are consistent with a relationship of acute leukemia to therapy for HD.

Acute Disease↗
PubMed1980

Defibrination in adult acute lymphoblastic leukaemia. Report of four cases.

Defibrination is a rare event in acute lymphoblastic leukaemia (ALL). This paper describes four cases of acute defibrination in a series of 52 adult patients with ALL. All four patients had blood clotting tests consistent with or suggesting defibrination prior to therapy, but haemorrhages and unequivocal laboratory evidence of defibrination developed only after leukaemic blast cells had been destroyed early during therapy for remission induction. All patients received supportive therapy, and three of them were also given a continuous IV heparin infusion. Haemorrhages were controlled and blood clotting tests were improved within 12--48 h.

Adolescent↗
PubMed1979

Adult acute lymphoblastic leukaemia: study of 32 patients and analysis of prognostic factors.

The clinical and haematological characters and the response to therapy of 32 consecutive patients with acute lymphoblastic leukaemia, aged more than 12 years, were reviewed. All patients were given vincristine (V) and (6-methyl) prednisolone (P) for 6 weeks; daunomycin (D) was added in 9 cases, and cyclophosphamide (C) + D in another 10 cases. 3 patients died during induction. 4 patients failed to achieve remission. 25 patients (78%) achieved complete remission (CR). All of them but one received 'prophylactic' central nervous system (CNS) therapy with cranial irradiation and i.t. methotrexate (MTX) and arabinosyl cytosine. CR was maintained with daily 6-mercaptopurine and weekly MTX. Median duration of CR was of 22 months. 2 patients are currently disease-free and off-therapy, 78 and 53 months after diagnosis, respectively. Blast cell membrane markers were studied in 21 consecutive cases: 3 patients had T-cell leukaemia and 2 patients B-cell leukaemia. Prognostic factors were evaluated basing on the present series of 32 patients, and on further 106 cases reported by others. Age (under and above 40) influenced significantly both the CR rate and the length of survival. In patients aged under 40, a circulating blast cell count higher than 25,000/microliter, or a platelet count lower than 50,000/microliter, negatively affected the survival.

Adolescent↗
PubMed1979

Management of nodular sclerosis Hodgkin's disease stage I, II A and B: evidence for a beneficial effect of MOPP on the relapse rate.

85 patients with previously untreated Hodgkin's disease with stage I, II A and B nodular sclerosis were treated. 31 of them with stage I and II A were submitted to radiotherapy alone. All are alive, but 9 of them (30%) relapsed. On the contrary, 35 patients with stage I and II A, and 19 with stage I, II and IIE B were submitted to radiotherapy followed by three courses of MOPP. All 54 patients are alive and relapse-free. No severe complication related to chemotherapy was observed. The analysis of results suggests that 3 courses of MOPP can significantly (Ip < 0.00025) reduce the relapse rate in patients with stage I and II nodular sclerosis, eligible for radiotherapy, without increasing morbidity.

Adolescent↗