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Biomedical subjects

M Monconduit

Publications and source records attributed to M Monconduit.

At least 73 records · Page 4Linked to original sources

Daily evaluation of circulating granulocyte-monocyte progenitors during bone marrow recovery from induction therapy in acute leukemia.

The notable increase of the circulating granulocyte-monocyte progenitors (PB CFU-GM) during bone marrow recovery following chemotherapy is a well known phenomenon. It has led to consider harvesting a large number of autologous stem cells by cytapheresis. Daily assessments have been conducted on the PB CFU-GM level in 9 patients with acute leukemia at the time of bone marrow regeneration after the first induction course in order to identify the circumstances of this rise. The PB CFU-GM maximum peak, of an average of 2142/ml, occurs between day 17 and day 23 after the chemotherapy has ended. A ten-fold increase of the PB CFU-GM level above normal values is maintained between 2 and 10 days. The PB CFU-GM peak coincides with that of the circulating immature myeloid cells and monocytes. The platelet rise above 100 X 10(9)/1 always occurs 2-7 days before the PB CFU-GM peak.

Acute Disease↗

Low-dose cytosine arabinoside treatment for acute nonlymphocytic leukemia in elderly patients.

Thirty patients older than 65 years of age with acute nonlymphocytic leukemia were treated with low-dose cytosine arabinoside (10 mg/m2 subcutaneously every 12 hours for 15 to 21 days). Fifteen achieved complete remission and five had partial remission. Treatment was more effective when initial bone marrow cellularity was low (P = 0.007). Four of six patients with secondary leukemia entered complete or partial remission. Therapy was well tolerated with reduced myelosuppression and few number of early deaths. Sixteen patients followed the whole treatment as outpatients. Six of 12 patients who achieved complete remission showed no evidence of post-therapeutic bone marrow aplasia. These data are consistent with the view that low-dose cytosine arabinoside acts on leukemic cells as a differentiating agent.

Acute Disease↗

Salmonella infection in hairy cell leukemia: report of a case.

A patient with hairy cell leukemia who developed mediastinal mass and fever is described. A CT-guided aspiration of the mass yielded Salmonella tiphymurium. Granulocyte response to infection was intact and could explain the favorable course of this unusual Salmonella infection. Although several reports deal with salmonellosis as a complication of immunodeficiency states, this type of infection is of rare occurrence in hairy cell leukemia.

Humans↗

[Combination chemotherapy with vincristine, melphalan, CCNA, cyclophosphamide, prednisone in myeloma].

The authors report the results of a prospective, multi-centre trial involving 87 patients with previously untreated myeloma who were treated by combination chemotherapy consisting of melphalan, cyclophosphamide, CCNU, prednisone and vincristine. 83.1% of patients had a high tumour mass (stage III on Durie and Salmon's classification). The response to treatment could be evaluated in 76 patients and 70% were found to respond. The median actuarial survival of the whole population is 30 months. The survival is significantly longer (p less than 0.001) in responders (median 40 months) than in non-responders (median: 17 months); the survival is significantly shorter (p less than 0.01) in subjects with renal failure (median: 10 months) than in subjects without renal failure (median: 36 months). This treatment is sufficiently well tolerated to be administered on an outpatient basis. One case of acute monoblastic leukaemia was observed. These results are similar to those reported in the literature.

Antineoplastic Combined Chemotherapy Protocols↗

[Value of the determination of beta-2-microglobulin in the monitoring of myeloma. Apropos of 290 determinations].

The authors first established a correlation between serum 2 microglobulin (beta 2 m) and creatinine (beta 2m) mg/1) = 0.033 X creatinine (mumol/l) + 0.236) in order to be able to calculate the ratio of measured theoretical beta 2 m, as a function of cell production only. Comparison of this ratio with total tumour mass. calculated according to Durie and Salmon, for 290 estimations, gave a very significant correlation (r = 0.31; p less than 0.0001). This correlation was also significant for the 70 estimations made in cases of myelomas with little or no secretion (7 light chain, 1 non-secreting, 1 IgD and 1 IgM) where the estimation is of the greatest importance as an indication of the course.

Beta-Globulins↗

A new prognostic classification of chronic lymphocytic leukemia derived from a multivariate survival analysis.

Survivals of two series of CLL patients (99 from a retrospective series and 196 from a prospective series) were studied separately. The three main staging systems (Rai, Binet, Rundles) agreed well, but as far as survival is concerned, too many stages are defined. The authors performed a Cox multivariate analysis of survival in order to isolate important prognostic factors at diagnosis and to use them to build a simple three-stage classification. Thrombopenia and anemia appeared as the most important risk factors. Among the nonanemic and nonthrombopenic patients, the number of involved areas was clearly related to prognosis in the authors' two series. This study allowed the authors to propose a new classification in three prognostic groups. Group C: anemia (Hb less than 10 g) and/or thrombopenia (platelets less than 100,000/mm3); about 15% of the patients; median of 2 years. Group B: no anemia, no thrombopenia, three or more involved areas (counting as one each of the following: axillary, cervical, inguinal, lymph nodes, whether unilateral or bilateral, spleen and liver); about 30% of patients; median of 7 years. Group A: no anemia, no thrombopenia, less than three involved areas; about 55% of patients; the survival of this group does not seem different from that of the French population of the same age and sex distribution. This three-stage classification only requires clinical examination and routine hemogram, has a good prognostic value which was confirmed on the series of Montserrat and Rozman (146 patients), and should therefore be helpful in planning new clinical trials.

Aged↗

[Comparison between 2 density gradients for separation of CFU].

We separated 40 bone marrow samples by centrifugation on two density gradients, ficoll-metrizoate sodium (lymphoprep) and percoll. There is no difference between the two methods when expressing the colony forming cells (CFU-C) per 2.10(5) bone marrow cells plated. But the absolute number of recovered CFU-C is significantly greater with percoll than with ficoll metrizoate sodium.

Bone Marrow Cells↗

Rheumatic symptoms in Crohn's disease and the HLA system.

The study of the distribution of the HLA phenotypes among 55 patients suffering from Crohn's disease did not show any significant difference compared to a control population. On the other hand, the same study limited to patients suffering both from Crohn's disease and peripheral articular manifestations showed a significant increase in the frequency of the HLA BW17.

Crohn Disease↗

[Rheumatic manifestations in 80 cases of Crohn's disease].

Out of a series of 80 patients suffering from Crohn's disease, 31 presented rheumatic manifestations. In 16 subjects this took the form of synovitis closely dependent on the enteritic evolution, which developed after the alimentary symptoms, and which worsened as they did and sometimes regressed as they did following medical or surgical treatment. In combination with erythema nodosum, aphtosis, and conjunctivitis, synovitis appears to be the expression of an immune response to the enteritic lesion. Three cases of chronic polyarthitis and 6 cases of asymptomatic sacro-ileitis were also observed, and 6 cases of spondylarthritis of a minor radiological type were observed that evolved independently of the Crohn's disease. Typing according to the HLA system using 26 antigens was carried out in 44 subjects; no difference in phenotype frequency was found between a control group (blood donors) and the group of subjects with Crohn's disease alone; however, the antigen W 17 was found significantly more frequently in those subjects with peripheral arthritis and the antigen W 27 was found more frequently in those with spondylarthritis. These findings suggest, although it is not certain, the existence of genetic susceptibility to rheumatic manifestations in certain sites in patients with Crohn's disease.

Arthritis↗

[Evaluation of the involvement of the spleen in Hodgkin's disease].

In the light of personal data and 60 cases in the literature, the authors attempt to evaluate the risk of splenic involvement during Hodgkin's disease. Neither clinical examination nor scintiscanning of the spleen, permit one with sufficient security to recognise splenic involvement. Study of the context reveals, on the contrary, that the following factors contribute to the splenic risk: --Signs of evolutivity: their presence implies splenic involvement in 63% of cases; --the histological type of the frequency of the splenic involvement increases from type 1 (38%) to type 4 (61%); --the distribution of the lymph nodes above the diaphragm, the spleen is involved in 66% of forms with cervical and mediastinal and axillary lymph node involvement, 56% in forms with cervical and axillary nodes alone and 24% in forms with cervical and mediastinal nodes alone; --the data obtained by lymphography, as 89% of patients with lumboaortic gland involvement, also had invasion of the spleen. There may be errors of interpretation of lymphography, depending on the series, of from 6 to 25%. Thus, assessment of the risk of splenic involvement in Hodgkin's disease is carried out less on the splenic signs themselves, than on the clinical, laboratory, histological and radiological context.

Adolescent↗

[Unilateral renal atrophy].

The authors report 45 cases of unilateral renal atrophy. The circumstances of discovery are related to the urological symptoms: pain, hematuria, pyuria. On the other hand, hypertension is rarely the reason for consultation. Women are more affected than men. Intravenous urography, retrograde cystography and arteriography are essential examinations to collect information concerning the etiology. Dynamic scintiscanning with measurement of the percentage of isotope fixed on the kidneys, has the advantage of permitting comparative evaluation of renal function on each side. In our study, obstruction of the urinary tract was more frequent than parenchymatous disease favoured by infection. Vascular abnormalities were rare. The etiological enquiry remained, however, negative in one third of cases. Surgical operation was necessary when a urological abnormality was the cause of persistence of severe symptoms. On the other hand, removal of the atrophic kidney does not seem to us advisable when decided simply to relieve hypertension. The latter point is particularly discussed.

Adult↗