Search PubMed⌕ Search

Biomedical subjects

P Lederlin

Publications and source records attributed to P Lederlin.

At least 55 records · Page 3Linked to original sources

[Lymphoproliferative syndromes after cardiac transplantation and treatment with cyclosporine. Report of 4 cases].

Immunosuppressive therapies may induce neoplasia. The administration of cyclosporine is associated with an increased frequency of lymphoproliferative disorders when compared with conventional therapies. This risk is related to the type of organ transplanted and immunosuppression modalities (type and intensity). In heart transplantation, the incidence of non-Hodgkin's lymphoma varies between 11.9 and 1.5% with onset usually about 6 months after transplantation. Four case reports are presented; 3 lymphomas and 1 multiple myeloma that developed, in heart transplant recipients receiving triple-drug immunosuppression: azathioprine, cyclosporine and prednisolone. Clinical and immunohistological characteristics of posttransplant lymphomas are described and etiopathological mechanisms, especially the role of cyclosporine, in the development of these lymphoproliferative disorders, are discussed.

Adult↗

[Immediate hematological toxicity during combination chemotherapy-radiotherapy of Hodgkin's disease].

The hematologic immediate toxicity during radiotherapy for Hodgkin's disease was studied from a series of 72 patients with stage IIB or III who received 3 courses or more of chemotherapy before radiotherapy. The toxicity in the group of 36 of them who received total nodal irradiation (TNI) was the most important. Sixteen of the 28 TNI had irradiation interrupted, 12 of them began with inverted Y type. The blood cells count at the beginning of the treatment was crucial; only 16% of the patients had interruption of irradiation when the blood cells count was normal; on the other side, 63% had interruption when the blood cells count was abnormal (P less than 0.05). Toxicity was due to the daily destruction of the dividing bone marrow stem cells located in the irradiated area, from the first day of treatment; there was a progressive decrease in the pool of these stem cells within a late resaturation. The absence of resaturation of this pool after initial chemotherapy and after the first part of irradiation explained the immediate and durable toxicity; in the same way, inverted Y irradiation destroyed a great part of active bone marrow (40%) and the pool of remaining stem cells with high mitotic index would be located in areas irradiated subsequently. So, waiting for the absolute normalisation of blood cells count before beginning irradiation and start irradiation by mantle field (rather than inverted Y) seem to be the 2 measures able to reduce the number of interruptions of irradiation due to hematotoxicity.

Adolescent↗

[Value of high-dose cytosine-arabinoside in the treatment of resistant acute leukemia].

Sixty-one patients with refractory or relapsed or secondary acute leukemia were treated with high-dose cytosine arabinoside (2-3 g/sq m in intravenous infusion every 12 hr to a 12-36 g/sq m total dose). m-Amsa or another antileukemic drug was given with cytosine arabinoside to 20 patients. Complete remission was achieved in 12 of 27 patients with acute myeloid leukemia, 5 of 8 patients with chemotherapy-induced leukemia, 3 of 7 patients with hematologic disorders in blastic crisis and 5 of 17 acute lymphoblastic leukemia patients. A similar response rate (6/16) was obtained when m-Amsa was given with cytosine-arabinoside. The median duration of remission was short (4 months in acute myeloid leukemia). Bone marrow transplantation was performed in 10 patients during the remission time. This regimen has acceptable toxicity; severe neurologic or hepatic disorders occurred in 18% of patients. These data suggest that high-dose cytosine arabinoside is an effective alternative in the treatment of resistant acute leukemia.

Acute Disease↗

Levamisole in chronic lymphocytic leukaemia: a prospective study of 15 patients.

Several haematological and immunological parameters were studied before and after a 4-week trial of oral levamisole (300 mg/week) in 15 patients with chronic lymphocytic leukaemia. We found no statistically significant difference in the mean peripheral blood counts of total lymphocytes, E-rosette-forming lymphocytes, monocytes, polymorphonuclear neutrophils, eosinophils and platelets. Mean serum levels of IgG, IgA, IgM, IgD, C3 and C4 were not statistically affected by levamisole nor was the mean lymphocyte stimulation modified by various mitogens (phytohaemagglutinin, concanavalin A, pokeweed mitogen, tuberculin, candidin). The mean IgE level was statistically increased (p less than 0.05) after levamisole administration but remained below the normal upper limit. A high rate (46%) of clinical and haematological adverse reactions (1 patient developed thrombocytopenia) was associated with levamisole administration. These results suggest that levamisole, as given in this trial, has no obvious beneficial effect and cannot be recommended in patients with chronic lymphocytic leukaemia.

Adult↗

[Lithium and acute myeloid leukemia].

The authors report a case of acute myeloid leukemia in a thirty-four-year-old man who had been under lithium carbonate for the last six months for manic-depressive psychosis. One year after treatment with cytosine-arabinoside, 6-thioguanine and daunorubicin, the patient is still in complete remission. In the medical literature we found seven additional reports of acute or chronic myeloid leukemia after lithium therapy. Lithium was found to enhance granulopoiesis. Our findings suggest that lithium may initiate or promote leukemia.

Adult↗

[Effect of cimetidine on human granulopoietic stem cells. In vitro study in 31 patients].

We studied the action of cimetidine at various concentrations on human hematopoeitic colony and cluster forming cells "in vitro" (CFUc). Bone marrow samples obtained from 31 patients with various hematological and neoplastic diseases were cultured in semisolid agar. When cimetidine was added to cultures there was a reduction of colony and macrocluster formation. At the concentration used in our study (20 micrograms/ml, 30 micrograms/ml, 40 micrograms/ml) these effects were not dose-related. We did not find any significant reduction of microcluster formation. These results are relevant with the hypothesis that histamine H2 receptors antagonists may have an inhibiting action on bone marrow CFUc proliferation. They point out the need for hematological surveillance during long-term cimetidine therapy.

Bone Marrow↗

[Hodgkin's disease with muscular involvement. 2 cases (author's transl)].

The authors report on two cases of Hodgkin's disease with muscular involvement. This exceptional complication occurred during the terminal phase of a stage IV disease in one case and during remission of a stage III disease in the other case, where it responded to combined chemotherapy. Muscular lesions in Hodgkin's disease may be due to extension from adjacent tissues or from dissemination through the blood stream. They do not necessarily indicate a more severe prognosis.

Adolescent↗

Multiple myeloma after phenytoin therapy.

We report a case of multiple myeloma in a 48-year-old woman treated with phenytoin for 55 months. This association may be fortuitous. The depressive effect of phenytoin on the immune responses, however, could account for the occurrence of the dysglobulinaemia. This case points out the need for periodic examination of serum proteins in patients chronically treated with hydantoin derivatives.

Female↗