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Biomedical subjects

P Solal-Celigny

Publications and source records attributed to P Solal-Celigny.

At least 37 records · Page 2Linked to original sources

Expression of the bcl-2 gene product in follicular lymphoma.

Expression of bcl-2 protein was analyzed in 140 cases of follicular lymphoma by immunohistologic staining of paraffin-embedded tissue; 85% of cases were positive, the frequency being related to histologic grade (100% for the small-cleaved cell type, 86% for the mixed cell type, and 76% for the large cell group). There was striking heterogeneity of bcl-2 content in a number of cases and the smaller neoplastic cells (i.e., centrocytes) were usually the most strongly labeled. In most cases, bcl-2 protein staining was much weaker in normal lymphoid cells than in the neoplastic cells. In several cases, staining for bcl-2 revealed patterns of neoplastic cell spread into adjacent tissue (e.g., normal follicles, lymphoid sinuses), and bcl-2 protein expression tended to be highest in these migratory cells.

Humans↗

[Diarrhea with malabsorption and exudative enteropathy caused by intestinal myeloid involvement in a patient with myeloproliferative syndrome].

A 41-year-old woman with a myelodysplastic syndrome complained of diarrhea with malabsorption and protein-losing enteropathy after splenectomy. No cause was found and various therapeutic regimens were not effective. Pathological examination of biopsies from stomach, small intestine, and large bowel showed infiltrations interpreted as inflammatory on routine technics. Blast cell infiltration was found on electron microscopy. Treatment by citarabine induced normalization of leukocytosis, and diarrhea disappeared. Six months after the onset of illness, she developed acute myeloblastic leukemia and died of infectious pneumonia. Blastic infiltration of the lamina propria could be responsible for the determinism of symptoms, because of the lack of another etiology, the intensity of the blastic infiltration and the effect of cytotoxic therapy, even in the absence of new biopsies.

Adult↗

Interleukin-2 and interferon-gamma production in follicular lymphomas.

In situ hybridization with specific RNA radiolabeled probes was used to analyze the production of interleukin-2 (IL-2) and interferon-gamma (IFN-gamma) by 21 low-grade follicular lymphomas (FLs). All of the 21 FLs tested contained lymphokine-synthesizing cells in the interfollicular and follicular areas. Enumeration of lymphokine synthesizing cells indicated heterogeneous IL-2 production among lymph nodes tested; 2 of the 21 had much higher densities of IL-2-producing cells (855 and 570/cm2) than did the remaining 19 (mean, 92 +/- 15/cm2). IFN-gamma-producing cells displayed no such variation (mean, 77 +/- 8 IFN-gamma-producing cells/cm2). The mean IL-2/IFN-gamma-producing cell ratio was 2.69 +/- 0.84, indicating preferential induction of IL-2. The detailed distribution of lymphokine-producing cells showed that IL-2 and IFN-gamma-producing cells were located mainly in the follicular areas. The mean follicular/interfollicular ratio was 1.82 +/- 0.16 for IL-2 and 1.92 +/- 0.19 for IFN-gamma-producing cells. The results show that T-cell activation, defined by lymphokine production, occurs in FL lymph nodes in direct contact with malignant B cells. Thus, lymphokine production may play an important role in the control of tumor growth, which is the result of interaction between tumor cells and host-derived immune reaction.

Humans↗

IL-2 mRNA expression in Tac-positive malignant lymphomas.

Expression of the IL-2 receptor (Tac antigen/CD25) is documented in malignant lymphomas. Because IL-2 is a major lymphocyte growth factor, an IL-2-dependent growth could be involved in the proliferation of Tac-positive lymphomas. Indeed such a mechanism has been demonstrated experimentally for the growth of T-cell lines. To investigate this point in human lymphomas, we used in situ hybridization to analyze the expression of the IL-2 gene in 20 non-Hodgkin's lymphomas, among which 12 expressed the IL-2 receptor. Nine of these were anaplastic large cell lymphomas expressing the Ki-1-related antigen. We here show that IL-2-producing cells are present in all the lymphomas we analyzed. As a mean, there is no significant difference in the percentage of IL-2-producing cells between Tac-positive and -negative lymphomas. However, the level of IL-2 production is highly heterogeneous in both groups, and the highest density of IL-2-producing cells was observed in 2 Tac-positive lymphomas. Simultaneous detection of cellular antigens and of IL-2 mRNA demonstrates that IL-2 is produced by reactive T cells rather than by tumor cells. These results suggest that if IL-2 is involved in the growth of Tac-positive lymphomas, it acts as a paracrine, rather than an autocrine, factor.

Adolescent↗

[Treatment of aggressive non-Hodgkin's lymphoma in aged patients with a combination of methyl-GAG, etoposide and prednimustine].

The authors report the results of a chemotherapy regimen of methyl-GAG, etoposide and prednimustine in 21 elderly patients (median age = 78 years) with aggressive non-Hodgkin's lymphoma. Sixteen patients responded (11 complete remissions, 5 partial remissions) with minor toxic side-effects. This regimen could be proposed for patients whose age and/or cardiovascular status prohibit treatment with usual anthracycline-containing chemotherapy programs.

Aged↗

[Intensive induction and early consolidation of acute lymphoid leukemia in the adult. A pilot study of feasibility and long-term development].

Between April and December, 1982, a multicentre pilot study was conducted in 45 patients aged from 16 to 73 years suffering from acute lymphoblastic leukaemia to test the feasibility of an intensive and short induction phase followed by an early consolidation phase. All patients received a 5-day course of induction chemotherapy with prednisone, vincristine, AraC and rubidazone, then a "triple A regimen" for consolidation, consisting of adriamycin, AraC and asparaginase. The complete remission rate was 73 per cent. Toxicity during induction was characterized by frequent infections, but the consolidation treatment was well tolerated. Thus, the sequence intensive induction-early consolidation proved feasible and acceptable. In terms of survival, 8 out of the 33 patients in remission are still alive and well after more than 4 1/2 years.

Adolescent↗

Age as the main prognostic factor in adult aggressive non-Hodgkin's lymphoma.

From 1975 to 1983, 73 patients with aggressive non-Hodgkin's lymphoma were treated with a first-generation program including Adriamycin, VM 26, cyclophosphamide, and prednisone. Thirty-nine patients were under 60 years of age, and 34 were 60 years or older. The clinical and histologic characteristics of the two groups were similar. Using either univariate or multivariate analysis, age appeared as the only prognostic factor. Patients under 60 had a median survival of 48 months, with a five-year survival rate of 47 percent and a five-year disease-free survival rate for complete-remission patients of 72 percent. Patients 60 years or older had a median survival of 18 months with a five-year survival rate of 18 percent and a five-year disease-free survival rate for complete-remission patients of 24 percent. These highly significant differences were related to a non-significantly decreased complete-remission rate and a significantly higher relapse rate in elderly patients. Since patient selection according to age could play a role in the results achieved with intensive chemotherapy programs, randomized trials comparing the various chemotherapy programs for aggressive non-Hodgkin's lymphoma are warranted.

Adolescent↗

[Marchiafava-Micheli syndrome and pregnancy].

Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired clonal disorder characterized by sensitive populations of erythrocytes, granulocytes and platelets. PNH is a disease of young adults with a slight female predominance. Several complications of PNH during pregnancy, could be prevented; chronic anemia, folate and iron deficiency, deep vein thrombosis. We report seven pregnancies, six of which were successful in four patients. One pregnancy was terminated after 25 weeks by a fetal death during an acute hemolytic crisis. Diagnosis of PNH was made in the four patients before the pregnancy by the acidified serum lysis assay and the sucrose lysis assay. During puerperium, acute hemolytic crisis, most probably triggered by delivery, were observed in two patients. Thrombotic complications could be prevented by early initiation of an anticoagulant therapy after delivery. The only neonatal complication, observed in two cases was iso immune hemolytic anemia related to the multiple blood transfusions received before and during pregnancy. These results show that successful pregnancies are possible in PNH women when monitoring is especially close. To allow optimal fetal development, patients were transfused with saline-washed or frozen-thawed packed red-cells to prevent the precipitation of hemolysis, so that the hemoglobin level remained higher than 10 g/dl. During the whole pregnancy, patients had to be given dietary supplementation with folic acid and iron therapy whenever deficiency was demonstrated, under close surveillance of hemolysis. To prevent thrombotic complications during pregnancy, anticoagulant therapy was used if the patients had to be bedridden, or within 8 hours following delivery.

Adult↗

[Interstitial lymphoid pneumonia and polyadenopathies in patients infected with the LAV/HTLV III virus].

Seven patients of Haitian and Central African origin were investigated for interstitial pneumonitis and unexplained chronic lymphadenopathy. A study of broncho-alveolar lavage fluid showed no opportunistic micro-organisms and disclosed a high alveolar lymphocyte count with more than 80% T8+ cells. In 3 patients, open lung biopsy showed lymphoid interstitial pneumonitis. Follicular hyperplasia was a constant finding in lymph nodes. Benign lymphocytic infiltration was found in other organs of all patients, associated with polyclonal hyperimmunoglobulinaemia, low peripheral T4+ cell count and LAV-Ig G antibodies.

Acquired Immunodeficiency Syndrome↗

Effects of ex-vivo plasma adsorption over protein A sepharose in acute leukemia.

Plasma adsorption over immobilized Staphylococcus aureus Cowan I has resulted in tumor regression in several animal and human trials. Protein A, because of its ability to bind IgGs has been considered as the effective component of Staphylococcus aureus. In 4 patients with acute leukemia, a plasma volume of 1500 cm3 was passed in an ex-vivo system over immobilized SpA-Sepharose and then reinfused. Almost all of the IgGs contained in the plasma volume could thus be removed. Toxic side-effects were mild. No significant clinical improvement could be obtained. Plasma incubation with SpA did not modify blast cell viability or leukemic progenitor cell growth. Along with others, this study shows that Protein A is probably not the mediator of the tumoricidal responses observed in studies using adsorption over Staphylococcus aureus Cowan I. The ex-vivo system prepared for this study could also be used for plasma IgG removal for the treatment of autoimmune or immune-complex related disorders.

Blood Cell Count↗

[Specific meningeal involvement in multiple myeloma].

Meningeal involvement is extremely rare in multiple myeloma. Its characteristic features can be derived from the 3 cases presented here and from the 11 cases previously published. Specific signs of meningeal myelomatosis include convulsions, confusion, cranial nerve palsies and plasma cells in the cerebrospinal fluid. Meningitis develops in patients with high tumoral mass myeloma, leukaemic in one-half of the cases. Treatment is ineffective, and death occurs within a few months.

Adult↗