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Biomedical subjects

S Sica

Publications and source records attributed to S Sica.

132 records · Page 8Linked to original sources
PubMedDate not supplied

Idarubicin combined with intermediate-dose cytosine arabinoside in the treatment of refractory acute leukemia.

From December, 1985 to October, 1987, 16 patients aged from 14 to 62 (median 34) with acute leukemia in relapse (10 affected by ANLL and 6 by ALL) were treated with the following regimen: Idarubicin 12 mg/m2/day on days 1-2-3, Ara-C 600 mg/m2 twice a day from day 1 to 6. Twelve patients (75%) achieved complete remission (C.R.). Two (12%) died during the induction phase from alveolar pneumonitis. One patient was resistant. The median duration of C.R. and survival was respectively 12 (range 6 to 100 +) and 23 weeks (4 to 108 +). The median duration of granulocytopenia was 16 days (range 10 to 24 days). The most frequent non-hematological complications consisted of nausea, vomiting, diarrhea and mucositis. Four patients had hepatic and splenic microabscesses of suspected mycotic etiology, and one showed a transient cardiac arrhythmia. The C.R. rate obtained in this series may be considered satisfaying since all but 3 patients were on treatment at the time of relapse. Yet the short duration of C.R. suggests the opportunity of performing consolidation cycles or suprelethal therapy followed by bone marrow transplantation.

Adolescent↗
PubMedDate not supplied

An evaluation of some inflammatory, coagulative and immune factors in progressive systemic sclerosis.

Thirty-five patients affected by Progressive System Sclerosis (PSS) (20 acrosclerosis and 15 diffuse sclerosis) were subjected to the following laboratory tests: Beta 2 microglobulin (B2m), Fibronectin, C3c, C4, Fibrinogen, Factor VIII Coagulant (F. VIII:C), Factor VIII related Antigen (F. VIII:Ag), IgG, ESR, Antithrombin III (AT III), alpha 1 Antitrypsin (alpha 1AT) and alpha 2 Macroglobulin (alpha 2M). The results showed that no difference was observed between the normal group and the groups of PSS patients with respect to alpha 1AT, alpha 2M, and AT III. In contrast the B2m, ESR, IgG, F. VIII:Ag results were significantly higher in the PSS patients, while Fibrinogen and C3c results were slightly higher, but no high enough to be of statistical significance. The two PSS patient subgroups did not produce significant results, only the C4 values were lower in the Diffuse Sclerosis subgroup. From these results it seem that the tests used are not very useful indifferentiating the two subgroups of the PSS patients.

Adult↗
PubMedDate not supplied

Autologous transplantation of peripheral blood progenitor cells mobilized by chemotherapy with or without G-CSF (filgrastim) in resistant lymphoproliferative diseases: enhanced hemopoietic recovery with filgrastim primed progenitors.

BACKGROUND AND METHODS: Bone marrow transplantation is increasingly used to overcome the bone marrow toxicity from myeloblative therapy. Peripheral blood progenitor cell transplantation (PBPCT) has been recognized as an alternative source of bone marrow for hemopoietic recovery after myeloblative therapy. In the steady state condition hemopoietic progenitors are scarce in peripheral blood; chemotherapy and growth factors are both able to increase PBPCs. Twenty-five patients affected by resistant lymphoproliferative diseases [4 multiple myeloma (MM), 19 non Hodgkin's lymphoma (NHL) and 2 Hodgkin's disease (HD)] were submitted to autologous peripheral blood progenitor cell transplantation (PBPCT). PBPCs were collected after chemotherapy (CT) alone (8 patients) or plus filgrastim (17 patients). Filgrastim was not administered after PBPCT in any case. RESULTS AND CONCLUSIONS: A statistically significant difference between the two groups was found for the following parameters: number of leukaphereses administered, amount of CFU-GM infused, time to hemopoietic recovery, amount of supportive care, number of days of antibiotic therapy, length of hospitalization. PBPCs primed with filgrastim CT appeared to be markedly superior to CT-recruited PBPCs in reducing the period of neutropenia and, surprisingly, of thrombocytopenia. Reduction in hematologic toxicity resulted in a decrease of transplantation-related toxicity and mortality, even in elderly and/or heavily pretreated patients.

Adolescent↗
PubMedDate not supplied

Extramedullary relapse after allogeneic bone marrow transplantation plus buffy-coat in two high risk patients.

In order to obtain an additional graft versus leukemia effect (GVL) and rapid engraftment, donor leukocyte infusion (DLI) was added to unseparated, sex-mismatched allogeneic bone marrow transplantation in two male patients (age 21, 26) affected by high risk hematological malignancies (refractory T-ALL, refractory B-LBL in leukemic phase). Graft versus host disease (GVHD) prophylaxis consisted of methotrexate (MTX) alone. DLI were obtained after G-CSF 16 ug/kg/day sc. A total of 2.36 and 5.8 x 10(6)/kg MNC, 5.4 and 11 x 10(6)/kg CD34+ cells, 1.3 and 1.3 x 10(6)/kg CD3+ lymphocytes, respectively, were infused. Hemopoietic recovery occurred promptly. Complete chimerism was detected by cytogenetic examination. One patient developed an extramedullary relapse that first involved the cranial nerves, and then the testes, soft tissue and skin; the other patient developed central nervous system disease and then bilateral paravertebral masses with progressive paraplegia. Despite complete medullary remission with normal female karyotype, both patients died from extramedullary progression of their disease. Our observation shows that, at least in high risk patients, no additional GVHD or GVL effect was evident after donor leukocyte infusion. Extramedullary relapse was not prevented despite good control of medullary disease.

Adult↗
PubMedDate not supplied

Granulocyte colony-stimulating factor-primed leukocyte transfusions in candida tropicalis fungemia in neutropenic patients.

Optimal management of fungemia in neutropenic patients is still controversial. Several reports have already stressed the poor prognosis in invasive candidiasis (80% mortality in several reports). Therefore granulocyte transfusions would appear to be useful in the management of these infections. We report the use of rhG-CSF-primed granulocyte transfusions plus amphotericin B in two neutropenic patients who developed life-threatening systemic fungal infections. This approach was successful and both patients fully recovered from the infection.

Acute Disease↗