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Martín Ventura S, García Molina C, Ortigosa Solórzano E, García Vela JA, Thuissard-Vasallo IJ, Lorente Ruifernández MT, Gallego Gil P, Martín Rubio I, Esteban A. Immune response in breast cancer surgery. A comparative and prospective study of different anesthetic techniques. Rev Esp Anestesiol Reanim (Engl Ed) 2022; 69:336-344. [PMID: 35760691 DOI: 10.1016/j.redare.2021.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 06/17/2021] [Indexed: 06/15/2023]
Abstract
INTRODUCTION The main reason for high mortality in breast cancer is local recurrence and metastasis, despite surgery as the first therapeutic option. The anesthesia used in the operation room can determine the immune response. METHODS A prospective, comparative and non- randomised study in patients undergoing breast cancer surgery was conducted in our hospital after obtaining approval from the Hospital's Institutional Review Board. Patients were divided in two groups: Group A received general anesthesia with propofol and opioids. Group B, in addition to general anesthesia, three interfascial blocks (Pec I, Pec II and BRILMA) were performed in all patients. Three blood samples were taken 1) previous anesthetic induction; 2) two hours after the end of the surgery and 3) 24-48 h after surgery. Leukocytes, CD3, CD4, CD8 and Natural Killer cells were determined at each time. RESULTS 103 patients were included. 59 (group A) received general anesthesia and 54 (group B) general anesthesia and interfascial blocks. Regarding baseline characteristics, age was significantly higher in the group that received general anesthesia and mastectomy was more frequent in the group that received interfascial blocks. We observed after surgery an increase in leukocytes level that returns close to baseline levels. On the other hand, a reduction in the immune response was observed that also returns to the previous level 48 h after surgery. Group A and B get similar results and also subgroups of hormonal receptors (HER+, PR and/or ER+). CONCLUSIONS Interfascial blocks in chest wall added to general anesthesia in breast cancer surgery has not shown a significant difference in the inflammatory response or immunological depression compared to general anesthesia as the only anesthetic technique. It seems to trend less immunological depression in the interfascial block group.
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Affiliation(s)
- S Martín Ventura
- Servicio de Anestesiología y Reanimación, Hospital Universitario de Getafe, Madrid, Spain.
| | - C García Molina
- Servicio de Anestesiología y Reanimación, Hospital Universitario de Getafe, Madrid, Spain
| | - E Ortigosa Solórzano
- Servicio de Anestesiología y Reanimación, Hospital Universitario de Getafe, Madrid, Spain
| | - J A García Vela
- Servicio de Hematología, Hospital Universitario de Getafe, Madrid, Spain
| | - I J Thuissard-Vasallo
- Departamento de Ciencias Biomédicas y de la Salud, Universidad Europea de Madrid, Madrid, Spain
| | | | - P Gallego Gil
- Servicio de Anestesiología y Reanimación, Hospital Universitario de Getafe, Madrid, Spain
| | - I Martín Rubio
- Servicio de Hematología, Hospital Universitario de Getafe, Madrid, Spain
| | - A Esteban
- Hospital Universitario de Getafe, CIBER de Enfermedades Respiratorias, Madrid, Spain
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Martín Moro F, Marquet Palomanes J, Delgado Trillo I, Piris Villaespesa M, López C, Herrera F, Rodríguez Martín E, Martínez Lorca A, García‐Cosío Piqueras M, Roldán Santiago E, García Marco JA, López Jiménez FJ, García Vela JA. FINDING A CONCORDANT OR DISCORDANT BONE MARROW INVOLVEMENT BY HISTOLOGY OR FLOW CYTOMETRY AT DLBCL NOS DIAGNOSIS IMPLIES A WORSE PROGNOSIS WHEREAS PET‐FDG DOES NOT. Hematol Oncol 2021. [DOI: 10.1002/hon.82_2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- F. Martín Moro
- Hospital Universitario Ramón y Cajal Hematology Department Madrid Spain
| | | | | | | | - C. López
- Hospital Universitario de Getafe Hematology Department Madrid Spain
| | - F. Herrera
- Hospital Universitario de Getafe Hematology Department Madrid Spain
| | | | - A. Martínez Lorca
- Hospital Universitario Ramón y Cajal Nuclear Medicine Department Madrid Spain
| | | | | | - J. A. García Marco
- Hospital Universitario Puerta de Hierro Hematology Department Madrid Spain
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Martín Moro F, Marquet Palomanes J, González Rodríguez A, Delgado Trillo I, López C, Herrera F, Villarrubia Espinosa J, Moreno Jiménez G, García Vela JA, López Jiménez FJ. A SINGLE BLOOD TEST IS ABLE TO CLASSIFY DLBCL PATIENTS IN THREE PROGNOSTIC CLUSTERS AT DIAGNOSIS. Hematol Oncol 2021. [DOI: 10.1002/hon.81_2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- F. Martín Moro
- Hospital Universitario Ramón y Cajal Hematology Department Madrid Spain
| | | | | | | | - C. López
- Hospital Universitario de Getafe Hematology Department Madrid Spain
| | - F. Herrera
- Hospital Universitario de Getafe Hematology Department Madrid Spain
| | | | - G. Moreno Jiménez
- Hospital Universitario Ramón y Cajal Hematology Department Madrid Spain
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Weitz I, Meyers G, Lamy T, Cahn JY, Uranga MT, García Vela JA, Sanz MA, Severino B, Kelly RJ, Hillmen P, Hill A. Cross-sectional validation study of patient-reported outcomes in patients with paroxysmal nocturnal haemoglobinuria. Intern Med J 2013; 43:298-307. [PMID: 22909078 DOI: 10.1111/j.1445-5994.2012.02924.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Accepted: 07/23/2012] [Indexed: 12/18/2022]
Abstract
BACKGROUND Paroxysmal nocturnal haemoglobinuria (PNH) is a rare, acquired, clonal haemopoietic stem cell disorder that causes chronic intravascular haemolysis, increases the risk of thrombosis and results in significant patient morbidity and mortality. The symptoms of PNH may have a major impact on patient quality of life. AIMS To assess patient fatigue and health-related quality of life in 29 patients with PNH using the Functional Assessment of Chronic Illness Therapy Fatigue subscale version 4 (FACIT-Fatigue) and the European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire-C30, version 3 (EORTC QLQ-C30). METHODS Following completion of the questionnaires, patients were interviewed to assess the validity, clarity, relevance and comprehensiveness of the assessments. RESULTS Overall, patients considered both the FACIT-Fatigue and EORTC QLQ-C30 instruments to be relevant and adequate in assessing the level of PNH-associated fatigue and other quality-of-life measures. The FACIT-Fatigue questionnaire was considered to be clear and to comprehensively cover PNH-related fatigue. The EORTC QLQ-C30 instrument was considered to be easy to understand, but of an overall lower relevance, although some differences between countries were observed. Patients suggested additional questions that could be incorporated into future EORTC QLQ-C30 versions to make it more relevant to PNH. CONCLUSIONS This study confirms the validity of the FACIT-Fatigue and the EORTC QLQ-C30 questionnaires in this patient population and their routine use should be considered in the management of patients with PNH.
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Affiliation(s)
- I Weitz
- Keck-USC School of Medicine, Los Angeles, California, USA
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García Vela JA, Delgado I, Bornstein R, Alvarez B, Auray MC, Martin I, Oña F, Gilsanz F. Comparative intracellular cytokine production by in vitro stimulated T lymphocytes from human umbilical cord blood (HUCB) and adult peripheral blood (APB). Anal Cell Pathol 2000; 20:93-8. [PMID: 11153612 PMCID: PMC4617490 DOI: 10.1155/2000/572952] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
To date over 400 HUCB transplants have been reported from different centers. It has been suggested that there is a reduced graft-versus-host-disease (GVHD) with HUCB compared to bone marrow transplantation. Since cytokine production by a cell is an indication of the cells function it is important to determinate the differences between APB and HUCB with respect to production of these soluble factors. Our aim was to analyse the intracellular cytokine production by HUCB and APB T lymphocytes with and emphasize on their possible role in GVHD. Heparinized HUCB samples from 8 normal full-term deliveries and 10 normal blood donors were stimulated 4 hours at 37 degrees C and 5% CO2 with phorbol 12-myristate 13-acetate (PMA) and lonomycin in the presence of brefeldine. Afterwards cells were stained with CD3, CD4 or CD8 in different combinations. Finally, after cell permeabilization, cells were stained with Il-2, Il-4 or IFN-gamma. Data acquisition was performed on a FACScan flow cytometer. Compared to APB, HUCB T lymphocytes produced less Il-2, Il-4 and IFN-gamma. In HUCB, Il-2, Il-4 and IFN-gamma were produced predominantly by CD4+ T cells. In APB, Il-2 and Il-4 were also produced predominantly by CD4+ cells compared with CD8+ T lymphocytes, however, IFN-gamma was produced by both CD4+ and CD8+ T cells. These results indicate that there are clear differences in the cytokine profile between T cells in APB and HUCB.
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Affiliation(s)
- J A García Vela
- Department of Hematology, Hospital Universitario de Getafe, Madrid, Spain.
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Abstract
The present study was designed to analyse the proportion of ALL patients in which the phenotypic detection of minimal residual disease (MRD) is feasible, based on the presence of aberrant phenotypes: lineage infidelity, asynchronous expression, overexpression and ectopic phenotype. For this purpose we have prospectively investigated the phenotype of blast cells from 25 patients at diagnosis using a large panel of monoclonal antibodies by multiparametric flow cytometry. The mean age was 23.3 +/- 17.3 with 10 children and 15 adults. 14 patients were classified as L1, 9 L2 and 2 L3 according to the FAB classification. 17 cases were B-lineage ALL and 8 T-ALL. 23 out of 25 cases (92%) included in this study displayed phenotypic aberrations at diagnosis (15 out of 17 cases of B-lineage ALL and all T-ALL patients). 76% of patients displayed two or more than two aberrancies. The phenotypic aberrations were lineage infidelity, found in 12 patients, asynchronous antigen expression detected in 17 patients, antigen overexpression in 4 patients and ectopic phenotype in 7 patients. In summary our results show that when a large panel of MoAbs is used for the immunophenotypical characterization of ALL, most patients display aberrant phenotypes, the coexistence of more than two aberrant antigen expressions being frequently detected. These results suggest that the use of immunological methods for the detection of MRD in ALL based on the existence of aberrant phenotypes could be of great help for the follow-up of patients in complete remission.
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Affiliation(s)
- J A García Vela
- Department of Hematology, Hospital Universitario de Getafe, Madrid, Spain.
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García Vela JA, Delgado I, Oña F. Myeloperoxidase detection by three-color flow cytometry in acute lymphoblastic leukemia. Am J Clin Pathol 1999; 112:122-4. [PMID: 10396294 DOI: 10.1093/ajcp/112.1.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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García Vela JA, Martin M, Delgado I, García Alonso L, Monteserin MC, Benito L, Somolinos N, Oña F. Acute myeloid leukemia M2 and t(8;21)(q22;q22) with an unusual phenotype: myeloperoxidase (+), CD13 (-), CD14 (-), and CD33(-). Ann Hematol 1999; 78:237-40. [PMID: 10391105 DOI: 10.1007/s002770050508] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Cases of myeloid surface antigen-negative acute myeloid leukemia (AML) are rare. We describe the morphological, cytochemical, immunologic, and cytogenetic features of two patients with AML with maturation (FAB M2) and the phenotype MPO+, CD13 (-), CD33(-), CD56(+). Cytogenetic studies demonstrated t(8;21)(q22;q22). These findings suggest an association between the lack of CD13 and CD33 in myeloperoxidase-positive AML and the presence of t(8;21).
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MESH Headings
- Adult
- Antibiotics, Antineoplastic/therapeutic use
- Antigens, CD/blood
- Antigens, Differentiation, Myelomonocytic/blood
- Antimetabolites, Antineoplastic/therapeutic use
- Bone Marrow Cells/classification
- CD13 Antigens/blood
- Cell Adhesion Molecules/blood
- Chromosomes, Human, Pair 21
- Chromosomes, Human, Pair 8
- Cytarabine/therapeutic use
- Female
- Flow Cytometry
- Humans
- Idarubicin/therapeutic use
- Immunophenotyping
- Leukemia, Myeloid, Acute/genetics
- Lipopolysaccharide Receptors/blood
- Male
- Membrane Glycoproteins/blood
- Peroxidase/blood
- Phenotype
- Sialic Acid Binding Ig-like Lectin 3
- Translocation, Genetic
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Affiliation(s)
- J A García Vela
- Department of Hematology, Hospital Universitario de Getafe, Madrid, Spain.
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García Vela JA, Pérez V, Monteserin MC, Oña F. Pure red cell aplasia associated with large granular lymphocytic leukemia: a rare association in Western countries. Haematologica 1998; 83:664-5. [PMID: 9718874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
The coexistence of large granular lymphocytic leukemia (LGLL) and pure red cell aplasia (PRCA) has been previously described, but is rare in Western countries (7% in a recent series of LGLL cases). We present the clinical features, hematological parameters and immunophenotype of two patients with PRCA associated with CD3+ LGLL.
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García Vela JA, Delgado I, García Alonso L, Monteserin MC, Benito L, Oña F, Lastra AM. Detection of minimal residual disease in B-cell chronic lymphocytic leukaemia by flow cytometry. Br J Haematol 1997; 99:464-5. [PMID: 9375774 DOI: 10.1046/j.1365-2141.1997.d01-3651.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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García Vela JA, Menor MD, Blanco L, Lastra AM. [Late post-transfusional hemolysis caused by anti-Kidd-b]. Sangre (Barc) 1992; 37:208-9. [PMID: 1440102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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García Vela JA. [Interleukin-6 and multiple myeloma]. Med Clin (Barc) 1992; 98:718. [PMID: 1602889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Gato Díez A, Gaspar Alonso-Vega G, García Vela JA, Montans Araujo J. [A multisecretory pancreatic tumor and associated hypouricemia]. Med Clin (Barc) 1992; 98:118-9. [PMID: 1313128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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