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Abrisqueta P, Loscertales J, Terol MJ, Ramírez Payer Á, Ortiz M, Pérez I, Cuellar-García C, Fernández de la Mata M, Rodríguez A, Lario A, Delgado J, Godoy A, Arguiñano Pérez JM, Berruezo MJ, Oliveira A, Hernández-Rivas JÁ, García Malo MD, Medina Á, García Martin P, Osorio S, Baltasar P, Fernández-Zarzoso M, Marco F, Vidal Manceñido MJ, Smucler Simonovich A, López Rubio M, Jarque I, Suarez A, Fernández Álvarez R, Lancharro Anchel A, Ríos E, Losada Castillo MDC, Pérez Persona E, García Muñoz R, Ramos R, Yáñez L, Bello JL, Loriente C, Acha D, Villanueva M. Real-World Characteristics and Outcome of Patients Treated With Single-Agent Ibrutinib for Chronic Lymphocytic Leukemia in Spain (IBRORS-LLC Study). Clin Lymphoma Myeloma Leuk 2021; 21:e985-e999. [PMID: 34511320 DOI: 10.1016/j.clml.2021.07.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 05/21/2021] [Revised: 07/16/2021] [Accepted: 07/19/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Ibrutinib demonstrated remarkable efficacy and favorable tolerability in patients with untreated or relapsed/refractory (R/R) chronic lymphocytic leukemia (CLL), including those with high-risk genetic alterations. The IBRORS-CLL study assessed the characteristics, clinical management and outcome of CLL patients receiving ibrutinib in routine clinical practice in Spain. PATIENTS Observational, retrospective, multicenter study in CLL patients who started single-agent ibrutinib as first-line treatment or at first or second relapse between January 2016 and January 2019. RESULTS A total of 269 patients were included (median age: 70.9 years; cardiovascular comorbidity: 55.4%, including hypertension [47.6%] and atrial fibrillation [AF] [7.1%]). Overall, 96.7% and 69% of patients underwent molecular testing for del(17p)/TP53 mutation and IGHV mutation status. High-risk genetic features included unmutated IGHV (79%) and del(17p)/TP53 mutation (first-line: 66.3%; second-line: 23.1%). Overall, 84 (31.2%) patients received ibrutinib as first-line treatment, and it was used as second- and third-line therapy in 121 (45.0%) and 64 (23.8%) patients. The median progression-free survival and overall survival were not reached irrespective of del(17p)/TP53, or unmutated IGHV. Common grade ≥3 adverse events were infections (12.2%) and bleeding (3%). Grade ≥3 AF occurred in 1.5% of patients. CONCLUSION This real-world study shows that single-agent ibrutinib is an effective therapy for CLL, regardless of age and high-risk molecular features, consistent with clinical trials. Additionally, single-agent ibrutinib was well tolerated, with a low rate of cardiovascular events. This study also emphasized a high molecular testing rate of del(17p)/TP53 mutation and IGHV mutation status in clinical practice according to guideline recommendations.
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Affiliation(s)
| | | | | | | | - Macarena Ortiz
- Hospital Regional Universitario de Málaga, Malaga, Spain
| | | | | | | | | | - Ana Lario
- Hospital Universitario Ramón y Cajal, Madrid, Spain
| | | | - Ana Godoy
- Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | | | - Ana Oliveira
- ICO L'Hospitalet, L'Hospitalet de Llobregat, Spain
| | | | | | | | | | - Santiago Osorio
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | | | - Fernando Marco
- Hospital Universitario de Basurto, Bilbo, Bizkaia, Spain
| | | | | | | | | | - Alexia Suarez
- Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas, Spain
| | | | | | - Eduardo Ríos
- Hospital Universitario Virgen de Valme, Sevilla, Spain
| | | | | | | | - Rafael Ramos
- Hospital Universitario de Badajoz, Badajoz, Spain
| | - Lucrecia Yáñez
- Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - José Luis Bello
- Hospital Clínico Universitario de Santiago-CHUS, Santiago de Compostela, A Coruña, Spain
| | | | - Daniel Acha
- Medical Department-Hematology Janssen-Cilag, S.A., Madrid, Spain
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Salar A, Domingo-Domenech E, Panizo C, Nicolás C, Bargay J, Muntañola A, Canales M, Bello JL, Sancho JM, Tomás JF, Rodríguez MJ, Peñalver FJ, Grande C, Sánchez-Blanco JJ, Palomera L, Arranz R, Conde E, García M, García JF, Caballero D, Montalbán C. First-line response-adapted treatment with the combination of bendamustine and rituximab in patients with mucosa-associated lymphoid tissue lymphoma (MALT2008-01): a multicentre, single-arm, phase 2 trial. The Lancet Haematology 2014; 1:e104-11. [DOI: 10.1016/s2352-3026(14)00021-0] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Accepted: 10/27/2014] [Indexed: 12/14/2022]
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3
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Pardal E, Coronado M, Martín A, Grande C, Marín-Niebla A, Panizo C, Bello JL, Conde E, Hernández MT, Arranz R, Bargay J, González-Barca E, Pérez-Ceballos E, Montes-Moreno S, Caballero MD. Intensification treatment based on early FDG-PET in patients with high-risk diffuse large B-cell lymphoma: a phase II GELTAMO trial. Br J Haematol 2014; 167:327-36. [DOI: 10.1111/bjh.13036] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Accepted: 05/29/2014] [Indexed: 12/26/2022]
Affiliation(s)
- Emilia Pardal
- Department of Haematology; Hospital Virgen del Puerto; Plasencia Spain
| | - Mónica Coronado
- Department of Nuclear Medicine; Hospital Universitario La Paz; Madrid Spain
| | - Alejandro Martín
- Department of Haematology; Hospital Universitario de Salamanca-IBSAL; Salamanca Spain
| | - Carlos Grande
- Department of Haematology; Hospital Universitario 12 de Octubre; Madrid Spain
| | - Ana Marín-Niebla
- Department of Haematology; Hospital Universitario Virgen del Rocío; IBIS/CSIC/Universidad de Sevilla; Sevilla Spain
| | - Carlos Panizo
- Department of Haematology; Clínica Universitaria de Navarra; Pamplona Spain
| | - José Luis Bello
- Department of Haematology; Complejo Hospitalario Universitario de Santiago; Universidad de Santiago de Compostela; Santiago de Compostela Spain
| | - Eulogio Conde
- Department of Haematology; Hospital Marqués de Valdecilla; Universidad de Cantabria; Santander Spain
| | - Miguel T. Hernández
- Department of Haematology; Hospital Universitario de Canarias; Santa Cruz de Tenerife Spain
| | - Reyes Arranz
- Department of Haematology; Hospital de La Princesa; Madrid Spain
| | - Joan Bargay
- Department of Haematology; Hospital Son Llàtzer; Palma de Mallorca Spain
| | - Eva González-Barca
- Department of Haematology; Institut Catalá d‘Oncologia; Hospital Duran i Reynals; L'Hospitalet de LLobregat Spain
| | - Elena Pérez-Ceballos
- Department of Haematology; Hospital General Universitario Morales Meseguer; Murcia Spain
| | - Santiago Montes-Moreno
- Department of Pathology; Hospital Universitario Marqués de Valdecilla; IFIMAV; Santander Spain
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Mateos MV, Martín ML, Gonzalez Y, Lahuerta JJ, Bladé J, Oriol A, Martinez J, Cibeira MT, de Paz R, Terol MJ, Garcia J, Bengoechea E, Martinez R, Martin A, de Arriba F, Palomera L, Hernandez JM, Bello JL, Miguel JS. A154 Bortezomib (Velcade)/Melphalan/Prednisone (VMP) Versus Velcade/Thalidomide/Prednisone (VTP) in Elderly. ACTA ACUST UNITED AC 2009. [DOI: 10.1016/s1557-9190(11)70481-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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5
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Gutiérrez NC, Castellanos MV, Martín ML, Mateos MV, Hernández JM, Fernández M, Carrera D, Rosiñol L, Ribera JM, Ojanguren JM, Palomera L, Gardella S, Escoda L, Hernández-Boluda JC, Bello JL, de la Rubia J, Lahuerta JJ, San Miguel JF. Prognostic and biological implications of genetic abnormalities in multiple myeloma undergoing autologous stem cell transplantation: t(4;14) is the most relevant adverse prognostic factor, whereas RB deletion as a unique abnormality is not associated with adverse prognosis. Leukemia 2006; 21:143-50. [PMID: 17024116 DOI: 10.1038/sj.leu.2404413] [Citation(s) in RCA: 146] [Impact Index Per Article: 8.1] [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: 11/09/2022]
Abstract
Fluorescence in situ hybridization (FISH) has become a powerful technique for prognostic assessment in multiple myeloma (MM). However, the existence of associations between cytogenetic abnormalities compels us to re-assess the value of each abnormality. A total of 260 patients with MM at the time of diagnosis, enrolled in the GEM-2000 Spanish transplant protocol, have been analyzed by FISH in order to ascertain the independent influence on myeloma prognosis of IGH translocations, as well as RB and P53 deletions. Survival analyses showed that patients with t(4;14), RB or P53 deletions had a significantly shorter survival than patients without these abnormalities. However, patients with RB deletions without other abnormalities in FISH analysis, displayed a similar outcome to those patients without genetic changes by FISH (46 vs 54 months, P=0.3). In the multivariate analysis the presence of t(4;14), RB deletion associated with other abnormalities, age >60 years, high proportion of S-phase cells and advanced stage of the disease according to the International Staging System retained their independent prognostic influence. In summary, RB deletion as a sole abnormality does not lead to a shortening in the survival of MM patients, whereas t(4;14) confers the worst prognosis in MM patients treated with high-dose chemotherapy.
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Affiliation(s)
- N C Gutiérrez
- Servicios de Hematología: Hospital Universitario de Salamanca and Centro de Investigación del Cáncer (CIC), Universidad de Salamanca-CSIC, Spain
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Abdulkader I, Fraga M, González-Quintela A, Caparrini A, Bello JL, Galbán C, Varo E, Diaz-Mediavilla J, Forteza J. Prolonged survival after liver transplantation for Hodgkin's disease-induced fulminant liver failure. Hepatogastroenterology 2005; 52:217-9. [PMID: 15783034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
A 30-year-old male with a past history of nodular lymphocyte predominance Hodgkin's disease in apparent complete remission for two years received a liver transplantation because of fulminant liver failure. Histopathological examination of the explanted liver showed massive infiltration by Hodgkin's disease. In spite of a nodal recurrence of Hodgkin's disease, the patient is alive and in excellent general condition six years after liver transplantation.
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Affiliation(s)
- I Abdulkader
- Department of Pathology, Hospital Clinico Universitario, Santiago de Compostela, Spain
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7
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San Miguel JF, Lahuerta JJ, García-Sanz R, Alegre A, Bladé J, Martinez R, García-Laraña J, De La Rubia J, Sureda A, Vidal MJ, Escudero A, Pérez-Esquiza E, Conde E, García-Ruiz JC, Cabrera R, Caballero D, Moraleda JM, Leon A, Besalduch J, Hernandez MT, Rifon J, Hernandez F, Solano C, Palomera L, Parody R, Gonzalez JD, Mataix R, Maldonado J, Constela J, Carrera D, Bello JL, De Pablos JM, Pérez-Simón JA, Torres JP, Olanguren J, Prieto E, Acebede G, Peñarrubia MJ, Torres P, Díez-Martín JL, Rivas A, Sánchez JM, Díaz-Mediavilla J. Are myeloma patients with renal failure candidates for autologous stem cell transplantation? Hematol J 2002; 1:28-36. [PMID: 11920166 DOI: 10.1038/sj.thj.6200003] [Citation(s) in RCA: 91] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/1999] [Accepted: 09/17/1999] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Renal function is one of the most important prognostic factors in multiple myeloma (MM). Patients with renal failure are generally excluded from high dose therapy even though they display a poor prognosis with conventional chemotherapy schemes. The aim of this study was to analyze the outcome of MM patients with renal insufficiency undergoing autologous stem cell transplantation (ASCT), including the evaluation of the quality of PB stem cell collections, kinetics of engraftment, transplant-related mortality, response to high dose chemotherapy and survival. MATERIALS AND METHODS From a total of 566 valuable patients included in the MM Spanish ASCT registry, three groups of patients were defined: group BA, patients with abnormal renal function at diagnosis but normal at transplant (73 cases); group BB, patients with abnormal function both at diagnosis and at transplant (14 cases); and group AA (control group, 479 cases), patients who constantly had normal renal function. RESULTS AND CONCLUSION Patients from groups BA and BB presented with a significantly higher number of adverse prognostic factors, reflecting that we were dealing with high tumor MM cases, as compared with patients from group AA. The number of mononuclear cells, CD34+ cells and CFU-GM cells collected in patients with non-reversible renal insufficiency was similar to those harvested in MM patients with normal renal function. Moreover, neutrophil and platelet engraftments were identical in patients with and without renal failure (days +11 and +12, respectively). By contrast, transplant-related mortality (TRM) was significantly higher in group BB patients (29%) than in groups BA (4.1%) and AA (3.3%). In multivariate analysis only three variables showed independent influence on TRM: poor performance status (ECOG 3), hemoglobin <9.5 g/dl and serum creatinine > or =5 mg/dl. The response to high dose therapy was independent of renal function. Interestingly, 43% of patients from group BB showed an improvement in renal function (creatinine < 2 mg/dl) after transplant. The three-year overall survival from transplantation was 56, 49 and 61% for the BB, BA and AA groups, respectively, with a statistically significant difference favoring group AA (P<0.01). PFS did not differ significantly between the three groups of patients. In multivariate analysis the only unfavorable independent prognostic factors for overall survival were poor performance status either at diagnosis or at transplant, high beta(2)-microglobulin levels, and no response to transplant. According to these results, ASCT is an attractive alternative for MM patients with renal insufficiency, and it should not constitute a criterion for exclusion from transplant unless patients display poor performance status and very high creatinine levels (>5 mg/dl).
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Affiliation(s)
- J F San Miguel
- Spanish Registry for Transplant in Multiple Myeloma, Grupo Español de Trasplante Hematopoyético (GETH), Spain.
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Quintás-Cardama A, Calviño J, Bello JL. The cadaveric option. Ann Intern Med 2000; 132:1007. [PMID: 10858164 DOI: 10.7326/0003-4819-132-12-200006200-00027] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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9
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Pérez-Encinas M, Quintas A, Bendaña A, Rabuñal MJ, Bello JL. Correlation and prognostic value of serum soluble ICAM-1, beta-2 microglobulin, and IL-2alphaR levels in non-Hodgkin's lymphoma. Leuk Lymphoma 1999; 33:551-8. [PMID: 10342582 DOI: 10.3109/10428199909058459] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [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: 11/13/2022]
Abstract
Serum levels of sICAM-1, sIL-2alphaR, and beta-2 microglobulin were measured in 63 patients with non-Hodgkin's lymphoma (NHL). The correlation between these serum markers as well as their relationship with NHL features and disease outcome were analyzed. Although in high-grade NHL sICAM-1 levels correlated with tumor mass, no correlation was found between sICAM-1 levels and tumor burden in low-grade NHL. When compared with sICAM-1 and beta-2 microglobulin, sIL-2alphaR showed the strongest correlation with the tumor burden. However, in multivariate analysis, including serum markers employed as continuous variables, the only parameteres which entered the regression model were beta-2 microglobulin (p=0.012) and sICAM-1 (p=0.019). In a dichotomized model, beta-2 microglobulin, aggressive histology, sICAM-1, age and number of nodal involved sites were found to be prognostically significant. Finally, by combining sICAM-1 and beta-2 microglobulin serum levels, a simple prognostic model useful for NHL was obtained.
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Affiliation(s)
- M Pérez-Encinas
- Division of Hematology, Hospital General de Galicia, University of Santiago de Compostela, Spain
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Quintás-Cardama A, Pérez-Encinas M, Gonzalez S, Bendaña A, Bello JL. Hydroxyurea-induced acute interstitial pneumonitis in a patient with essential thrombocythemia. Ann Hematol 1999; 78:187-8. [PMID: 10348150 DOI: 10.1007/s002770050498] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [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: 10/28/2022]
Abstract
Hydroxyurea is a drug widely used to control myeloproliferative disorders, due in part to its relative lack of severe side effects. We present a case of acute interstitial pneumonitis in a patient who was treated with hydroxyurea for essential thrombocythemia. The clinical course suggests that the interstitial pneumonitis was induced by hydroxyurea. This is the first case of hydroxyurea-induced acute interstitial pneumonitis reported in the literature.
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Affiliation(s)
- A Quintás-Cardama
- Department of Hematology, Hospital Xeral de Galicia, Complexo Hospitalario Universitario de Santiago de Compostela, La Coruña, Spain
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11
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Aguado MJ, Hernandez-Navarro F, Bello JL, Ojeda E, de Bustos JG, Arrieta R. Autotransplantation in chronic myeloid leukemia. Bone Marrow Transplant 1998; 22:831. [PMID: 9827987 DOI: 10.1038/sj.bmt.1701421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Pérez-Encinas M, Villamayor M, Campos A, González S, Bello JL. Tumor burden and serum level of soluble CD25, CD8, CD23, CD54 and CD44 in non-Hodgkin's lymphoma. Haematologica 1998; 83:752-4. [PMID: 9793264] [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: 02/09/2023] Open
Abstract
We studied the value of soluble CD25, CD8, CD23, CD54 and CD44 serum levels as tumor burden markers in lymphoma. Soluble CD25 compared with the others sCD and the usual serum factors (albumin, lactate dehydrogenase, beta 2-microglobulin, uric acid and C-reactive protein), showed the strongest correlation with the Ann Arbor stage and the number of affected localizations. sCD25 level is the most sensitive serum marker for tumor burden in lymphoma.
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Pérez Encinas M, Bello JL, Bendaña A, Rabuñal MJ, González S, Abuín I, Noya M, Cadarso C. [Detection of soluble interleukin-2 receptor in the serum of patients with non-Hodgkin's lymphoma]. Med Clin (Barc) 1998; 111:161-7. [PMID: 9732831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Patients with non-Hodgkin's lymphoma (NHL) have increased serum levels of soluble interleukin-2 receptor (sCD25). In this study the authors investigate: a) the value of sCD25, compared to other serum markers, as tumor marker, and b) the relationship of the sCD25 with the response to therapy and prognosis. PATIENTS AND METHODS Serum interleukin-2 receptor (sCD25) levels were measured at diagnosis in 63 patients with NHL (low-grade lymphoma 30 and high-grade lymphoma 33). RESULTS High levels of sCD25 were found in these patients compared to a control group (median 1,757 U/ml vs 385 U/ml; p < 0.0001). Significant differences were also found between the high-grade group and the low-grade group, as a whole and within the same Ann Arbor stage. sCD25 showed a correlation coefficient higher than other serum parameters (albumin, LDH, beta 2-microglobulin, uric acid, C-reactive protein) with Ann Arbor stage and with the number of involved lymph nodes or extralymphatic organs. In the high-grade NHL, the median of sCD25 (3,000 U/ml) separates patients with differences in the overall survival (p = 0.0138) and in percentage of complete remisions (p = 0.0079). All the patients with sCD25 < or = 3,000 U/ml reached the remision. The association sCD25 > 3,000 U/ml and albumin < 3.5 g/dl selected to 5 out of 6 patients who failed induction chemotherapy, and only 2 out of 22 who reached the remision. CONCLUSIONS The sCD25 is the best serum factor for estimating tumor burden in NHL. sCD25 level isolates or associated with albumin provides prognostic information.
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Affiliation(s)
- M Pérez Encinas
- Servicio de Hematología y Hemoterapia, Hospital General de Galicia, Santiago de Compostela
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Richard C, Romón I, Perez-Encinas M, Baro J, Rabuñal MJ, Mazorra F, Garcia de Polavieja M, Briz M, Ortin M, Iriondo A, Hermida G, Conde E, Bello JL, Zubizarreta A. Splenectomy for poor graft function after allogeneic bone marrow transplantation in patients with chronic myeloid leukemia. Leukemia 1996; 10:1615-8. [PMID: 8847896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
We report four patients with chronic myeloid leukemia (CML) that showed poor graft function after a non-T-depleted bone marrow transplantation (BMT) from an HLA-compatible sibling donor and who were successfully treated with splenectomy. Conditioning was done with cyclophosphamide (CY) and total body irradiation (TBI) without additional splenic irradiation. Three patients had enlarged spleens before BMT. The nucleated cell dose infused ranged from 2.3-3.2 x 10(8)/kg. Bone marrow (BM) examination prior to splenectomy showed BM aplasia (three cases) or hypocellularity (one case). At splenectomy no patient had evidence of cytomegalovirus (CMV) infection or severe acute GVHD; and three patients had moderately enlarged spleens. All patients were transfusion dependent. Complete hematological recovery was obtained in all patients. BM cellularity was normal 1 month after splenectomy. Complete chimerism of donor origin was documented. The four patients are alive (+16 to +58 months after BMT). Thus, in patients with CML, a poor graft function may be successfully corrected by splenectomy.
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Affiliation(s)
- C Richard
- Department of Hematology, Marqués de Valdecillá University Hospital, Santander, Spain
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Abstract
Familial chronic myeloproliferative syndrome (CMS) was observed in five members from two different generations of the same kindred. Diagnosis included agnogenic myeloid metaplasia (case 1), polycythemia vera (case 2), and essential thrombocythemia (cases 3-5). Cases 1-3 were siblings, case 5 was the daughter of case 1, and case 4 was the cousin of cases 1, 3. Age at diagnosis ranged from 28 to 75 years, cases 1 and 3 were male, and the others were female. The diagnosis was made after an episode of cerebral thrombosis in one patient, during a study for headache and dizziness in another, and fortuitously in the three remainders. All patients had splenomegaly and varying degrees of thrombocytosis. The cytogenetic exam was normal in all four cases. A woman patient was treated with interferon during a pregnancy. Fetal growth was retarded, and the newborn showed bone and genital malformations. No environmental leukemogen factor was found. This familial case strengthens Dameshek's theory of a common pathogenesis of CMS and suggests a genetic and hereditary etiology.
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Affiliation(s)
- M Pérez-Encinas
- Services of Hematology-Hemotherapy, Hospital General de Galicia, Santiago de Compostela, Spain
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Manso F, Bello JL, Feliu J, García de Bustos J, Losada G, Quevedo E. [Plasma cell leukemia: our experience in 4 cases]. Rev Clin Esp 1991; 189:328-30. [PMID: 1767090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Clinical findings and response to treatment in four cases with plasma cell leukemia (PCL) out of 152 patients of multiple myeloma diagnosed at the Hospital La Paz from 1969 to 1988 are studied. Three of the four plasma cell leukemia cases presented a primary form, and one a secondary form. Our cases had a lower incidence of lymphadenopathy and splenomegaly than reported in previous series. The incidence of serum M band in PCL was similar to that found in multiple myeloma. The four patients received combination chemotherapy; one of them attained PR lasting for 2 months, and the remaining three failed to respond to similar therapy. The mean duration of survival was less than 8 months. Current treatments are reviewed.
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Affiliation(s)
- F Manso
- Servicio de Hematología, Hospital La Paz, Madrid
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Bello JL, Burgaleta C, Magallon M, Herruzo R, Villar JM. Hematological abnormalities in hemophilic patients with human immunodeficiency virus infection. Am J Hematol 1990; 33:230-3. [PMID: 2316506 DOI: 10.1002/ajh.2830330403] [Citation(s) in RCA: 13] [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: 12/31/2022]
Abstract
Hematological abnormalities are common in patients with AIDS or AIDS-related complex. We studied cytological characteristics in peripheral blood and bone marrow samples of 33 hemophilic patients with HIV Infection and in six HIV negatives. The HIV-positive patients presented leukopenia (60.6%), thrombocytopenia (69.9%), and anemia (57.5%). Bone marrow showed abnormalities of maturation in one or more cell lines similar to those described in other HIV-infected groups of patients. These findings were more prominent in megakaryocytes and granulocytic series. Lymphocytosis, plasmocytosis, and increased hemophagocytosis were also common. These alterations do not appear in HIV-negative patients and seem related to a direct effect of HIV on bone marrow cells or to alterations in T-cell regulatory functions.
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Affiliation(s)
- J L Bello
- Hospital La Paz, Servicio de Hematologia, Madrid, Spain
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Magallón M, Bello JL, Herruzo R, Ortega F, Martín Villar J. [Pathogenesis of peripheral cytopenias in hemophiliac patients]. Sangre (Barc) 1989; 34:337-42. [PMID: 2515601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The frequent occurrence of peripheral cytopenias is a common clinical fact in patients with HIV-1 infection, and its pathogenetic mechanism is not clear, although several hypotheses have been proposed. Such cytopenias are frequently observed in haemophilic patients, in whom the immunologic alteration induced by continuous antigenic stimulants derived from plasma concentrate therapy has been postulated as an additional causative factor. One-hundred and forty five haemophiliacs treated with commercial antihaemophilic concentrates were studied. The patients were divided into three therapeutic groups according to the mean number of units of therapeutic factor VIII administered per Kg every year in the four years prior to the study (group I: less than 500 U; group II: between 501 and 1500 U; group III: more than 1500 U). The occurrence of cytopenias in the patients was co-ordinated with the presence or absence of HIV infection and the therapeutic group. The statistical studies showed clear correlation between peripheral cytopenias and presence of anti-HIV markers, regardless of the amount of concentrates perceived (except for the total neutrophil count).
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Fernández LE, Valiente OG, Mainardi V, Bello JL, Vélez H, Rosado A. Isolation and characterization of an antitumor active agar-type polysaccharide of Gracilaria dominguensis. Carbohydr Res 1989; 190:77-83. [PMID: 2790840 DOI: 10.1016/0008-6215(89)84148-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.1] [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: 01/02/2023]
Abstract
Cold water extraction of the red alga Gracilaria dominguensis, followed by cetyltrimethylammonium bromide fractionation, gave a highly sulfated, agar-type polysaccharide which inhibited the transplantation of Ehrlich ascites carcinoma in mice. The structure of the polysaccharide has been investigated by methylation analysis, and 1H- and 13C-n.m.r. spectroscopy, and was shown to be mainly composed of alternating (1----3)-linked beta-D-galactopyranosyl 6-sulfate and (1----4)-linked 3,6-anhydro-alpha-L-galactopyranosyl residues.
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Affiliation(s)
- L E Fernández
- Departamento de Bioquímica, Instituto Nacional de Oncología y Radiobiología, Havana, Cuba
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Quiles FJ, Bello JL, Magallón M, Martín Villar J. [Lymphomas in hemophiliac patients. Apropos of 2 cases]. Med Clin (Barc) 1987; 88:215. [PMID: 3561057] [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: 01/06/2023]
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