RESUMEN
Osteonecrosis is usually considered to be a minor and rare late sequelae of treatment for Hodgkin's Disease (HD). However, over ten years six patients out of a total of 53 patients treated for HD at the haematology department of a district general hospital developed osteonecrosis, an incidence of 11.3%. Routine isotope bone scanning of patients produced two further asymptomatic cases. These results suggest a higher incidence than previously suspected of a problem which caused our patients considerable morbidity. Further measures are required to identify and adequately treat a significant cause of late morbidity following chemotherapy for HD.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Enfermedad de Hodgkin/tratamiento farmacológico , Osteonecrosis/inducido químicamente , Adolescente , Adulto , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Osteonecrosis/epidemiología , Estudios RetrospectivosRESUMEN
Ninety-eight adult patients with acute myeloid leukemia were given variable remission induction/consolidation regimens containing idarubicin. Sixty-nine (70%) were new cases (median age, 56 years) and 29 (30%) were in relapse (n = 24) or had primary refractory disease (n = 5) (median age, 46 years). Complete remission (CR) rates were 57% (39 of 69 patients) of the newly diagnosed patients, with no difference for those below or above 55 years of age (56% v 59%) or for patients exhibiting white blood cell counts of less or more than 50 x 10(9)/L (52% v 69%; P = .8). Of the 39 patients who achieved CR, 26 (67%, 38% of the total number of patients) remain in CR with a median follow-up of 3 months (range, 0 to 61 months). Forty-two percent of the relapsed cases (10 of 24 patients) and 60% of the primary refractory disease cases (three of five patients) achieved CR. Of these 13 responders, six are alive (three continuing in CR and three relapsed) with a median follow-up of 3 months (range, 1 to 20 months), and seven have died with a median survival of 7 months (range, 0 to 12 months). Of the 52 patients who have achieved CR, 84% did so with one course of treatment and 16% with two courses. The presence of normal cytogenetic analysis or favorable chromosomal aberrations significantly improved overall CR rates. The patients in this study had significantly more unfavorable cytogenetic abnormalities than the historic controls. Reported toxicity was hepatic in 13%, cardiac in 9%, and renal in 7% of all cases. These data suggest a comparable efficacy of idarubicin to other anthracyclines in remission induction of acute myeloid leukemia, with a promising role in relapsed/refractory disease.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Idarrubicina/administración & dosificación , Leucemia Mieloide/tratamiento farmacológico , Enfermedad Aguda , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Femenino , Humanos , Idarrubicina/efectos adversos , Cariotipificación , Leucemia Mieloide/genética , Masculino , Persona de Mediana Edad , Inducción de Remisión , Análisis de SupervivenciaRESUMEN
We report a rare association of Von Willebrands disease and idiopathic immune thrombocytopenia in pregnancy. The major threat to the successful outcome of the pregnancy was posed by the acquired disorder. The use of high dose immunoglobulin allowed a normal delivery, without any adverse effects on mother or child.
Asunto(s)
Inmunización Pasiva , Complicaciones Hematológicas del Embarazo/inmunología , Trombocitopenia/complicaciones , Enfermedades de von Willebrand/complicaciones , Adulto , Femenino , Humanos , Inmunoglobulina G/administración & dosificación , Infusiones Intravenosas , Embarazo , Trombocitopenia/inmunología , Enfermedades de von Willebrand/inmunologíaRESUMEN
An amidolytic assay of factor X based on the new chromogenic peptide substrate S 2337 (Kabi Diagnostica) was adapted for use with the Kem-o-Mat (Coulter Electronics) automated substrate analyser. Factor X was assayed in 25 healthy controls and in 375 patients on Warfarin therapy. The results in the control group correlated well with a one stage coagulation factor X assay. A good correlation was also found when the S 2337 factor X assay was compared with Thrombotest (Nyegaard & Co.) results in the patients. From the regression line of the S 2337 factor X assay on the Thrombotest results, the comparable range for factor X amidolytic activity in well controlled anticoagulated patients was found to be 22.5-37.5% with this method. Concordant classification of patients by both tests according to proposed therapeutic ranges demonstrated fully concordant information in 76% and fully discordant information in none. This study demonstrates that chromogenic substrate assays for anticoagulant control can be readily automated. Amidolytic assays of factor X based on the S 2337 substrate, therefore, warrant further clinical investigation as a potential method for controlling maintenance oral anticoagulant therapy.
Asunto(s)
Anticoagulantes/administración & dosificación , Factor X/análisis , Adulto , Anciano , Autoanálisis , Pruebas de Coagulación Sanguínea , Compuestos Cromogénicos , Humanos , Persona de Mediana Edad , Warfarina/administración & dosificaciónRESUMEN
An amidolytic assay employing the chromogenic substrate S 2337 (Kabi Diagnostica) was used to assay factor X in 35 healthy controls and in 100 outpatients receiving oral anticoagulant therapy. This method correlated well with a coagulation assay of factor X in the control group (r = 0.88). When compared with two routine tests for the control of anticoagulant theray (Thrombotest and prothrombin ratio) good correlation was obtained between the methods, r = 0.84 and r = -0.74 respectively. These results suggest that a chromogenic substrate assay for factor X might be a suitable method for the maintenance control of oral anticoagulant therapy.