Asunto(s)
Neoplasias Colorrectales/sangre , Granulocitos/fisiología , Neoplasias Renales/sangre , Monocitos/fisiología , Neutrófilos/fisiología , Antígenos CD/sangre , Quimiotaxis de Leucocito , Neoplasias Colorrectales/inmunología , Citocinas/sangre , Receptores ErbB/sangre , Granulocitos/inmunología , Humanos , Neoplasias Renales/inmunología , Monocitos/inmunología , Neutrófilos/inmunología , Fagocitosis , Receptores de Factor Estimulante de Colonias de Granulocito/sangre , Receptores de Factor Estimulante de Colonias de Granulocitos y Macrófagos/sangre , Receptores de Interleucina-1/sangre , Receptores de Interleucina-4/sangre , Receptores del Factor de Necrosis Tumoral/sangreRESUMEN
The aim of the present study was to better understand the possibility of utilizing growth factors of the myelomonocytic line in acute leukemias. The study is an examination of morphological changes and marker behavior in peripheral and bone marrow cells in AML and APL during treatment both with all-transretinoic acid (ATRA) alone and in association with chemotherapy and G-CSF. The same treatment was carried out in a patient who had been diagnosed with Vaquez's disease 15 years earlier and currently presented a bone marrow and peripheral picture of AML (80% myeloblasts) with thrombocytopenia. We observed that treatment with ATRA, alone or in association with chemotherapy, was followed by a remission of AML and especially of APL, with amelioration of the general condition of the patients. The addition of G-CSF to ATRA at the end of chemotherapy, during consequent pancytopenia, produced a rapid increase in mature peripheral granulocytes and an apparent medullary complete remission, which was more prolonged in APL than in AML; there was no increase in peripheral blasts. Discontinuation of G-CSF was followed by a relapse in the patient with AML. A patient with Vaquez's disease, in remission for 15 years and presenting a progressive increase in bone marrow and peripheral myeloblasts, did not have a positive response to the administration of ATRA; however, the association of G-CSF to ATRA was followed by a complete remission. The morphological changes observed in bone marrow and peripheral granulocytes (with changes in the main cellular markers: CD11b, CD13, CD14, CD15, CD34) seemed to express progressive modification of the single elements towards differentiation, with progressive bone marrow reduction and peripheral disappearance of blasts. The data agree with the changes observed in in vitro blasts cultured in the presence of ATRA and G-CSF.
Asunto(s)
Antineoplásicos/uso terapéutico , Crisis Blástica/tratamiento farmacológico , Células Sanguíneas/efectos de los fármacos , Médula Ósea/efectos de los fármacos , Leucemia Mieloide Aguda/tratamiento farmacológico , Leucemia Promielocítica Aguda/tratamiento farmacológico , Adulto , Anciano , Anciano de 80 o más Años , Factor Estimulante de Colonias de Granulocitos/uso terapéutico , Humanos , Persona de Mediana Edad , Policitemia Vera/tratamiento farmacológico , Tretinoina/uso terapéuticoRESUMEN
SLE is a complex systemic disease which probably has a multifactorial genesis. The basis alteration takes the form of a severe immunoregulation disorders. From an epidemiological point of view, there are no certain links with country of origin or race; knowledge of the disease's etiology is equally limited. Clinical symptoms are widely variable according to the prevalent organ or apparatus pathology. The symptomatology of SLE is in fact highly polymorphous thus making it complex and sometimes difficult to diagnose. From a prognostic point of view, over recent years the future of these patients has appeared brighter than in the past. The current therapeutic approach uses a number of measures which can be used in combination or sequentially. It is precisely this varying combination of therapies that has led to a marked prolongation of survival and long disease-free periods.