RESUMO
We performed a retrospective analysis on 421 adult patients who underwent unrelated cord blood transplantation (UCBT) for ALL. Median age was 32 years; 46% were in first CR (CR1), 32% in CR2 and 22% had advanced disease. Double UCBT was performed in 173 patients (41%). Myeloablative conditioning (MAC) was given to 314 patients (75%). Cumulative incidence (CI) of 60-day neutrophil recovery was 78%. CI of acute and chronic GVHD was 33 and 26%, respectively. Non-relapse mortality (NRM) at 2 years was 42%. Age⩾35 years (P<0.0001), advanced disease at UCBT (P<0.0001) and use of MAC (P<0.0001) were associated with increased NRM. Relapse incidence (RI) at 2 years was 28%; use of reduced intensity conditioning (RIC) (P=0.0002) was associated with increased RI. Two-year leukemia-free survival (LFS) was 39% for patients in CR1, 31% for CR2 and 8% for advanced disease. In multivariate analysis, factors associated with decreased LFS rate were: age ⩾35 years (P=0.034), use of MAC (P=0.032) and advanced disease (P<0.0001). These results show that UCBT is a valuable option to treat high-risk adult ALL when in remission. Strategies to decrease toxicity and relapse are needed to improve final outcomes.
Assuntos
Transplante de Células-Tronco de Sangue do Cordão Umbilical/métodos , Doença Enxerto-Hospedeiro/etiologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia , Adolescente , Adulto , Idoso , Europa (Continente) , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento , Doadores não Relacionados , Adulto JovemRESUMO
La regeneración de los tejidos periodontales ha sido siempre el máximo objetivo de la terapia periodontal. El principio de la regeneración tisular guiada (RTG) se basa en colocar una barrera en íntimo contacto con el diente para que el efecto periodontal sea colonizado únicamente por células del ligamento periodontal, produciendose la regeneración de nuevo cemento radicular, ligamento periodontal y hueso alveolar. El primer material barrera usado ampliamente para RTG fue la membrana no reabsorbible de politetrafluorureotileno expandido. Se ha demostrado qeu este material ha disminuido mucho en los ultimos años debido a la aparición de nuevos biomateriales más sencillos de usar y que presentan un riesgo menor de complicaciones. En esta revisión de literatura, proponemos una serie de situaciones en las cuales consideramos que a pesar de las dificultades y desventajas de su uso, debido a la severidad del defecto, su empleo está indicado.
Regeneration of periodontal tissues has always been the ultimate goal of periodontal therapy. The principle of guided tissue regeneracióon (RTG) is to place a barrier in intimate contact with the tooth for periodontal effect is colonized only by periodontal ligament cells, resulting in the regeneration of new cementum, periodontal ligament and alveolar bone. The first widely used barrier material for RTG was non-absorbable membrane politetrafluorureotileno expanded. It has been shown qeu this material has decreased greatly in recent years due to the emergence of new biomaterials easier to use and have a lower risk of complications. In this literature review, propose a number of situations where we believe that despite the difficulties and disadvantages of its use, due to the severity of the defect, its use is indicated.
Assuntos
Masculino , Feminino , Humanos , Doenças Periodontais , Regeneração Tecidual Guiada Periodontal , Regeneração Tecidual Guiada Periodontal/métodos , Regeneração ÓsseaRESUMO
Wegener's granulomatosis may appear with the classic granulomatous necrotizing vasculitis affecting both high and low airway and renal glomerule, and rarely small vessels in any other location. In this way we may find generalized and localized forms of the disease. Three atypical cases of the disease are reported. The first one as a limited form with only airway affection. The second one as an unusual case of otitis with progressive affection of I, II, V, VI, VII and VIII cranial nerves. The third one was a generalized case with sinusitis and orbital pseudotumor. Both first and second cases have been controlled for a very long period of time of 22 and 14 years respectively, and none of them has presented any other location of the disease.