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Idarubicin in combination with cytarabine and VP-16 in the treatment of post-MDS AML patients
274 Supportive malignancies Wolfgang Klinische serologic, W:Yhr;nger A-1090
hemotherapy
in
patients
with
Abteilung Universitlit Giirtel 19-20 WIEN.
fiir Wien
Blutgruppen-
Austria
the of
In patients with malignant diseases, the concept of blood component therapy must be strictly followed in order to correct in the best possible manner the cellular and humoral deficiencies. The main difficulties observed are due to immunisations against antigens on thrombocytes (HLA class -1 and olatelet-suecific factors). The strateaies to avoid such antibodies (ieukocyte-free-red cell or platelet concentrates) and the therapy of alloimmunised patients (matching for HLA class I and for olatelet-soecific factors) are extensively d&.xssed, as well as the oossj ble immunosuonressjnn indncnd hy blood transfusions.
IDARUBICIN VP-16 IN PATIENTS
B-CELL LYMPHOMA AS POSSIBLE 0~ MIXED CRYOGLOBULINEMIA WITH HEPATITIS C VIRUS INFECTION
Mayr
The advances in chemotherapy for treatment of patients with malignancies imply a dramatic increase in the use blood components in such cases.
I.R.Miccolis,
EvoLuTro~ ASSOCIATED
R.
E.M.Poqliani,
MALIGNANT
IN COMBINATION WITH CYTAPABINE THE TREATMENT OF POST-MDS
L.Baldicchi, M.Mangiagalli
Int. Medicine Institute of Milan Haematology Dpt. H. Donisetti 106 -MONZA
and
AND AML
P.Pioltelli, G.M.Corneo
University San Gerard0
of via
Fifteen patients with a primary syndrome transformed myelodysplastic (MDS) acute non lymphoblastic leukemia (AML) into treated with intensive chemotherapy were containing Idarubicin as regimen Anthracycline. A complete response (CR) was in 10 patients (70%). In five of obtained patients only one course of these was needed to achieve CR. The chemotherapy median time to achieve CR was 32 days ( range 16-42). A partial remission “as (PR) obtained in two patients after two induction course of chemotherapy. Only one patient died during the first course of induction following ARDS complication. chemotherapy Whereas the chemotherapy regimen failed in A short interval between MDS two patients. and transformation into AML was associated with a better chance of achieving CR. Age, type of MDS, peripheral blood or karyotype, bone marrow findings had no influence on the free result of chemotherapy. The event survival for the patients who achieved CR was 15 months from CR. In the patients who achieved a CR, the actuarial survival from CR 18 months. These preliminary results was needs to be tested in a multicenter prospective study comparing Idarubicin and other anthracyclines compounds.
Mixed cryoglobulinemia (MC) is a beqn IymphoprolilcrPtlvc disc,xc charxterized by purpura, weakness. arthralgias and by c~rcul~tmg mixed (IgC-lgMl cryoglobulins. Multiple organ involvcmcnts have all, been described during the clinical course of MC; namely chronic hcpahtis, ncphropathy, peripheral neuropathy and/or systemic vasculitis. Pathogencsis of MC is due to tissue deposition of clrculatinp immune complexes and complement. Recently. the assoclption bctwce~ MC and hepatitis C wuus (HCVl mnrkcrs in over 90% of ~ahmts has sucacstcd an nnportant causative rolq for this virus. This hypothcszs has been reinforced by HCV-RNA dctcction in the pcriphcrpl mononuclear blood cells (Feni ct al., Blood 1993 in press). In some c~scs, MC can cvolvc to a malignant non-Hodgkin’s B-cell lymphoma (NHLl. Here, we report 0 patients lptsl with type II (IgMkl mtxed cryoglobuhncmi~ (2 male and 6 females, mean age 58fll yrs. mean dixase duration 5.4t4.5 yrsl, who developed a NHL after a follow-up period of 4.1533.2 yrs. NHL WJS suspected by the presence of fever, diffuse lymphoadcnomegaly and/or splenomcgaly and confirmed by pathological findings. Histological NHL phenotypmg was made according to Workmg Formulation classtfication. The main data of 8 MC pts wth NHL are shown in the table.
A low-grade MLSL was found in SO% of MC pts; while MLI and MLDM were both present in 25% of cases. In 3/8 MC ‘pts, abnormally high levels of U and C4 complement frnctions were detected at the time of NHL diagnosis, while ‘in the others the typical hypocomplemcntemia persisted. Antibodies anti-HCV were detected in 86% of cttscs by ELISA and RIBA II. This data seems to confirm OUT preliminary hypothesis that HCV may trigger the lymphoprolifcration underlying MC, which in some genetically predisposed subjects can switch wel to malignant NHL.
hemotherapy
in
patients
with
Abteilung Universitlit Giirtel 19-20 WIEN.
fiir Wien
Blutgruppen-
Austria
the of
In patients with malignant diseases, the concept of blood component therapy must be strictly followed in order to correct in the best possible manner the cellular and humoral deficiencies. The main difficulties observed are due to immunisations against antigens on thrombocytes (HLA class -1 and olatelet-suecific factors). The strateaies to avoid such antibodies (ieukocyte-free-red cell or platelet concentrates) and the therapy of alloimmunised patients (matching for HLA class I and for olatelet-soecific factors) are extensively d&.xssed, as well as the oossj ble immunosuonressjnn indncnd hy blood transfusions.
IDARUBICIN VP-16 IN PATIENTS
B-CELL LYMPHOMA AS POSSIBLE 0~ MIXED CRYOGLOBULINEMIA WITH HEPATITIS C VIRUS INFECTION
Mayr
The advances in chemotherapy for treatment of patients with malignancies imply a dramatic increase in the use blood components in such cases.
I.R.Miccolis,
EvoLuTro~ ASSOCIATED
R.
E.M.Poqliani,
MALIGNANT
IN COMBINATION WITH CYTAPABINE THE TREATMENT OF POST-MDS
L.Baldicchi, M.Mangiagalli
Int. Medicine Institute of Milan Haematology Dpt. H. Donisetti 106 -MONZA
and
AND AML
P.Pioltelli, G.M.Corneo
University San Gerard0
of via
Fifteen patients with a primary syndrome transformed myelodysplastic (MDS) acute non lymphoblastic leukemia (AML) into treated with intensive chemotherapy were containing Idarubicin as regimen Anthracycline. A complete response (CR) was in 10 patients (70%). In five of obtained patients only one course of these was needed to achieve CR. The chemotherapy median time to achieve CR was 32 days ( range 16-42). A partial remission “as (PR) obtained in two patients after two induction course of chemotherapy. Only one patient died during the first course of induction following ARDS complication. chemotherapy Whereas the chemotherapy regimen failed in A short interval between MDS two patients. and transformation into AML was associated with a better chance of achieving CR. Age, type of MDS, peripheral blood or karyotype, bone marrow findings had no influence on the free result of chemotherapy. The event survival for the patients who achieved CR was 15 months from CR. In the patients who achieved a CR, the actuarial survival from CR 18 months. These preliminary results was needs to be tested in a multicenter prospective study comparing Idarubicin and other anthracyclines compounds.
Mixed cryoglobulinemia (MC) is a beqn IymphoprolilcrPtlvc disc,xc charxterized by purpura, weakness. arthralgias and by c~rcul~tmg mixed (IgC-lgMl cryoglobulins. Multiple organ involvcmcnts have all, been described during the clinical course of MC; namely chronic hcpahtis, ncphropathy, peripheral neuropathy and/or systemic vasculitis. Pathogencsis of MC is due to tissue deposition of clrculatinp immune complexes and complement. Recently. the assoclption bctwce~ MC and hepatitis C wuus (HCVl mnrkcrs in over 90% of ~ahmts has sucacstcd an nnportant causative rolq for this virus. This hypothcszs has been reinforced by HCV-RNA dctcction in the pcriphcrpl mononuclear blood cells (Feni ct al., Blood 1993 in press). In some c~scs, MC can cvolvc to a malignant non-Hodgkin’s B-cell lymphoma (NHLl. Here, we report 0 patients lptsl with type II (IgMkl mtxed cryoglobuhncmi~ (2 male and 6 females, mean age 58fll yrs. mean dixase duration 5.4t4.5 yrsl, who developed a NHL after a follow-up period of 4.1533.2 yrs. NHL WJS suspected by the presence of fever, diffuse lymphoadcnomegaly and/or splenomcgaly and confirmed by pathological findings. Histological NHL phenotypmg was made according to Workmg Formulation classtfication. The main data of 8 MC pts wth NHL are shown in the table.
A low-grade MLSL was found in SO% of MC pts; while MLI and MLDM were both present in 25% of cases. In 3/8 MC ‘pts, abnormally high levels of U and C4 complement frnctions were detected at the time of NHL diagnosis, while ‘in the others the typical hypocomplemcntemia persisted. Antibodies anti-HCV were detected in 86% of cttscs by ELISA and RIBA II. This data seems to confirm OUT preliminary hypothesis that HCV may trigger the lymphoprolifcration underlying MC, which in some genetically predisposed subjects can switch wel to malignant NHL.