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Pena-Burgos EM, De Sabando DPL, Utrilla C, Pozo-Kreilinger JJ, Sastre A, Rubio P, Escudero A, Mendiola-Sabio M, Pérez-Martínez A. First Reported Case of Malignant Ectomesenchymoma with p.Leu122Arg Mutation in MYOD1 Gene: Extensive Intra- and Extracranial Tumor in a 15-Year-Old Female. Head Neck Pathol 2023; 17:855-863. [PMID: 36913073 PMCID: PMC10514254 DOI: 10.1007/s12105-023-01542-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 02/08/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND Ectomesenchymomas (EMs) are extremely rare neoplasms composed of malignant mesenchymal components and neuroectodermal derivatives. They are described in a wide variety of locations, with the head and neck region being one of the most frequently involved areas. EMs are usually managed as high-risk rhabdomyosarcomas and have similar outcomes. METHODS We present the case of a 15-year-old female with an EM that arose in the parapharyngeal space and extended into the intracranial space. RESULTS Histologically, the tumor presented an embryonal rhabdomyosarcomatous mesenchymal component and the neuroectodermal component was constituted by isolated ganglion cells. Next-generation sequencing (NGS) revealed a p.Leu122Arg (c.365 T > G) mutation in the MYOD1 gene, a p.Ala34Gly mutation in the CDKN2A gene, and CDK4 gene amplification. The patient was treated with chemotherapy. She died 17 months after the debut of symptoms. CONCLUSION(S) To our knowledge, this is the first reported case in English literature of an EM with this MYOD1 mutation. We suggest combining PI3K/ATK pathway inhibitors in these cases. NGS should be performed in EMs cases to detect mutations with potential treatment options.
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Affiliation(s)
- E M Pena-Burgos
- Pathology Department, La Paz University Hospital, Paseo de La Castellana, 261, 28046, Madrid, Spain.
| | | | - C Utrilla
- Radiology Department, La Paz University Hospital, Madrid, Spain
| | - J J Pozo-Kreilinger
- Pathology Department, La Paz University Hospital, Paseo de La Castellana, 261, 28046, Madrid, Spain
| | - A Sastre
- Pediatric Oncology Department, La Paz University Hospital, Madrid, Spain
| | - P Rubio
- Pediatric Oncology Department, La Paz University Hospital, Madrid, Spain
| | - A Escudero
- Pediatric Oncology Department, La Paz University Hospital, Madrid, Spain
| | - M Mendiola-Sabio
- La Paz University Hospital, Molecular Pathology and Therapeutic Targets Group, Instituto de Investigación del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | - A Pérez-Martínez
- Pediatric Oncology Department, La Paz University Hospital, Madrid, Spain
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Barcia V, Monfá E, de León B, Martinez-Rosero C, Sánchez-Montero S, Barnes C, Lucas C, Sastre A, Estifan J, Prieto M. Eliminando el concepto de enfermedad renal crónica no filiada: a propósito de 2 casos de nefropatía túbulo-intersticial autosómica dominante con variante patogénica MUC-1. Nefrologia 2022. [DOI: 10.1016/j.nefro.2022.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Marco A, Guerrero RA, Turu E, Gallego C, Teixidó N, Sastre A, Caylà JA. Is it possible to eliminate hepatitis C from the prisons of Catalonia, Spain, in 2021? Rev Esp Sanid Penit 2019; 21:38-41. [PMID: 31498858 PMCID: PMC6788204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 07/17/2018] [Indexed: 10/29/2022]
Abstract
AIM Predict the elimination of chronic hepatitis C in Catalan prisons. MATERIAL AND METHOD We analyzed the trend of the prevalence of HCV-RNA and anti-hepatitis C treatments prescribed in Catalonia in the period 2002-2016. Using linear exponential smoothing from the historical values in the time series, we estimate the time required to eliminate hepatitis C as a public health problem in prisons (prevalence of hepatitis C virus RNA<1%). RESULTS A total of 1264 treatments were administered by 12/31/2016. The prevalence of hepatitis C virus RNA was 31.2% in 2002, decreasing to 8.81% in 2016. We estimate that prevalence will reach 0-0.5% in 5 years (second half 2021; 95% CI: 2019-2025). DISCUSSION Appropriate actions can eliminate hepatitis C infection in prisoners. We estimate that by 2021 hepatitis C infection will no longer be a public health problem in Catalonia prisons.
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Affiliation(s)
- A Marco
- Prison Health Programme. Catalonian Health Institute Prison Health ProgrammeCatalonian Health InstituteSpain,Centre for Biomedical Research on the Epidemiology and Public Health Network (Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP))Centre for Biomedical Research on the Epidemiology and Public Health NetworkSpain
| | - RA Guerrero
- Prison Health Programme. Catalonian Health Institute Prison Health ProgrammeCatalonian Health InstituteSpain
| | - E Turu
- Prison Health Programme. Catalonian Health Institute Prison Health ProgrammeCatalonian Health InstituteSpain
| | - C Gallego
- Primary Prison Healthcare Team of Roca del Vallés-1, BarcelonaPrimary Prison Healthcare Team of Roca del Vallés-1BarcelonaSpain
| | - N Teixidó
- Primary Prison Healthcare Team of Sant Esteve Sesrovires-1, BarcelonaPrimary Prison Healthcare Team of Sant Esteve Sesrovires-1BarcelonaSpain
| | - A Sastre
- Primary Prison Healthcare Team of Sant Esteve Sesrovires-2, BarcelonaPrimary Prison Healthcare Team of Sant Esteve Sesrovires-2BarcelonaSpain
| | - JA Caylà
- Centre for Biomedical Research on the Epidemiology and Public Health Network (Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP))Centre for Biomedical Research on the Epidemiology and Public Health NetworkSpain,Epidemiology Service. Public Health Agency of BarcelonaEpidemiology ServicePublic Health Agency of BarcelonaSpain
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Marco A, Guerrero RA, Turu E, Gallego C, Teixidó N, Sastre A, Caylà JA. Is it possible to eliminate hepatitis C from the prisons of Catalonia, Spain, in 2021? Rev esp sanid penit 2019. [DOI: 10.4321/s1575-06202019000100006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Guterrez-Camino A, Martin-Guerrero I, Garcia de Andoin N, Navajas A, Sastre A, Carbone Bañeres A, Astigarraga I, Garcia-Orad A. Involvement of SNPS in mir3117 and mir3689 in pediatric acute lymphoblastic leukemia susceptibility. Eur J Cancer 2017. [DOI: 10.1016/s0959-8049(17)30548-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Umerez M, Gutierrez-Camino A, Martin-Guerrero I, Garcia De Andoin N, Sastre A, Navajas A, Astigarraga I, Garcia-Orad A. SNPS in microRNAs associated with methotrexate plasma levels in Spanish children with acute lymphoblastic leukemia. Eur J Cancer 2017. [DOI: 10.1016/s0959-8049(17)30546-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Fodor Z, Hoelbling C, Krieg S, Lellouch L, Lippert T, Portelli A, Sastre A, Szabo KK, Varnhorst L. Up and Down Quark Masses and Corrections to Dashen's Theorem from Lattice QCD and Quenched QED. Phys Rev Lett 2016; 117:082001. [PMID: 27588847 DOI: 10.1103/physrevlett.117.082001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Indexed: 06/06/2023]
Abstract
In a previous Letter [Borsanyi et al., Phys. Rev. Lett. 111, 252001 (2013)] we determined the isospin mass splittings of the baryon octet from a lattice calculation based on N_{f}=2+1 QCD simulations to which QED effects have been added in a partially quenched setup. Using the same data we determine here the corrections to Dashen's theorem and the individual up and down quark masses. Our ensembles include 5 lattice spacings down to 0.054 fm, lattice sizes up to 6 fm, and average up-down quark masses all the way down to their physical value. For the parameter which quantifies violations to Dashen's theorem, we obtain ϵ=0.73(2)(5)(17), where the first error is statistical, the second is systematic, and the third is an estimate of the QED quenching error. For the light quark masses we obtain, m_{u}=2.27(6)(5)(4) and m_{d}=4.67(6)(5)(4) MeV in the modified minimal subtraction scheme at 2 GeV and the isospin breaking ratios m_{u}/m_{d}=0.485(11)(8)(14), R=38.2(1.1)(0.8)(1.4), and Q=23.4(0.4)(0.3)(0.4). Our results exclude the m_{u}=0 solution to the strong CP problem by more than 24 standard deviations.
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Affiliation(s)
- Z Fodor
- Department of Physics, Wuppertal University, Gaussstr. 20, D-42119 Wuppertal, Germany
- Institute for Theoretical Physics, Eötvös University, Pázmány P. sét. 1/A, H-1117 Budapest, Hungary
- IAS/JSC, Forschungszentrum Jülich, D-52425 Jülich, Germany
| | - C Hoelbling
- Department of Physics, Wuppertal University, Gaussstr. 20, D-42119 Wuppertal, Germany
| | - S Krieg
- Department of Physics, Wuppertal University, Gaussstr. 20, D-42119 Wuppertal, Germany
- IAS/JSC, Forschungszentrum Jülich, D-52425 Jülich, Germany
| | - L Lellouch
- CNRS, Aix-Marseille U., U. de Toulon, Centre de Physique Théorique, UMR 7332, F-13288 Marseille, France
| | - Th Lippert
- IAS/JSC, Forschungszentrum Jülich, D-52425 Jülich, Germany
| | - A Portelli
- CNRS, Aix-Marseille U., U. de Toulon, Centre de Physique Théorique, UMR 7332, F-13288 Marseille, France
- School of Physics & Astronomy, University of Southampton, SO17 1BJ Southampton, United Kingdom
- School of Physics & Astronomy, The University of Edinburgh, EH9 3FD Edinburgh, United Kingdom
| | - A Sastre
- Department of Physics, Wuppertal University, Gaussstr. 20, D-42119 Wuppertal, Germany
- CNRS, Aix-Marseille U., U. de Toulon, Centre de Physique Théorique, UMR 7332, F-13288 Marseille, France
| | - K K Szabo
- Department of Physics, Wuppertal University, Gaussstr. 20, D-42119 Wuppertal, Germany
- IAS/JSC, Forschungszentrum Jülich, D-52425 Jülich, Germany
| | - L Varnhorst
- Department of Physics, Wuppertal University, Gaussstr. 20, D-42119 Wuppertal, Germany
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Iparraguirre L, Umerez M, Gutierrez-Camino A, Martín-Guerrero I, de Andoin NG, Sastre A, Navajas A, Astigarraga I, García-Orad A. MicroRNA SNPs as novel markers of methotrexate toxicity in pediatric acute lymphoblastic leukemia. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)61499-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Ruiz-Pinto S, Pita G, Patiño-García A, García-Miguel P, Alonso J, Pérez-Martínez A, Sastre A, Gómez-Mariano G, Lissat A, Scotlandi K, Serra M, Ladenstein R, Lapouble E, Pierron G, Kontny U, Picci P, Kovar H, Delattre O, González-Neira A. Identification of genetic variants in pharmacokinetic genes associated with Ewing Sarcoma treatment outcome. Ann Oncol 2016; 27:1788-93. [PMID: 27287205 DOI: 10.1093/annonc/mdw234] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 05/30/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Despite the effectiveness of current treatment protocols for Ewing sarcoma (ES), many patients still experience relapse, and survival following recurrence is <15%. We aimed to identify genetic variants that predict treatment outcome in children diagnosed with ES. PATIENTS AND METHODS We carried out a pharmacogenetic study of 384 single-nucleotide polymorphisms (SNPs) in 24 key transport or metabolism genes relevant to drugs used to treat in pediatric patients (<30 years) with histologically confirmed ES. We studied the association of genotypes with tumor response and overall survival (OS) in a discovery cohort of 106 Spanish children, with replication in a second cohort of 389 pediatric patients from across Europe. RESULTS We identified associations with OS (P < 0.05) for three SNPs in the Spanish cohort that were replicated in the European cohort. The strongest association observed was with rs7190447, located in the ATP-binding cassette subfamily C member 6 (ABCC6) gene [discovery: hazard ratio (HR) = 14.30, 95% confidence interval (CI) = 1.53-134, P = 0.020; replication: HR = 9.28, 95% CI = 2.20-39.2, P = 0.0024] and its correlated SNP rs7192303, which was predicted to have a plausible regulatory function. We also replicated associations with rs4148737 in the ATP-binding cassette subfamily B member 1 (ABCB1) gene (discovery: HR = 2.96, 95% CI = 1.08-8.10, P = 0.034; replication: HR = 1.60, 95% CI = 1.05-2.44, P = 0.029), which we have previously found to be associated with poorer OS in pediatric osteosarcoma patients, and rs11188147 in cytochrome P450 family 2 subfamily C member 8 gene (CYP2C8) (discovery : HR = 2.49, 95% CI = 1.06-5.87, P = 0.037; replication: HR = 1.77, 95% CI = 1.06-2.96, P = 0.030), an enzyme involved in the oxidative metabolism of the ES chemotherapeutic agents cyclophosphamide and ifosfamide. None of the associations with tumor response were replicated. CONCLUSION Using an integrated pathway-based approach, we identified polymorphisms in ABCC6, ABCB1 and CYP2C8 associated with OS. These associations were replicated in a large independent cohort, highlighting the importance of pharmacokinetic genes as prognostic markers in ES.
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Affiliation(s)
- S Ruiz-Pinto
- Human Genotyping Unit-CeGen, Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - G Pita
- Human Genotyping Unit-CeGen, Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - A Patiño-García
- Clinical Genetics Unit, University Clinic of Navarra (CUN), Pamplona, Spain
| | - P García-Miguel
- Department of Pediatric Hemato-Oncology, Hospital Universitario La Paz, Madrid, Spain
| | - J Alonso
- Pediatric Solid Tumor Laboratory, Human Genetic Department, Research Institute of Rare Diseases, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - A Pérez-Martínez
- Department of Pediatric Hemato-Oncology, Hospital Universitario La Paz, Madrid, Spain
| | - A Sastre
- Department of Pediatric Hemato-Oncology, Hospital Universitario La Paz, Madrid, Spain
| | - G Gómez-Mariano
- Pediatric Solid Tumor Laboratory, Human Genetic Department, Research Institute of Rare Diseases, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - A Lissat
- Department of Pediatrics, Division of Oncology and Hematology, Charité Universitaetsmedizin, Berlin, Germany
| | - K Scotlandi
- Experimental Oncology Laboratory, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - M Serra
- Experimental Oncology Laboratory, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - R Ladenstein
- Department of Pediatrics, Children's Cancer Research Institute, St Anna Kinderkrebsforschung e.V., Medical University, Vienna, Austria
| | - E Lapouble
- Somatic Genetics Unit, Institut Curie, Paris, France
| | - G Pierron
- Somatic Genetics Unit, Institut Curie, Paris, France
| | - U Kontny
- Division of Paediatric Haematology, Oncology and Stem Cell Transplantation, Department of Paediatrics and Adolescent Medicine, University Medical Centre, Aachen, Germany
| | - P Picci
- Experimental Oncology Laboratory, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - H Kovar
- Department of Pediatrics, Children's Cancer Research Institute, St Anna Kinderkrebsforschung e.V., Medical University, Vienna, Austria
| | - O Delattre
- Inserm U830, Centre de Recherche, Institut Curie, Paris, France
| | - A González-Neira
- Human Genotyping Unit-CeGen, Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
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Aspromonte S, Sastre A, Boix A, Cocero M, Alonso E. Optimization and modelling of the supercritical CO2 deposition of Co O nanoparticles in MCM41. J Supercrit Fluids 2016. [DOI: 10.1016/j.supflu.2015.11.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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González B, Bueno D, Rubio P, San Román S, Plaza D, Sastre A, García-Miguel P, Fernández L, Valentín J, Martínez I, Pérez-Martínez A. An immunological approach to acute myeloid leukaemia. Anales de Pediatría (English Edition) 2016. [DOI: 10.1016/j.anpede.2015.07.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Borsanyi S, Dürr S, Fodor Z, Frison J, Hoelbling C, Katz SD, Krieg S, Kurth T, Lellouch L, Lippert T, Portelli A, Ramos A, Sastre A, Szabo K. Isospin splittings in the light-baryon octet from lattice QCD and QED. Phys Rev Lett 2013; 111:252001. [PMID: 24483739 DOI: 10.1103/physrevlett.111.252001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Indexed: 06/03/2023]
Abstract
While electromagnetic and up-down quark mass difference effects on octet baryon masses are very small, they have important consequences. The stability of the hydrogen atom against beta decay is a prominent example. Here, we include these effects by adding them to valence quarks in a lattice QCD calculation based on Nf=2+1 simulations with five lattice spacings down to 0.054 fm, lattice sizes up to 6 fm, and average up-down quark masses all the way down to their physical value. This allows us to gain control over all systematic errors, except for the one associated with neglecting electromagnetism in the sea. We compute the octet baryon isomultiplet mass splittings, as well as the individual contributions from electromagnetism and the up-down quark mass difference. Our results for the total splittings are in good agreement with experiment.
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Affiliation(s)
- Sz Borsanyi
- Department of Physics, Wuppertal University, Gaussstrasse 20, D-42119 Wuppertal, Germany
| | - S Dürr
- Department of Physics, Wuppertal University, Gaussstrasse 20, D-42119 Wuppertal, Germany and IAS/JSC, Forschungszentrum Jülich, D-52425 Jülich, Germany
| | - Z Fodor
- Department of Physics, Wuppertal University, Gaussstrasse 20, D-42119 Wuppertal, Germany and IAS/JSC, Forschungszentrum Jülich, D-52425 Jülich, Germany and Institute for Theoretical Physics, Eötvös University, Pázmány Peter sétany 1/A, H-1117 Budapest, Hungary
| | - J Frison
- Aix-Marseille Université, CNRS, CPT, UMR 7332, 13288 Marseille, France and Université de Toulon, CNRS, CPT, UMR 7332, 83957 La Garde, France
| | - C Hoelbling
- Department of Physics, Wuppertal University, Gaussstrasse 20, D-42119 Wuppertal, Germany
| | - S D Katz
- Institute for Theoretical Physics, Eötvös University, Pázmány Peter sétany 1/A, H-1117 Budapest, Hungary and MTA-ELTE Lendület Lattice Gauge Theory Research Group, H-1117 Budapest, Hungary
| | - S Krieg
- Department of Physics, Wuppertal University, Gaussstrasse 20, D-42119 Wuppertal, Germany and IAS/JSC, Forschungszentrum Jülich, D-52425 Jülich, Germany
| | - Th Kurth
- Department of Physics, Wuppertal University, Gaussstrasse 20, D-42119 Wuppertal, Germany
| | - L Lellouch
- Aix-Marseille Université, CNRS, CPT, UMR 7332, 13288 Marseille, France and Université de Toulon, CNRS, CPT, UMR 7332, 83957 La Garde, France
| | - Th Lippert
- IAS/JSC, Forschungszentrum Jülich, D-52425 Jülich, Germany
| | - A Portelli
- Aix-Marseille Université, CNRS, CPT, UMR 7332, 13288 Marseille, France and Université de Toulon, CNRS, CPT, UMR 7332, 83957 La Garde, France and School of Physics and Astronomy, University of Southampton, Southampton SO17 1BJ, United Kingdom
| | - A Ramos
- Aix-Marseille Université, CNRS, CPT, UMR 7332, 13288 Marseille, France and Université de Toulon, CNRS, CPT, UMR 7332, 83957 La Garde, France
| | - A Sastre
- Aix-Marseille Université, CNRS, CPT, UMR 7332, 13288 Marseille, France and Université de Toulon, CNRS, CPT, UMR 7332, 83957 La Garde, France
| | - K Szabo
- Department of Physics, Wuppertal University, Gaussstrasse 20, D-42119 Wuppertal, Germany
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Navajas A, Lassaletta A, Morales A, López-Ibor B, Sábado C, Moscardó C, Mateos E, Molina J, Sagaseta M, Sastre A. Efficacy and safety of liposomal cytarabine in children with primary CNS tumours with leptomeningeal involvement. Clin Transl Oncol 2012; 14:280-6. [PMID: 22484635 DOI: 10.1007/s12094-012-0796-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [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: 12/28/2022]
Abstract
PURPOSE To assess the efficacy and safety of liposomal cytarabine in the treatment of de novo and relapsed leptomeningeal involvement in children with primary CNS tumours. METHODS Data from clinical charts were entered into a database for consecutive unselected patients (n=20) from nine Spanish centres. Diagnosis of leptomeningeal involvement was confirmed by cytology, MRI and/or CT scan. The dose of liposomal cytarabine used varied from 20 to 50 mg, by age. RESULTS There were 8 females and 12 males, mean age 7.3 years (range 8 months to 18 years). The tumours were: 10 medulloblastomas, 4 ependymomas, 3 primitive neuroectodermal tumours and 3 other tumours. Fourteen had undergone previous chemotherapy and 12 radiotherapy. Nine received concurrent chemotherapy and 2 concurrent radiotherapy. Median follow-up was 244.5 days (range 12- 869). Patients received a median of 5 doses (range 1-9) of liposomal cytarabine. A neurological response (complete or partial) was seen in 11/19 (58%) and a cytological response in 7/10 (64%). Median time to neurological progression exceeded 180 days (range 12-869). Adverse effects were reported in 11/20 patients, but none was grade IV. DISCUSSION Liposomal cytarabine was well tolerated and efficacious in this patient group, but prospective randomised trials are needed.
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Affiliation(s)
- A Navajas
- Hospital de Cruces, Barakaldo, Guipúzcoa, Spain
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Rubio PM, Labrandero C, Riesco S, Plaza D, González B, Muñoz GM, Sastre A. Successful response to infliximab of recurrent pericardial graft versus host disease in a pediatric patient. Bone Marrow Transplant 2012; 48:144-5. [DOI: 10.1038/bmt.2012.91] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Gomes AM, Fontan MP, Rodriguez-Carmona A, Sastre A, Cambre HD, Muniz AL, Falcon TG. Categorization of sodium sieving by 2.27% and 3.86% peritoneal equilibration tests--a comparative analysis in the clinical setting. Nephrol Dial Transplant 2009; 24:3513-20. [DOI: 10.1093/ndt/gfp319] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Abstract
BACKGROUND/AIMS Bilateral adrenal neuroblastoma is rare and can be due to multifocal primary or contralateral metastasis. Staging is confusing in these patients and treatment guidelines are difficult to set. The present study examines the clinical, biological and therapeutic features of bilateral adrenal neuroblastoma. METHODS We identified 4 cases primarily located in both adrenals out of 148 neuroblastomas treated between 1992 and 2006. We studied the clinicopathological findings and biological features, including MYCN amplification, and analyzed the treatment strategies and results. RESULTS All patients were younger than 6 months of age and all had multiple liver metastases. Three had subcutaneous nodules and massive liver enlargement. All underwent chemotherapy prior to operation. Two babies had large bilateral tumors without preservable glands and underwent bilateral adrenalectomy. Both had MYCN gene amplification and died of widespread (brain and bone) metastases some weeks later. In the remaining two patients adrenalectomy was performed on the side of the larger tumor with tumor enucleation on the other side to preserve hormonal function followed by 2 courses of mild chemotherapy in one patient. These tumors were not amplified. Both of these children are doing well. CONCLUSIONS Bilateral adrenal neuroblastomas fit neither into stage 4 s nor into stage 4. Their clinical behavior is exceptional with a number of multicystic forms, variable MYCN amplification, widespread metastases and a high mortality. Bilateral adrenalectomy is sometimes unavoidable, but unilateral removal with contralateral enucleation, partial resection or observation are valid alternatives. Mortality is higher than in regular stage 4 s cases. This particular group of neuroblastomas required individually tailored therapeutic strategies based on the size, extent and prognostic markers.
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Affiliation(s)
- F Pederiva
- Department of Pediatric Surgery, Hospital Universitario La Paz, Paseo de la Castellana 261, Madrid, Spain
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Andres AM, Hernandez F, Lopez-Santamaría M, Gámez M, Murcia J, Leal N, López Gutierrez JC, Frauca E, Sastre A, Tovar JA. Surgery of liver tumors in children in the last 15 years. Eur J Pediatr Surg 2007; 17:387-92. [PMID: 18072021 DOI: 10.1055/s-2007-989270] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AIM Aim of the study was to review our experience in the management of liver tumors in children over the last 15 years. PATIENTS AND METHODS A cohort of 78 children with liver tumors managed in our institution between 1991 and 2006 was retrospectively reviewed. There were 45 males and 33 females with a mean age of 32 +/- 41 months at diagnosis. Most tumors were malignant (n = 57); the most frequently occurring tumor was hepatoblastoma (n = 47), followed by hepatocarcinoma (n = 5), sarcoma (n = 4), and lymphoma (n = 1). Vascular tumors (n = 12) predominated among the benign tumors followed by mesenchymal hamartoma (n = 4), focal nodular hyperplasia (n = 3), adenoma (n = 1), and inflammatory pseudotumor (n = 1). We reviewed the epidemiologic features, clinical presentation, diagnosis, treatment and outcomes. We employed MRI and angio-CT for SIOPEL PRETEXT staging and selected the management accordingly for malignant tumors. We analyzed the long-term survival using Kaplan-Meier curves. RESULTS Benign tumors had an excellent outcome with both medical or surgical management. Of the malignant tumors 4 were PRETEXT I and were treated by left lateral segmentectomy with 100 % survival; 20 were PRETEXT II (12 left and 8 right lobe) and were treated by lobectomy of the corresponding side, except for 1 case which required OLT (90 % survival); 9 children had PRETEXT III tumors requiring trisegmentectomy or extended lobectomies with OLT in 1 case (77.7 % survival). Fourteen children had PRETEXT IV tumors: 10 received OLT and 9 of them are still alive (64.2 % survival). Overall survival was 80.8 %, and actuarial survival at 6 years was 82.2 %. Other malignant tumors had variable results. CONCLUSIONS Outcomes have improved much in the last years. Surgical removal is necessary in most cases. Transplantation is a very useful adjunct. Treatment of these tumors should be concentrated in centers with expertise.
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Affiliation(s)
- A M Andres
- Department of Pediatric Surgery, Transplantation Unit, Hospital Universitario La Paz, Madrid, Spain
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Ferreira BI, Alonso J, Carrillo J, Acquadro F, Largo C, Suela J, Teixeira MR, Cerveira N, Molares A, Goméz-López G, Pestaña A, Sastre A, Garcia-Miguel P, Cigudosa JC. Array CGH and gene-expression profiling reveals distinct genomic instability patterns associated with DNA repair and cell-cycle checkpoint pathways in Ewing's sarcoma. Oncogene 2007; 27:2084-90. [PMID: 17952124 DOI: 10.1038/sj.onc.1210845] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Ewing's sarcoma (ES) is characterized by specific chromosome translocations, the most common being t(11;22)(q24;q12). Additionally, other type of genetic abnormalities may occur and be relevant for explaining the variable tumour biology and clinical outcome. We have carried out a high-resolution array CGH and expression profiling on 25 ES tumour samples to characterize the DNA copy number aberrations (CNA) occurring in these tumours and determine their association with gene-expression profiles and clinical outcome. CNA were observed in 84% of the cases. We observed a median number of three aberrations per case. Besides numerical chromosome changes, smaller aberrations were found and defined at chromosomes 5p, 7q and 9p. All CNA were compiled to define the smallest overlapping regions of imbalance (SORI). A total of 35 SORI were delimited. Bioinformatics analyses were conducted to identify subgroups according to the pattern of genomic instability. Unsupervised and supervised clustering analysis (using SORI as variables) segregated the tumours in two distinct groups: one genomically stable (< or =3 CNA) and other genomically unstable (>3 CNA). The genomic unstable group showed a statistically significant shorter overall survival and was more refractory to chemotherapy. Expression profile analysis revealed significant differences between both groups. Genes related with chromosome segregation, DNA repair pathways and cell-cycle control were upregulated in the genomically unstable group. This report elucidates, for the first time, data about genomic instability in ES, based on CNA and expression profiling, and shows that a genomically unstable group of Ewing's tumours is correlated with a significant poor prognosis.
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Affiliation(s)
- B I Ferreira
- Molecular Cytogenetics Group, Centro Nacional de Investigaciones Oncológicas (CNIO), and CIBER on Rare Diseases (CIBERER), Madrid, Spain
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Muñoz A, Olivé T, Martinez A, Bureo E, Maldonado MS, Diaz de Heredia C, Sastre A, Gonzalez-Vicent M. Allogeneic hemopoietic stem cell transplantation (HSCT) for Wiskott-Aldrich syndrome: a report of the Spanish Working Party for Blood and Marrow Transplantation in Children (GETMON). Pediatr Hematol Oncol 2007; 24:393-402. [PMID: 17710656 DOI: 10.1080/08880010701454404] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Allogeneic stem cell transplantation is the only curative treatment for Wiskott-Aldrich syndrome. The authors retrospectively analyzed the outcome with this procedure in 13 patients with severe Wiskott-Aldrich syndrome transplanted in 5 Spanish centers from 1989 to 2006. A patient was transplanted twice from the same donor due to a late engraftment failure. Age at transplant ranged from 7 to 192 months (median 30 months). There were 10 matched donors (3 related and 7 unrelated), 2 mismatched unrelated, and 1 haploidentical. Conditioning regimen consisted of busulfan and cyclophosphamide (BuCy) in 11 cases and fludarabine and melfalan (1) or BuCy (1). ATG was added in transplants from non-genetically matched donors. GvHD prophylaxis consisted of cyclosporine and methotrexate in most patients plus T-cell depletion in the haploidentical HSCT. Nine of the 13 transplanted patients are alive with complete clinical, immunologic, and hematologic recovery 8-204 months (median 101 months) after HSCT. Eight surviving patients had been transplanted from matched donors (3 related and 5 unrelated) and 1 from a haploidentical donor. Four patients died, 2 transplanted from matched donors (1 from acute GvHD and organ failure, 1 from a lymphoproliferative disorder after a second transplant), and 2 transplanted from mismatched unrelated donors (1 from acute GvHD and organ failure, 1 from graft failure and infection). Allogeneic hemopoietic stem cell transplantation must be utilized in all patients with severe Wisckott-Aldrich syndrome, using the most suitable graft variant for each patient.
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Affiliation(s)
- A Muñoz
- Department of Pediatrics, Hospital Ramon y Cajal-University of Alcalá, Madrid, Spain.
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Petrich M, Cortina JL, Hartung J, Aguilar M, Sastre A, Beyer L, Gloe K. EXTRACTION OF GOLD (III) FROM HYDROCHLORIC ACID SOLUTIONS BY N-(THIOCARBAMOYL)BENZAMIDINES. Solvent Extraction and Ion Exchange 2007. [DOI: 10.1080/07366299308918145] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Sastre A, Alvarez-Navascués R, Marín R. [Renal infarction]. Nefrologia 2007; 27:522. [PMID: 17944597] [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: 05/25/2023] Open
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22
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Sastre A, Gago E, Baños M, Gómez E. [Acute renal failure in the transretinoic syndrome]. Nefrologia 2007; 27:184-90. [PMID: 17564563] [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: 05/15/2023] Open
Abstract
UNLABELLED The all-trans retinoic acid (ATRA) is the treatment of first line of acute promyelocytic leukemia (APL). ATRA is usually well tolerated, but a few major side effects can be observed, ATRA syndrome (RAS) being the most important of them, potentially fatal. The manifestations of this Syndrome are fever, weight gain, pulmonary infiltrates, pleural or pericardial effusions, hypotension, liver dysfunction and renal failure. MATERIAL AND METHODS We studied to the 29 patients diagnosed in (January of 2002 - December of 2004) of acute promyelocytic leukemia (APL), which were treated with ATRA, all received the 45 dose of mg/m(2)/d . The diagnosis of the leukemia was made by citomorphologist analysis. The criterion of renal insufficiency, it was an increase of the creatinina superior to 20% of the basal level. The definition of the transretinoico acid Syndrome was based on the clinical criteria of Frankel. RESULTS Fourteen patients presented the Transretinoico Syndrome (48.3%), 11 of which (37.9%) died. The fundamental differences between the patients with or without ATRA were: fever (14 vs. 9, p=0,017), gain of weight (14 vs 0, p=0,000), pleural effusion (14 vs 2, p=0.000), pulmonary infiltrates (13 vs 1, p=0,000), cardiac failure (12 versus 2, p=0,000), respiratory distress (12 versus 4, p=0,003), presence of renal failure (10 vs 4, p=0,02), necessity of substitute renal treatment (6 vs 0, p=0,006) and arterial hypotension (12 vs. 3, p=0,001). The acute renal failure appeared in 10 of the 14 patients with SAR (71.4%), to 12+/-5 (1-25) days of the beginning of the treatment and their duration it was of 14+/-5 (1-46) days. Six (60%) needed substitute renal treatment and 5 (50%) died. Of the patients who survived, only a patient continues in dialysis. In both patient in that renal biopsy was made, the study showed signs of cortical necrosis. CONCLUSIONS The appearance of acute renal failure in the course of the SAR is frequent, being observed deterioration of the renal function that needs substitute renal treatment in more than half the cases. The association of RAS with renal failure entails the high mortality (50%). The diagnosis and the precocious restoration of suitable the preventive measures and therapeutic are very important to avoid in possible the this serious complication of the treatment with ATRA.
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Affiliation(s)
- A Sastre
- Servicio de Nefrología, Hospital Central de Asturias, Oviedo.
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Sastre A, Díaz Corte C, Rodríguez Suárez C. [Encapsulating sclerosing peritonitis]. Nefrologia 2007; 27:772-773. [PMID: 18336114] [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: 05/26/2023] Open
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24
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Sastre A, Alvarez Navascués R, Marín R, Seco M. [Unknown origin fever and acute renal failure]. Nefrologia 2007; 27:643-644. [PMID: 18045044] [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: 05/25/2023] Open
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25
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Sastre A, Baños M, Seco M, Gómez Huertas E. [The recurrence of vasculitis in the renal transplant treatment with Rituximab]. Nefrologia 2007; 27:645-646. [PMID: 18045045] [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: 05/25/2023] Open
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26
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Andrés AM, Avila LF, Luis AL, Encinas JL, Sastre A, López-Gutiérrez JC, Martínez L, Queizán A, Martínez-Urrutia MJ, Jaureguizar E, Tovar JA. [Soft tissue sarcomas (1991-2004)]. Cir Pediatr 2006; 19:210-6. [PMID: 17352109] [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: 05/14/2023]
Abstract
BACKGROUND The aim of this study is to review the results of the treatment of soft tissue sarcomas (STS) in our Department during the last 13 years. MATERIAL AND METHODS Fifty-seven children (39 rhabdomyosarcomas (RMS) and 18 other types of sarcomas) have been treated. Nineteen RMS were excluded because they were treated by oher departments. The charts of 39 chidren were analysed evaluating several parameters (age, sex, location, histology, initial stage, clinical and surgical treatment and results) as prognostic factors using actuarial survival analyses and log-rank tests. RESULTS 1. RMS: Median age at diagnosis was 2.3 years (range 6 m-16y). Twelve were genitourinary, 3 thoracic, 3 abdominal, 1 was located in limb and 1 in the neck. Histologically, 13 were embryonal, 5 botryoid, 1 alveolar and 1 fusiform. At diagnosis, 74% were in stages I or II. Fine needle aspiration biopsy (FNAB) was made in 5 children and the result was always imprecise or mistaken. Surgical biopsy was made before the definitive surgery in 12 cases. In the remaining 8 children the diagnosis was made only after surgical resection. With an mean follow-up of 70 +/- 43 moths, 6 children died. The prognostic factors associated with poor outcomes were genitourinary location, non radical excission, the presence of distant metastases at onset and alveolar histology. 2. Other sarcomas: Median age at diagnosis was 10.9 years (range 4 days-15 years). Among this group, there were 6 fibrosarcomas, 4 indifferentiated sarcomas, 3 synovial sarcomas, 2 abdominal desmoplastic small round cell tumours, 2 neurofibrosarcomas and 1 leiomyosarcoma. Only 9 received chemotherapy and one radiotherapy. All but one were operated. Five out ot the 19 died. CONCLUSIONS Although the role of surgery is crucial, it is necessary to refine the initial histological diagnosis, because neither the PAAF or the biopsy have always been correct. The negative prognostic factors in our series were metastases present at diagnosis, genitourinary location and alveolar (RMS), desmoplastic or indifferenciated histology.
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Affiliation(s)
- A M Andrés
- Departamento de Cirugía Pediátrica, Hospital Universitario La Paz, Madrid.
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Kedari CS, Coll T, Fortuny A, Sastre A. Third Phase Formation in the Solvent Extraction System Ir(IV)—Cyanex 923. Solvent Extraction and Ion Exchange 2005. [DOI: 10.1081/sei-200068505] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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del Cerro MJ, Sanabria Carretero P, Reinoso Barbero E, Sastre A. [Venous catheter migration to the pulmonary artery]. Rev Esp Anestesiol Reanim 2005; 52:381. [PMID: 16038187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Affiliation(s)
- M J del Cerro
- Servicios de Anestesia, Cardiología. Hospital Infantil Universitario La Paz. Madrid
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29
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Badell I, Muñoz A, Ortega JJ, Martínez A, Madero L, Bureo E, Verdeguer A, Fernandez-Delgado R, Cubells J, Soledad-Maldonado M, Olivé T, Sastre A, Baro J, Díaz MA. Long-term outcome of allogeneic or autologous haemopoietic cell transplantation for acute lymphoblastic leukaemia in second remission in children. GETMON experience 1983–1998. Bone Marrow Transplant 2005; 35:895-901. [PMID: 15778727 DOI: 10.1038/sj.bmt.1704932] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [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
We present a retrospective study of long-term outcome and predictive factors of survival and relapse in 219 paediatric patients with acute lymphoblastic leukaemia (ALL) in second remission. They received allogeneic (allo) or autologous (auto) haemopoietic cell transplantation (HCT) depending on the availability of a matched sibling donor. The probability of event-free survival (EFS) for the total patient group was 0.35+0.03 at 14 years. No significant differences were observed for EFS between allo- and auto-HCT: 0.39+0.05 vs 0.32+0.04 (P=0.43). A better EFS was seen in patients with a late relapse (LR) (P=0.06 and 0.02, for allogeneic and autologous respectively). Significantly better EFS was observed in allo-HCT patients under 10 years of age and in auto-HCT patients with leukocytes at diagnosis below 25 x 109/l and late relapse. Predictive factors of failure in both groups were early relapse (ER), medullary relapse and age over 10 years. The probability of relapse (RP) for the total group of patients was 0.57+0.03, and it was significantly higher in auto-HCT patients: 0.65+0.04 vs 0.42+0.06 (P=0.002). Factors predictive for relapse were medullary and early relapse, auto-HCT and WBC >25 x 109/l at diagnosis.
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Affiliation(s)
- I Badell
- Hospital Sant Pau, Barcelona, Spain.
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Verdeguer A, Muñoz A, Cañete A, Pardo N, Martínez A, Donat J, Gómez P, Bureo E, Fernández JM, Cubells J, Maldonado M, Sastre A. Long-term results of high-dose chemotherapy and autologous stem cell rescue for high-risk neuroblastoma patients: a report of the Spanish working party for BMT in children (Getmon). Pediatr Hematol Oncol 2004; 21:495-504. [PMID: 15552813 DOI: 10.1080/08880010490477284] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The authors retrospectively analyzed the long-term outcome of 67 patients over 1 year of age at diagnosis with high-risk neuroblastoma (stage 4 or stage 3 with N-myc amplification) who were treated with megatherapy and stem cell rescue from 1984 to 1998. Median age at transplant was 4 years (range 1.6-15 years). The source of cells was peripheral stem cells in 29 and bone marrow in 38 patients. In 12 patients, an in vitro purging of bone marrow harvest was performed. Most patients were conditioned with melphalan, BCNU, and VM-26. After transplant 19 patients received complementary treatment with IL-2 (16) or 13-cis-retinoic acid (3). Six patients (8%) died from transplant-related toxicity and 39 from disease progression. Three patients were alive with active disease at the time of analysis. Nineteen patients are alive and disease-free at a median follow-up of 104 months. Five-year event-free survival is 0.30. Survival of patients who received a purged graft was not significantly better than the rest. Post-transplant complementary treatment significantly improved overall and event-free survival (p = .01 and p = .04, respectively).
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Luis AL, Martínez L, Hernández F, Sastre A, García P, Queizán A, Tovar JA. [Congenital neuroblastomas]. Cir Pediatr 2004; 17:89-92. [PMID: 15285592] [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: 04/30/2023]
Abstract
BACKGROUND We consider congenital neuroblastomas (CN) those detected in pregnancy or at the very first hours of life. Due to perinatal sonography, its incidence has increased in the last years. We present herein our experience in the treatment of this condition and we try to find out any different clinical pattern from those neuroblastomas diagnosed later in life. METHODS We review the CN treated in our hospital from 1990 to 2003, analyzing diagnosis, localization, tumor staging, N-myc amplification, treatment and evolution. RESULTS Among the 107 neural tumors managed during this period (89 neuroblastomas, 18 ganglioneuromas), 8 were congenital neuroblastomas (7 girls, 1 boy). Two patients had prenatal diagnosis and 6 tumours were detected in routine exploration or casual findings upon neonatal examination. Six were abdominal, 1 thoracoabdominal and 1 abdominopelvic with dumbbell invasion. Three tumours were classified like stage 1, 1 stage 2, 1 stage 3, 1 stage 4 and 2 stage 4S. Although most of them had unfavorable histology, we didn't find N-myc amplification in any tumor. All patients were operated upon, with preoperative chemotherapy in 2 of them. Resection was complete in 7 out of the 8 tumors. The patient who presented neurological symptoms at birth recovered neither motility nor bladder function after resection. All of them survive after 60+/-53 months of follow-up. CONCLUSIONS The outcome in this group of neuroblastomas is better that expected, probably because of its abdominal location. On the contrary in dumbbell neuroblastomas, neurological damage at birth seems to be irreversible.
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Affiliation(s)
- A L Luis
- Departamento de Cirugía Pediátrica, Hospital Infantil La Paz, Madrid
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Delgado J, Fernandez-Jimenez MC, Martinez A, Sastre A, Garcia-Miguel P, Hernandez-Navarro F, Arrieta R. Analysis of factors affecting PBPC collection in low-weight children with malignant disorders. Cytotherapy 2004; 6:43-9. [PMID: 14985166 DOI: 10.1080/14653240310004566] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [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: 10/26/2022]
Abstract
BACKGROUND PBPC collection in children weighing </=25 kg is hampered by technical and clinical problems related to vascular access, low total blood volume, anticoagulation, side effects, and psychological impact. The aim of this study was to analyze several clinical and technical factors, other than pre-apheresis CD34(+) count, that may affect PBPC collection in these low-weight children. METHODS Data from 88 leukaphereses performed in 45 children were analyzed, including pre-apheresis CD34(+) cell count, COBE Spectra software (version 4.7 versus 6.0), apheresis volume [standard versus large-volume leukapheresis (LVL)] and patient's diagnosis, age, weight and sex. RESULTS The median number of PBPC collected was 6.68 mononuclear cells (MNC)x10(8)/kg (range 2.36-19.05) and 1.69 CD34(+) cellsx10(6)/kg (range 0.08-13.79). Multivariate analysis showed that factors independently associated with the CD34(+) cell yield per apheresis were pre-apheresis CD34(+) cell count (P<0.001), diagnosis (P=0.008) and apheresis volume (P=0.009). Recruitment of CD34(+) cells was also independently affected by the apheresis volume, being higher in the LVL group (P=0.008). DISCUSSION We have demonstrated that, apart from the well-known influence of the pre-apheresis CD34(+) cell count, two other factors have a major impact on the CD34(+) cell yield: patient's diagnosis and apheresis volume. In addition, taking into account that side effects were mild and tolerable, we have confirmed that LVL is a safe and effective procedure in children </=25 kg, and that AutoPBSC software could be reliably used in these patients, provided that an experienced team performs the procedure.
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Affiliation(s)
- J Delgado
- Department of Hematology, Hospital Universitario La Paz, Madrid, Spain
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Affiliation(s)
- B Llombart
- Department of Dermatology, University Clinical Hospital, 46010 Valencia, Spain.
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Cavestany D, Cibils J, Freire A, Sastre A, Stevenson JS. Evaluation of two different oestrus-synchronisation methods with timed artificial insemination and resynchronisation of returns to oestrus in lactating Holstein cows. Anim Reprod Sci 2003; 77:141-55. [PMID: 12695051 DOI: 10.1016/s0378-4320(03)00032-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [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: 10/27/2022]
Abstract
To examine the outcomes of adding medroxyprogesterone acetate (MAP) to the ovsynch protocol with the traditional ovsynch protocol in both cycling and anoestrus cows, and to evaluate a resynchronisation protocol, 742 cows averaging more than 40 days postpartum were assigned to the following four treatments: (1) ovsynch (OVS): day 0: GnRH; day 7: PGF2alpha; day 9: a similar dose of GnRH; day 10: timed artificial insemination (TAI), approximately 16-20h later; (2) ovsynch+MAP (MAP): the same ovsynch protocol plus an intravaginal insert made of polyurethane sponge impregnated with 300mg of MAP immediately after the first GnRH treatment and on day 7, at the time of the PG treatment, the sponge was removed; (3) resynchronisation (MAP+ODB): 1mg of oestradiol benzoate (ODB) on day 13 after TAI and a new sponge impregnated with MAP was inserted and; on day 20, 1mg of ODB was given and the sponge removed; and (4) no resynchronisation (No MAP): only oestrus detection and AI at any repeat oestrus detected after TAI. Progesterone was measured in milk samples collected on days -17, -10, -3, 13 and 20 (TAI=day 0). Based on milk P4 at days -17 and -10, 27.4% of the cows were still anoestrus. At PG injection, 67.7% of the cycling and 21.3% of the anoestrus cows had elevated P4. Farm, days postpartum and parity variations were detected in both cases. On day 20 after TAI 42.6% of cycling and 8.3% of the anoestrous cows had elevated P4. Pregnancy rates were similar in both pre-breeding treatments (20%), but interactions (P<0.001) were detected between treatment and cycling activity (for anoestrous cows: MAP=34.9%; OVS=11.1%. Average interval from TAI to subsequent AI was 37+/-3 days. Resynchronisation resulted in more (P<0.001) cows in oestrus between days 18 and 25 after TAI. Conception rate in the MAP+ODB treatment was lower (P<0.05) than the No MAP group (22.8% versus 47.4%). It was concluded that the addition of a progestin to the ovsynch protocol resulted in increased pregnancy rates of cows treated during anoestrus. The benefit of including MAP with the ovsynch protocol for cycling cows is equivocal.
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Affiliation(s)
- D Cavestany
- Instituto Nacional de Investigación Agropecuaria, INIA La Estanzuela, C. Correos 39173, 70000 Colonia, Uruguay.
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Cascales Sánchez P, Sastre A, García Picazo D, González Camuñas PI, García Blázquez E, Moreno Resina JM. [Treatment of postoperative intrahepatic biloma due to liver trauma with external percutaneous drainage]. Gastroenterol Hepatol 2002; 25:335-6. [PMID: 11985809 DOI: 10.1016/s0210-5705(02)79033-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Gómez-Coronado D, Entrala A, Alvarez JJ, Ortega H, Olmos JM, Castro M, Sastre A, Herrera E, Lasunción MA. Influence of apolipoprotein E polymorphism on plasma vitamin A and vitamin E levels. Eur J Clin Invest 2002; 32:251-8. [PMID: 11952810 DOI: 10.1046/j.1365-2362.2002.00983.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Plasma concentrations of vitamins A and E are positively correlated with those of concurrent lipids and, on the other hand, lipid levels are influenced by apolipoprotein E polymorphism. Therefore, the effect of this polymorphism on both vitamins was analysed in an adult population. MATERIALS AND METHODS Subjects were recruited from a working population. Their anthropometric, lifestyle and dietary intake variables and menopausal status were recorded. Their apolipoprotein E phenotype and their plasma vitamins A and E (by high-performance liquid chromatography) and lipid (enzymatically) concentrations were determined after an overnight fast. The associations of the phenotype with vitamins and lipids were studied in men and women separately and controlling for significant covariates. RESULTS The apolipoprotein E phenotype was associated with the concentrations of total, low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol in women, whereas no associations with lipids were found in men. Vitamin A and vitamin E levels were higher in men than in women, but only the difference in the former persisted after lipid adjustment. Apolipoprotein E2 slightly increased vitamin A levels in women, an effect which was still evident with lipid adjustment. Actually, both the apolipoprotein E phenotype and triglyceride were selected as significant predictors of this vitamin by multiple regression. This phenotype did not affect vitamin E levels in either sex. CONCLUSIONS Lipids do not mediate the effect of gender on vitamin A levels. Apolipoprotein E polymorphism is an independent determinant of vitamin A levels in women. Pending confirmation by others, we propose that enhancement of this vitamin may contribute to the beneficial impact of the epsilon2 allele on human ageing and health.
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Affiliation(s)
- D Gómez-Coronado
- Servicio de Bioquímica-Investigación, Hospital Ramón y Cajal, Madrid, Spain.
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Cook MR, Gerkovich MM, Sastre A, Graham C. Side effects of low-dose pyridostigmine bromide are not related to cholinesterase inhibition. Aviat Space Environ Med 2001; 72:1102-6. [PMID: 11763111] [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: 02/23/2023]
Abstract
BACKGROUND Pretreatment with pyridostigmine bromide (PB) has become part of standard military procedures for protection against the effects of possible chemical warfare attack. The purpose of the work reported here was to quantify the type, intensity and frequency of side effects of low-dose PB, and to examine factors that predict the intensity and frequency of side effects. METHOD A double-blind, cross-over, placebo (PL)-controlled design was used. Of the 67 subjects, 33 received 30 mg PB every 8 h for 13 doses, and 34 received 60 mg on the same schedule. Order of PB and PL administration was counterbalanced. RESULTS Overall, side effects were mild, even at the 60-mg dose level. More side effects were reported when volunteers were taking PB than when they were taking placebo. Women reported more symptoms than men. Neither cholinesterase inhibition nor plasma levels of PB predicted side effect scores during the PB week; the best predictor of side effect scores during the PB week was side effect scores during the PL week. CONCLUSION PB is well tolerated by healthy young people, even when twice the recommended military dose is administered.
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Affiliation(s)
- M R Cook
- Midwest Research Institute, Kansas City, MO 64110, USA.
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Abstract
Healthy men (n = 22) and women (n = 24), 40-60 years of age, were exposed all-night (23:00-07:00 hr) to 60-Hz magnetic fields at an intensity (resultant flux density = 28.3 microTesla [microT]) well within the occupational-exposure range, or sham exposed under equivalent, counter-balanced, no-exposure ( < or = 0.2 microT) control conditions. Concentrations of melatonin, and the major metabolite of melatonin, 6-hydroxymelatonin-sulfate (6-OHMS), in first-void morning urine were not altered in either gender by exposure to the magnetic field, compared to control conditions. Statistical analysis also failed to reveal any evidence for exposure-related alterations in blood concentrations of multiple hematologic and immune system parameters (CD3, CD4, CD8, natural killer [NK] cells). The present results replicate and extend earlier negative findings based on the exposure of young men to power-frequency magnetic fields.
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Affiliation(s)
- C Graham
- Midwest Research Institute, Kansas City, Missouri 64110, USA.
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Abstract
We determined if all-night exposure to 60 Hz magnetic fields at an intensity well within the upper range of occupational exposures (resultant intensity = 127.3 microTesla [muT]) resulted in suppression of melatonin or its major metabolite 6-hydroxymelatonin-sulfate (6-OHMS) in the first-void morning urine of 24 healthy male volunteers. Measures collected after continuous and intermittent magnetic field exposure test conditions were compared to similar measures collected after an equivalent no-exposure control condition. Urinary concentrations of melatonin and 6-OHMS did not differ as a function of type of magnetic field exposure, nor did they differ between field exposure and control conditions. These results demonstrate that the nocturnal secretion and metabolism of melatonin are not altered in humans by field exposure at an intensity over 600 times higher than that typically encountered in the home.
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Affiliation(s)
- C Graham
- Midwest Research Institute, Kansas City, Missouri 64110, USA.
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Graham C, Cook MR, Gerkovich MM, Sastre A. Examination of the melatonin hypothesis in women exposed at night to EMF or bright light. Environ Health Perspect 2001; 109:501-507. [PMID: 11401762 PMCID: PMC1240310 DOI: 10.1289/ehp.01109501] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
It has been hypothesized that the increased incidence of breast cancer in industrial societies is related to greater exposure to power-frequency electric and magnetic fields (EMF) and/or the presence of high levels of light at night (LAN). EMF and LAN are said to reduce circulating levels of the hormone melatonin which, in turn, allows estrogen levels to rise and stimulate the turnover of breast epithelial stem cells and increase the risk for malignant transformation. Three laboratory-based studies, in which a total of 53 healthy young women were exposed at night to EMF or to LAN under controlled exposure conditions, were performed to determine whether such exposures reduce melatonin and are associated with further alterations in estrogen. All-night exposure to industrial-strength magnetic fields (60 Hz, 28.3 microT) had no effect on the blood levels of melatonin or estradiol. In contrast, nocturnal melatonin levels were profoundly suppressed, and the time of peak concentration was significantly delayed in women exposed to LAN, regardless of whether they were in the follicular or luteal phase of the menstrual cycle. These changes, however, were not associated with alterations in point-for-point matching measures of estradiol. Women who chronically secrete high or low amounts of melatonin each night (area-under-curve range: 86-1,296 pg/mL) also did not differ in their blood levels of estradiol. Taken together, these results are consistent with a growing body of evidence which generally suggests that environmental EMF exposure has little or no effect on the parameters measured in this report.
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Affiliation(s)
- C Graham
- Midwest Research Institute, Kansas City, Missouri, USA.
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Grau J, Ribera JM, Tormo M, Indiano JM, Vercher J, Sandoval V, Ramírez G, Sastre A, Flores E, García-Conde J. [Results of treatment with 2-chlorodeoxyadenosine in refractory or relapsed Langerhans cell histiocytosis. Study of 9 patients]. Med Clin (Barc) 2001; 116:339-42. [PMID: 11333766 DOI: 10.1016/s0025-7753(01)71821-0] [Citation(s) in RCA: 9] [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: 11/16/2022]
Abstract
BACKGROUND To analyse the results of the treatment with 2-chlorodeoxyadenosine (2CdA) in 9 patients with refractory or relapsed Langerhans cell histiocytosis (LCH) tracted in 8 Spanish hospitals between 1993 and 1999. PATIENTS AND METHOD In the 9 patients the following data were recorded: age, sex, organ involvement by LCH, first treatment and response, dose, number of cycles and schedule of administration 2CdA, response to 2CdA treatment, toxicity, disease-free survival (DFS) and overall survival (OS). RESULTS Median age was 25 years (range, 6-63). All patients had multiorganic involvement by LCH, with severe organ dysfunction in 4. 2CdA was administered as second line treatment in 7 cases and as third line in 2. The 2CdA dose was 0.1 mg/kg per day during 5 days in the majority of patients, and interval between cycles was 4 weeks. In 2 cases a complete remission (CR) was achieved and 4 cases attained a partial remission (PR) (overall response rate 66%). The main toxicity was hematologic, with neutropenia grade > 2 in 5 cases and thrombocytopenia > 2 in 5. Four patients had infections, with fatal evolution in one of them. After a median follow-up of 8 months (range 2-17), 2 patients remained in CR (12 months both), 4 in PR (range 2-12 months) and one had active disease (17 months). The other two died due to progressive disease and Aspergillus spp. sepsis, respectively. The actuarial probabilities of DFS and OS were 58% (95% CI, 38-78%) and 71% (95% CI, 54-88%), respectively. CONCLUSIONS 2CdA is an active drug for patients with refractory or relapsed LCH, and its main toxicity is myelosuppression. The usefulness of 2CdA, isolated or in combination with other drugs, in patients with refractory or relapsed LCH must be assessed in controlled studies.
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Affiliation(s)
- J Grau
- Hospital Universitari Germans Trias i Pujol. Badalona. Barcelona
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Abstract
OBJECTIVE Heart rate variability (HRV) is a noninvasive indicator of sympathetic and vagal cardiovascular control known to be tightly correlated with sleep stages. Recent studies indicate that HRV in humans is altered by nocturnal exposure to power-frequency (60 Hz) magnetic fields. Given the central origin of autonomic cardiac control, we determined if field exposure in the beta(1) EEG/MEG frequency range was a more effective stimulus for HRV alteration than 60 Hz fields, and explored the mechanisms involved. METHODS Healthy young men were exposed (n=9) overnight to an intermittent magnetic field (16 Hz, 28.3 microTesla, microT), or sham exposed (n=9), under blind test conditions in a laboratory exposure facility. RESULTS Field exposure was associated (P<0.05) with reduced power in the low band of the HRV frequency spectrum, and with decreases in mean heart rate. Analysis of the timing of the R waves surrounding each on-off transition of the intermittent field revealed no evidence for a direct effect on the cardiac pacemaker. CONCLUSIONS Magnetic field exposure in the EEG/MEG beta(1) frequency range alters HRV via a CNS effect. Phase-resetting experiments rule out a direct effect on the cardiac pacemaker. Biophysical calculations of the intensity of the electric fields induced in brain versus heart under the present exposure conditions are also consistent with and support a central rather than a peripheral site of action.
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Affiliation(s)
- A Sastre
- Midwest Research Institute, 425 Volker Boulevard, Kansas City, MO 64110, USA.
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Abstract
OBJECTIVE To determine if controlled exposure to power-frequency magnetic fields alters heart rate variability (HRV) and polysomnographic endpoints in healthy men (n=22) and women (n=24), 40-60 years of age. METHODS A randomized, double-blind, crossover design was used. Study endpoints collected during all-night exposure to 60 Hz magnetic fields at an occupational intensity (resultant flux density=28.3 microTesla, microT) were compared to similar endpoints obtained under equivalent, counterbalanced, no-exposure (< or =0.2 microT) control conditions. RESULTS Older men, but not women, exposed to the magnetic fields showed power reductions in the LF band of the HRV frequency spectrum, which is associated with sympathetically-mediated blood pressure and thermoregulatory control (P<0.04). Older women, but not men, exposed to the fields showed a pattern of disrupted sleep, with reductions in the duration of REM sleep (P=0.03), and strong trends for reductions in sleep efficiency (P=0.06) and total sleep time (P=0.06). CONCLUSIONS The gender-specific effects seen here with older volunteers replicate the results of previous exposure studies with younger men and women.
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Affiliation(s)
- C Graham
- Midwest Research Institute, 425 Volker Boulevard, Kansas City, MO 64110, USA.
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Abstract
Phthalocyanines linked to C60 have been synthesized by two general strategies. One of them involves the addition of an azomethine ylide prepared in situ from a formyl phthalocyanine to C60, and the other one involves a statistical condensation of two substituted phthalonitriles, one of them bearing the C60 moiety covalently attached. These new phthalocyanine-fullerene dyads have been studied by cyclic voltammetry and Osteryoung square wave voltammetry, and inter- and intramolecular electronic interactions between the two electroactive subunits have been demonstrated.
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Affiliation(s)
- A Gouloumis
- Departamento de Quimica Organica, Universidad Autonoma de Madrid, Spain
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Marco F, Bureo E, Ortega JJ, Badell I, Verdaguer A, Martínez A, Muñoz A, Madero L, Olivé T, Cubells J, Castel V, Sastre A, Maldonado MS, Díaz MA. High survival rate in infant acute leukemia treated with early high-dose chemotherapy and stem-cell support. Groupo Español de Trasplante de Médula Osea en Niños. J Clin Oncol 2000; 18:3256-61. [PMID: 10986058 DOI: 10.1200/jco.2000.18.18.3256] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [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: 11/20/2022] Open
Abstract
PURPOSE Infants with acute leukemia have a poor prognosis when treated with conventional chemotherapy. It is still unknown if stem-cell transplantation (SCT) can improve the outcome of these patients. In the present study, we review our experience with SCT in infant acute leukemia to clarify this issue. PATIENTS AND METHODS We report the results of 26 infants who were submitted to a SCT for acute leukemia. There were 15 cases of acute myeloid leukemia and 10 cases of acute lymphoid leukemia. One patient had a bilineal leukemia. Twenty-two patients were in their first complete response (CR1), three were in their second CR, and one was in relapse. Eight patients were submitted to allogeneic SCT, and 18 underwent autologous SCT. RESULTS With a median follow-up of 67 months, the 5-year overall survival and disease-free survival (DFS) are 64% (SE = 9%) and 63% (SE = 10%), respectively. Autologous and allogeneic SCT offered similar outcome. There was not any transplant-related mortality, and all deaths were caused by relapse in the first 6 months after SCT. In multivariate analysis, the single factor associated with better DFS was an interval between CR1 and SCT of less than 4 months (P: <.025). CONCLUSION SCT is a valid option in the treatment of infant acute leukemia, and it may overcome the high risk of relapse with conventional chemotherapy showing very reduced toxicity. This study suggests that SCT should be performed in CR1 in the early phase of the disease.
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Affiliation(s)
- F Marco
- Servicio de Hematología, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
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Graham C, Sastre A, Cook MR, Kavet R, Gerkovich MM, Riffle DW. Exposure to strong ELF magnetic fields does not alter cardiac autonomic control mechanisms. Bioelectromagnetics 2000; 21:413-21. [PMID: 10972945] [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: 02/17/2023]
Abstract
Clinical and epidemiological studies attest that alterations in heart rate variability (HRV) are predictive of specific types of cardiovascular morbidity and mortality in otherwise healthy persons. Recent reports also suggest that changes in HRV may be associated with exposure to intermittent magnetic fields (60 Hz, 28.3 microT) in the laboratory and that mortality is increased in cardiac disease categories related to altered HRV for utility workers whose jobs involve longer exposure to elevated magnetic fields. This study combined three approaches to learn more about the specific exposure circumstances under which changes in HRV occur. First, cardiac autonomic control, as indexed by HRV spectral analysis measures, was measured in 24 men during exposure to a much higher intensity field than any previously examined (resultant flux density = 127.3 microT [1273 milliGauss, mG]). Second, HRV measures from the same individual were compared across three relevant test conditions: intermittent and continuous field exposure and during a no-exposure, control condition. Third, electrocardiographic data were analyzed to determine if the precise timing of when the magnetic field switched on or off in relation to the cardiac cycle results in phase-resetting of the human cardiac rhythm. HRV measures were not altered by either field exposure condition compared to the control condition, and no evidence for a phase-resetting mechanism was found. Further research is needed to resolve the differences between the present and the earlier laboratory-based studies of HRV and to determine if cardiac rhythm disturbances are associated with exposure to the more complex magnetic fields found in the man-made environment.
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Affiliation(s)
- C Graham
- Midwest Research Institute, Kansas City, MO 64110, USA.
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