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De León Reyes NS, Mederos S, Varela I, Weiss LA, Perea G, Galazo MJ, Nieto M. Transient callosal projections of L4 neurons are eliminated for the acquisition of local connectivity. Nat Commun 2019; 10:4549. [PMID: 31591398 PMCID: PMC6779895 DOI: 10.1038/s41467-019-12495-w] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 09/15/2019] [Indexed: 12/11/2022] Open
Abstract
Interhemispheric axons of the corpus callosum (CC) facilitate the higher order functions of the cerebral cortex. According to current views, callosal and non-callosal fates are determined early after a neuron’s birth, and certain populations, such as cortical layer (L) 4 excitatory neurons of the primary somatosensory (S1) barrel, project only ipsilaterally. Using a novel axonal-retrotracing strategy and GFP-targeted visualization of Rorb+ neurons, we instead demonstrate that L4 neurons develop transient interhemispheric axons. Locally restricted L4 connectivity emerges when exuberant contralateral axons are refined in an area- and layer-specific manner during postnatal development. Surgical and genetic interventions of sensory circuits demonstrate that refinement rates depend on distinct inputs from sensory-specific thalamic nuclei. Reductions in input-dependent refinement result in mature functional interhemispheric hyperconnectivity, demonstrating the plasticity and bona fide callosal potential of L4 neurons. Thus, L4 neurons discard alternative interhemispheric circuits as instructed by thalamic input. This may ensure optimal wiring. It is traditionally believed that callosal and non-callosal fates are determined early after a neuron’s birth, and that cortical layer (L) 4 excitatory neurons of the primary somatosensory (S1) barrel cortex project only ipsilaterally. However, here authors demonstrate, using a novel axonal retrotracing strategy, that L4 neurons develop transient interhemispheric axons that are refined in an area- and layer-specific manner during postnatal development.
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Affiliation(s)
- N S De León Reyes
- Department of Cellular and Molecular Biology, Centro Nacional de Biotecnología, Consejo Superior de Investigaciones Científicas (CNB-CSIC), Campus de Cantoblanco, Darwin 3, 28049, Madrid, Spain
| | - S Mederos
- Instituto Cajal, CSIC. Av. Doctor Arce, 37, 28002, Madrid, Spain
| | - I Varela
- Department of Cellular and Molecular Biology, Centro Nacional de Biotecnología, Consejo Superior de Investigaciones Científicas (CNB-CSIC), Campus de Cantoblanco, Darwin 3, 28049, Madrid, Spain
| | - L A Weiss
- Department of Cellular and Molecular Biology, Centro Nacional de Biotecnología, Consejo Superior de Investigaciones Científicas (CNB-CSIC), Campus de Cantoblanco, Darwin 3, 28049, Madrid, Spain
| | - G Perea
- Instituto Cajal, CSIC. Av. Doctor Arce, 37, 28002, Madrid, Spain
| | - M J Galazo
- Department of Cell and Molecular Biology and Tulane Brain Institute, Tulane University, 6400 Freret Street, Percival Stern Hall suite 2000, New Orleans, LA, 70118, USA
| | - M Nieto
- Department of Cellular and Molecular Biology, Centro Nacional de Biotecnología, Consejo Superior de Investigaciones Científicas (CNB-CSIC), Campus de Cantoblanco, Darwin 3, 28049, Madrid, Spain.
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Barrio-Alonso E, Hernández-Vivanco A, Walton CC, Perea G, Frade JM. Cell cycle reentry triggers hyperploidization and synaptic dysfunction followed by delayed cell death in differentiated cortical neurons. Sci Rep 2018; 8:14316. [PMID: 30254284 PMCID: PMC6156334 DOI: 10.1038/s41598-018-32708-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 09/14/2018] [Indexed: 11/09/2022] Open
Abstract
Cell cycle reentry followed by neuronal hyperploidy and synaptic failure are two early hallmarks of Alzheimer's disease (AD), however their functional connection remains unexplored. To address this question, we induced cell cycle reentry in cultured cortical neurons by expressing SV40 large T antigen. Cell cycle reentry was followed by hyperploidy in ~70% of cortical neurons, and led to progressive axon initial segment loss and reduced density of dendritic PSD-95 puncta, which correlated with diminished spike generation and reduced spontaneous synaptic activity. This manipulation also resulted in delayed cell death, as previously observed in AD-affected hyperploid neurons. Membrane depolarization by high extracellular potassium maintained PSD-95 puncta density and partially rescued both spontaneous synaptic activity and cell death, while spike generation remained blocked. This suggests that AD-associated hyperploid neurons can be sustained in vivo if integrated in active neuronal circuits whilst promoting synaptic dysfunction. Thus, cell cycle reentry might contribute to cognitive impairment in early stages of AD and neuronal death susceptibility at late stages.
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Affiliation(s)
- E Barrio-Alonso
- Department of Molecular, Cellular and Developmental Neurobiology, Cajal Institute (CSIC), Madrid, Spain
| | - A Hernández-Vivanco
- Department of Functional and Systems Neurobiology, Cajal Institute (CSIC), Madrid, Spain
| | - C C Walton
- Department of Molecular, Cellular and Developmental Neurobiology, Cajal Institute (CSIC), Madrid, Spain
| | - G Perea
- Department of Functional and Systems Neurobiology, Cajal Institute (CSIC), Madrid, Spain
| | - J M Frade
- Department of Molecular, Cellular and Developmental Neurobiology, Cajal Institute (CSIC), Madrid, Spain.
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Olivera P, Gabilondo M, Constans M, Tàssies D, Plensa E, Pons V, Las Heras G, Jiménez C, Campoy D, Bustins A, Oliver A, Marzo C, Canals T, Varela A, Sorigue M, Sánchez E, Ene G, Perea G, Vicente L, López M, Cerdá M, Johansson E, Aguinaco MR, Santos N, Mateo J, Reverter JC, Moya Á, Santamaría A. Tromboc@t Working Group recommendations for management in patients receiving direct oral anticoagulants. Med Clin (Barc) 2018; 151:210.e1-210.e13. [PMID: 29602444 DOI: 10.1016/j.medcli.2018.01.022] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 01/07/2018] [Accepted: 01/25/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND AND OBJECTIVES In recent years, direct oral anticoagulants (DOACs) have become an alternative to vitamin K antagonists (VKA) for the prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation (NVAF) as well as for prevention and treatment of deep venous thrombosis. Pivotal trials have demonstrated non-inferiority and potential superiority compared to warfarin, which increases the options of anticoagulant treatment. In our setting, the Anticoagulant Treatment Units (ATUs) and Primary Care Centres (PCCs) play an important role in the education, follow-up, adherence control and management in special situations of anticoagulated patients. These considerations have motivated us to elaborate the present consensus document that aims to establish clear recommendations that incorporate the findings of scientific research into clinical practice to improve the quality of care in the field of anticoagulation. MATERIAL AND METHODS A group of experts from the Catalan Thrombosis Group (TROMBOC@T) reviewed all published literature from 2009 to 2016, in order to provide recommendations based on clinical evidence. RESULTS As a result of the project, a set of practical recommendations have been established that will facilitate treatment, education, follow-up and management in special situations of anticoagulated patients with ACODs. CONCLUSIONS Progressive increase in the use of DOACs calls for measures to establish and homogenise clinical management guidelines for patients anticoagulated with DOACs in ATUs and PCCs.
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Affiliation(s)
- Pável Olivera
- Unidad de Trombosis y Hemostasia, Departamento de Hematología, Hospital Universitari Vall d' Hebron, Barcelona, España
| | - Miren Gabilondo
- Departamento de Hematología, Hospital Universitario Araba Txagorritxu, Vitoria, España
| | - Mireia Constans
- Unidad de Trombosis y Hemostasia, Departamento de Hematología, Hospital Universitari Vall d' Hebron, Barcelona, España
| | - Dolors Tàssies
- Unidad de Hemostasia y Trombosis, Departamento de Hemoterapia y Hemostasia (ICMHO), Hospital Clínic, Barcelona, España
| | - Esther Plensa
- Departamento de Hematología, Consorci Sanitari del Maresme, Mataró, España
| | - Verónica Pons
- Unidad de Trombosis y Hemostasia, Departamento de Hematología, Hospital Universitari Vall d' Hebron, Barcelona, España
| | - Germán Las Heras
- Departamento de Hematología, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, España
| | - Carmen Jiménez
- Departamento de Hematología, Hospital del Mar , Barcelona, España
| | - Desirée Campoy
- Departamento de Hematología, Hospital Universitari Sagrat Cor, Barcelona, España
| | - Anna Bustins
- Departamento de Hematología, Hospital Universitari Doctor Josep Trueta, Girona, España
| | - Artur Oliver
- Departamento de Hematología, Fundació Puigvert, Barcelona, España
| | - Cristina Marzo
- Departamento de Hematología, Hospital Universitari Arnau de Vilanova, Lleida, España
| | - Tania Canals
- Unidad de Trombosis y Hemostasia, Departamento de Hematología, Hospital Universitari Vall d' Hebron, Barcelona, España
| | - Anna Varela
- Unidad de Trombosis y Hemostasia, Departamento de Hematología, Hospital Universitari Vall d' Hebron, Barcelona, España
| | - Marc Sorigue
- Unidad de Trombosis y Hemostasia, Hospital Universitari Germans Trias i Pujol, Badalona, España
| | - Eva Sánchez
- Unidad de Trombosis y Hemostasia, Departamento de Hematología, Hospital Universitari Vall d' Hebron, Barcelona, España
| | - Gabriela Ene
- Departamento de Hematología, Hospital Sant Joan de Déu de Martorell , España
| | - Granada Perea
- Departemento de Hematología, Corporació Sanitaria Parc Taulí, Sabadell, España
| | - Laura Vicente
- Departamento de Hematología, Consorci Sanitari de Terrasa - Hospital de Terrasa, , España
| | - Meritxell López
- Departamento de Hematología, Hospital Universitario Mútua Terrassa, España
| | - María Cerdá
- Unidad de Trombosis y Hemostasia, Departamento de Hematología, Hospital Universitari Vall d' Hebron, Barcelona, España
| | - Erik Johansson
- Unidad de Trombosis y Hemostasia, Departamento de Hematología, Hospital Universitari Vall d' Hebron, Barcelona, España
| | - M Reyes Aguinaco
- Departamento de Hematología, Hospital Universitari Joan XXIII , Tarragona, España
| | - Nazly Santos
- Departamento de Hematología, Hospital Universitari Arnau de Vilanova, Lleida, España
| | - José Mateo
- Unidad de Trombosis y Hemostasia, Departamento de Hematología, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | | | - Ángel Moya
- Unidad de Arritmias, Departamento de Cardiología, Hospital Universitari Vall d' Hebron, Barcelona, España
| | - Amparo Santamaría
- Unidad de Trombosis y Hemostasia, Departamento de Hematología, Hospital Universitari Vall d' Hebron, Barcelona, España.
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San-José P, Aguadero V, Perea G, Estrada M, Berlanga E. Gamma heavy-chain disease accompanied with follicular lymphoma: a case report. Biochem Med (Zagreb) 2018; 28:010802. [PMID: 29472805 PMCID: PMC5806617 DOI: 10.11613/bm.2018.010802] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 12/08/2017] [Indexed: 11/17/2022] Open
Abstract
Heavy chain diseases (HCD) are B-cell lymphoprolipherative disorders characterized by the production of monoclonal heavy chains without associated light chains. Some cases of gamma-HCD (γ-HCD) are concurrent with other lymphoid neoplasm. The monoclonal component is not always detectable by serum electrophoresis, and often an immunofixation procedure is necessary to detect this component. Prognosis is variable, and no established guidelines for follow-up are available. We describe a case of a challenging diagnosis of γ-HCD due to the absence of clinical signs frequently reported in the disease (anaemia and palatal oedema among others). Haematological malignancy was the first suspicion but bone marrow examination was negative. In addition, the presence of an autoimmune bicytopenia and a Klinefelter syndrome complicated the clinical context of the patient. A thoracoabdominal computed tomography reported many small adenopathies whose pathological and immunohystochemical study revealed a follicular lymphoma. Shortly after, serum inmunofixation secondary to an abnormal electrophoretic pattern revealed a gamma paraprotein without light chains. Eventually, γ-HCD in association with follicular lymphoma was the final diagnosis. This is the first case reporting this association.
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Affiliation(s)
- Paula San-José
- Clinical Laboratory, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Spain
| | - Vicente Aguadero
- Clinical Laboratory, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Spain
| | - Granada Perea
- Clinical Laboratory, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Spain.,Hematology Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Spain
| | - Meritxell Estrada
- Clinical Laboratory, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Spain.,Hematology Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Spain
| | - Eugenio Berlanga
- Clinical Laboratory, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Spain
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Wassmuth R, Hristova K, Monney P, Olander RFW, Rodriguez Munoz D, Huayan X, Pagourelias E, Loardi C, Moreno J, Miljkovic T, Takase H, Latet SC, Henquin R, America R, Carter-Storch R, Panelo ML, Fernandez-Golfin C, Cho IJ, Petrini J, Buonauro A, Liu B, Mapelli M, Tamulenaite E, De Chiara B, Minden H, Kostova V, Nesheva N, Katova TZ, Bojadzhiev L, Crisinel V, Reverdin S, Conti L, Mach F, Mueller H, Jeanrenaud X, Bochud M, Ehret G, Sundholm JKM, Ojala T, Andersson S, Sarkola T, Moya Mur JL, Berlot B, Fernandez-Golfin C, Moreno Planas J, Casas Rojo E, Garcia Martin A, Jimenez Nacher JJ, Hernandez-Madrid A, Franco Diez E, Matia Frances R, Zamorano JL, Zhigang YANG, Yingkun GUO, Jing CHEN, Duchenne J, Mirea O, Triantafyllis A, Michalski B, Vovas G, Delforge M, Van Cleemput J, Bogaert J, Voigt JU, Saccocci M, Tamborini G, Veglia F, Pepi M, Alamanni F, Zanobini M, Zuniga Sedano JJ, Alexanderson E, Martinez C, Bjelobrk M, Pavlovic K, Ilic A, Colakovic S, Dodic S, Tanaka T, Machii M, Nonaka D, Van Herck PL, Claeys MJ, Haine SE, Miljoen HP, Segers VF, Vandendriessche TR, De Winter BY, Hoymans VY, Vrints CJ, Lombardero M, Perea G, Miele MM, De Amicis DAV, Mannacio VAM, Dahl JS, Christensen NL, Soendergaard EV, Marcussen N, Moeller JE, Fernandez-Palomeque C, Garcia-Vega D, Mont-Girbau L, Pardo A, Izurieta C, Boretti I, Hinojar R, Gonzalez-Gomez A, Garcia Martin A, Casas E, Salido L, Barrios V, Ruiz S, Moya JL, Hernandez Antolin R, Jimenez Nacher JL, Zamorano JL, Chang HJ, Choi HH, Lee SY, Shim CY, Ha JW, Chung N, Ring M, Caidahl K, Eriksson MJ, Esposito R, Santoro C, Monteagudo JM, Trimarco B, Galderisi M, Zamorano JL, Baig S, Hayer M, Steeds R, Edwards N, Fusini L, Zagni P, Muratori M, Agostoni P, Tamborini G, Gripari P, Ghulam Ali S, Pepi M, Fiorentini C, Valuckiene Z, Jurkevicius R, Peritore A, Botta L, Belli O, Musca F, Casadei F, Russo C, Giannattasio C, Moreo A. Poster Session 6Assessment of morphology and functionP1222Multimodality imaging for left atrial appendage occluder sizingP1223Longitudinal left atrial strain is a main predictor for long term prognosis on atrial fibrillation after CABG operation patientsP1224Comparison of 2D and 3D left ventricular volumes measurements: results from the SKIPOGH II studyP1225Adjusting for thoracic circumference is superior to body surface area in the assessment of neonatal cardiac dimensions in foetal growth abnormalityP1226Maximal vortex suction pressure: an equivocal marker for optimization of atrio-ventricular delayP1227Volume-time curve of cardiac magnetic resonance assessed left ventricular dysfunction in coronary artery disease patients with type 2 diabetes mellitusP1228Thickness matters, but not in the same way for all strain parametersP1229Digging deeper in postoperative modifications of right ventricular function: impact of pericardial approach and cardioplegiaP1230Left atrial function evaluated by 2D-speckle tracking echocardiography in diabetes mellitus populationP1231The influence of arterial hypertension duration on left ventricular diastolic parameters in patients with well regulated arterial blood pressureP1232Investigation of factors affecting left ventricular diastolic dysfunction determined using mitral annulus velocityP1233High regulatory T-lymphocytes after ST-elevation myocardial infarction relate with adverse left ventricular remodelling assessed by 3D-echocardiographyP1234Prevalence of paradoxical low flow/low gradient severe aortic stenosis measure with 3 dimensional transesophageal echocardiographyP1235Coronary microvascular and diastolic dysfunctions after aortic valve replacement: comparison between mechanical and biological prosthesesP1236Normal-flow, low gradient aortic stenosis is common in a population of patients with severe aortic valve stenosis undergoing aortic valve replacementP1237Analysis of validity and reproducibility of calcium burden visual estimation by echocardiographyP12383D full automatic software in the evaluation of aortic stenosis severity in TAVI patients. Preliminary resultsP1239Differential impact of net atrioventricular compliance on clinical outcomes in patients with mitral stenosis according to cardiac rhythmP1240Aortic regurgitation affects the intima-media thickness of the right and left common carotid artery differentlyP1241Global longitudinal strain: an hallmark of cardiac damage in mitral valve regurgitation. Experience from the european registry of mitral regurgitationP1242Echocardiographic characterisation of Barlow's disease versus fibroelastic deficiencyP1243Echocardiographic screening for rheumatic heart disease in a ugandan orphanage - feasibility and outcomesP1244Alterations in right ventricular mechanics upon follow-up period in patients with persistent ischemic mitral regurgitation after inferoposterior myocardial infarctionP1245Ten-years conventional mitral surgery in patients with mitral regurgitation and left ventricular dysfunction: clinical and echocardiographic outcomes. Eur Heart J Cardiovasc Imaging 2016. [DOI: 10.1093/ehjci/jew266] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Jung IH, Kurnicka K, Enache R, Nagy AI, Martins E, Cereda A, Vitiello G, Magda SL, Styczynski G, Lo Iudice F, De Barros Viegas H, Shahab F, Trunina I, Mata Caballero R, De Barros Viegas H, Marques A, Shimoni S, Generati G, Generati G, Bendix Salkvist Jorgensen T, Chen TE, Andrianova A, Fernandez-Golfin C, Corneli MC, Ali M, Seo HS, Kim MJ, Lichodziejewska B, Goliszek S, Dzikowska-Diduch O, Zdonczyk O, Kozlowska M, Kostrubiec M, Ciurzynski M, Palczewski P, Pruszczyk P, Popa E, Coman IM, Badea R, Platon P, Calin A, Beladan CC, Rosca M, Ginghina C, Popescu BA, Jurcut R, Venkateshvaran AI, Sola SC, Govind SC, Dash PK, Lund L, Manouras AI, Merkely B, Magne J, Aboyans V, Boulogne C, Lavergne D, Jaccard A, Mohty D, Casadei F, Spano F, Santambrogio G, Musca F, Belli O, De Chiara B, Bokor D, Giannattasio C, Corradi E, Colombo CA, Moreo A, Vicario ML, Castellani S, Cammelli D, Gallini C, Needleman L, Cruz BK, Maggi E, Marchionni N, Bratu VD, Mincu RI, Mihai CM, Gherghe AM, Florescu M, Cinteza M, Vinereanu D, Sobieraj P, Bielicki P, Krenke R, Szmigielski CA, Petitto M, Ferrone M, Esposito R, Vaccaro A, Buonauro A, Trimarco B, Galderisi M, Mendes L, Dores H, Melo I, Madeira V, Patinha J, Encarnacao C, Ferreia Santos J, Habib F, Soesanto AM, Sedyawan J, Abdurrazak G, Sharykin A, Popova NE, Karelina EV, Telezhnikova ND, Hernandez Jimenez V, Saavedra J, Molina L, Alberca MT, Gorriz J, L Pais J, Pavon I, Navea C, Alonso JJ, Mendes L, Sonia S, Madeira V, Encarnacao C, Patinha J, Melo I, Ferreia Santos J, Cruz I, Joao I, Gomes AC, Caldeira D, Lopes L, Fazendas P, Pereira H, Edri O, Edri O, Schneider N, Schneider N, Abaye N, Abaye N, Goerge J, Goerge J, Gandelman G, Gandelman G, Bandera F, Alfonzetti E, Guazzi M, Bandera F, Villani S, Ferraro O, Alfonzetti E, Guazzi M, Ramberg E, Bhardwaj P, Nepper ML, Binko TS, Olausson M, Fink-Jensen T, Andersen AM, Roland J, Gleerup Fornitz G, Ong K, Suri RM, Enrique-Sarano M, Michelena HI, Burkhart HM, Gillespie SM, Cha S, Mankad SV, Saidova MA, Bolotova MN, Salido Tahoces L, Izurieta C, Villareal G, Esteban A, Urena Vacas A, Ayala A, Jimenez Nacher JJ, Hinojar Baydes R, Gonzalez Gomez A, Garcia A, Mestre JL, Hernandez Antolin R, Zamorano Gomez JJ, Perea G, Covelli Y, Henquin R, Ronderos R, Hepinstall MJ, Cassidy CS, Pellikka PA, Pislaru SV, Kane G. P569Diastolic dyssynchrony is associated with exercise intolerance in hypertensive patients with left ventricular hypertrophyP570Echocardiographic pattern of acute pulmonary embolism, analysis of consecutive 511 patientsP571Clinical significance of ventricular interdependence and left ventricular function in patients with pulmonary hypertension receiving specific vasodilator therapyP572Haemodynamic characteristics and ventricular mechanics in post-capillary and combined pre- and post-capillary pulmonary hypertensionP573Relationship between hematological response and echocardiographic features in patients with light chains systemic amyloidosisP574Myocardial changes in patients with anorexia nervosaP575Giant cell arteritis presenting as fever of unknown origin: role of clinical history, early positron emission tomography and ultrasound screeningP576Subclinical systolic dysfunction in systemic sclerosis is not influenced by standard rheumatologic therapy - a 4D echocardiographic studyP577Cardiac index correlates with the degree of hepatic steathosis in obese patients with obstructive sleep apneaP578Myocardial mechanics in top-level endurance athletes: a three-dimensional speckle tracking studyP579The athlete heart: what happens to myocardial deformation in physiological adaptation to sportsP580Association between left ventricle intrinsic function and urine protein-creatinine ratio in preeclampsia before and after deliveryP581Dilatation of the aorta in children with bicuspid aortic valveP582Cardiovascular functional abnormalities in patients with osteogenesis imperfectaP583Dobutamine stress test fast protocol: diagnostic accuracy and securityP584Prognostic value of non-positive exercise echocardiography in the patients submitted to percutaneous coronary interventionP585The use of myocardial strain imaging in the detection of coronary artery disease during stress echocardiographyP586Preserved O2 extraction exercise response in heart failure patients with chronotropic insufficiency: evidence for a central cardiac rather than peripheral oxygen uptake limitationP587Major determinant of O2 artero-venous difference at peak exercise in heart failure and healthy subjectsP588Stress echocardiography with contrast perfusion analysis for a more sensitive test for ischemic heart diseaseP589Assessment of mitral annular physiology in myxomatous mitral disease with 3D transesophageal echocardiography: comparison between early severe mitral regurgitation and decompensated groupP590Three-dimensional transesophageal echocardiographic assessment of the mitral valve geometry in patients with mild, moderate and severe chronic ischemic mitral regurgitationP591Left atrial appendage closure. Multimodality imaging in device size selectionP592Contributions of three-dimensional transesophageal echocardiography in the evaluation of aortic atherosclerotic plaquesP593Agitated blood-saline is superior to agitated air-saline for echocardiographic shunt studies. Eur Heart J Cardiovasc Imaging 2016; 17:ii102-ii109. [DOI: 10.1093/ehjci/jew248.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Nomdedéu JF, Puigdecanet E, Bussaglia E, Hernández JJ, Carricondo M, Estivill C, Martí-Tutusaus JM, Tormo M, Zamora L, Serrano E, Perea G, de Llano MPQ, García A, Sánchez-Ortega I, Ribera JM, Nonell L, Aventin A, Solé F, Brunet MS, Sierra J. Feasibility of the AML profiler (Skyline™ Array) for patient risk stratification in a multicentre trial: a preliminary comparison with the conventional approach. Hematol Oncol 2016; 35:778-788. [PMID: 27140599 DOI: 10.1002/hon.2304] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 03/15/2016] [Accepted: 03/31/2016] [Indexed: 12/11/2022]
Abstract
Deoxyribonucleic acid microarrays allow researchers to measure mRNA levels of thousands of genes in a single experiment and could be useful for diagnostic purposes in patients with acute myeloid leukaemia (AML). We assessed the feasibility of the AML profiler (Skyline™ Array) in genetic stratification of patients with de novo AML and compared the results with those obtained using the standard cytogenetic and molecular approach. Diagnostic bone marrow from 31 consecutive de novo AML cases was used to test MLL-PTD, FLT3-ITD and TKD, NPM1 and CEBPAdm mutations. Purified RNA was used to assess RUNX1-RUNX1T1, PML-RARα and CBFβ-MYH11 rearrangements. RNA remnants underwent gene expression profiling analysis using the AML profiler, which detects chromosomal aberrations: t(8;21), t(15;17), inv(16), mutations (CEBPAdm, ABD-NPM1) and BAALC and EVI1 expression. Thirty cases were successfully analysed with both methods. Five cases had FLT3-ITD. In one case, a t(8;21) was correctly detected by both methods. Four cases had inv(16); in one, the RNA quality was unsatisfactory and it was not hybridized, and in the other three, the AML profiler detected the genetic lesion - this being a rare type I translocation in one case. Two cases with acute promyelocytic leukaemia were diagnosed by both methods. Results for NPM1 mutations were concordant in all but two cases (2/11, non-ABD mutations). Analysis of costs and turnaround times showed that the AML profiler was no more expensive than the conventional molecular approach. These results suggest that the AML profiler could be useful in multicentre trials to rapidly identify patients with AML with a good prognosis. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Josep F Nomdedéu
- Hematology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Eulalia Puigdecanet
- Servei d'Analisi de Microarrays, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Elena Bussaglia
- Hematology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | - Maite Carricondo
- Hematology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Camino Estivill
- Hematology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | - Mar Tormo
- Hematology Department, Hospital Clínico de Valencia, INCLIVA, Valencia, Spain
| | - Lurdes Zamora
- Hematology Department, Institut Recerca contra la Leucemia Josep Carreras (IJC), ICO Badalona Hospital Germans Trias i Pujol, Badalona, Spain
| | - Elena Serrano
- Bioinformatic Platform, IIB Sant Pau, Barcelona, Spain
| | - Granada Perea
- Laboraotory Service, UDIAT-CD, Parc Taulí Hospital Universitari, Sabadell, Spain
| | | | - Antoni García
- Hematology Department, Hospital Arnau de Vilanova, Lleida, Spain
| | | | - Josep Maria Ribera
- Hematology Department, Institut Recerca contra la Leucemia Josep Carreras (IJC), ICO Badalona Hospital Germans Trias i Pujol, Badalona, Spain
| | - Lara Nonell
- Servei d'Analisi de Microarrays, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Anna Aventin
- Hematology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Francesc Solé
- Hematology Department, Institut Recerca contra la Leucemia Josep Carreras (IJC), ICO Badalona Hospital Germans Trias i Pujol, Badalona, Spain
| | - Maria Salut Brunet
- Hematology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Jorge Sierra
- Hematology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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8
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Cuadrado-Tejedor M, Garcia-Barroso C, Sanzhez-Arias J, Mederos S, Rabal O, Ugarte A, Franco R, Pascual-Lucas M, Segura V, Perea G, Oyarzabal J, Garcia-Osta A. Concomitant histone deacetylase and phosphodiesterase 5 inhibition synergistically prevents the disruption in synaptic plasticity and it reverses cognitive impairment in a mouse model of Alzheimer's disease. Clin Epigenetics 2015; 7:108. [PMID: 26457123 PMCID: PMC4599811 DOI: 10.1186/s13148-015-0142-9] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 09/28/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Given the implication of histone acetylation in memory processes, histone deacetylase inhibitors (HDACIs) have been postulated as potential modulators of cognitive impairment in Alzheimer's disease (AD). However, dose-dependent side effects have been described in patients with the currently available broad-spectrum HDACIs, explaining why their therapeutic potential has not been realized for chronic diseases. Here, by simultaneously targeting two independent enzyme activities, histone deacetylase (HDAC) and phosphodiesterase-5 (PDE5), we propose a novel mode of inhibitory action that might increase the therapeutic specificity of HDACIs. RESULTS The combination of vorinostat, a pan-HDACI, and tadalafil, a PDE5 inhibitor, rescued the long-term potentiation impaired in slices from APP/PS1 mice. When administered in vivo, the combination of these drugs alleviated the cognitive deficits in AD mice, as well as the amyloid and tau pathology, and it reversed the reduced dendritic spine density on hippocampal neurons. Significantly, the combination of vorinostat and tadalafil was more effective than each drug alone, both against the symptoms and in terms of disease modification, and importantly, these effects persisted after a 4-week washout period. CONCLUSIONS The results highlight the pharmacological potential of a combination of molecules that inhibit HDAC and PDE5 as a therapeutic approach for AD treatment.
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Affiliation(s)
- M Cuadrado-Tejedor
- Neurobiology of Alzheimer's Disease, Neurosciences Division, Center for Applied Medical Research (CIMA), University of Navarra, Pio XII, 31008 Pamplona, Spain.,Anatomy Department, School of Medicine, University of Navarra, Pamplona, Spain
| | - C Garcia-Barroso
- Neurobiology of Alzheimer's Disease, Neurosciences Division, Center for Applied Medical Research (CIMA), University of Navarra, Pio XII, 31008 Pamplona, Spain
| | - J Sanzhez-Arias
- Small Molecule Discovery Platform, Molecular Therapeutics Program, Center for Applied Medical Research (CIMA), University of Navarra, Pio XII, 55, 31008 Pamplona, Spain
| | - S Mederos
- Cajal Institute, CSIC, Madrid, Spain
| | - O Rabal
- Small Molecule Discovery Platform, Molecular Therapeutics Program, Center for Applied Medical Research (CIMA), University of Navarra, Pio XII, 55, 31008 Pamplona, Spain
| | - A Ugarte
- Small Molecule Discovery Platform, Molecular Therapeutics Program, Center for Applied Medical Research (CIMA), University of Navarra, Pio XII, 55, 31008 Pamplona, Spain
| | - R Franco
- Neurobiology of Alzheimer's Disease, Neurosciences Division, Center for Applied Medical Research (CIMA), University of Navarra, Pio XII, 31008 Pamplona, Spain.,Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | - M Pascual-Lucas
- Neurobiology of Alzheimer's Disease, Neurosciences Division, Center for Applied Medical Research (CIMA), University of Navarra, Pio XII, 31008 Pamplona, Spain
| | - V Segura
- Bioinformatics Unit, Center for Applied Medical Research (CIMA), University of Navarra, Pamplona, Spain
| | - G Perea
- Cajal Institute, CSIC, Madrid, Spain
| | - J Oyarzabal
- Small Molecule Discovery Platform, Molecular Therapeutics Program, Center for Applied Medical Research (CIMA), University of Navarra, Pio XII, 55, 31008 Pamplona, Spain
| | - A Garcia-Osta
- Neurobiology of Alzheimer's Disease, Neurosciences Division, Center for Applied Medical Research (CIMA), University of Navarra, Pio XII, 31008 Pamplona, Spain
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9
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Abstract
Astrocytes are important regulatory elements in brain function. They respond to neurotransmitters and release gliotransmitters that modulate synaptic transmission. However, the cell- and synapse-specificity of the functional relationship between astrocytes and neurons in certain brain circuits remains unknown. In the dorsal striatum, which mainly comprises two intermingled subtypes (striatonigral and striatopallidal) of medium spiny neurons (MSNs) and synapses belonging to two neural circuits (the direct and indirect pathways of the basal ganglia), subpopulations of astrocytes selectively responded to specific MSN subtype activity. These subpopulations of astrocytes released glutamate that selectively activated N-methyl-d-aspartate receptors in homotypic, but not heterotypic, MSNs. Likewise, astrocyte subpopulations selectively regulated homotypic synapses through metabotropic glutamate receptor activation. Therefore, bidirectional astrocyte-neuron signaling selectively occurs between specific subpopulations of astrocytes, neurons, and synapses.
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Affiliation(s)
- R Martín
- Instituto Cajal, Consejo Superior de Investigaciones Científicas, 28002 Madrid, Spain
| | - R Bajo-Grañeras
- Instituto Cajal, Consejo Superior de Investigaciones Científicas, 28002 Madrid, Spain
| | - R Moratalla
- Instituto Cajal, Consejo Superior de Investigaciones Científicas, 28002 Madrid, Spain. Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - G Perea
- Instituto Cajal, Consejo Superior de Investigaciones Científicas, 28002 Madrid, Spain
| | - A Araque
- Department of Neuroscience, University of Minnesota, Minneapolis, MN 55455, USA.
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10
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Jung H, Kim M, Youn H, Wozniak-Skowerska I, Skowerski M, Skowerski M, Hoffmann A, Hoffmann A, Kolasa J, Kolasa J, Skowerski T, Skowerski T, Sosnowski M, Sosnowski M, Wnuk-Wojnar A, Wnuk-Wojnar A, Gasior Z, Gasior Z, Mizia-Stec K, Mizia-Stec K, Schirmer H, Forsdahl S, Sildnes T, Trovik T, Iqbal A, Astrom Aneq M, Engvall J, Abreu A, Oliveira L, Portugal G, Goncalves M, Mota Carmo M, Santa Clara H, Pereiro T, Oliveira M, Branco L, Ferreira R, Moody W, Sze Lin L, Bloxham N, Fraser H, Taylor R, Holloway B, Edwards N, Ferro C, Townend J, Steeds R, Perea G, Corneli M, Meretta A, Aguirre M, Rosa D, Henquin R, Ronderos R, Perez Balino N, Sunman H, Yorgun H, Sahiner L, Kaya B, Hazirolan T, Ozer N, Aytemir K, Tokgozoglu L, Kabakci G, Oto A, Peovska I, Srbinovska E, Hristova E, Otljanska M, Bosevski M, Arnaudova F, Andova V, Iwaki T. Moderated Posters session * Cardiovascular computed tomography, magnetic resonance and nuclear imaging: 13/12/2013, 08:30-12:30 * Location: Moderated Poster area. Eur Heart J Cardiovasc Imaging 2013. [DOI: 10.1093/ehjci/jet210] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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11
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Navarrete M, Perea G, Maglio L, Pastor J, Garcia de Sola R, Araque A. Astrocyte Calcium Signal and Gliotransmission in Human Brain Tissue. Cereb Cortex 2012; 23:1240-6. [DOI: 10.1093/cercor/bhs122] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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12
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Florensa L, Navarro JT, Pérez Vila ME, Domingo A, De la Banda E, Rozman M, Camós M, Millá F, Perea G, Alonso E, Ayats R, Aventín A, Cabezudo E, Espinet B, Merino A, Romero P, Sánchez C, Tuset E, Solé F, Feliu E, Fernández C, Gallart M, Vallespí T, Woessner S. [Persistent polyclonal B-cell lymphocytosis: study of 35 cases]. Med Clin (Barc) 2011; 136:565-73. [PMID: 21396665 DOI: 10.1016/j.medcli.2010.09.048] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2010] [Revised: 08/02/2010] [Accepted: 09/02/2010] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND OBJECTIVES Persistent polyclonal B-cell lymphocytosis (PPBL) is a rare entity, presenting especially in adult smoker women. It is characterized by an increase of serum IgM, DR7-HLA haplotype, cytogenetic abnormalities and multiple IgH/BCL-2 rearrangements. To date, it has not been elucidated whether this is a benign or premalignant disorder. We analyzed the PPBL characteristics with especial attention to its evolution. PATIENTS AND METHODS Thirty-five PPBL patients from 5 hospitals in Catalonia were retrospectively analyzed. A simultaneous morphologic review of the blood smears was performed by members of the GCCH in a 16 multiple-observer optic microscope. Clinical and biological data were also analyzed. RESULTS PPBL presents in the majority of cases with persistent polyclonal B-cell lymphocytosis and affects primarily smoker women. The morphologic hallmark, in absence of viral infections, is the presence of activated lymphocytes with bilobulated and/or cleaved nuclei, and nuclear pockets in the ultrastructural study. Increased serum IgM, HLA-DR7 haplotype, chromosomal abnormalities such as i(3)(q10) and multiple IgH/BCL-2 rearrangements were detected. Thirty-four out of 35 patients are alive after a median follow up of 70.7 months. One patient died because of lung adenocarcinoma and another developed a follicular lymphoma without relation to PPBL. CONCLUSIONS PPBL has an asymptomatic and stable evolution, although it frequently presents genetic abnormalities. It remains unknown whether it is a premalignant entity, similar to monoclonal gammopathies of unknown significance. Hence, accurate cytologic diagnosis and follow-up are essential.
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Affiliation(s)
- Lourdes Florensa
- Laboratori de Citologia Hematològica, Servei de Patologia, Hospital del Mar, Barcelona, España.
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13
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Pons I, Monteagudo M, Lucchetti G, Muñoz L, Perea G, Colomina I, Guiu J, Obiols J. Correlation between immature platelet fraction and reticulated platelets. Usefulness in the etiology diagnosis of thrombocytopenia. Eur J Haematol 2010; 85:158-63. [PMID: 20477866 DOI: 10.1111/j.1600-0609.2010.01468.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Reticulated platelets (RP) are a surrogate marker for megakaryocytic activity, but the limitation of this determination is the lack of standardization of methodology. The determination of the immature platelet fraction (IPF) is performed in a simple, automated, and reproducible way between laboratories. We analyzed the correlation between IPF and RP, and usefulness of IPF in patients with thrombocytopenia. METHODS RP were determined by flow cytometry using double staining with thiazole orange and CD61 PerCP. IPF was performed with Sysmex XE2100 analyzer. We used a control group with normal platelets, and thrombocytopenic patients were classified into three groups: Group 1. Central thrombocytopenia, Group 2. Thrombocytopenia as a result of enhanced peripheral platelet destruction, and Group 3. Peripheral non-immune thrombocytopenia by abnormal distribution. RESULTS Fourteen controls and 66 patients were analyzed. Group 1: 25 patients, they had mean and confidence interval 95% (95% CI) for IPF 8.67% (6.49-10.46%) and RP 4.08% (2.86-5.30%). Group 2: 20 patients, they had mean and 95%CI for IPF 16.80% (12.20-21.39%) and RP 16.14% (9.89-22.40%). Group 3: 21 patients, they had mean and 95% CI for IPF 9.04% (6.95-11.14%) and RP 5.23% (3.41-7.05%). The overall Pearson linear correlation between IPF and RP was r: 0.65. There were statistically significant differences in values of IPF and RP between Group 2 and the other two groups (P < 0.01). CONCLUSION There is a good correlation between IPF and RP mainly in thrombocytopenia by peripheral destruction. Determination of IPF is an easy technique in their implementation, standardized and reproducible, so it could be a useful screening technique in patients with thrombocytopenia.
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Affiliation(s)
- Issac Pons
- Internal Medicine Department, Corporació Sanitària Parc Taulí- Instituto Universitario, Universidad Autónoma de Barcelona, Sabadell, Barcelona
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14
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Nomdedéu JF, Perea G, Estivill C, Badell I, Lasa A, Aventín A. Microsatellite instability may involve the pentanucleotide repeat of the PIG3 promoter in bcr/abl acute lymphoblastic leukemia. Leuk Res 2007; 32:186-8. [PMID: 17367854 DOI: 10.1016/j.leukres.2007.01.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2007] [Revised: 01/25/2007] [Accepted: 01/26/2007] [Indexed: 12/01/2022]
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15
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Lasa A, Carricondo MT, Carnicer MJ, Perea G, Aventín A, Nomdedeu JF. A new D816 c-KIT gene mutation in refractory AML1-ETO leukemia. Haematologica 2006; 91:1283-4. [PMID: 16956837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023] Open
Abstract
One of the most common genetic events in acute myeloid leukemia (AML) is the t(8;21) (q22;q22) translocation, which contributes to leukemic transformation. However, different lines of evidence suggest that the AML1-ETO rearrangement is not sufficient to cause the full leukemic phenotype. Secondary genetic alterations such as mutations in receptor tyrosine kinases are thus required to induce overt AML. The incidence of c-KIT mutations in exon 17 was evaluated in 37 Spanish patients with AML1-ETO+ leukemias. c-KIT mutations were present in only two cases (6.6%) and were shown to be associated with an adverse outcome. The frequency of c-KIT mutations described here is much lower than in other reports.
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16
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Serrano E, Lasa A, Perea G, Carnicer MJ, Brunet S, Aventín A, Sierra J, Nomdedéu JF. Acute myeloid leukemia subgroups identified by pathway-restricted gene expression signatures. Acta Haematol 2006; 116:77-89. [PMID: 16914901 DOI: 10.1159/000093636] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2005] [Accepted: 08/05/2005] [Indexed: 11/19/2022]
Abstract
Acute myeloid leukemia (AML) is a heterogeneous group of disorders characterized by abnormal proliferation of myeloid precursors and a maturation block. Underlying genetic lesions determine an altered expression program (transcriptosome) that can be studied in depth by massive technologies. Alternatively, we selected a pathway profiling strategy based on the current knowledge in order to stratify de novo AML patients and identify those cases which would potentially benefit from the use of new chemotherapeutic agents. One hundred and thirty-two RNA samples obtained from de novo adult AML patients were tested for FLT3, FLT3-LG, NDST1, HDAC2, ATRX, FOS, DNMT1, DNMT3A, DNMT3B, NBS1, RAD50, MRE11A, Meis1 and Meis2 expression using quantitative PCR (qPCR) assays. Clinical and biologic findings were correlated with expression results. Cluster analysis was also performed. FLT3 expression defined three subgroups of patients. The best outcome was found in the group with the lowest FLT3 expression. Intermediate levels of FLT3 were associated with the worst outcome. Patients with low levels of ATRX more frequently presented an adverse karyotype whereas cases with preserved ATRX levels showed an excellent outcome. In accordance with previous results, Meis1 downregulation is a useful surrogate marker indicating a good prognosis in AML patients. Simple qPCR platforms may help to identify different biologic subgroups in AML.
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Affiliation(s)
- Elena Serrano
- Laboratori d'Hematologia, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
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17
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Perea G, Lasa A, Aventín A, Domingo A, Villamor N, Queipo de Llano MP, Llorente A, Juncà J, Palacios C, Fernández C, Gallart M, Font L, Tormo M, Florensa L, Bargay J, Martí JM, Vivancos P, Torres P, Berlanga JJ, Badell I, Brunet S, Sierra J, Nomdedéu JF. Prognostic value of minimal residual disease (MRD) in acute myeloid leukemia (AML) with favorable cytogenetics [t(8;21) and inv(16)]. Leukemia 2006; 20:87-94. [PMID: 16281071 DOI: 10.1038/sj.leu.2404015] [Citation(s) in RCA: 132] [Impact Index Per Article: 7.3] [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: 11/09/2022]
Abstract
Most patients with acute myeloid leukemia (AML) and t(8;21) or inv(16) have a good prognosis with current anthracycline- and cytarabine-based protocols. Tandem analysis with flow cytometry (FC) and real-time RT-PCR (RQ-PCR) was applied to 55 patients, 28 harboring a t(8;21) and 27 an inv(16), including one case with a novel CBFbeta/MYH11 transcript. A total of 31% (n=17) of CR patients relapsed: seven with t(8;21) and 10 with inv(16). The mean amount of minimal residual disease (MRD) detected by FC in relapsed and nonrelapsed patients was markedly different: 0.3 vs 0.08% (P=0.002) at the end of treatment. The mean number of fusion transcript copies/ ABL x 10(4) also differed between relapsed and non-relapsed patients: 2385 vs 122 (P=0.001) after induction, 56 vs 7.6 after intensification (P=0.0001) and 75 vs 3.3 (P=0.0001) at the end of chemotherapy. Relapses were more common in patients with FC MRD level >0.1% at the end of treatment than in patients with < or = 0.1%: cumulative incidence of relapse (CIR) was 67 and 21% (P=0.03), respectively. Likewise, using RQ-PCR, a cutoff level of >10 copies at the end of treatment correlated with a high risk of relapse: CIR was 75% for patients with RQ-PCR >10 compared to 21% for patients with RQ-PCR levels < or = 10 (P=0.04). Combined use of FC and RQ-PCR may improve MRD detection, and provide useful clinical information on relapse kinetics in AML patients.
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MESH Headings
- Acute Disease
- Adolescent
- Adult
- Aged
- Child
- Child, Preschool
- Chromosome Inversion
- Chromosomes, Human, Pair 16/genetics
- Chromosomes, Human, Pair 21/genetics
- Chromosomes, Human, Pair 8/genetics
- Cytogenetic Analysis
- Female
- Flow Cytometry
- Follow-Up Studies
- Humans
- Kinetics
- Leukemia, Myeloid/genetics
- Leukemia, Myeloid/metabolism
- Leukemia, Myeloid/therapy
- Male
- Middle Aged
- Neoplasm, Residual/diagnosis
- Neoplasm, Residual/genetics
- Neoplasm, Residual/therapy
- Prognosis
- Recurrence
- Reverse Transcriptase Polymerase Chain Reaction
- Risk Factors
- Survival Rate
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Affiliation(s)
- G Perea
- Hematology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
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Abstract
We introduce a simple model to produce EEG-like signals. The model is based on the assumption that the number of active nerve cells that generate an electric field, at a given time, is essentially chaotic. In accordance, we use the logistic equation together with a spike-like function to simulate the neuronal activity processes. With this model, we are able to generate EEG-like patterns, with quite a short time of calculation. Real pre-recorded neuronal and simulated signals, as well as their power spectra, are compared in terms of the main conventional EEG frequency peaks.
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Affiliation(s)
- G Perea
- Instituto de Física e Instituto de Investigación Sobre el Trabajo, Universidad de Guanajuato, León, Gto 37150, Mexico.
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Monzo M, Brunet S, Urbano-Ispizua A, Navarro A, Perea G, Esteve J, Artells R, Granell M, Berlanga J, Ribera JM, Bueno J, Llorente A, Guardia R, Tormo M, Torres P, Nomdedéu JF, Montserrat E, Sierra J. Genomic polymorphisms provide prognostic information in intermediate-risk acute myeloblastic leukemia. Blood 2006; 107:4871-9. [PMID: 16507781 DOI: 10.1182/blood-2005-08-3272] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.2] [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
AbstractCurrent prognostic factors for acute myeloblastic leukemia (AML) are not sufficient to accurately predict the group of patients in the intermediate-risk category who will successfully respond to treatment. Distinct patterns of inherited functional genomic polymorphisms might explain part of these heterogeneous prognoses. We used the allelic discrimination method to identify polymorphisms in GSTT1, SULT1C2, CDA, SXR (drug metabolic pathways), XPD, XPA, XPG, ERCC1, TOP2A (DNA repair), VEGF (angiogenesis), and MDR1 (multidrug resistance) genes in 110 adult patients with intermediate-risk AML, enrolled in the CETLAM-99 prospective trial. A multivariate prognostic model adjusted for age, white blood cell (WBC) count, French-American-British group, cytogenetics, MLL rearrangement, internal tandem duplication of FLT3 (FLT3-ITD), induction courses to achieve complete remission, and germline polymorphisms, was used to detect independent risk factors associated with clinical outcome. This analysis showed an increased risk of refractoriness to chemotherapy in the group of patients with XPA variant alleles (RR = 14; P = .02). In the same model, increased relapse risk was associated with SULT1C2 heterozygosity (RR = 4.1; P = .004), FLT3-ITD (RR 3.3; P = .003), and MDR1 variant alleles (RR = 2.4; P = .02). Adverse prognostic variables for overall survival were XPA (RR = 3.4; P = .02) and MDR1 (RR = 2.1; P = .02) variant alleles, and WBC count (RR = 2.1; P = .02). These findings might be useful in selecting risk-adapted treatment strategies in intermediate-risk AML.
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Affiliation(s)
- Mariano Monzo
- Hospital Clínic, Hospital Universitario de la Santa Creu i Sant Pau, Barcelona, Spain
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20
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Perea G, Domingo A, Villamor N, Palacios C, Juncà J, Torres P, Llorente A, Fernández C, Tormo M, Queipo de Llano MP, Bargay J, Gallart M, Florensa L, Vivancos P, Martí JM, Font L, Berlanga J, Esteve J, Bueno J, Ribera JM, Brunet S, Sierra J, Nomdedéu JF. Adverse prognostic impact of CD36 and CD2 expression in adult de novo acute myeloid leukemia patients. Leuk Res 2005; 29:1109-16. [PMID: 16095690 DOI: 10.1016/j.leukres.2005.02.015] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2005] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND OBJECTIVES A consecutive series of acute myeloid leukemias (AML) patients was analyzed in conditions which reduce the inter-assay variations (the same flow cytometer, the same observers and the same panel of monoclonal antibodies) in order to investigate the prognostic information provided by flow cytometry. DESIGN AND METHODS Two hundred and sixty-six bone marrow (BM) samples from 326 patients enrolled in the LMA-99 protocol from the CETLAM group were studied by multiparametric flow cytometry. Immunophenotyping studies were performed on erythrocyte-lysed BM samples. Antigen expression of leukemic cells was analyzed using triple stainings with fluorochrome-conjugated combinations of monoclonal antibodies. RESULTS CD2 was positive in 21 cases (8%); an associated inv(16) was detected in eight CD2+ cases (38%). Two-year overall survival (OS) rate for CD2+/inv(16)+ patients was 75%, whereas it was 0% for CD2+/inv(16)- patients and 47% for CD2- patients (p=0.0001). CD36 was expressed in 37% of patients (n=98). Two-year leukemia-free survival (LFS) rate was 34% for CD36+ patients and 55% for CD36- patients (p=0.001). In the multivariate analysis, CD2+ (RR=8.4; p=0.0001) and adverse karyotype (RR=10.2; p=0.0001) were associated with a lower CR rate, CD36+ (RR=1.5; p=0.03), CD2+ (RR=2; p=0.04) and adverse karyotype (RR=4; p=0.0001) were associated with a lower OS and CD36+ (RR=2; p=0.002) and adverse karyotype (RR=3.5; p=0.005) predicted a lower LFS. CONCLUSIONS CD2+ patients had a very poor OS when CD2/inv(16)+ cases were excluded. CD36 and CD2 expression at diagnosis can provide prognostically important information in adult de novo AML.
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Affiliation(s)
- G Perea
- Laboratori d'Hematologia, Hospital de la Santa Creu i Sant Pau, Avda Sant Antoni M. Claret, 167, 08025 Barcelona, Spain
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21
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Perea G, Altés A, Montoto S, López-Guillermo A, Domingo-Doménech E, Fernández-Sevilla A, Ribera JM, Grau J, Pedro C, Angel Hernández J, Estany C, Briones J, Martino R, Sureda A, Sierra J, Montserrat E. Prognostic indexes in follicular lymphoma: a comparison of different prognostic systems. Ann Oncol 2005; 16:1508-13. [PMID: 15939718 DOI: 10.1093/annonc/mdi269] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.9] [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: 11/14/2022] Open
Abstract
BACKGROUND The International Prognostic Index (IPI), initially designed for aggressive lymphomas, is also used in follicular lymphoma (FL) and other indolent lymphomas. Two new prognostic indexes have recently been proposed for FL [the Italian Lymphoma Intergroup (ILI) Index and the Follicular Lymphoma International Prognostic Index (FLIPI)]. PATIENTS AND METHODS Three indexes, IPI [age >60 years, extranodal involvement two or more sites, elevated lactate dehydrogenase (LDH), Eastern Cooperative Oncology Group performance status > or =2, stage > or =3], ILI (age >60 years, extranodal involvement two or more sites, elevated LDH, male sex, B symptoms, erythrocyte sedimentation rate > or =30 mm first hour) and FLIPI (age >60 years, stage > or =3, elevated LDH, nodal involvement five or more, haemoglobin level < or =12 g/dl) were calculated in 411 patients with FL. RESULTS Overall concordance between the three indexes was 54%. A total of 126 (31%) patients were included in the high-risk group according to IPI, 131 (32%) according to ILI and 157 (38%) after FLIPI application. Ten-year overall survival rates after applying the prognostic indexes (IPI, ILI and FLIPI) were, respectively: 72%, 71% and 72%, in the low-risk group; 51%, 60% and 49% in the intermediate-risk group; and 24%, 16% and 31% in the high-risk group. CONCLUSIONS In this series, all three indexes, IPI, ILI and FLIPI, were useful to classify FL patients into differentiated risk groups, although the FLIPI identified a larger proportion of high-risk patients than the IPI and ILI.
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Affiliation(s)
- G Perea
- Clinical Hematology Division, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Spain.
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Nomdedéu JF, Perea G, Estivill C, Lasa A, Carnicer MJ, Brunet S, Aventín A, Sierra J. Microsatellite instability is not an uncommon finding in adult de novo acute myeloid leukemia. Ann Hematol 2005; 84:368-75. [PMID: 15789228 DOI: 10.1007/s00277-005-1035-3] [Citation(s) in RCA: 13] [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] [Received: 12/22/2004] [Accepted: 02/24/2005] [Indexed: 01/03/2023]
Abstract
To investigate the biologic relevance of microsatellite instability (MSI) in de novo acute myeloid leukemia (AML), 102 consecutive adult patients were analyzed by using a panel of seven microsatellites (BAT25, BAT26, D13S1267, D13S174, D2S123, D5S346 and Mdf15). Frame-shift mutations in the repetitive sequences in the coding region of MSH3, MSH6, BAX, TGFBRII and IGFRII were also investigated by using a fluorescent PCR-based assay. Methylation-specific PCR was used to determine the methylation status of hMLH1 in MSI+ cases. MSH3, MSH6 and MLH1 expression was also analyzed in 68 cases by means of real-time quantitative PCR. MSI was detected in 20 cases: 14 cases had MSI-high (instability of at least two microsatellite markers) and 6 cases corresponded to MSI-low (a single polymorphic marker with instability). Six MSI+ cases showed an associated MLL rearrangement (p=0.002). No single case showed a mutation in the repetitive sequences of the MSH3, MSH6, BAX, TGFBRII and IGFRII genes. Most samples displayed low mRNA levels of the repair genes. hMLH1 promoter was hypermethylated in five MSI+ cases. Overall survival analysis revealed no adverse effect of MSI positivity. These results suggest that MSI may be a common biologic finding in de novo AML.
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Affiliation(s)
- Josep F Nomdedéu
- Department of Hematology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
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Nomdedéu J, Carricondo MT, Lasa A, Perea G, Aventin A, Sierra J. Low frequency of exon 3 PTPN11 mutations in adult de novo acute myeloid leukemia. Analysis of a consecutive series of 173 patients. Haematologica 2005; 90:412-3. [PMID: 15749679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
A total of 173 samples obtained from adult patients with de novo acute myeloid leukemia (AML) were assayed for exon 3 PTPN11 mutations by single strand conformation polymorphism (SSCP) analysis and direct sequencing. Only three monocytic leukemias had point mutations (1.73%).
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Montoto S, López-Guillermo A, Altés A, Perea G, Ferrer A, Camós M, Villela L, Bosch F, Esteve J, Cervantes F, Bladé J, Nomdedeu B, Campo E, Sierra J, Montserrat E. Predictive value of Follicular Lymphoma International Prognostic Index (FLIPI) in patients with follicular lymphoma at first progression. Ann Oncol 2005; 15:1484-9. [PMID: 15367408 DOI: 10.1093/annonc/mdh406] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.2] [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: 02/01/2023] Open
Abstract
BACKGROUND Different prognostic scores have been proposed to predict the outcome of follicular lymphoma (FL) patients at diagnosis. A new prognostic index specifically addressing FL patients, the Follicular Lymphoma International Prognostic Index (FLIPI), has recently been developed, which might also be useful in patients with progression. PATIENTS AND METHODS One hundred and three patients (55 male, 48 female; median age 59 years) with FL in first relapse/progression after an initial response to therapy (50 complete responders/ 53 partial responders) were included in the study. RESULTS Five-year survival from progression (SFP) was 55% (95% confidence interval 44%-66%). The distribution according to the FLIPI at relapse was 39% good prognosis, 24% intermediate prognosis and 37% poor prognosis. Five-year SFP for these groups were 85%, 79% and 28%, respectively (P < 0.0001). Other variables at relapse with prognostic significance for SFP were age, presence of B symptoms, performance status, bulky disease, number of involved nodal sites, lactate dehydrogenase level, hemoglobin level, histological transformation, the Italian Lymphoma Intergroup prognostic index for FL and the International Prognostic Index for aggressive lymphomas. In the multivariate analysis bulky disease (P=0.01), presence of B symptoms (P=0.03) and FLIPI at relapse (P=0.0003) were the most important variables for predicting SFP. CONCLUSIONS In patients with FL at first relapse/progression, the FLIPI, along with the presence of bulky disease and B symptoms, are features that predict SFP and thus could be useful to select candidates for experimental treatments.
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Affiliation(s)
- S Montoto
- Department of Hematology and Hematopathology Unit, Hospital Clínic, IDIBAPS, Barcelona
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25
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Perea G, Altés A, Bellido M, Aventín A, Bordes R, Ayats R, Remacha AF, Espinosa I, Briones J, Sierra J, Nomdedéu JF. Clinical utility of bone marrow flow cytometry in B-cell non-Hodgkin lymphomas (B-NHL). Histopathology 2004; 45:268-74. [PMID: 15330805 DOI: 10.1111/j.1365-2559.2004.01937.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [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: 11/27/2022]
Abstract
AIM To determine the efficacy of flow cytometry (FC) in the assessment of bone marrow (BM) in B-cell non-Hodgkin lymphoma (B-NHL). FC is a common practice, but is far from being validated. METHODS AND RESULTS Morphological analysis and FC immunophenotyping were performed on 421 samples. T-cell lymphomas, Hodgkin's disease, chronic lymphocytic leukaemia and hairy cell leukaemia were not included in the study. Clonality was assessed by the standard kappa/lambda/CD19 test. Aberrant immunophenotypes present in the B-cell subpopulation were also investigated. A double-step procedure was employed in all cases to increase the sensitivity of the FC procedure. Of 380 evaluable samples, 188 corresponded to follicular lymphoma (FL), 58 to diffuse large B-cell lymphoma (DLBCL), 57 to mantle cell lymphoma (MCL), seven to Burkitt's lymphoma and the remaining 70 samples to other low-grade lymphomas. Morphological marrow infiltration was found in 148 cases, and flow immunophenotyping identified 138 cases with BM involvement. A concordance between the two methods was detected in 298 cases (79%). There was a discordance in 82 cases (21%): morphology positive/FC negative in 46 cases and morphology negative/FC positive in 36 (61% of all cases with discordance were from FL). There was no difference in outcome when patients with discordances were compared with patients without discordances. CONCLUSIONS Most samples showed concordance between morphological and FC results. FC identified BM involvement in the absence of morphological infiltration. Morphology/FC discordance seems to have no influence on the outcome of FL patients.
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Affiliation(s)
- G Perea
- Department of Haematology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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Abstract
During the last years, a great amount of evidence demonstrates the existence of bidirectional communication between astrocytes and neurons, which has revealed an important active role of astrocytes in the physiology of the nervous system. As a consequence of this evidence, a new concept of the synaptic physiology--"the tripartite synapse"--has been proposed, in which the synapse is formed by three functional elements, i.e., the pre- and postsynaptic elements and the surrounding astrocytes. In this scenario astrocytes play an active role as dynamic regulatory elements in neurotransmission by reciprocally exchanging information with the pre- and postsynaptic elements. The control of the Ca2+ excitability in astrocytes is a key element in this loop of information exchange. In the present article we review and discuss our current knowledge of the properties of the astrocyte intracellular Ca2+ signal and its modulation by the synaptic activity.
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Affiliation(s)
- G Perea
- Instituto Cajal, Consejo Superior de Investigaciones Científicas, Madrid, Spain
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Nomdedéu JF, Perea G, Estivill C, Lasa A, Brunet S, Aventín A, Sierra J. Loss of heterozygosity of the polymorphic PIG3 microsatellite with low frequency in de novo acute myeloid leukemias. Leukemia 2004; 18:1148-9. [PMID: 15085148 DOI: 10.1038/sj.leu.2403379] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Perea G, Altés A, Montoto S, López-Guillermo A, Bosch F, Jiménez M, Esteve J, Domingo E, Ribera JM, Pedro C, Martino R, Briones J, Sureda A, Brunet S, Sierra J, Montserrat E. International and Italian prognostic indices in follicular lymphoma. Haematologica 2003; 88:700-4. [PMID: 12801847] [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: 03/03/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The International Prognostic Index (IPI), initially designed for aggressive lymphomas, has been successfully used in patients with follicular lymphoma (FL). The Italian Lymphoma Intergroup (ILI) created a new prognostic index specific for FL. The aim of this study was to compare which of these two indices is more useful when applied to a large group of FL patients. DESIGN AND METHODS Both indices, IPI (age >60 years, extranodal involvement >=2 sites, elevated lactate dehydrogenase, ECOG >=2, stage >=3) and ILI (age >60 years, extranodal involvement >=2 sites, elevated lactate dehydrogenase, male sex, B symptoms, erythrocyte sedimentation rate >=30 mm 1(st) hour) were calculated in a group of 398 FL patients. Overall survival (OS) and progression-free survival (PFS) associated with each prognostic group were calculated according to the Kaplan-Meier method. RESULTS The overall concordance between both indices was 73%. According to the IPI 122 patients (31%) were in the higher risk group, whereas according to the ILI 132 (33%) were; concordance between the high risk groups was 66%. The 10-years OS and PFS rates after applying the IPI system were 73% and 37%, respectively, in the low risk groups; 47% and 26%, in the intermediate risk groups and 25% and 2%, in the high risk groups (log-rank=69.2 and 41.3, respectively; p<0.0001). According to ILI index the 10-year OS and PFS were 60% and 34%, respectively, in the low risk groups; 59% and 30%, in the intermediate risk groups and 17% and 0%, in the high risk groups (log-rank=86.6 and 58.5, respectively; p<0.0001). INTERPRETATION AND CONCLUSIONS Both the IPI and ILI index, are useful for classifying FL patients into different risk groups. Although it seems that the ILI index has a higher discriminating power among groups, significant differences were not observed in identifying FL patients with a poor outcome.
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Affiliation(s)
- Granada Perea
- Department of Hematology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
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Perea G, Araque A. [New information pathways in the nervous system: communication between astrocytes and neurones]. Rev Neurol 2003; 36:137-44. [PMID: 12589601] [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: 02/28/2023]
Abstract
INTRODUCTION AND METHOD Astrocytes, a type of glial cell in the central nervous system (CNS), have been classically considered as trophic, structural and supportive cells for neurons. However, in recent years, accumulating evidence suggest a more active role of astrocytes in the physiology of neurons, being involved in the information processing of the CNS. Astrocytes exhibit both a form of excitability based on variations of the intracellular Ca2+ concentration, and a form of communication based on intercellular Ca2+ waves. Furthermore, synaptically released neurotransmitters mobilize Ca2+ from the astrocytic intracellular stores, i.e., the astrocytic cellular excitability can be triggered by the synaptic activity. Finally, astrocytes release the transmitter glutamate to the extracellular space through a Ca2+ dependent mechanism, modulating the neuronal electrical activity and the synaptic transmission. As a consequence of the demonstration of these new forms of cellular communication between astrocytes and neurons, the concept of tripartite synapse has been proposed, in which the synapse is functionally constituted by three elements, i.e., the pre and postsynaptic elements and the surrounding astrocytes. CONCLUSION The novel results discussed in the present review support the presence of new and complex information pathways in the CNS, which are based on the existence of bidirectional communication between astrocytes and neurons, and which have relevant consequences on the cellular mechanisms responsible for the information processing of the CNS.
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Affiliation(s)
- G Perea
- Instituto Cajal, Consejo Superior de Investigaciones Cientificas, Madrid, España
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Remacha AF, Souto JC, Rámila E, Perea G, Sarda MP, Fontcuberta J. Enhanced risk of thrombotic disease in patients with acquired vitamin B12 and/or folate deficiency: role of hyperhomocysteinemia. Ann Hematol 2002; 81:616-21. [PMID: 12454698 DOI: 10.1007/s00277-002-0560-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2002] [Accepted: 10/07/2002] [Indexed: 11/30/2022]
Abstract
A number of studies have identified elevated levels of homocysteine (Hcy) as a risk factor for thrombosis. Given the relationship between Hcy and thrombosis, a high prevalence of thrombosis would be expected in patients with megaloblastic anemia. The aim of our study was to determine whether an acquired vitamin B12/folate deficiency is a risk factor for thrombosis. A retrospective case and control study was performed that included 193 cases with reduced levels of vitamin B12/folate. The cases were divided initially into two groups (105 with serum vitamin B12 < or =150 pmol/l and/or low red cell folate < or = 450 nmol/l and 88 with serum vitamin B12 between 150 and 200 pmol/l and/or red cell folate between 450 and 590 nmol/l). The control group consisted of 87 additional patients who had normal levels of serum vitamin B12, red cell folate, and normal renal function. Serum Hcy, thrombotic events, and risk factors were evaluated in all participants. Eight patients (9%) in the control group had had previous vascular events although only three of these events (37.5%) were observed between the vitamin study and 2 years prior to the study. In the case group, 20% of the patients had a history of thrombosis. In contrast with controls, 85% of cases suffered thrombosis between the time they were diagnosed and 2 years prior to the time they were diagnosed as showing a vitamin deficiency. Multivariate analysis demonstrated that vitamin deficiency was a significant risk factor for arterial thrombosis [adjusted odds ratio (OR) 3.3, confidence interval (CI) 1.1-10.2]. However, when hyperhomocysteinemia was included in the analysis, vitamin deficiency was no longer a risk factor, suggesting that hyperhomocysteinemia was responsible for arterial thrombotic risk in these patients (adjusted OR 2.5, CI 1.1-5.8). As a consequence of hyperhomocysteinemia, patients with acquired vitamin deficiency of vitamin B12/folate had a high risk of thrombosis. However, a more extensive study that controls risk variables and genetic factors is needed to sort out the various contributing factors.
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Affiliation(s)
- A F Remacha
- Department of Hematology, Hospital de la Santa Creu i Sant Pau, Avda. Padre Claret 167, Barcelona 08025, Spain.
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Salar A, Martino R, Perea G, Ribera JM, López-Guillermo A, Guardia R, Escoda L, Altés A, Sierra J, Montserrat E. High-dose infusional ifosfamide, etoposide plus methylprednisolone followed by dexamethasone, high-dose ara-C and cisplatinum and autologous stem cell transplantation for refractory or relapsed aggressive non-Hodgkin's lymphoma. Haematologica 2002; 87:1028-35. [PMID: 12368156] [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: 02/26/2023] Open
Abstract
BACKGROUND AND OBJECTIVES A salvage program including infusional high-dose ifosfamide plus etoposide (IFOVM) was evaluated in patients with refractory or relapsed aggressive non-Hodgkin's lymphoma. DESIGN AND METHODS Forty-six patients were included. IFOVM consisted of ifosfamide (10 g/m2 as a 72-hour continuous infusion), etoposide (900 mg/m2) and methylprednisolone; responding patients underwent two cycles of DHAP and subsequently an autologous peripheral blood stem cell transplantation (APBSCT) with BEAM as the conditioning regimen. RESULTS All but one patient showed tumor regression following IFOVM. Myelosuppression was brief but 26 patients developed neutropenic fever. All but two patients proceeded to DHAP. Overall response rate to IFOVM/DHAP was 59% (29% CR and 30% PR). Refractory patients had a significantly lower response rate than relapsed patients (39% vs. 85% p=0.002). All refractory patients with intermediate-high or high IPI progressed during IFOVM/DHAP. Twenty-seven patients proceeded to APBSCT. Two-year overall survival of patients with low or low-intermediate IPI was 47% [95% CI 25-69%], which was significantly better than that obtained in patients with intermediate-high or high IPI (11% [95% CI 0-22%] p=0.0001). INTERPRETATION AND CONCLUSIONS This sequential regimen of IFOVM, followed by DHAP and consolidated with BEAM is active in relapsed or refractory patients with low or low-intermediate IPI aggressive lymphoma. However, it has little activity in those patients with intermediate or high IPI, especially in refractory lymphomas.
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Affiliation(s)
- Antonio Salar
- Department of Clinical Hematology from Hospital del Mar, Hospital de la Santa Cruz y San Pablo, Hospital Germans Trias i Pujol, Hospital Clínic, Barcelona, Spain.
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Martino R, Perea G, Caballero MD, Mateos MV, Ribera JM, de Oteyza JP, Arranz R, Terol MJ, Sierra J, San Miguel JF. Cyclophosphamide, pegylated liposomal doxorubicin (Caelyx), vincristine and prednisone (CCOP) in elderly patients with diffuse large B-cell lymphoma: results from a prospective phase II study. Haematologica 2002; 87:822-7. [PMID: 12161358] [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: 02/26/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Anthracycline-based combination chemotherapy regimens are the standard therapy for patients with diffuse large B-cell lymphoma (DLBCL), but such regimens may be poorly tolerated in elderly patients. DESIGN AND METHODS In a prospective phase II study we analyzed the feasibility of a regimen (CCOP) that includes pegylated liposomal doxorubicin (Caelyx ) plus vincristine, cyclophosphamide and prednisone in patients with DLBCL above the age of 60 years. RESULTS Thirty-three patients, with a median age of 74 years, were enrolled in the study. The overall response rate was 64% (49% complete remissions and 15% partial remissions). The estimated one-year overall and event-free survivals were 55% (95% CI, 38-72) and 45% (95%CI, 28-62), respectively. The only relevant toxicity was neutropenia, which reached grades 3-4 in 21 cases (64%). INTERPRETATION AND CONCLUSIONS These results suggest that CCOP appears to be an acceptable alternative for elderly patients with DLBCL, and randomized trials against a conventional doxorubicin-containing regimen are justified.
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Affiliation(s)
- Rodrigo Martino
- Servei d'Hematologia Clínica, Hospital de la Santa Creu i Sant Pau, Av. Sant Antoni M(a) Claret 167, 08025 Barcelona, Spain.
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Bellido M, Rubiol E, Ubeda J, Estivill C, Perea G, Rego-Araujo J, Aventín A, Bordes R, Sierra J, Nomdedéu JF. Clonal heterogeneity assessed by flow cytometry in B-cell lymphomas arising from germinal centers. Am J Clin Pathol 2002; 117:864-70. [PMID: 12047137 DOI: 10.1309/dd89-m2cq-00mr-ekta] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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] Open
Abstract
Patients with mature follicular B-cell lymphomas develop aggressive non-Hodgkin lymphomas (NHLs) during disease progression. It is controversial whether most diffuse large B-cell lymphomas (DLBCLs) and Burkitt lymphomas (BLs) emerge as de novo lymphomas or from an original follicular lymphoma. To distinguish clonally related populations in aggressive NHL, we studied the immunophenotypic features of 18 consecutive samples from 16 patients. Three flow cytometric patterns were distinguished: (1) a homogeneous neoplastic population of large B cells with phenotypic features of follicular center cells; (2) 2 atypical populations of B cells, small monoclonal B cells, and large B cells with loss of some surface antigens; and (3) 2 clonal populations of small and large B cells sharing the same light-chain isotype. The 3 flow cytometric patterns were observed, respectively, in de novo DLBCL and BL, transformation into BL, and transformation into DLBCL. Flow cytometric data can provide valuable information about the natural history of NHL.
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MESH Headings
- Biomarkers, Tumor/analysis
- Blotting, Southern
- Cell Transformation, Neoplastic/genetics
- Cell Transformation, Neoplastic/pathology
- Chromosome Banding
- Clone Cells
- DNA, Neoplasm/analysis
- Female
- Flow Cytometry/methods
- Genetic Heterogeneity
- Germinal Center/pathology
- Humans
- Immunophenotyping
- Lymphoma, B-Cell/classification
- Lymphoma, B-Cell/genetics
- Lymphoma, B-Cell/pathology
- Lymphoma, Follicular/genetics
- Lymphoma, Follicular/immunology
- Lymphoma, Follicular/pathology
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/immunology
- Lymphoma, Large B-Cell, Diffuse/pathology
- Male
- Polymerase Chain Reaction
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Affiliation(s)
- Mar Bellido
- Department of Hematology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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Perea G, Sureda A, Martino R, Altés A, Martínez C, Cabezudo E, Amill B, Martín-Henao GA, González Y, Muñoz L, Peyret M, Brunet S, Sierra J. Predictive factors for a successful mobilization of peripheral blood CD34+ cells in multiple myeloma. Ann Hematol 2001; 80:592-7. [PMID: 11732870 DOI: 10.1007/s002770100351] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.1] [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: 11/25/2022]
Abstract
We analyzed the prognostic factors for a successful mobilization and peripheral blood stem cell collection in a series of 57 consecutive patients with multiple myeloma (MM); a new scoring system to predict an adequate mobilization in this subset of patients was also constructed. A total of 221 aphereses were performed in 57 patients with MM. The median time from diagnosis to mobilization was 12 months (range 4-120). Only one line of chemotherapy was administered before mobilization to 36 patients and two or more to 21. The median number of alkylating chemotherapy cycles was 6 (2-33). Two patients were mobilized in complete remission, 32 in partial response, and 23 in stable/progressive disease. Significant adverse prognostic factors for collecting 2.5 x 10(6) CD34+cells/kg or more were: a period of at least 12 months from diagnosis, at least six cycles of alkylating agents, and a plasma cell infiltration of 20% or more prior to mobilization. Patients with three risk factors had a probability of only 0.38 (95% CI 0.3-0.9) for adequate mobilization. Ten patients failed to mobilize; a period from diagnosis of 12 months or more and female sex were unfavorable factors. Patients with two risk factors had a probability of 0.50 (95% CI 0.2-0.8) for failing the mobilization procedure. These findings indicate that MM patients must be mobilized early in the course of the disease, with minimal disease burden before severe hematopoietic progenitor cell injury due to cumulative therapy.
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Affiliation(s)
- G Perea
- Clinical Hematology Division and Blood Bank, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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Perea G, Remacha A, Besses C, Jiménez M, Florensa L, Cervantes F. Is polycythemia vera a serious disease in young adults? Haematologica 2001; 86:543-4. [PMID: 11410422] [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: 02/20/2023] Open
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Rámila E, Sureda A, Martino R, Santamaría A, Franquet T, Puzo C, Montesinos J, Perea G, Sierra J. Bronchoscopy guided by high-resolution computed tomography for the diagnosis of pulmonary infections in patients with hematologic malignancies and normal plain chest X-ray. Haematologica 2000; 85:961-6. [PMID: 10980635] [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] Open
Abstract
BACKGROUND AND OBJECTIVES High-resolution computed tomography (HRCT) of the chest is able to demonstrate the presence of pulmonary infiltrates in febrile neutropenic patients with normal chest X-rays. Fiberoptic bronchoscopy with bronchoalveolar lavage (BAL) is a safe procedure for the etiological diagnosis of pulmonary infiltrates in oncohematologic patients. The objective of this study was to determine the diagnostic yield and subsequent therapeutic changes of a protected BAL (p-BAL) guided by HRCT in febrile oncohematologic patients unresponsive to broad-spectrum antibiotics with a normal chest X-ray. DESIGN AND METHODS Twenty-two episodes from 20 oncohematologic patients were included: group A, 9 episodes (8 patients) with no respiratory symptoms and group B, 13 episodes (12 patients) with signs or symptoms of pulmonary infection. HRCT and p-BAL were performed in all episodes within the first 24 hours. RESULTS HRCT showed abnormalities in all 22 episodes (bilateral abnormalities in 14 of the 22 episodes [64%]) and the most frequent pattern was ground-glass infiltrate (7 out of 22 episodes). An infectious agent was isolated in 12 of the 22 episodes, 5 in group A and 7 in group B with a diagnostic yield of 54%. Antimicrobial therapy was modified in 12 of the 22 episodes (54%): 5 in group A and 7 in group B. In 6 episodes, treatment was changed according to HRCT results and in the remaining 6 due to positive microbiologic results. Modifications in empirical therapy were associated with a favorable response in 44% episodes of group A and in 31% of group B. INTERPRETATION AND CONCLUSIONS Oncohematologic patients with fever of unknown origin unresponsive to empirical antibiotics and with a normal chest X-ray can be candidates to undergo a HRCT. This subgroup of high-risk patients can benefit from a combined strategy consisting of BAL guided by a previous HRCT.
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Affiliation(s)
- E Rámila
- Clinical Hematology Division; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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Altés A, López R, Martino R, Martinez C, Cabezudo E, Muñoz L, Santamaría A, Perea G, Briones J, Salar A, Sureda A, Brunet S, Madoz P, Sierra J. Mobilization kinetics of peripheral blood progenitor cells after IAPVP-16 salvage chemotherapy plus G-CSF in lymphoproliferative disorders. Bone Marrow Transplant 2000; 26:127-32. [PMID: 10918421 DOI: 10.1038/sj.bmt.1702476] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [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: 11/08/2022]
Abstract
We have explored the efficacy of salvage chemotherapy combination, IAPVP-16 (ifosfamide 5 g/m2 on day 1; VP-16 100 mg/m2 on days 1-3; ara-C 1.2 g/m2/12 h on days 1 and 2; methylprednisolone 80 mg/m2 on days 1-5) plus G-CSF for PBPC mobilization. This protocol was used in 45 patients with relapsed or refractory lymphoproliferative diseases who underwent 85 leukaphereses. In 41 patients > 2 x 106/kg CD34+ cells were obtained after a median of two procedures. The median number of CD34+ cells harvested was 3.2 x 106/kg per apheresis and 8.4 x 106/kg per patient. Seven of 10 patients who had failed previous mobilization attempts achieved more than 2 x 106 CD34+ cells/kg in a maximum of three aphereses. A history of previous mobilization failure and a low platelet count (<150 x 109/l) negatively influenced the CD34+ cell yield in univariate and multivariate analyses. A good correlation was found between the circulating CD34+ cells/microl and the CD34+ cells and CFU-GM in the leukaphereses products (r = 0.93 and r = 0.73, P < 0.001), and > or =17 CD34+ cells/microl predicted the achievement of > 2 x 106/kg CD34+ cells in a single leukapheresis in more than 90% of cases. IAPVP-16 plus G-CSF may be specially indicated in tandem transplantations or CD34+ selection and in patients who have failed previous mobilization attempts.
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Affiliation(s)
- A Altés
- Clinical Hematology Division, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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Perea G, Salar A, Altés A, Brunet S, Sierra J. Acute hepatomegaly with severe liver toxicity due to all-trans-retinoic acid. Haematologica 2000; 85:551-2. [PMID: 10800178] [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: 02/16/2023] Open
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Perea G, Sánchez R, Yong M. [Comparison of growth rate of Helisoma duryi (Wetherby, 1879) and Helisoma scalare (Jay, 1839) (Mollusca: Planorbidae)]. Rev Cubana Med Trop 1985; 37:150-4. [PMID: 3914002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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