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Mrsić M, Labar B, Serventi-Seiwerth R, Potočki K, Fumić K, Stern-Padovan R, Prutki M, Duraković N, Bogdanić V. P102 Bone marrow trabnsplantation for acute myeloid leukemia from donor with Gaucher disease followed by enzyme replacement therapy (ERT). Leuk Res 2007. [DOI: 10.1016/s0145-2126(07)70450-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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2
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Radman I, Basić N, Labar B, Kovacević J, Aurer I, Bogdanić V, Zupancić-Salek S, Nemet D, Jakić-Razumović J, Mrsić M, Santek F, Grgić-Markulin L, Boban D. Long-term results of conventional-dose salvage chemotherapy in patients with refractory and relapsed Hodgkin's disease (Croatian experience). Ann Oncol 2002; 13:1650-5. [PMID: 12377656 DOI: 10.1093/annonc/mdf271] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The aim of this study was to analyze outcome of patients with Hodgkin's disease (HD) in whom first-line chemotherapy with mustine/vincristine/procarbazine/prednisone (MOPP) had failed. PATIENTS AND METHODS From January 1982 to December 1989 among 210 patients treated with MOPP and radiotherapy to initial bulky sites, 65 patients were primary refractory to or relapsed after initial treatment. RESULTS Twenty-nine of 65 patients (44%) were primary refractory to initial chemotherapy, 20 relapsed within 12 months after complete remission (CR) and 16 relapsed after CR that lasted more than 12 months. Patients with primary refractory HD and early relapse (<12 months after CR) were treated with doxorubicin/bleomycin/vinblastine/darcarbazine. In patients with late relapse (>12 months after CR) MOPP was repeated. The median follow-up for all patients was 115 months. The overall response rate was 63%. Thirty-three patients (51%) achieved a second CR and eight patients (12%) partial response. Remission rate was greatest in patients with late relapse (CR >12 months) (75 versus 55% for early relapse versus 35% for primary refractory HD) (P <0.01). At 10 years, overall and failure-free survival rates were 21 and 16%, respectively. Patients who were in first remission longer than 12 months had a superior overall survival (37 versus 18% for early relapse) and failure-free survival (24 versus 10% for early relapse). No patient with primary refractory HD was alive beyond 52 months after initial treatment failure (P <0.01). Main prognostic factors were duration of the first remission and tumor bulk at relapse. CONCLUSIONS Our results confirm previous observations that a significant proportion of patients with HD who experience induction treatment failure cannot be cured with conventional treatment and probably need more aggressive therapy.
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Affiliation(s)
- I Radman
- Department of Internal Medicine, Division of Hematology, Clinical Hospital Center Rebro, Zagreb, Croatia
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3
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Mrsić M, Grgić M, Budisić Z, Podolski P, Bogdanić V, Labar B, Jakić-Razumović J, Restek-Samarzija N, Gosev M. Trastuzumab in the treatment of advanced breast cancer: single-center experience. Ann Oncol 2002; 12 Suppl 1:S95-6. [PMID: 11521730 DOI: 10.1093/annonc/12.suppl_1.s95] [Citation(s) in RCA: 3] [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: 11/14/2022] Open
Abstract
A significant number of women with advanced breast cancer fail to respond to standard-dose chemotherapy. From the beginning of 1999, 17 women with HER2 positive advanced breast cancer received Herceptin as monotherapy or in combination with paclitaxel or other non-anthracyclines. Eight (47%) women previously received high-dose chemotherapy followed by haematopoiesis stem cell rescue. Three women received Herceptin alone, eleven Herceptin plus paclitaxel and three Herceptin and some of the other non-anthracyclines (CCNU, cisplatin and gemcitabine). In the group of patients who received Herceptin monotherapy, one has partial response (PR), one stable disease (SD) and in the third patient the disease progressed. Out of three patients who received Herceptin in combination with other non-anthracyclines, two have SD and one progressed. In the group of 11 women who received Herceptin + Taxol, 7 (64%) patients achieved PR, 2 (18%) SD, and 2 (18%) had disease progression. Grade 3-4 neutropenia has been observed in four (23%) women. Febrile neutropenia was observed in two cases and resolved completely when antibiotics were introduced. Other grade 3 toxicity that has been noted is peripheral neuropathy in three (18%) patients, diarrhoea in four (23%) and onycholysis in one (6%). Serial heart ultrasound showed no significant decline in left ventricular ejection fraction. According to our preliminary experience, Herceptin therapy showed promising results in women with metastatic breast cancer.
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Affiliation(s)
- M Mrsić
- University Hospital Center Zagreb, Croatia.
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4
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Mrsić M, Grgić M, Budišić Z, Podolski P, Bogdanić V, Labar B, Jakić-razumović J, Restek-samaržija N, Gošev M. Ann Oncol 2001; 12:95-96. [DOI: 10.1023/a:1011116224931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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5
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Bogdanić V, Aurer I, Labar B, Hitrec V, Nemet D, Mrsić M. Treatment of chronic myeloid leukemia in relapse after umbilical cord blood transplantation. Haematologica 1998; 83:575-6. [PMID: 9676036] [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: 02/08/2023] Open
Abstract
Umbilical cord blood (UCB) is increasingly used as a source of hematopoietic progenitor cells for allotransplantation. Donor-derived buffy coat cells are considered optimal treatment for leukemia relapses after transplantation of allogeneic bone marrow. Experience with relapses after UCB transplants are sparse. Here we report a girl who received an UCB transplant for chronic myeloid leukemia, relapsed after three years, failed to respond to donor buffy coat cells, but achieved a complete hematologic, cytogenetic, and molecular remission on interferon-alpha.
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Gregurek R, Labar B, Mrsić M, Batinić D, Ladika I, Bogdanić V, Nemet D, Skerlev M, Jakić-Razumović J, Klain E. Anxiety as a possible predictor of acute GVHD. Bone Marrow Transplant 1996; 18:585-9. [PMID: 8879622] [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: 02/02/2023]
Abstract
In order to determine the influence of anxiety on the development of BMT complications and survival, we analysed data on 35 consecutive patients undergoing BMT in our Centre between June 1992 and December 1994. All patients received bone marrow from HLA-identical MLC non-responsive siblings. For GVHD prophylaxis, all patients received cyclosporin (CsA) and short methotrexate (MTX). The diagnosis and severity of acute GVHD were defined according to the Seattle Transplant Team criteria. The patients were tested with the Spielberger STAI test as a measure of anxiety as a state (STAI-S) and as a trait (STAI-T). The STAI-S/1 and STAI-T/1 were performed during the first week of isolation (day -5 to day -3 prior BMT) and STAI-S/2 and STAI-T/2 at the end of the discharge from laminar air flow units (day +35 to day +40 post-transplant). During isolation all patients had daily psychiatric support. Out of 35 patients, 31 (89%) fulfilled the STAI-S and STAI-T during the first week and at discharge from laminar air flow isolation. The level of anxiety at the beginning of isolation as measured by STAI-S/1 and STAI-T/1 tests had been significantly higher in patients who subsequently developed acute grade II-IV GVHD as compared to patients with GVHD grade 0-I (P < 0.001), irrespective of age, sex or stage of the disease prior to BMT. In those patients who died, the STAI-S/1, STAI-T/1 and STAI-T/2 tests had been almost identical to those of surviving patients, while STAI-S/2 had been significantly higher (P = 0.034). These data clearly indicate an association between the level of anxiety and the risk for BMT complications, but this should be confirmed in further controlled clinical trials.
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Affiliation(s)
- R Gregurek
- Department of Psychological Medicine, University Hospital Centre Zagreb, Croatia
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Labar B, Masszi T, Morabito F, Mistrik M, Holowiecki J, Bogdanić V, Nemet D, Mrsić M, Krieger O, Lutz D. Allogeneic bone marrow transplantation for acute leukaemia--IGCI experience. International Group for Chemo-Immunotherapy. Bone Marrow Transplant 1996; 17:1009-12. [PMID: 8807107] [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: 02/02/2023]
Abstract
From October 1984 to December 1994, 142 patients from six IGCI-BMT centers (78 acute myelogenous leukemia and 64 acute lymphoblastic leukemia) received allogeneic bone marrow from their HLA-identical sibling. The probability of LFS at 60 months is 41% for AML patients and 39% for ALL patients. A better LFS was documented in patients allografted in first CR compared to the patients treated in advanced stage of the disease. The overall relapse rate is 27% for AML patients and 45% for ALL patients. The relapse rate is higher for patients allografted in advanced stage of the disease (47 vs 26% at 60 months for AML and 55 vs 38% at 60 months for ALL). The incidence of moderate to severe acute GVHD is between 45-50% for both AML and ALL patients. Chronic GVHD was documented in 30% of AML patients and 38% of ALL patients. Transplant-related mortality for both AML and ALL is about 25%. Relapse and GVHD with or without infection are the main causes of death. These results confirmed that allogeneic BMT is very effective therapy for patients with acute leukemia, especially for patients transplanted in first CR.
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Affiliation(s)
- B Labar
- University Hospital Rebro, Department of Medicine, Zagreb, Croatia
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8
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Jandrlić M, Kalenić S, Labar B, Nemet D, Jakić-Razumović J, Mrsić M, Plecko V, Bogdanić V. An autopsy study of systemic fungal infections in patients with hematologic malignancies. Eur J Clin Microbiol Infect Dis 1995; 14:768-74. [PMID: 8536724 DOI: 10.1007/bf01690991] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The aim of this study was to determine the incidence of fungal infections detected on autopsy in a group of 40 patients with hematologic malignancies treated with intensive chemotherapy or bone marrow transplantation, and to evaluate the risk factors for fungal infections. A control group included 38 patients with nonhematologic diseases and without granulocytopenia but with at least one of the known risk factors for fungal infections. Standard histopathological and microbiological methods were used. A higher incidence of invasive fungal infections was found in patients with hematologic malignancies as compared to the control group (p < 0.01). The predominant causes of fungal infections were Candida albicans and Aspergillus spp. The incidence of fungal infections caused by Aspergillus was higher (p < 0.05) in patients with hematologic malignancies than in the control group. The independent risk factors for fungal infections were fungal colonization, number of antibiotics and duration of antibiotic therapy, duration of fever and skin rash. A higher proportion of fungal infections was diagnosed on autopsy than during the patients' life (p < 0.01).
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Affiliation(s)
- M Jandrlić
- Department of Microbiology, Zagreb University Hospital, Croatia
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9
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Bogdanić V, Aurer I, Hitrec V, Boban D, Nemet D, Zupancić-Salek S, Labar B. Donor buffy-coat infusion and chemotherapy for leukemia in relapse after marrow transplantation. Haematologica 1995; 80:338-40. [PMID: 7590504] [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: 01/26/2023] Open
Abstract
A patient relapsing with blastic lymphoid transformation of chronic myeloid leukemia after bone marrow transplantation received donor buffy-coat infusion. Low-dose chemotherapy was added because of a rapid WBC increase. Complete hematologic and cytogenetic remission was obtained. The patient remained in complete hematologic and cytogenetic remission for four months until he died in an accident. Two patients with acute leukemia failed to respond to a similar treatment.
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MESH Headings
- Acute Disease
- Adult
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Blast Crisis/drug therapy
- Blast Crisis/therapy
- Bone Marrow Transplantation
- Combined Modality Therapy
- Cytarabine/administration & dosage
- Daunorubicin/administration & dosage
- Fatal Outcome
- Female
- Humans
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/therapy
- Leukemia, Myeloid/therapy
- Leukocyte Transfusion
- Male
- Methylprednisolone/administration & dosage
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy
- Remission Induction
- Salvage Therapy
- Vincristine/administration & dosage
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Affiliation(s)
- V Bogdanić
- Department of Internal Medicine, Medical School, Zagreb, Croatia
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10
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Nemet D, Grahovac B, Labar B, Mrsić M, Radman I, Bogdanić V, Hitrec V, Zaher D, Aurer I, Sertić D. Molecular monitoring of minimal residual disease in acute promyelocytic leukemia by the polymerase chain reaction assay for the PML/RAR alpha (retinoic acid receptor-alpha) fusion transcript in patients treated with all-trans retinoic acid followed by chemotherapy. Haematologica 1995; 80:238-40. [PMID: 7672716] [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: 01/26/2023] Open
Abstract
Five acute promyelocytic leukemia (APL) patients who achieved a complete remission (CR) with all-trans retinoic acid (ATRA) underwent residual disease monitoring through reverse transcription polymerase chain reaction (PCR) for PML/retinoic acid receptor-alpha (PML/RAR alpha) fusion transcript. All received consolidation chemotherapy in CR, one in the form of autologous bone marrow transplantation (ABMT). In four of the patients PCR was positive for the PML/RAR alpha transcript immediately after ATRA treatment and/or after the first consolidation chemotherapy course. In the patient treated with ABMT, positivity was still detected six months after ABMT. One patient given five repeated courses of chemotherapy was PCR negative for PML/RAR alpha after 14 months in CR. Our pilot study confirmed that ATRA is a highly efficient induction therapy for APL in various stages of the disease, but ATRA alone cannot cure the disease. PCR should be considered a fundamental assay for assessing minimal residual disease in CR that will influence further treatment strategies and permit evaluation of treatment results.
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Affiliation(s)
- D Nemet
- Department of Medicine, University Hospital Rebro, Zagreb, Croatia
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11
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Maravić N, Bogdanić V, Aurer I, Nemet D, Labar B. Severe hyperlipidemia following treatment with PUVA for acute skin GVHD. Bone Marrow Transplant 1994; 14:173. [PMID: 7951110] [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: 01/28/2023]
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12
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Zunec R, Grubić Z, Čečuk E, Brkljačić L, Kerhin V, Humar I, Tomašković Z, Bogdanić V, Kaštelan A. Correlation between DPB1 compatibility and graft versus host disease in related bone marrow transplantation. Hum Immunol 1994. [DOI: 10.1016/0198-8859(94)90241-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
RAS mutations are found in about 25% of acute myeloid leukemia (AML) cases. The importance of these changes is unknown. If RAS mutations confer growth advantage to leukemia subclones in which they emerge, substantially more nonconservative than conservative mutations should be found. The incidence of conservative mutations was not reported previously. We sequenced N-RAS and K-RAS codons 12 and 13 and N-RAS codon 61 in 20 subjects with newly diagnosed AML. Four nonconservative N-RAS mutations and 4 conservative K-RAS mutations were found. There were no differences between subjects with AML and nonconservative RAS mutations and those with conservative or without RAS mutations. Additional studies are needed to examine the incidence of conservative RAS mutations in subjects with AML.
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Affiliation(s)
- I Aurer
- Department of Internal Medicine, Medical School and University Hospital Rebro, Zagreb, Croatia
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14
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Bogdanić V, Nemet D, Kastelan A, Latin V, Petrovecki M, Brkljacić-Surlaković L, Kerhin-Brkljacić V, Aurer I, Konja J, Mrsić M. Umbilical cord blood transplantation in a patient with Philadelphia chromosome-positive chronic myeloid leukemia. Transplantation 1993; 56:477-9. [PMID: 8356607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- V Bogdanić
- Department of Internal Medicine, University Hospital Center and Medical School, University of Zagreb, Croatia
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15
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Labar B, Mrsić M, Pavletić Z, Bogdanić V, Nemet D, Aurer I, Radman I, Filipović-Grcić N, Sertić D, Kalenić S. Prostaglandin E2 for prophylaxis of oral mucositis following BMT. Bone Marrow Transplant 1993; 11:379-82. [PMID: 8504271] [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: 01/31/2023]
Abstract
Between October 1988 and December 1990, 60 patients with leukaemia (25 with AML, 19 ALL and 16 CML) undergoing BMT were randomised in a double-blind clinical trial to receive prostaglandin E2 (PGE) (Prostin E2, 0.5 mg per tablet) or placebo for prophylaxis of oral mucositis. Patients had to dissolve tablets in the mouth three times daily starting 7 days before BMT and continuing until 21 days after BMT. The incidence of severe oral mucositis was similar for both groups, 55% in patients receiving PGE and 52% in patients receiving placebo. The duration of severe mucositis did not differ between PGE and placebo groups (chi-square 0.95, p = NS). The incidence of HSV infection was significantly higher in patients receiving PGE. Patients with HSV infection receiving PGE also had a higher incidence of severe oral mucositis. The results presented indicate that PGE is not effective for prophylaxis of oral mucositis in BMT recipients.
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Affiliation(s)
- B Labar
- Department of Medicine, School of Medicine, University of Zagreb, Croatia
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16
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Mrsić M, Nemet D, Labar B, Bogdanić V, Radman I, Zupancić-Salek S, Kovacević-Metelko J, Aurer I, Maravić N. Chemotherapy versus allogeneic bone marrow transplantation in adults with acute lymphoblastic leukemia. Transplant Proc 1993; 25:1268-70. [PMID: 8442109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- M Mrsić
- Department of Medicine, University Hospital Rebro, Zagreb, Croatia
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17
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Labar B, Bogdanić V, Nemet D, Kovacević-Metelko J, Mrsić M, Pavletić Z, Zupancić-Salek S, Radman I, Aurer I. Antilymphocyte globulin for treatment of pure red cell aplasia after major ABO incompatible marrow transplant. Bone Marrow Transplant 1992; 10:471-2. [PMID: 1464014] [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: 12/27/2022]
Abstract
A patient developed pure red cell aplasia after ABO incompatible BMT for leukemia. He did not respond to plasma exchange. Antilymphocyte globulin therapy was followed by complete and permanent erythroid recovery with disappearance of recipient-derived isoagglutinins.
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Affiliation(s)
- B Labar
- Department of Internal Medicine, School of Medicine, University of Zagreb, Croatia
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18
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Labar B, Bogdanić V, Nemet D, Mrsić M, Vrtar M, Grgić-Markulin L, Kalenić S, Vujasinović S, Presecki V, Jakić-Razumović J. Total body irradiation with or without lung shielding for allogeneic bone marrow transplantation. Bone Marrow Transplant 1992; 9:343-7. [PMID: 1617318] [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: 12/27/2022]
Abstract
From June 1986 to June 1990, 64 patients with leukaemia (25 acute myelogenous leukaemia, 21 acute lymphoblastic leukaemia and 18 chronic myeloid leukaemia) undergoing marrow transplantation were randomized to receive cyclophosphamide (CY) and fractionated total body irradiation (TBI) without lung shielding (n = 33) or CY and fractionated TBI with lung shielding (n = 31, control group) as conditioning. Patients conditioned with TBI without lung shielding received a significantly higher total lung dose compared with the control group (p less than 0.0001). The 3-year leukaemia-free survival for patients receiving TBI without lung shielding is 54 +/- 18% versus 51 +/- 18% for patients receiving TBI with lung shielding (p = ns). There was no significant difference in the probability of leukaemia relapse (22 +/- 18% for TBI without lung shielding versus 24 +/- 18% for control group; p = ns). The probability of interstitial pneumonitis is 15 +/- 14% for TBI without lung shielding and 5 +/- 5% for TBI with lung shielding (p = ns). A higher incidence of lung fungal infection (15 versus 3%) and interstitial pneumonitis (12 versus 3%) has been documented in patients receiving TBI without lung shielding compared with the control group. The results indicate that higher radiation dose to the lung did not increase antileukaemic efficacy of TBI but seemed to be associated with the increased pulmonary toxicity.
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MESH Headings
- Adult
- Bone Marrow Transplantation/adverse effects
- Cyclophosphamide/therapeutic use
- Dose-Response Relationship, Radiation
- Female
- Graft vs Host Disease/prevention & control
- Humans
- Incidence
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/epidemiology
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/radiotherapy
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/epidemiology
- Leukemia, Myeloid, Acute/radiotherapy
- Lung/radiation effects
- Lung Diseases/epidemiology
- Lung Diseases/mortality
- Male
- Methotrexate/therapeutic use
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/epidemiology
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/radiotherapy
- Prospective Studies
- Radiation Protection
- Transplantation, Homologous
- Whole-Body Irradiation/methods
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Affiliation(s)
- B Labar
- Department of Medicine, School of Medicine, University of Zagreb, Croatia
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19
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Mrsić M, Labar B, Bogdanić V, Nemet D, Pavletić Z, Plavsić F, Dobrić I, Marusić M, Francetić I, Kastelan A. Combination of cyclosporin and methotrexate for prophylaxis of acute graft-versus-host disease after allogeneic bone marrow transplantation for leukemia. Bone Marrow Transplant 1990; 6:137-41. [PMID: 2207450] [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: 12/30/2022]
Abstract
From May 1985 to July 1989, 76 patients with leukemia (30 acute myelogenous leukemia, 24 acute lymphoblastic leukemia and 22 chronic myeloid leukemia) were randomized to receive either cyclosporin (CSP) alone (n = 39) or CSP combined with methotrexate (CSP + MTX, n = 37) for graft-versus-host disease (GVHD) prophylaxis. Patients were conditioned with total body radiation and cyclophosphamide followed by bone marrow infusion from an HLA-identical sibling. Engraftment of the transplanted bone marrow was similar in both groups. The incidence of moderate to severe acute GVHD was significantly higher in the CSP group compared with the CSP + MTX group (20 (51%) versus 9 (25%), chi 2 = 4.76, p less than 0.02). There was no significant difference in the incidence of chronic GVHD. Survival was significantly better for the CSP + MTX group (63 +/- 16%) compared to CSP alone (42 +/- 18%). Leukemia-free survival tended to be better for the CSP + MTX group (55 +/- 17% versus 32 +/- 16%).
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Affiliation(s)
- M Mrsić
- Department of Medicine, School of Medicine, University of Zagreb, Yugoslavia
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20
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Batinić D, Marusić M, Pavletić Z, Bogdanić V, Uzarević B, Nemet D, Labar B. Relationship between differing volumes of bone marrow aspirates and their cellular composition. Bone Marrow Transplant 1990; 6:103-7. [PMID: 2207448] [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: 12/30/2022]
Abstract
We compared the cellular composition of the first 1.0 ml volume bone marrow aspirate with that of an aliquot from the total bone marrow harvest at the end of the procedure in 17 healthy bone marrow donors. Each sample was assayed for its content of red blood cells, nucleated cells, CD2+, CD4+, CD8+, CD19+, HLA-DR+, CD56+, CD13+, CD33+, CD34+ and KiM8+ cells and CFU-GM. On the basis of data obtained, we estimated that the first 1.0 ml samples had 8.0 +/- 5.2% (SD) and the transplant samples 20.8 +/- 8.5% contamination with nucleated blood cells. The calculation revealed that both types of bone marrow samples had 100% volume contamination with peripheral blood, i.e. that bone marrow cells were aspirated within blood fluid volume. Nucleated cell concentration was 3-fold, and CFU-GM concentration 10-fold lower in the transplant than in the first-puncture 1.0 ml bone marrow samples. Various marker-positive cells appeared in transplant samples in concentrations that depended on their abundance in the first-puncture 1.0 ml and blood samples. Taken together, our data suggest that bone marrow harvesting would be substantially improved if individual aspirates were small in volume and taken from bone puncture sites as distant as possible.
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Affiliation(s)
- D Batinić
- Department of Clinical Laboratory Diagnostics, Zagreb Clinical Center, Yugoslavia
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Pavletić Z, Petrovecki M, Bogdanić V, Nemet D, Uzarević B, Matek Z, Marković J, Marusić M, Labar B. The significance of immunological monitoring after allogeneic bone marrow transplantation. Bone Marrow Transplant 1989; 4 Suppl 3:111. [PMID: 2627597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Z Pavletić
- Department of Internal Medicine, University Hospital Rebro, Zagreb, Yugoslavia
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22
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Stavljenić A, Cvorisćec D, Plavsić F, Bogdanić V, Labar B. Evaluation of renal function in patients treated with bone marrow transplantation. Bone Marrow Transplant 1989; 4 Suppl 3:112-3. [PMID: 2627598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- A Stavljenić
- Department of Clinical Laboratory Diagnostics, Zagreb University School of Medicine, Yugoslavia
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23
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Zupancić-Salek S, Aurer I, Bogdanić V, Nemet D, Mrsić M, Labar B. Donor characteristics in allogeneic bone marrow transplantation. Bone Marrow Transplant 1989; 4 Suppl 3:107. [PMID: 2627595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- S Zupancić-Salek
- Department of Medicine, University Hospital Rebro, Zagreb, Yugoslavia
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24
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Nemet D, Labar B, Bogdanić V, Hauptman E, Jaksić B, Minigo H, Sertić D, Mrsić M, Pavletić Z, Kovacević J. High dose cytosine arabinoside in the treatment of adult acute myelogenous leukaemia. Bone Marrow Transplant 1989; 4 Suppl 3:42-4. [PMID: 2697399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- D Nemet
- Department of Medicine, University Hospital Rebro, Zagreb, Yugoslavia
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25
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Labar B, Nemet D, Minigo H, Bogdanić V, Jaksić B, Malesević M, Mrsić M. Aclarubicin in the treatment of de-novo acute myelocytic leukaemia. Bone Marrow Transplant 1989; 4 Suppl 3:45-6. [PMID: 2697400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- B Labar
- Department of Medicine, Clinical Hospital Center, Rebro, Zagreb, Yugoslavia
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26
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Labar B, Bogdanić V, Nemet D, Mrsić M, Pavletić Z, Zupancić S, Radman I, Aurer I. Allogeneic BMT for AML in Zagreb. Bone Marrow Transplant 1989; 4 Suppl 3:86-7. [PMID: 2697413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- B Labar
- Department of Medicine, Clinical Hospital Center-Rebro, Zagreb, Yugoslavia
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27
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Gasparović V, Labar B, Puljević D, Skodlar J, Bogdanić V, Ivanović D, Gjurasin M. Elimination of antibodies by plasma exchange in ABO incompatible bone marrow transplantation. Bone Marrow Transplant 1989; 4 Suppl 3:109. [PMID: 2627596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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28
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Nemet D, Labar B, Bogdanić V, Kolevska T, Skodlar J, Mrsić M, Pavletić Z, Kalenić S, Vrtar M, Marusić M. Treatment of acute leukaemia with intensive radiochemotherapy and autologous bone marrow transplantation--Zagreb experience. Bone Marrow Transplant 1989; 4 Suppl 3:90-1. [PMID: 2697415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- D Nemet
- Department of Medicine, University Hospital Rebro, Zagreb, Yugoslavia
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29
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Mrsić M, Labar B, Bogdanić V, Nemet D, Pavletić Z, Plavsić F, Dobrić I, Kastelan A, Marusić M, Zupancić-Salek S. Combination of cyclosporine and methotrexate for prophylaxis of acute graft versus host disease after allogeneic bone marrow transplantation for leukaemias. Bone Marrow Transplant 1989; 4 Suppl 3:95-6. [PMID: 2697416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- M Mrsić
- Department of Medicine, Clinical Hospital Centre Rebro, Zagreb, Yugoslavia
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30
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Pavletić Z, Labar B, Bogdanić V, Nemet D, Mrsić M, Stavljenić A, Cvoriscec D, Presecki V, Petrovecki M. Serum neopterin in patients receiving bone marrow transplant. Bone Marrow Transplant 1989; 4 Suppl 3:97-8. [PMID: 2627615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Z Pavletić
- Department of Internal Medicine, University Hospital Rebro, Zagreb, Yugoslavia
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Bogdanić V, Labar B, Mrsić M, Nemet D, Serventi-Seiwerth R. Low-dose Ara-C in the treatment of myelodysplastic syndromes. Bone Marrow Transplant 1989; 4 Suppl 3:26-7. [PMID: 2697395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- V Bogdanić
- Department of Medicine, Clinical Hospital Center-Rebro, Zagreb, Yugoslavia
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32
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Bogdanić V, Labar B, Nemet D, Mrsić M, Pavetić Z, Aurer I. Allogeneic bone marrow transplantation for ALL in Zagreb. Bone Marrow Transplant 1989; 4 Suppl 3:88-9. [PMID: 2697414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- V Bogdanić
- Department of Medicine, University Hospital Rebro, School of Medicine, Zagreb, Yugoslavia
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Labar B, Bogdanić V, Nemet D, Vrtar M, Mrsić M. Total body irradiation with or without lung shielding for allogeneic bone marrow transplantation. Bone Marrow Transplant 1989; 4 Suppl 3:108. [PMID: 2697391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- B Labar
- Department of Internal Medicine, University Hospital Rebro, Zagreb, Yugoslavia
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Nemet D, Labar B, Bogdanić V, Kolevska T, Mrsić M, Pavletić Z, Kalenić S, Vrtar M, Marusić M, Markulin-Grgić L. [Treatment of neoplastic hematologic diseases with intensive radio-chemotherapy and transplantation of cryopreserved autologous bone marrow]. Lijec Vjesn 1989; 111:348-53. [PMID: 2633014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Autologous bone marrow transplantation (ABMT) allows application of intensive myeloablative therapy aimed at eradication of neoplastic disease by facilitating haematopoietic reconstitution. Between March and June 1988, four patients (two with acute myelogenous leukaemia in first remission, one with acute lymphoblastic leukaemia in second remission, and one with Burkitt lymphoma, stage IV with CNS involvement in second remission) received this treatment. Methods of collecting, processing and freezing bone marrow as well as thawing and reinfusion of the marrow into patients after intensive chemoradiotherapy are described. Viability of bone marrow cells tested by the dye exclusion method after freezing and thawing process was 89, 88, 91 and 78%, respectively. CFU-GM recovery in culture, as a test of marrow stem cells clonogenicity was between 63,3 and 156,5%. Patients received between 1,7 and 3,0 x 10(8)/kg nucleated cells and 4,0 to 7,6 x 10(4)/kg CFU-GM, respectively. In all four patients stable haematopoietic reconstitution was achieved. The bone marrow function was evident mainly at 11th day after marrow reinfusion. Leukocyte count reached 1,0 x 10(0)/L in 11 to 15 days, and granulocyte count raised more than 0,5 x 10(9)/L in 19 to 37 days after transplantation. Platelet recovery was prolonged with the minimum of 29 days and maximum of more than 60 days to reach 20 x 10(9)/L. Side effects caused by the intensive radiochemotherapy were moderate. Bacterial, fungal and viral infections in early posttransplant period were successfully treated. All patients have survived and left the hospital 63, 54, 36 and 65 days after ABMT, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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Batinić D, Pavletić Z, Kolevska T, Bogdanić V, Zalud I, Nemet D, Marusić M, Labar B. Lymphocyte subsets in normal human bone marrow harvested for routine clinical transplantation. Bone Marrow Transplant 1989; 4:229-32. [PMID: 2499393] [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: 01/01/2023]
Abstract
Bone marrow and peripheral blood of 25 healthy bone marrow donors from our allogeneic bone marrow transplantation program were assessed for cell subsets bearing T11(CD2), T4(CD4), T8(CD8), B1(CD20) J5(CALLA, CD10), Mo1(CD11b), MY7(CD13). Mo2(CD14), MY9(CD33) and NKH-1 antigens. Bone marrow cell samples were taken for analysis at the start or at the end of the harvesting procedure of aspiration from the iliac crest. All samples were analysed on a flow cytometer at the lymphocyte window as obtained on the two-parameter (L90oLSxFALS) scatter diagram. There were no differences in the lymphocyte subset composition of bone marrow samples taken at the start or at the end of the harvesting procedure. In contrast to the majority of literature data, a high CD4/CD8 ratio was detected in bone marrow samples: it did not differ from that in the peripheral blood. The proportions of CD2 and CD4 T cell markers in the bone marrow correlated with those in the peripheral blood, thus further documenting a substantial bone marrow contamination with peripheral blood cells. A relatively large aspirate volume (4-5 ml) obtained from individual aspiration sites was identified as the only factor possibly accounting for the high-level contamination of bone marrow samples with peripheral blood. This conclusion was corroborated by low T cell proportions and low CD4/CD8 ratios found in the bone marrow washed from bone fragments and in bone marrow samples aspirated at first bone puncture in a volume of 1.0 ml. Taken together, these findings imply that less vigorous suction may decrease the number of T lymphocytes in bone marrow harvested for transplantation purposes.
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Affiliation(s)
- D Batinić
- Department of Clinical Laboratory Diagnostics and Hematology, Zagreb Clinical Center, Croatia, Yugoslavia
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Dobrić I, Vujasinović S, Labar B, Bogdanić V, Nemet D, Kastelan A, Baricević B, Vranesić D, Skrinjar L. [Changes in the skin in transplantation versus host reaction. 2. Our clinical findings from observations using light microscopy and electron microscopy]. Lijec Vjesn 1989; 111:76-80. [PMID: 2747408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
A clinical, light microscope and electron microscope study of skin changes was undertaken in 19 patients after bone marrow transplantation. Thirteen of the total number of 19 patients were clinically suspect of the acute and 6 of the chronic form of GvHD. Skin biopsy between the seventh and thirtieth day following transplantation confirmed the diagnosis of the acute form of GvHD in 7 of the 19 patients. In 4 of the 6 patients in whom skin biopsy did not verify the diagnosis of the acute form of GvHD, completely atypical rash in addition to signs of GvHD of the liver and intestines developed between the 30th and 50th day following transplantation. In all 6 patients who were clinically suspect of the chronic form of GvHD, skin biopsy performed some 4-10 months after transplantation confirmed the diagnosis of chronic, sclerodermoid or lichenoid GvHD. Furthermore in 71% of the patients with histologically verified chronic form of skin GvHD, symptoms of liver and intestine GvHD were present too at the time of the skin biopsy. With regard to the fact that histologically the least reliable seems to be the diagnosis of Grade 1 cutaneous GvHD, the authors recommend that regular dermatological follow-up examinations be made in the period of 7 to 50 days following transplantation in addition to skin biopsy in the case of appearance of any rash. Electron microscopy revealed in both forms of GvHD, the acute and the chronic, the most significant epidermal changes, i.e. degeneration of the cellular organelles and the appearance of numerous intracytoplasmic vacuoles.
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Pavletić Z, Labar B, Cepelja Z, Mrsić M, Kovacević-Metelko J, Bogdanić V, Nemet D. [Agranulocytosis--incidence and clinical significance (review of 37 of our cases)]. Lijec Vjesn 1988; 110:413-7. [PMID: 3246939] [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: 01/04/2023]
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38
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Dobrić I, Vujasinović S, Kastelan A, Baricević B, Labar B, Bogdanić V, Nemet D. [Changes in the skin due to the graft-versus-host reaction. 1. Pathogenesis and diagnosis]. Lijec Vjesn 1988; 110:436-8. [PMID: 3246943] [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: 01/04/2023]
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39
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Aurer I, Kolevska T, Labar B, Kracun I, Nemet D, Marusić M, Bogdanić V. [Bone marrow cultures from patients with acute myeloid leukemia]. Lijec Vjesn 1988; 110:405-9. [PMID: 3246937] [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: 01/04/2023]
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40
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Labar B, Bogdanić V, Nemet D, Kastelan A, Pavletić Z, Mrsić M, Vrtar M, Dobrić I, Brkljacić V, Markulin-Grgić L. [Bone marrow transplantation]. Lijec Vjesn 1987; 109:449-52. [PMID: 3320648] [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: 01/05/2023]
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41
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Labar B, Bogdanić V, Kaštelan A, Grgičević D, Vrtar M, Grgić-Markulin L, Francetić I, Balabanić-Kamauf B, Kerhin-Brkljačić V, Dobrić I, Boban D. Bone marrow transplantation for leukemia (a year experience in Zagreb, Yugoslavia). Leuk Res 1986. [DOI: 10.1016/0145-2126(86)90209-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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42
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Kamauf-Balabanić B, Francetić I, Bogdanić V. [Prevention of infection in patients treated with bone marrow transplantation]. Lijec Vjesn 1985; 107:453-5. [PMID: 3934484] [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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43
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Pistotnik M, Grgicević D, Bogdanić V. [Transfusion of thrombocytes: a review of the preparation of the concentrate and its use]. Lijec Vjesn 1985; 107:207-10. [PMID: 4010453] [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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44
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Francetić I, Kamauf-Balabanić B, Labar B, Bogdanić V. [Preventive administration of antimicrobial drugs in patients treated by bone marrow transplantation]. Lijec Vjesn 1985; 107:125-7. [PMID: 3884945] [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: 01/07/2023]
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45
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Grgicević D, Labar B, Bogdanić V, Kerhin-Brkljacić V, Kastelan A. [Transfusion therapy in patients with severe aplastic anemia after bone marrow transplantation]. Lijec Vjesn 1985; 107:85-9. [PMID: 3884943] [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: 01/07/2023]
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46
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Labar B, Bogdanić V, Kastelan A, Grgicević D, Vrtar M, Krajina Z, Kamauf-Balabanić B, Kerhin-Brkljacić V, Francetić I, Zimonja-Krisković J. [Transplantation of bone marrow in the treatment of severe aplastic anemia]. Lijec Vjesn 1984; 106:219-23. [PMID: 6381945] [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: 01/19/2023]
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47
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Bogdanić V, Dobrić I, Labar B. [Graft-versus-host reaction as a complication of bone marrow transplantation]. Lijec Vjesn 1984; 106:238-40. [PMID: 6381946] [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: 01/19/2023]
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