RESUMO
In this report we show the chromosomal changes seen in a group of 303 Mexican patients with de novo Acute Myeloblastic Leukemia (AML). Two hundred forty-two patients were diagnosed and treated at two hospitals affiliated with the Instituto Mexicano del Seguro Social (IMSS). These are the Centro Medico Nacional Siglo XXI and Centro Medico La Raza Hospitals; the remaining 61 patients were diagnosed and treated at the Hospital General de Mexico (HGM). Clonal abnormalities were detected in 75.6% of the patients; this result agrees with what has been reported in other large series of AML studies. The incidence of changes per hospital was similar in patients from the IMSS hospitals (72-75%), while an increase was seen in patients from the HGM (85.2%). The chromosomal changes seen in this study in order of frequency were: t(15;17)[18.8%], t(9;22)[9.2%], miscellaneous chromosomal changes (mainly rearrangements of chromosomes 1,2,3,12y17)[8.2%], abnormalities of 16q22 [7.3%], t(8;21)[6.3%], -7/del(7q)[5.6%], t(6;9)[5.3%], and abnormalities of 11q23 [4.6%]. We reported an increase in the incidence of certain types of chromosomal changes seen in cases of AML, in comparison with reports from other countries. These differences could be due to methodological variations, although ethnic, socioeconomic and nutritional differences must not be disregarded. We support this finding when comparing distribution of changes in the population of patients seen in the IMSS hospitals with those from the HGM; the main difference lies in the socioeconomic level.
Assuntos
Aberrações Cromossômicas , Leucemia Mieloide/genética , Doença Aguda , Adolescente , Adulto , Idoso , Deleção Cromossômica , Cromossomos Humanos Par 15/ultraestrutura , Cromossomos Humanos Par 17/ultraestrutura , Células Clonais/ultraestrutura , Feminino , Hospitais Gerais , Hospitais Públicos , Humanos , Incidência , Leucemia Mieloide/epidemiologia , Leucemia Mieloide/patologia , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Células-Tronco Neoplásicas/ultraestrutura , Cromossomo Filadélfia , Previdência Social , Fatores Socioeconômicos , Translocação GenéticaRESUMO
Shear-induced aggregation requires the platelet glycoprotein complexes (Gp), the von Willebrand factor (vWf) and ADP. The Bernard Soulier syndrome (BS) and the gray platelet syndrome (GPS) are platelet function defects characterized by absence of GP Ib/IX and alpha granules, respectively, with mucocutaneous hemorrhages, prolonged bleeding time (BT) and moderate thrombocytopenia in both syndromes. There are reports that desmopressin (DDAVP) shortens the BT in some patients with platelet dysfunction. The purpose of this study was to evaluate the response t(DDAVP) in four female patients (2 with GPS plus Marfan's disease and 2 BS). All had bleeding episodes, BTs > 10 minutes, platelet counts (PC) between 40-88 x 10(9)/L and defects in platelet aggregation. The DDAVP was administered at a dose of 0.3 microgram/kg in 15 to 30 mL of isotonic saline given by slow intravenous drip in 30 to 45 min. All patients were studied before and after DDAVP administration (BT, PC, platelet factor, mean platelet volume, factors F.VIII:C, FvW:Ag, FvW:RiC of, and platelet aggregation). After DDAVP infusion the patients had a BT < 6 min, and increased levels of F. VIII:C, FvW:Ag and FvW:RiC of (> 100 Ul/dL), and the bleeding disappeared. We conclude that there was a good response to DDAVP probably associated with improved platelet adhesion, and increases in the multimers of the von Willebrand factor.
Assuntos
Síndrome de Bernard-Soulier/tratamento farmacológico , Desamino Arginina Vasopressina/uso terapêutico , Adolescente , Adulto , Síndrome de Bernard-Soulier/sangue , Síndrome de Bernard-Soulier/complicações , Síndrome de Bernard-Soulier/genética , Biopolímeros , Tempo de Sangramento , Desamino Arginina Vasopressina/farmacologia , Avaliação de Medicamentos , Feminino , Humanos , Síndrome de Marfan/complicações , Pessoa de Meia-Idade , Adesividade Plaquetária/efeitos dos fármacos , Agregação Plaquetária/efeitos dos fármacos , Deficiência do Pool Plaquetário/sangue , Deficiência do Pool Plaquetário/complicações , Deficiência do Pool Plaquetário/genética , Estudos Prospectivos , Síndrome , Fator de von Willebrand/metabolismoRESUMO
We report three patients with acquired inhibitors against F VIII:C/F vW:Ag complex. Two patients had acquired hemophilia A. The three patients presented with bleeding diathesis. Case 1 was a 19 years old woman with Graves-Basedow disease; case 2 was a 40 years old woman with systemic lupus erythematosus of four years; and case 3 a 38 years old woman who had had rheumatoid arthritis for five years and was in her 3d month postpartum. The F VIII:C level was below 8 U/dL in all cases. The F vW:Ag, ristocetin cofactor and platelet aggregation with ristocetin were diminished in the two cases with von Willebrand. Inhibitor to F VIII:C was 50, 38 and 20 Bethesda units, respectively, for cases 1, 2 and 3. The three patients showed clinical response to DDAVP and cryoprecipitates with partial response in laboratory tests. All patients responded to corticosteroid treatment, but immunosuppressive treatment was necessary in case 3.
Assuntos
Hemofilia A/etiologia , Doenças de von Willebrand/etiologia , Adulto , Feminino , Hemofilia A/diagnóstico , Humanos , Doenças de von Willebrand/diagnósticoRESUMO
Para conocer los estimulantes mitógenos más adecuados para la iniciación de la actividad mitótica de los blastos se utilizaronultivos de 20 muestras de células de leucemia aguda linfoblástica (LAL). Se analizaron diferentes concentraciones de fitohemaglutinina (PHA), lectina (Phitolacca americana) (FL) y 2-mercaptoetanol (2-ME) mediante la estimulación de cultivos celulares de 20 muestras. La mucoproteina extraída de las plantas (PHA) resultó ser el mejor activador de la mitosis y de la proliferación. A una concentración de 2.5 mg/ml, ocurrió la división celular; en su ausencia, no se observó proliferación celular. Por otra parte, la FL tuvo un efecto menor de la activación de la mitosis en los cultivos; y el 2-ME no presentó efecto alguno sobre la proliferación de estas células. Además, se observó que la acción mitogénica de la PHA implica la activación de la replicación del ADN celular, tal y como lo demostró la incorporación de [3H]-timidina
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Leucemia-Linfoma Linfoblástico de Células Precursoras/imunologia , Mitógenos , Ativação Linfocitária/imunologia , Células Cultivadas/ultraestrutura , Leucemia-Linfoma Linfoblástico de Células Precursoras/patologia , Sistema Hematopoético/ultraestruturaRESUMO
The gross structure and the expression of the c-myc oncogene were analyzed in primary cells from 15 acute lymphoblastic leukemia patients. Southern blot analysis was used to detect possible alterations in the structure of this gene. Alterations (rearrangement and/or amplification) were observed in seven of the 15 samples studied. When the expression of MYC protein was evaluated by Western blot analysis, we found no correlation between c-myc gene alterations and p67 c-myc, which was expressed in the 15 samples studied. The analysis of expression also revealed various MYC-related proteins (115, 110 and 60 kD). These proteins were expressed at variable levels in all leukemic cells, other transformed cells, and in normal peripheral blood lymphocytes (PBL) induced to proliferate with interleukin 2. We detected the 110 kD and 40 kD MYC-related proteins in fresh normal PBL and in samples from patients in complete remission. These studies indicate that the c-myc alterations and protein expression are unrelated to percentage of leukemic blasts, cell morphology or immunophenotype. Our work shows that the expression of MYC-related proteins from 115, 60 and 40 kD is associated with mechanisms of cell activation, and perhaps these proteins may play a role in cellular proliferation-transformation.
Assuntos
Genes myc/genética , Leucemia-Linfoma Linfoblástico de Células Precursoras , Proteínas Proto-Oncogênicas c-myc/biossíntese , Humanos , Leucemia-Linfoma Linfoblástico de Células Precursoras/genética , Biossíntese de Proteínas , Proteínas/imunologia , Proteínas Proto-Oncogênicas c-myc/imunologiaRESUMO
Fracture of the left maxillary tuberosity during surgical extraction of multiple teeth, involving the maxillary sinus and pterigomaxillary fossa in a male patient with classic hemophilia due to factor VIII deficiency, is reported. The subject was treated by a private dentist and afterwards admitted at the Oral and Maxillofacial Surgery unit of the "20 de Noviembre" Hospital, ISSSTE, where extraction was completed and the fracture detected at surgery. The patient was then referred to Hematology and substitute therapy of factor VIII for two weeks was prescribed but, eventually, persistent bleeding led to suturing the external carotid.