Louise Debusscher

Relative response of patients with myelodysplastic syndromes and other transfusion-dependent anaemias to deferasirox (ICL670): a 1-yr prospective study

Objectives/methods:  This 1‐yr prospective phase II trial evaluated the efficacy of deferasirox in regularly transfused patients aged 3–81 yrs with myelodysplastic syndromes (MDS; n = 47), Diamond–Blackfan anaemia (DBA; n = 30), other rare anaemias (n = 22) or β‐thalassaemia (n = 85). Dosage was determined by baseline liver iron concentration (LIC).

Effectiveness of betamethasone in management of severe infections. A double-blind study.

STEROIDS might be of benefit to the patient with a serious infection.1 In 1961 a Cooperative double-blind study of the effects of administering a dose of 300 mg of hydrocortisone to patients with s...

Empiric Therapy for Cancer Patients: Comparative Study of Ticarcillin-Tobramycin, Ticarcillin-Cephalothin, and Cephalothin-Tobramycin

Three combinations of antibiotics (cephalothin-tobramycin, cephalothin-ticarcillin, and ticarcillin-tobramycin) were administered empirically to 186 patients with cancer who were suspected of having a life-threatening infection. In approximately one-half of these patients, gram-negative infection was documented bacteriologically and consisted of septicemia in 50% of these patients. The three antimicrobial regimens were similarly effective and resulted in a favorable clinical response in approximately 55% of the patients. The administration of the cephalothin-tobramycin combination was associated with a significantly higher frequency of nephrotoxicity than that of the other two regimens.

Fever of unexplained origin in patients with cancer

Abstract Long standing fever, with no obvious origin, has been found in 47 (0·7%) of 6,880 patients admitted to a cancer hospital. Among these patients 27 (57·4%) had leukemia or lymphoma, although this type of illness did not represent a majority among the patients admitted to this hospital. Infection caused the fever in 27 (57·4%) patients and was most often due to localized infections. Gram-negative rods were most frequently responsible for it. Fever was attributed to the cancer itself in 18 (38·3%) patients: 5 had acute leukemia in relapse, 6 had extensive lymphomas, 7 presented widespread metastatic carcinomas, and, in 6 of them, large liver metastases were present.

Professional rehabilitation of lymphoma patients: a study of psychosocial factors associated with return to work

During the last ten years a substantial reduction in mortality has been obtained for Hodgkins and non-Hodgkins lymphoma. Since lymphoma treatment is often accompanied by side effects and long-term sequelae, however, patients often have problems with rehabilitation. It is thus very important that these problems and needs be identified. Going back to work is one of the main objectives of rehabilitation and can be taken as a valuable indicator of the problems and needs of such patients. We therefore conducted a study at the Jules Bordet Institute between December 1989 and December 1990. Of the patients in remission and able to go back to work, only 54% of them have done so. Anxiety, depression, and treatment toxicity interfere with return to work, and the likelihood of job reentry increases with the time lapse since the end of treatment. Rehabilitation programs must focus on alleviating illness and treatment sequelae as soon as treatment ends.

Use of Carbenicillin and Polymyxin B for Therapy of Gram-Negative Bacilli Infections

Twenty-one therapeutic trials with a combination of carbenicillin and polymyxin B were conducted for initial treatment of severe infections caused by gram-negative bacilli. Failure to respond to therapy was observed in 7 out of 13 patients with septicemia or bronchopneumonia. No serious toxicity of this antibiotic regimen was encountered.

Hepatic Candidosis in a Patient with Acute Leukemia Leber-Candidose bei einem Patienten mit akuter Leukämie

Summary: Isolated hepatic candidosis has been described more frequently in patients with leukemia and consists in a particular clinical entity which remains difficult to control. We report here the case of a patient treated for acute nonlymphoblastic who developed hepatic candidosis two months after the end of intensive consolidation therapy.

Variations of the proliferative activity of leukemic myeloblasts related to the stage of the disease

The proliferative activity of bone marrow myeloblasts has been studied by means of tritiated thymidine (3HTdR) and autoradiography. Twenty-six patients in the active phase or in complete remission of acute myeloblastic leukemia (AML), 16 in relapse or in remission of chronic myeloid leukemia (CML) and 10 hematologically normal reference patients have been investigated.

Pneumonia caused by Gram-negative bacilli in hospitalized patients presenting malignant disease

Abstract Pneumonias due to Gram-negative bacilli are described in 37 patients with cancer who were admitted to a specialized center for cancer therapy over a 6 -month period. Klebsiella and Pseudomonas aeruginosa accounted for most cases. The pneumonias represented 4·3% of all hospital admissions and accounted for 32% of the deaths occurring in the hospital over the study-period. The disease was much more frequent in men. All the infections, except two, were probably hospital-acquired, but those developing within six days of admission had a lower mortality rate ( 40% ) than those developing later ( 70% ). The overall mortality rate was 62% and mortality correlated best with the clinical severity of the underlying neoplasm. On X-ray study lower-lobe bronchopneumonias were characteristic but Klebsiella frequently involved the upper lobes. All three cases of pneumonia caused by Proteus were associated with empyemas. Associated purulent bronchitis was characteristic in Pseudomonas pneumonias. Post mortem examination was performed in 19 cases and showed interstitial pneumonias with polymorphonuclear infiltrates of alveoli and bronchial mucosa. Hemorrhages and necrosis were frequent in pneumonias caused by Klebsiella. Multiple antibiotic resistance was commonplace. Pathogenic strains isolated in early occurring pneumonias were more sensitive to antibiotics than bacteria isolated from pneumonias occurring later. The drug of choice here was gentamicin.

Prolifération cellulaire et action de la chimiothérapie dans les lymphomes malins de type lymphocytaire en phase leucémique

SummaryTen patients with malignant lymphocytic lymphoma (diffuse or nodular) have been studied in the leukaemic phase of their disease. The leukaemic cells of the blood and in some cases the bone marrow, a lymph node or a pleural effusion were labelled with tritiated thymidine in vitro and/or in vivo. This made it possible to show that in the peripheral blood, the fraction of cells in DNA synthesis (S) is greater than in the “true” myeloblasts and lymphoblastic leukaemias. The “S” fraction was also found to be variable from patient to patient and in any one patient from one site to another (blood, marrow, lymph node, pleural effusion).The labelling of these cells made it possible to study the mode of action of Vincristine on the cell cycle, twenty-four hours after an injection of 2 mg/m2. The % of lymphoma cells labelled and/or blocked in mitosis when compared to that of the erythroblasts in the same marrow sample, did not suggest a preferential effect on the malignant cells. Moreover, the % of cells labe...