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ABSTRACT: Behçet disease (BD) has a low prevalence in the Spanish population. Only a few reports have been published on the clinical features of BD in our country. The aim of this study is to determine the type and frequency of these features of BD in a population of patients in the Community of Valencia.
We retrospectively studied clinical data from patients with BD diagnosed between 1990 and 2005 in La Fe, General and Doctor Peset Universitary Hospitals. All Patients fulfilled the International Study Group Criteria for the diagnosis of BD. Statistical analysis was carried out using the chi2 test.
Seventy four patients (40 male and 34 female) were studied. The most frequent manifestations were oral (98.5%) and genital aphthae (82.4%), followed by cutaneous lesions (64.2%), ocular lesions (42.5%), fever (39.4%) and vascular manifestations (28.4%). Venous manifestations were more frequent than arterial events. Gastrointestinal lesions occurred more frequently in females compared with males (p = 0.002). Vascular and ocular manifestations were more severe in males than in females. With respect to cardiovascular risk factors, 32.4% of patients were smokers, 20.3% were hyperlipidemic, 19% hypertensive, 13.5% obese and 9.5%diabetic. Cardiovascular risk factors were not related to thrombotic events or posterior uveitis in these patients (p > 0.05).
BD in patients in the community of Valencia is characterized by a variety of clinical manifestations similar to other geographical areas. Gastrointestinal manifestations occur more frequently in female patients, and venous thrombotic manifestations were more frequent than arterial events. Cardiovascular risk factors do not seem to play a role in the development of thrombotic events and posterior uveitis in these patients.
Medicina Clínica 11/2006; 127(13):496-9. · 1.38 Impact Factor
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Julián Torre-Cisneros, José Román,
Antonio Torres,
Concepción Herrera,
Juan José Caston,
Antonio Rivero,
Eva Mingot,
Rafael Rojas,
Carmen Martín,
Francisco Martínez,
Pedro Gómez
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ABSTRACT: Of 100 bone marrow transplant recipients, 30 (30%) received a CD4(+) lymphocyte-depleted graft (1x10(6) CD8(+) T lymphocytes/kg of body weight). Replication of Epstein-Barr virus (EBV) was observed in 40 patients (40%). The use of a CD4(+) lymphocyte-depleted graft was the only independent risk factor for replication of EBV (relative risk, 11.5; 95% confidence interval, 5.8-22.8; P<.0001). Nevertheless, EBV load in those patients was not higher than in the rest of patients, and the low EBV load prevented the development of lymphoproliferative disease. These results suggest that the presence of CD8(+) T lymphocytes in the bone marrow graft can control EBV load, thereby reducing the risk of developing lymphoproliferative disease.
The Journal of Infectious Diseases 12/2004; 190(9):1596-9. · 6.41 Impact Factor
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David Gallardo,
Salut Brunet,
Antonio Torres,
Manuela Alonso-Nieto,
Carlos Vallejo,
Antonio Jiménez,
Marcos González,
Guillermo Sanz,
David Serrano,
Ildefonso Espigado, [......],
Enric Carreras,
Carmen Martiín,
César Sanz-Rodríguez,
Jorge Sierra,
Javier Zuazu,
M Francisca González-Escribano,
Juan R González, José Román,
Jaime Pérez De Oteyza,
Rafael De La Cámara
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ABSTRACT: The role of human leukocyte antigen (HLA)-DPB1 as a transplantation antigen is controversial. A higher incidence of acute graft-versus-host disease (aGVHD) has been described after unrelated donor bone marrow transplant when both HLA-DPB1 alleles were mismatched.
We investigated the impact of a single HLA-DPB1 mismatch after HLA-A-B-DRB1 identical sibling donor transplantation on aGVHD. We analyzed 627 adult patient-donor pairs and identified 30 pairs without HLA-DPB1 identity (4.78%). In 17 cases, the patient had an allele that was not shared by the donor.
The cumulative incidence of grades II-IV aGVHD was higher in the HLA-DPB1 mismatched group (66.7% vs. 35.7%, p=0.012). The HLA-DPB1 mismatch was identified by multivariate analysis as an independent risk factor for aGVHD (p=0.020, RR=2.68, 95% CI: 1.73-3.62).
HLA-DPB1 can mediate alloreactive responses. A single HLA-DPB1 mismatch increases the risk of aGVHD after sibling donor stem cell transplantation.
Transplantation 05/2004; 77(7):1107-10. · 4.00 Impact Factor
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Miguel A Sanz,
Guillermo Martín,
Marcos González,
Angel León,
Chelo Rayón,
Concha Rivas,
Dolors Colomer,
Elena Amutio,
Francisco J Capote,
Gustavo A Milone,
Javier De La Serna, José Román,
Eva Barragán,
Juan Bergua,
Lourdes Escoda,
Ricardo Parody,
Silvia Negri,
María J Calasanz,
Pascual Bolufer
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ABSTRACT: All-trans-retinoic acid (ATRA) increases the efficacy of chemotherapy when used for induction and maintenance treatment of acute promyelocytic leukemia (APL), but its role in consolidation is unknown. Since November 1996, 426 patients with newly diagnosed APL have received induction therapy with ATRA and idarubicin. Before November 1999 (LPA96 study), consolidation therapy consisted of 3 courses of anthracycline monochemotherapy. After November 1999 (LPA99 study), patients with intermediate and high risks of relapse received consolidation therapy with ATRA and increased doses of anthracyclines. Of the 384 patients who achieved complete remission (90%), 382 proceeded to consolidation therapy. Seven patients died in remission (1.8%). The 3-year cumulative incidence of relapse for patients in the LPA96 and LPA99 studies was 17.2% and 7.5%, respectively (P =.008). Patients treated with ATRA in consolidation therapy showed an overall reduction in the relapse rate from 20.1% to 8.7% (P =.004). In intermediate-risk patients the rate decreased from 14.0% to 2.5% (P =.006). This improved antileukemic efficacy also translated into significantly better disease-free and overall survival. A risk-adapted strategy combining anthracycline monochemotherapy and ATRA for induction and consolidation therapy of newly diagnosed APL results in improved antileukemic efficacy and a high degree of compliance.
Blood 03/2004; 103(4):1237-43. · 9.90 Impact Factor
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Isabel Moreno,
Guillermo Martín,
Pascual Bolufer,
Eva Barragán,
Eva Rueda, José Román,
Pascual Fernández,
Pilar León,
Armando Mena,
José Cervera,
Antonio Torres,
Miguel A Sanz
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ABSTRACT: Cytogenetics is the most important prognostic factor in acute myeloid leukemia (AML). However, a high proportion of patients show normal or intermediate-risk karyotypes. In these patients, other determinants could help to identify those with a higher risk of relapse. Recently, internal tandem duplications (ITD) and D835 mutations in FLT3 tyrosine kinase receptor have been shown to confer a bad prognosis in AML.
We analyzed the incidence of these mutations in a total of 208 patients of different AML subsets and their prognostic relevance in non-promyelocytic de novo AML.
FLT3 mutations were detected in 24% of de novo AML, 42% of acute promyelocytic leukemia (APL) and 17% of secondary AML. Four patients showed both ITD and D835 mutations. Ninety-four per cent of the patients with FLT3 alterations were classified into the intermediate-risk group. There was no association between the presence of FLT3 alterations and response to induction while the alterations were associated with a worse disease-free survival and event-free survival in both the overall and intermediate-risk patients.
Our data confirm that any of the mutations in FLT3 confer a bad prognosis in AML. Because of the high prevalence of these mutations within the intermediate-risk group, their detection could be useful to identify patients with a poor prognosis.
Haematologica 02/2003; 88(1):19-24. · 6.42 Impact Factor
