19 research outputs found
Influenza vaccination for immunocompromised patients: systematic review and meta-analysis from a public health policy perspective.
Immunocompromised patients are vulnerable to severe or complicated influenza infection. Vaccination is widely recommended for this group. This systematic review and meta-analysis assesses influenza vaccination for immunocompromised patients in terms of preventing influenza-like illness and laboratory confirmed influenza, serological response and adverse events
Influenza virus vaccine in B-cell chronic lymphocytic leukaemia patients.
The clinical reaction and the immunological response to influenza virus vaccine were studied in 43 B-cell chronic lymphocytic leukaemia patients. The Vaxigrip vaccine was administered containing the antigens A/Ghizhou/54/89, A/Singapore/6/86, and B/Yamagata/16/88. The side-effects observed were minimal and well tolerated. Antibody production with titres > 1:20 on day 15 was observed at least for one antigen in 35 patients (81%). In 23 of them (63%) this response was retained on days 30 and 60. Patients with IgG levels (< 700 mg/dl) responded less well as compared to those having normal IgG levels (> 700 mg/dl)
Influenza vaccination in patients with haematologic malignancies: analysis of practices in 200 patients in a single center
Serum syndecan-1, basic fibroblast growth factor and osteoprotegerin in myeloma patients at diagnosis and during the course of the disease
Neovascularisation and bone resorption are related to myeloma disease
activity. Objectives: To investigate the possible prognostic importance
of serum syndecan-1, basic fibroblast growth factor (bFGF) and
osteoprotegerin (OPG) levels, the relationship between them, with
parameters of disease activity and the effect of treatment on their
levels.<LF>Patients and Methods: Twenty-seven patients were studied from
diagnosis and an additional five from remission, for a median follow-up
of 40 months. Twenty-three patients received chemotherapy plus
bisphosphonates and nine only bisphosphonates. Sera from 11 healthy
individuals (HI) were used as controls. Cytokines were determined by
commercially available enzyme-linked immunosorbent assays (ELISA) kits.
Results: In HI, median syndecan-1 was 40 ng/mL (28-75), bFGF 8 pg/mL
(7-30), OPG 35 pg/mL (4-100). Pretreatment median serum syndecan-1 was
177.5 ng/mL (34-3500), bFGF 11.5 pg/mL (8-65) and OPG 100 pg/mL
(4-1000). Pretreatment syndecan-1, bFGF and OPG serum levels were
increased in patients compared with HI (P = 0.001, 0.03 and 0.01,
respectively). Syndecan-1 and bFGF levels were correlated with stage (P
= 0.004 and 0.03, respectively). Both syndecan-1 and OPG levels were
correlated with beta(2)M (P = 0.04 and 0.01, respectively). Patients
with elevated syndecan-1 and bFGF serum levels had shorter survival than
patients with normal levels (P = 0.01 and 0.05, respectively). After
chemotherapy syndecan-1 and OPG levels were found to be decreased in
responders and syndecan-1 level was reduced in patients receiving
bisphosphonates alone. Conclusions: Pretreatment syndecan-1, bFGF and
OPG levels were found to be increased at diagnosis. Syndecan-1 and OPG
fluctuated according to MM activity. Elevated serum syndecan-1 and bFGF
levels predicted short survival
Vaccination of patients with haematological malignancies with one or two doses of influenza vaccine: a randomised study
A morphometric study of bone marrow angiogenesis in hairy cell leukaemia with clinicopathological correlations
Bone marrow angiogenesis has recently been implicated in the
pathophysiology and course of various haematological malignancies.
Little is known, however, about the significance of this phenomenon in
hairy cell leukaemia (HCL). We evaluated various morphometric
characteristics of microvessels, highlighted by means of anti-CD34
immunohistochemistry, in the bone marrow of 44 patients with typical
HCL, before and after treatment with interferon-alpha (IFN-alpha).
Overall, bone marrow from 103 HCL patients and 20 controls was examined.
Microvessel density (MVD) and several size- and shape-related parameters
were quantified in the region of most intense vascularization using
image analysis. MVD, size- related parameters and the percentage of
branching microvessels were higher in HCL than in controls. Likewise,
perimeter counts were higher in partial/non-responders than in complete
responders. Achievement of complete response was accompanied by smaller
calibre microvessels. IFN-alpha induced a decrease in MVD and branching
values in cases with diffuse marrow involvement. In univariate analysis,
progression-free survival was adversely affected by MVD, branching and
major axis length. Multivariate analysis indicated that MVD/branching
independently affected progression-free survival and the likelihood of
complete response. Our data suggest that the generation of bone marrow
microvessels indicated an increased risk of progression and IFN-alpha
treatment failure in HCL. Furthermore, the prognostic significance of
angiogenesis requires the concomitant assessment of MVD and the
complexity of the microvascular network
Waldenstrom's macroglobulinemia: clinical course and prognostic factors in 60 patients - Experience from a single hematology unit
Waldenstrom’s macroglobulinemia (WM) is a lymphoplasmacytic lymphoma
characterized by the presence in patients’ serum of an I-M monoclonal
component. We report on our experience with 60 WM patients, focusing on
their clinical findings, response to treatment, and the possible
identification of prognostic factors. Of these patients, 70% presented
with fatigue, and lymphadenopathy was observed in 22%, splenomegaly in
18%, hepatomegaly in 13%, and extranodal site of involvement in 6%.
Bleeding tendency was seen in 17%, infections in 17%, hyperviscosity
syndrome in 12%, and cardiac failure in 25% of the patients. The
median of IgM levels was 30 g/l with hypoalbuminemia in 20% of cases,
hypogammaglobulinemia in 27%, polyclonal hypergammaglobulinemia in
15%, kappa light-chain restriction in 78%, and Bence-Jones proteinuria
in 54%. Anemia was frequent (85%), followed by leukocytosis (18%),
lymphocytosis (12%), leukopenia (10%), and thrombocytopenia (10%).
Cryoglobulinemia and autoimmune hemolytic anemia were encountered in
5%. In all cases but two, bone marrow was involved. Of 50 patients
initially treated with intermittent oral chlorambucil, 46 (92%)
responded. Median overall survival was 108 months. Factors associated
with adverse prognosis were age greater than or equal to65 years
(p=0.06), presence of lymphadenopathy (p=0.06), bone marrow infiltration
greater than or equal to50% (p=0.007), international prognostic index
(IPI) greater than or equal to3 (p=0.0001), and Morel’s scoring system
(p=0.04). Concluding, we found in this series of WM patients that
chlorambucil is an effective treatment and that the parameters of age,
lymphadenopathy, percentage of bone marrow infiltration, IPI, and
Morel’s scoring system carry prognostic significance
Waldenstrom's macroglobulinemia: clinical course and prognostic factors in 60 patients - Experience from a single hematology unit (vol 80, pg 722, 2001)
Response to vaccination against different types of antigens in patients with chronic lymphocytic leukaemia
Kikuchi's lymphadenopathy: A relatively rare but important cause of lymphadenopathy in Greece, potentially associated with the antiphospholipid syndrome
Kikuchi-Fujimoto disease is a form of reactive lymphadenopathy, which was Wrstly described in Japan, but is uncommon in the Western world. We retrospectively reviewed the medical records of nine cases of adult or adolescent Kikuchi's disease diagnosed in a single Haematology Unit in Athens, Greece between 1990 and 2006. The median age of the patients was 25 years (14-40) and 8/9 were females. All patients presented with cervical lymphadenopathy sparing the supraclavicular fossa; one had associated axillary lymphadenopathy, seven had fever and two were asymptomatic. The median duration of lymphadenopathy before presentation was 30 days (10-45). Just palpable splenomegaly was recorded in three patients. The median value of the maximal lymph node diameter was 2 cm (1-5) and only 1/9 had nodes &gt;2 cm in their largest diameter. Lymphadenopathy was tender in two patients; hard nodes were observed in three patients. The median leukocyte count was 4.7 × 10 9/l (2.2-4.9) with a normal diVerential in 7/9 patients. No infectious agent could be demonstrated. One patient had clinical and laboratory evidence of primary antiphospholipid syndrome (APLS). In conclusion, Kikuchi's disease represents a rare but important diagnostic possibility for patients presenting with lymphadenopathy in Greece and other western countries. In this setting, autoimmune disorders, mainly lupus and APLS, should be considered and excluded by the appropriate laboratory work-up. © Springer-Verlag 2009