52 research outputs found
Post-transplant events Combined administration of alpha-erythropoietin and filgrastim can improve the outcome and cost balance of autologous stem cell transplantation in patients with lymphoproliferative disorders
autologous transplantation; erythropoietin; engraftment kinetic
Conditioning regimens in acute myeloid leukemia.
Current intensive consolidation chemotherapy for patients with acute myeloid leukemia (AML) produces median remission duration of 12-18 months, with less than 30% of patients surviving 5 years free of disease. Post-remission therapy is necessary to prevent relapse in most patients with AML; therefore, the aim of post-remission treatment is to eradicate the minimal residual disease. Nevertheless, the optimal form of treatment is still under debate. The choice among the possible approaches (intensive chemotherapy, autologous or allogeneic hematopoietic stem cell transplantation) relies on two main factors: the expected risk of relapse, as determined by biological features, and expected morbidity and mortality associated with a specific option. In this review, we focus on the different preparative regimens before autologous and allogeneic hematopoietic stem cell transplantation in patients with AML, stressing the importance of an adequate conditioning regimen as a mandatory element of a successful AML therapy, in both the allogeneic and the autologous transplant setting
BNP levels are related to days of hospitalization independently to the pathology in critical care settings
Background: Increased brain natriuretic peptide (BNP) levels have
been related to several conditions, such as acute heart failure (AHF),
pulmonary embolism (PE) and acute coronary syndromes (ACS).
Particularly among elderly patients, a longer hospitalization is related
to higher morbidity and mortality. The usefulness of BNP as a
prognostic factor is amply demonstrated in different subpopulations
of both medical and surgical patients.
Aims: To evaluate the relationship between BNP levels and length of
in-hospital stay in patients with PE, ACS, AHF, septic and cardiogenic
shock admitted to our internal medicine department (IMD).
Methods: We retrospectively evaluated 500 consecutive patients
admitted to our IMD. BNP was evaluated at the admission in all the
patients. Each patient underwent a complete diagnostic workup. We
evaluated the curve-fit correlation between BNP levels and days of
hospitalization using SPSS 13.0 for windows systems.
Results: Mean age was 80 \ub1 9.85 years, males representing 58 % of
the sample. AHF represented 74.9 %, ACS 13.5 %, PE 11.6 % of the
sample. We found that BNP levels and days of hospitalization were
better described by a logarithmic regression model (R2: 0.674,
p\0.0001) (Figure 1).
Conclusions: Among elderly patients admitted in an IMDs, higher
BNP levels are associated to longer hospitalizations independently to
the pathology. This relationship is better described by a logarithmic
regression model. However, larger cohorts are required to validate
this observation
BNP levels at the admission are related with days of hospitalization in patients with acute heart failure and the overall risk of death
Background: Acute Heart Failure (AHF) is a frequent condition
associated to poor prognosis among elderly patients admitted to
Internal Medicine departments (IMDs). Length of hospitalization is
associated to higher mortality among medical patients. Increased
brain natriuretic peptide (BNP) levels have been associated, in this
subset, to a raised mortality and morbidity.
Aims: to evaluate whether BNP levels at admission could be associated
to longer hospitalizations and survival time in the subset of
patients who die of AHF.
Methods: we enrolled 400 consecutive patients admitted to our IMD
with a clinical diagnosis ofAHF.BNPwas evaluated in all patients at the
admission. Subjects were stratified in four categories: BNP less than
100 pg/ml (group 1), 101\u2013500 pg/ml (group 2), 501\u20131500 pg/ml (group
3) and BNP higher than 1501 pg/ml (group 4). Each patient underwent to
a complete diagnosticworkup. PatientswithBNP levels less than 100 pg/
ml or a final diagnosis other than AHF were excluded. Kaplan\u2013Meier
model with log-rank test was used to assess the differences. Statistical
analysis was performed with SPSS 13 package for Windows systems.
Results: 293 patients were suitable for final analysis. Mean age was
80 \ub1 9.85 years, males representing 58 % of the sample. Among
patients who were successfully dismissed, group 4 had a significantly
longer hospitalization time (16.6 days, 95 %CI: 13.7\u201319.5) than patients
in group 3 (13.1 days, 95 %CI:11.7\u201314.6) or group 2 (12.3 days, 95 %
CI: 10.6\u201313.9) (p\0.05, all ties, Figure 1).Among patientswho died of
AHF, subjects in group 2 had a significantly longer survival time (mean:
46.0 days, SE 3.71) than patients in group 3 (mean: 36.7 days, SE 2.51)
or group 4 (mean: 22.9 days, SE 1.88) (p\0.05, all ties, Figure 2).
Conclusions: BNP is useful for diagnosis and prognostic stratification
in patients with AHF. If confirmed in larger cohorts, it could
also be used to predict longer hospitalizations among specific
subsets of patients. Among elderly patients admitted into IMD who
will die of AHF, higher BNP levels are independently associated to
a faster progression of the pathology and death. BNP levels at the
admission of patients should be considered as a powerful tool
that can help the physicians not only in diagnosis but also in
the prognostic stratificatio
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