Search

Hypercoagulability is a commonly described complication in patients with Cushing's syndrome. Recent clinical studies have indicated various abnormalities of coagulation and fibrinolysis parameters which may be related to that phenomenon. The aim of this study was to investigate the mechanisms underlying the hypercoagulable state in patients with Cushing's syndrome. Research methods and procedures A wide range of serum markers involved in the processes of blood coagulation and fibrinolysis was measured in a group of 33 patients with Cushing's syndrome and 31 healthy controls. No participant was taking medication which could influence the result or had known diseases, except hypertension and diabetes, which could affect blood coagulation or fibrinolysis parameters. Results Patients with Cushing's syndrome had higher levels of clotting factors II (P = 0.003), V (P < 0.001), VIII (P < 0.001), IX (P < 0.001), XI (P < 0.001) and XII (P = 0.019), protein C (P < 0.001), protein S (P < 0.001), C1-inhibitor (P < 0.001) and plasminogen activator inhibitor-1 (PAI-1) (P = 0.004). The activity of fibrinolytic markers, plasminogen (P < 0.001), antithrombin (P < 0.001) and antithrombin antigen (P = 0.001) was also increased in the patient group. Conclusion The study has demonstrated hypercoagulability in patients with Cushing's syndrome manifest as increased prothrombotic activity and compensatory activation of the fibrinolytic system. We propose the introduction of thromboprophylaxis in the preoperative and early postoperative periods, combined with a close follow-up in order to prevent possible thromboembolic events in patients with Cushing's syndrome.

Allogeneic tem cell transplantation as a postremssion therapy for acute leukaemia

From October 1984 to March 199, 64 patients with acute lymphoblastic leukemia in first or second complete remission received allogeneic bone marrow from therir HLA-identical sibling. Median age was 28 (range 18-49 years). Patients were conditioned with cyclophosphamide 120 mg/kg and total body irradiation (TBI), 12 Gy, at a dose rate of 2.9-5.7 cGy/min in a three 4Gy fractions given daily over 3 days. For GVHD prophylaxis patients received cyclosporine alone or standard short methotrexate and cyclosporine. Amedian of 2.1 (range 1.2-5.2) x 10E8/kg of marrow cells were infused. The median follow-up period is 85 months (range 6-150). Overall probability of LFS is 35% at 60 months. Patients allografted in first CR had better LFS 52% compared to the patients treated in second CR, 30% (p

ATRA and anthracyclines in the treatment of acute promyelocytic leukaemia

alogeneic transplants, acute leukemia

L-asparaginase and acute lymphoblastic leukemia

Hodgkin disease

malignant lymphoma and stem cell transplants

To determine the impact of age on the outcome of bone marrow transplantation in patients with acute leukemia. 241 patients with acute leukemia who underwent transplantation of allogeneic (152 patients) or autologous (89 patients) bone marrow were included in the study. Allogeneic transplant was from an HLA-identical sibling. Cyclophosphamide followed by the total body irradiation or cyclophosphamide and busulfan were used in the conditioning regimen. Leukemia-free survival (LFS) was significantly better in younger patients compared to the older ones for all patients (LFS for younger patients was between 40-43% and for patients >45 years 27% ; p45 years ; p45 years 34% and 29%, respectively ; p45 years and 13-19% for younger age groups ; p45 years 31% (p