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Objective: To evaluate safety and efficacy of first and second-line treatments for immune thrombocytopenic purpura (ITP) in patients older than 15 years. Material and method: A retrospective study was done with patients with immune thrombocytopenic purpura from January 2001 to December 2011. Treatment of first-line included: corticoids (prednisone or hydrocortisone) or immunoglobulin (IgG). Second-line: splenectomy, rituximab, immunosuppressive drugs (cyclophosphamide, azathioprine or mycophenolate) and danazol were prescribed. Respond criteria: complete (CR), platelets > 100 x 109/L; partial (PR), platelets > 30 x 109/L, without bleeding; no response, the remaining. Results: 116 patients were included, 74% women. Mean age was 45 years (15-90). The average initial platelets were 28 x 109/L (0-90). The mean follow-up was 19 months (12-120). The corticoids were administered on 108 and IgG on 8. They were cured 59 (51%); three deaths (3%) by intracranial hemorrhage. Complications: arterial hypertension and hyperglycemia (10 and 9). Fifty-four patients received second-line treatment. The most common was splenectomy but none showed more efficiency (p=0.5). Overall final results: CR 82%, temporal remissions with relapses 10% and without remission 3%. Complications: infections, cytopenias, increase of transaminases and pancreatitis (7, 4, 2, 1). All were related to the use of immunosuppressive drugs. Conclusions: First-line treatment is enough to cure 51% of the patients. The second-line treatments were effective in 31%. By lower toxicity, splenectomy and rituximab are preferable to immunosuppressant. [ABSTRACT FROM AUTHOR]

Introduction. The incidence and prevalence of head and neck injuries presented in the population served Unit Dental Specialties, allows us to generate hypotheses for conducting analytical studies to infer prevention policies and medical care, for the early identification of lesions, their comprehensive and immediate management, histopathological diagnoses1,965, organized by gender, age, type of benign nonmalignant lesion, anatomic site location by comparing our results with the published literature were processed. Objective. The aim of this study was to obtain accurate and reliable own statistics that allow us to determine the incidence and prevalence of histopathological diagnoses in soft, bone and dental head and neck tissues, with variables of gender, age, anatomical site location injury caused by the Pathology Oral and Maxillofacial Unit of Dental Specialties, Mexico City a 7-year period 1,965 histopathological diagnoses. Material and methods. The information was obtained from the1,965 histological reports with full details of age, gender, anatomic location of the lesion and lamellae present in the service file of Oral and Maxillofacial Pathology Unit Dental Specialties, generated for 7 years, were analyzed with the SPSS system, measures of central tendency to determine the gender, age and fashion media and anatomical location of the lesions, making a subdivision of each site and anatomical region where lesions, lesion type were presented according to their evolution, reporting 10 histopathological diagnoses presented in the study, comparing our results with those reported in the published literature. Results. The results allows us to detect the most common diseases presented in the oral cavity, with fibrous hyperplasia, coinciding with published reports comparing our study with a larger universe, coinciding in most variables, female gender 61% 1:1.59, 39% male, age ages presented in the study population was 1 to 90 years, the frequency of the ages of the patients had lesions was between 46-50 years old, the average was 41.9 years, the rate lesion presented was 97.4% benign lesions, 2.56% malignant lesions, the site of anatomical location was divided into soft, hard and skin tissue injuries occurred in lips 19%, followed by the buccal mucosa with 18%, language 16.3%, 8% lower gum, each of the anatomical regions was subdivided into specific sites, the hard tissues were subdivided into maxillary 9.5%, 8% jaw, salivary glands were divided into minor and major glands, malignant lesion present with was the most frequently squamous cell carcinoma 59%, followed by basal cell carcinoma 10%, comparing our results with those published in international and national literature. [ABSTRACT FROM AUTHOR]

Background: Current treatment of acute leukemia is chemotherapy; the liver toxicity is frequently observed which can avoid chemotherapy programs compliance. Iron overload is directly related to serum ferritin, to prevent organ dysfunction, it is necessary to consider chelation therapy in these patients. Objective: To evaluate the effect of reduced serum ferritin, administering deferasirox, on levels of AST and ALT, in patients with acute leukemia and receiving chemotherapy. Material and method: An experimental, prospective, longitudinal and non-random study was performed including patients older than 15 years diagnosed with acute leukemia and managed with a program of intensive chemotherapy, complete remission, with ALT + AST greater than 90 IU/L and serum ferritin greater than 1,000 ng/mL. Patients received deferasirox at doses of 30 mg/kg/day. Results: After beginning the use of deferasirox, the minimum observation time was 6 months and the maximum at the end of the study, 12 months. There were no notable changes in the numbers of bilirubin, alkaline phosphatase, albumin and creatinine. At the end of the study the mean of units transfused after the initial units was 9. Trend was noted receiving fewer transfusions in patients with acute myeloid leukemia treated with deferasirox. Conclusions: Deferasirox reduces the number of serum ferritin and influences the decrease of ALT and AST. The decrease in AST, ALT and serum ferritin allowed programs meet time and dose chemotherapy. Deferasirox tolerance was good. [ABSTRACT FROM AUTHOR]

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Introduction: The prognosis, in the long term, of adolescents and young adults with acute de novo lymphoblastic leukemia, treated with a pediatric type protocol., Objective: To analyze the efficacy and tolerability of a chemotherapy regimen of pediatric type on patients 15-35 years old with de novo acute lymphoblastic leukemia, Ph(-)., Methods: A retrospective study of patients received from 2001 to 2013, without initial infiltration of the central nervous system. They received the regimen called LALÍN. Terminal goals: frequency of initial remission, probability of survival free of leukemia and event-free survival for five years., Results: We included 101 patients; there were 29 relapses and 19 deaths. There was initial remission in 97% of the cases; survival free of leukemia of 0.58 and event-free survival 0.44. No difference in patients aged 16-21 years vs. 22-35 (p > 0.55). Negative prognostic factors: abnormal karyotypes, except hyperdiploids (p = 0.001); > 5% of blasts, on 14 day induction (p = 0. 0001); delay in the punctuality of the courses of the chemotherapy regimen (p = 0.0001)., Conclusion: A pediatric type regimen is applicable to patients aged from 16 to 35 years with acute lymphoblastic leukemia, without greater toxicity and a best survival free of leukemia. The count of > 5% of blasts and the delay in the execution of the stages of the chemotherapy regimen are the stronger negative prognostic factors.

Objective: To determine the overall survival (OS) of Ph1 positive chronic myeloid leukemia (CML) patients treated with allogeneic hematopoietic stem cell transplant (AHSCT) vs. imatinib., Material and Methods: We retrospectively included CML patients treated with related donor myeolablative and non-myeloablative AHSCT, between 1992 and 2009. Another group consisted of a patient cohort treated with imatinib between 2001 and 2009. The main variable was the persistence of hematologic remission., Results: The AHSCT/ imatinib groups included 36/46 patients, average age was 36/46, patients in chronic phase 34/44 and in blastic phase, 2/2. The number of myeloablative/non-myeloablative transplants was 28/8. Imatinib was administered at a dose of 400 to 800 mg/day (median 500 mg). The following events developed in both groups: death 14/3, hematological progression 4/5, 17/41 are alive and in hematological remission (p = 0.00009). The OS probability is 0.42 and 0.76 at 100 months (p = 0.0001). The decrease in absolute risk is 42%. The OS after 17 years remains unmodified in the AHSCT group after the first 6 years., Conclusion: OS at 100 months is superior with imatinib than with AHSCT (p = 0.0001).

Objective: To ascertain the efficacy and safety of two chemotherapy regimens, one designed for adults and the other for children, in adolescent patients with acute lymphoblastic leukemia (ALL)., Methods: Between 2001-2006, we included patients aged 15-25, with de novo, Phi(-) ALL, without initial central nervous system (CNS) infiltration. Twenty patients received a chemotherapy regimen designed for children with high-risk ALL (LALIN) and twenty a regimen for adults (LALA). Both were intensive and included dexamethasone, daunorubicin, cyclophosphamide, vincristine, cytarabine, methotrexate and mercaptopurine as well as CNS prophylaxis. Elective suspension of chemotherapy occurred at two and three years respectively, in patients with continued complete remission., Results: Patients in both groups were comparable in age, sex, presence and size of hepatosplenomegaly, initial leukocytes and platelet counts. Predominant in both groups was L2 morphology and B-cell CD10(+) immunophenotype. Results for the LALIN/ LALA groups were: failures 2/0 (p=0.49); relapses 0/4 (p= 0.05); therapy associated deaths 4/7 (p= 0.48); and event free survival at 70 months follow-up was 70% and 40% (p=0.12)., Conclusions: In patients aged 15-25, with de novo ALL, a chemotherapy regimen designed for children had significantly less relapses than a regimen for adults. We saw no increase in toxicity in the LALIN versus the LALA group.

Autoimmune diseases are characterized by immune response against self antigens. One of the current research interests in this field is oriented toward development of tolerance. One of the newest options in the search for tolerance is autologous bone marrow transplantation: a variant of bone marrow transplant in which the patient's own hematopoietic stem cells are reinfused after myeloablative therapy. The idea of using bone marrow transplant in treatment of autoimmune diseases derived from observing remission in autoimmune diseases in patients transplanted due to coexisting neoplastic disease. Although an isolated initial report of bone marrow transplant as treatment for autoimmune disease questioned the utility of this procedure, over all, results are encouraging. To compile information in a programmed and systematic manner, it is necessary to send more patients in all stages of immune diseases to specialized centers to be included in large multicenter randomized trials. In time, the role for this procedure in autoimmune diseases will become clear.