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    G. Kusminsky

    Universidad Austral, Medicina, Faculty Member
    Cinquenta y tres pacientes (ptes) recibieron transplante alogenico con celulas progenitoras extraidas de la sangre periferica (PSP); 25 ptes eran mujeres y 28 varones. La edad media del grupo fue de 20 anos, (rango 2-550. Los diagnosticos... more
    Cinquenta y tres pacientes (ptes) recibieron transplante alogenico con celulas progenitoras extraidas de la sangre periferica (PSP); 25 ptes eran mujeres y 28 varones. La edad media del grupo fue de 20 anos, (rango 2-550. Los diagnosticos fueron leucemia mieloide aguda (LMA) en 16 ptes, leucemia linfoblastica aguda (LLA) en 15, leucemia mieloide cronica (LMC) en primera fase cronica en 12, aplasia medular en 4, sindrome mielodisplasico en 3 y Enfermedad de Hodgkin en recaida luego de trasplante autologo, talasemia mayor y sindrome de Hunter en 1 caso, respectivamente. Los acondicionamientos fueron en 38 ptes radioterapia corporal total 1200 cGy y ciclofosfamida 120 mg/kg EV; en 10 ptes busulfan 16 mg/kg y ciclosfosfamida 120 mg/kg EV, 3 ptes radioterapia linfoide total (RLT) y ciclosfosfamida, 2 ptes con otros agentes quimioterapicos. Los PSP se infundieron a traves de un cateter sin ningun tipo de manipulacion. La profilaxis de injerto vs huesped (EICH) se realizo con ciclosporina ...
    PREDICTED AND MEASURED ENERGY EXPENDITURE IN MECHANICALLY VENTILATED CRITICALLY ILL CHILDREN – A COMPARISON OF STANDARD EQUATIONS WITH INDIRECT CALORIMETRY L.L. Tietze1, K. Kok1, I.L. Jarnvig2, T. Hartvig Jensen2, C. Molgaard1,3, M.J.... more
    PREDICTED AND MEASURED ENERGY EXPENDITURE IN MECHANICALLY VENTILATED CRITICALLY ILL CHILDREN – A COMPARISON OF STANDARD EQUATIONS WITH INDIRECT CALORIMETRY L.L. Tietze1, K. Kok1, I.L. Jarnvig2, T. Hartvig Jensen2, C. Molgaard1,3, M.J. Allingstrup2 1University Hospital CopenhagenRigshospitalet, Pediatric Nutrition Unit, Copenhagen, Denmark 2University Hospital CopenhagenRigshospitalet, Department of Intensive Care, Copenhagen, Denmark 3University of Copenhagen, Pediatric and International NutritionDepartment of NutritionExercise and Sports, Copenhagen, Denmark
    ... GLOBULINA ANTILINFOCITARIA EN APLASIA MEDULAR ración del balance normal de las subpoblaciones linfocitarias o inducir la producción de cierta he ... Packed red-cells were transfused when symptoms of anemia developed or when... more
    ... GLOBULINA ANTILINFOCITARIA EN APLASIA MEDULAR ración del balance normal de las subpoblaciones linfocitarias o inducir la producción de cierta he ... Packed red-cells were transfused when symptoms of anemia developed or when hemoglo-bin was 7 g/dl or less. ...
    In vitro studies were performed in a patient with B-cell chronic lymphocytic leukemia who developed pure red cell aplasia (CLL-PRCA). The patient's irradiated circulating mononuclear blood cells and supernatant markedly inhibited... more
    In vitro studies were performed in a patient with B-cell chronic lymphocytic leukemia who developed pure red cell aplasia (CLL-PRCA). The patient's irradiated circulating mononuclear blood cells and supernatant markedly inhibited normal marrow erythroid (but not granulocyte-monocyte) progenitor colony proliferation. In contrast, irradiated peripheral blood mononuclear cells and supernatant obtained from a B-CLL patient (Rai stage III) and from a hematologically normal donor, did not affect hematopoietic progenitor colony growth. These findings suggest that the anemia of CLL-PRCA evolves different mechanisms of those causing anemia in CLL, and is mediated through cellular and secretory mechanisms.
    Research Interests:
    ... TALIA HAHN, GUSTAVO KUSMINSKY, LUCETTE BASSOUS and ALAIN BERREBI ... Fernandez, LA, MacSween, JM and Langley, G. R. (1986) lmmunoregulation of B lymphocyte colony formation by T cell subsets in patients with chronic lymphocytic... more
    ... TALIA HAHN, GUSTAVO KUSMINSKY, LUCETTE BASSOUS and ALAIN BERREBI ... Fernandez, LA, MacSween, JM and Langley, G. R. (1986) lmmunoregulation of B lymphocyte colony formation by T cell subsets in patients with chronic lymphocytic leukemia. Blood. 67,294300. ...
    Results: Patients homozygous for the single nucleotide polymorphism at codon 10 had increased non-relapse mortality (at 3 years: 46.8% versus 29.4%, P=0.014) and reduced overall survival (at 5 years 29.3% versus 42.2%, P=0.013); the... more
    Results: Patients homozygous for the single nucleotide polymorphism at codon 10 had increased non-relapse mortality (at 3 years: 46.8% versus 29.4%, P=0.014) and reduced overall survival (at 5 years 29.3% versus 42.2%, P=0.013); the differences remained statistically ...
    We studied 298 patients with severe aplastic anaemia (SAA) allografted in four Latin American countries. The source of cells was bone marrow (BM) in 94 patients and PBSCs in 204 patients. Engraftment failed in 8.1% of recipients with no... more
    We studied 298 patients with severe aplastic anaemia (SAA) allografted in four Latin American countries. The source of cells was bone marrow (BM) in 94 patients and PBSCs in 204 patients. Engraftment failed in 8.1% of recipients with no difference between BM and PBSCs (P=0.08). Incidence of acute GvHD (aGvHD) for BM and PBSCs was 30% vs 32% (P=0.18), and for grades III-IV was 2.6% vs 11.6% (P=0.01). Chronic GvHD (cGvHD) between BM and PBSCs was 37% vs 59% (P=0.002) and extensive 5% vs 23.6% (P=0.01). OS was 74% vs 76% for BM vs PBSCs (P=0.95). Event-free survival was superior in patients conditioned with anti-thymocyte globulin (ATG)-based regimens compared with other regimens (79% vs 61%, P=0.001) as excessive secondary graft failure was seen with other regimens (10% vs 26%, P=0.005) respectively. In multivariate analysis, aGvHD II-IV (hazard ratio (HR) 2.50, confidence interval (CI) 1.1-5.6, P=0.02) and aGvHD III-IV (HR 8.3 CI 3.4-20.2, P<0.001) proved to be independent negativ...
    Fifty three patients (pts) received an allogeneic hematopoietic transplant using peripheral blood progenitor cells (PBPC). Diagnosis were acute myeloid leukemia (AML) in 16 pts, acute lymphoblastic leukemia (ALL) in 15, chronic myeloid... more
    Fifty three patients (pts) received an allogeneic hematopoietic transplant using peripheral blood progenitor cells (PBPC). Diagnosis were acute myeloid leukemia (AML) in 16 pts, acute lymphoblastic leukemia (ALL) in 15, chronic myeloid leukemia (CML) in first chronic phase in 12, aplastic anemia in 4, myelodysplasia in 3 and Hodgkin's disease, major thalasemia and Hunter's syndrome in one each. Mean age was 20 years-old (2-55), 28 males and 25 females. Conditioning regimens were total body irradiation with 1200 cGy and cyclophosphamide 120 mg/kg in 38 pts, busulfan 16 mg/kg and cyclophosphamide 120 mg/kg in 10 pts, total lymphoid irradiation and cyclophosphamide in 3, 2 pts received other chemotherapy based conditionings. PBPC were infused unmanipulated through a central catheter. Graft versus host disease (GVHD) prophylaxis was cyclosporin and short course methotrexate. Donors were 6/6 HLA compatible siblings in 52 cases and 5/6 match in one case. PBPC mobilization was done...
    From February 1992 to February 1995, 77 patients with APL were treated with ATRA in induction (59 patients de novo, 6 in first relapse, 1 with APL secondary to a mielodisplastic syndrome). The dose used was 45 mg/k/day-30 mg/k/day until... more
    From February 1992 to February 1995, 77 patients with APL were treated with ATRA in induction (59 patients de novo, 6 in first relapse, 1 with APL secondary to a mielodisplastic syndrome). The dose used was 45 mg/k/day-30 mg/k/day until complete remission (CR) was achieved; of the 66 evaluable patients, 50 achieved complete remission (78%). Among the 14 patients who did not attain CR, 13 died, 10 of bleeding episodes and 3 of retinoic syndrome; one was rescued with chemotherapy. We proposed consolidation treatment with high dose Ara-C and Idarubicin to the 49 patients in complete remission; 6 could not receive it and 5 died; the disease free survival period of the other patients was 81% (CI95 90%-66%) at one year and 74% (CI95 91%-52%) at two years. We consider that our results are similar to those of other groups and we are inclined to continue with this treatment protocol.
    To evaluate in a multivariate analysis the prognostic factors associated with hematopoietic recovery and the supportive care requirements after autotransplant of progenitor cells (PC) from various sources: bone marrow (BMPC), BMPC... more
    To evaluate in a multivariate analysis the prognostic factors associated with hematopoietic recovery and the supportive care requirements after autotransplant of progenitor cells (PC) from various sources: bone marrow (BMPC), BMPC & peripheral blood (PBPC), and PBPC alone. A total of 570 patients with hematological malignancies and solid tumors underwent high-dose therapy followed by autotransplant. PBPC were obtained after mobilization with chemotherapy and/or cytokines. One-hundred five patients received BMPC, 217 received BMPC & PBPC and 248 PBPC alone; all of the patients received G-CSF or GM-CSF after infusion. In a multivariate analysis the recovery of neutrophils was adversely associated with low numbers of nucleated cells infused (P < 0.13), bone marrow progenitor cell source, and diagnosis of multiple myeloma and acute leukemia (P < 0.001). The factors that adversely affected platelet recovery were low number of nucleated cells and diagnosis of multiple myeloma and acute leukemia (P < 0.001). We conclude that BMPC adversely affect neutrophil recovery while low numbers of nucleated cells and diagnosis of multiple myeloma and acute leukemia adversely affect both neutrophil and platelet recovery.