Three patients with Chronic Myeloid Leukemia (CML) in chronic phase received Interferon-a during pregnancy, starting from the 1 st trimester. No maternal complications were reported. The 3 patients delivered normal looking babies apart from one baby who was found to have transient mild thrombocytopenia. Subsequently these children were followed for 30, 12, and 4 months and all had normal growth and development. Am.
Various hematological abnormalities commonly occur in active tuberculosis (TB) but thrombocytopenia is exceedingly rare and immune thrombocytopenic purpura (ITP) is reported in only a few cases. A 28-year-old male presented with thrombocytopenia-induced epistaxis and generalized purpura that did not respond to intravenous immunoglobulin but did resolve after antituberculoustreatment The characteristics of this rarely documented association are reviewed.
Background: this work aims at determining the efficacy of modified CHOP combination in which Vinorelbine (Navelbine) replaces Vincristine for the treatment of aggressive Non-Hodgkin's Lymphomas (NHL).
Patients and methods: This open label pilot study included 19 patients with aggressive NHL and one patient with low grade NHL who were treated with the new combination which we abbreviated as P-CAN (Prednisolone 100 mg/day PO day 1-5, Cyclophosphamide 750 mg/m2 i.v day 1, Adriamycin (Doxorubicin) 60 mg/m2 i.v day 1, Navelbine (Vinorelbine) 30 mg/m2 i.v day). The patients1 were 13 males and 6 females, mean age 50 years (34-65), performance state 0-2, International Prognostic Index (IPI) 0-3. Seven patients Stage I, one patient Stage II, eight patients Stage III and 3 patients in Stage IV. 14 patients with nodal disease and five patients with extra-nodal disease. They received total of 97 cycles of the chemotherapy (3-7 cycles).
Results: 18 out of 19 patients achieved complete response (CR). In one patient the response could not be assessed, one patient progressed while on treatment. Toxicity was mainly hematological. The 3 years overall survival (OS) and disease free survival (DFS) was 83%.
Conclusion: P-CAN is an effective, well tolerated combination in chemo-naive aggressive NHL. The addition of Vinorelbine to steroid, Adriamycin, and Cyclophosphamide seems improve the response. Further larger trials are needed to study this combination and its impact on longer overall survival.
A patient with Philadelphia chromosome positive chronic myeloid leukemia (CML) being treated with INF-a conceived during treatment which continued for the whole course of her pregnancy. A female infant was born at 40th week of gestation and was found to have a platelet count of 56 x 109/L which returned to normal after two weeks.
A literature review of similar cases showed no abnormalities in the infants of mothers receiving INF-a during pregnancy. The safety of INF-a during pregnancy requires further study before its routine use during pregnancy can be recommended.
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