Malnutrition as a prognostic factor in lymphoblastic leukaemia: a multivariate analysis

One hundred and twenty eight Brazilian children with lymphoblastic leukaemia were intensively treated with a Berlin-Frankfurt-Munich based protocol. More children had a white cell count above 50 x 10(9)/l (31%) then observed in developed countries. After a median follow up of 31 months (11-58 months), the estimated probability of relapse free survival was 41% (7%) for the whole group. After adjustment in the Cox's multivariate model, malnutrition was the most significant adverse factor affecting duration of complete remission. Age above 8 years and high peripheral white cell count were also significant adverse factors. Among the nutritional indices, the height for age and weight for age z scores were both significant, whether the cut off points of z-2 or z = -1.28 were chosen to define malnutrition. A strong statistical association between the two indices was found; the contribution of height for age z score to the prediction of relapse free survival was more significant. Children with height for age z score < -2 had a relapse risk of 8.2 (95% confidence interval 3.1 to 21.9) relative to children with z score > -2. The results of this study suggest that socioeconomic and nutritional factors should be considered in the prognostic evaluation of children with leukaemia in developing countries.     

HPLC测定益肤霜中红霉素和地塞米松的含量

采用ＨＰＬＣ测定益肤霜中红霉素和地塞米松的含量，控制制剂的质量。色谱条件：固定相为Ｋｒｏｍａｓｉｌ Ｃ１８柱；流动相为乙腈－０．２ｍｏｌ／Ｌ醋酸铵－水，流速０．８ｍｌ／ｍｉｎ；检测波长２１５ｎｍ。以ｃ对峰面积Ａ作直线回归，红霉素在１．５－２４ｇ／Ｌ地塞米松在２０－３００ｍｇ／Ｌ的范围内，其浓度与峰面积呈直线关系。红霉素回收率为９９．６９％；地塞米松的回收率为１００．２８％。本法操作简便，结果准确，     

Antithrombin III, Antifactor Xa and Heparin

Methods have been devised for the measurement of antithrombin and of the natural inhibitor of activated factor X.
The relation between heparin and its plasma cofactor and the destruction of thrombin and activated factor X were studied. As observed by other workers, heparin has more effect on the speed of thrombin neutralized than on the amount neutralized after 1 hr of incubation. When the neutralization of activated factor X was studied it was found that heparin at very low concentrations, with a plasma cofactor, promoted the progressive destruction of activated factor X.     

Cyclosporin A is associated with faster engraftment and less mucositis than methotrexate after allogeneic bone marrow transplantation

S ummary . Thirty-eight patients with severe aplastic anaemia or acute leukaemia received HLA-identical sibling marrow transplants. Seventeen were treated with methotrexate and 21 with cyclosporin A (CyA) to minimize graft-versus-host disease post transplant. Marrow engraftment was more rapid and oropharyngeal mucositis less severe in those receiving CyA. This resulted in a shorter period of neutropenia and thrombocytopenia, fewer platelet and granulocyte transfusions and less fever. These benefits have to be weighed against the increased nephrotoxicity of CyA.