Pregnancy in acromegaly is very rare. Amenorrhea and infertility are common manifestations in acromegaly. The pregnancy may be influenced by acromegaly in many ways and pregnancy itself may influence the course of a pituitary tumor. We report of a case of pregnancy in a woman who was diagnosed with acromegaly during the course of pregnancy. Her pregnancy was uneventful and she delivered a healthy baby at 38 weeks by cesarean section. No treatment was undertaken during the pregnancy and transsphenoidal surgery was performed after the delivery.
Acromegaly* ; Amenorrhea ; Cesarean Section ; Female ; Humans ; Infertility ; Pituitary Neoplasms ; Pregnancy*

Dendritic cells (DCs) are potent antigen-presenting cells for the induction and activation of cytotoxic T lymphocytes. We tested whether bone marrow derived DCs are capable of inducing protective immunity against a murine lymphoma (A20). DCs were grown from tumor-bearing BALB/c mice by culturing bone marrow cells. BALB/c mice were injected (sc) with A20 cells on day 0. Intraperitoneal immunization with DCs mixed with lethally irradiated A20 cells were started when the tumor reached ca. 4-5 mm in diameter (Group A) or on day -7 (Group B). Booster immunizations were given every 3-4 days for four weeks. By 31 days in group A, there was a significant reduction in tumor growth in the mice immunized with DCs mixed with irradiated A20 cells as compared with the control groups (p=0.016). In group B, tumor growth was completely inhibited and there was no tumor growth following extended observations after completion of immunization. Thus, DCs mixed with irradiated tumor cells can induce an antitumor effect. This provides a rationale for the use of DCs mixed with irradiated tumor cells in immunotherapy for minimal residual disease of lymphomas.
Animals ; Apoptosis/immunology ; Bone Marrow Cells/immunology ; Cell Division/immunology ; Cell Line, Tumor ; Dendritic Cells/*immunology/transplantation ; Female ; Immunization/*methods ; Lymphocyte Culture Test, Mixed ; Lymphoma/*immunology/pathology/*therapy ; Mice ; Mice, Inbred BALB C ; Neoplasm Transplantation ; T-Lymphocytes, Cytotoxic/immunology

The purpose of this study was to develop a cost-effective protocol for the mobilization of peripheral blood stem cells (PBSC) in patients with malignancy. Thirty consecutive patients were randomized to mobilize PBSC with the late addition of a standard 250 microg dose of G-CSF (Neutrogen) from day 8 or early addition of the same dose of G-CSF from day 2, following cyclophosphamide (CY) 4 g/m2. The median yield of CD34+ cells from evaluated patients was 7.87 x 10(6)/kg (range, 2.06-27.25), collected in a median of four apheresis (range, 2-9). Target CD34 + cell doses > or = 2.0 x 10(6)/kg were achieved in all patients able to be evaluated. There were no statistically significant differences in CD34+ cell yields or toxicities. Overall engraftment occurred with median days to neutrophils > or = 0.5 x 10(9)/L or platelets > 20 x 10(9)/L of 11 and 17 days, respectively. However, the duration of G-CSF administration was markedly shorter in the late use of G-CSF group than in the early use of G-CSF group, with a median of 9 days compared with 15 days (p>0.001). PBSC harvesting after priming with CY plus delayed use of G-CSF made it a safe and cost-effective procedure.
Adult ; Aged ; Antigens, CD34/metabolism ; Antigens, CD34/immunology ; Antineoplastic Agents, Alkylating/therapeutic use* ; Antineoplastic Agents, Alkylating/adverse effects ; Breast Neoplasms/therapy ; Comparative Study ; Cost-Benefit Analysis ; Cyclophosphamide/therapeutic use* ; Cyclophosphamide/adverse effects ; Drug Administration Schedule ; Female ; Graft Survival ; Granulocyte Colony-Stimulating Factor/therapeutic use* ; Granulocyte Colony-Stimulating Factor/adverse effects ; Hematopoietic Stem Cell Mobilization/methods* ; Hematopoietic Stem Cell Mobilization/economics* ; Hematopoietic Stem Cell Mobilization/adverse effects ; Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells/metabolism ; Hematopoietic Stem Cells/immunology ; Human ; Lymphoma, Non-Hodgkin/therapy ; Male ; Middle Age ; Multiple Myeloma/therapy ; Sarcoma, Ewing's/therapy

BACKGROUND: Bortezomib targets molecular dysregulation of nuclear factor-kappaB activation and cell cycle control, which are characteristic features of diffuse large B-cell lymphoma (DLBCL). We evaluated the safety and efficacy of bortezomib treatment with dose-dense cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) every 2 weeks (CHOP-14). METHODS: Untreated DLBCL patients were enrolled. A phase I dose-escalation study with 1.0, 1.3, and 1.6 mg/m2 bortezomib administration on day 1 and 4 in addition to the CHOP-14 regimen was performed to determine the maximum tolerated dose (MTD) and the dose-limiting toxicity (DLT). Lenograstim 5 microg/kg/d was administered on day 4-13. The bortezomib dose from the phase I study was used in the phase II study. RESULTS: Nine and 37 patients were enrolled in the phase I and phase II studies, respectively. The analysis of the phase II results (40 patients) included data of the 3 patients in the last MTD dose cohort of the phase I trial. During the phase I trial, no DLT was observed at any bortezomib dose; therefore, the recommended dose was 1.6 mg/m2. In phase II, the overall response rate was 95% (complete response: 80%; partial response: 15%). Nine out of the 40 patients showed grade 3 sensory neuropathy, and 22 required at least 1 dose reduction. Three patients could not complete the intended 6 cycles of treatment because of severe neuropathy. CONCLUSION: Bortezomib plus CHOP-14 was highly effective for the treatment of untreated DLBCL patients, but in many cases, dose or schedule modification was required to reduce neurotoxicity.
Appointments and Schedules ; B-Lymphocytes ; Boronic Acids ; Cell Cycle Checkpoints ; Cohort Studies ; Cyclophosphamide ; Doxorubicin ; Granulocyte Colony-Stimulating Factor ; Humans ; Lymphoma, B-Cell ; Maximum Tolerated Dose ; Prednisone ; Pyrazines ; Recombinant Proteins ; Vincristine ; Bortezomib

BACKGROUND: The optimal timing of peripheral blood stem cell (PBSC) collection is essential to successful procurement of sufficient PBSC for engraftment. The purpose of this study was to evaluate the peripheral blood parameters that may predict the apheretic yield of circulating stem cells in patients with breast cancer. METHODS: We did a retrospective review of 29 patients with breast cancer (14 : high risk, 15 : metastatic disease) who underwent mobilizing therapy from Dec. 1992 to Jan. 1999. Immediately prior to 119 consecutive PBSC collection procedures, the PB white blood cell (WBC) and monocyte were determined and correlated with stem cell parameters namely, CD34+ cell and mononuclear cell content. RESULTS: The median of 0.57x106CD34+cells/kg patient body weight (range, 0-9.39) were collected per harvest. The WBC on the day of apheresis showed only weak correlation with the mononuclear cells collected (r=0.26). In contrast, the WBC count and monocyte count in PB did not correlated with CD34+ cells harvested CONCLUSION: WBC and monocyte count are not appropriate parameters to identify the exact timing for apheresis and predict the amount of peripheral blood stem cells collected in patients with breast cancer.
Blood Component Removal ; Body Weight ; Breast Neoplasms* ; Breast* ; Humans ; Leukocyte Count* ; Leukocytes* ; Monocytes ; Retrospective Studies ; Stem Cells*