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- Juliusson, Gunnar, et al.
(författare)
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Increased remissions from one course for intermediate-dose cytosine arabinoside and idarubicin in elderly acute myeloid leukaemia when combined with cladribine. A randomized population-based phase II study
- 2003
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Ingår i: British Journal of Haematology. - : Wiley. - 0007-1048 .- 1365-2141. ; 123:5, s. 810-818
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Tidskriftsartikel (refereegranskat)abstract
- Cladribine has single-drug activity in acute myeloid leukaemia (AML), and may enhance the formation of the active metabolite (ara-CTP) of cytosine arabinoside (ara-C). To evaluate the feasibility of adding intermittent cladribine to intermediate-dose ara-C (1 g/m(2)/2 h) b.i.d. for 4 d with idarubicin (CCI), we performed a 2:1 randomized phase II trial in AML patients aged over 60 years. Primary endpoints were time to recovery from cytopenia and need for supportive care following the first course. Sixty-three patients (median 71 years, range 60-84 years) were included, constituting 72% of all eligible patients. Toxicity was limited, with no differences between the treatment arms. The early toxic death rate was 11%. The median time to recovery from neutropenia and thrombocytopenia was 22 and 17 d from the start of course no. 1, respectively, and the requirement for platelet and red cell transfusions was four and eight units respectively. Patients had a median of 8 d with fever over 38degreesC, and 17 d with intravenous antibiotic treatment. The overall complete remission (CR) rate was 62%, with 51% CR from one course of CCI in comparison with 35% for the two-drug therapy (P = 0.014). The median survival with a 2-year follow-up was 14 months, and the 2-year survival was over 30%, with no differences between the treatment arms. Considering the median age and our population-based approach, the overall results are encouraging.
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- Hogberg, L, et al.
(författare)
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The impact of active intervention on the spread of penicillin-resistant streptococcus pneumoniae in Swedish day-care centres
- 2004
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Ingår i: Scandinavian Journal of Infectious Diseases. - : Informa UK Limited. - 1651-1980 .- 0036-5548. ; 36:9, s. 629-635
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Tidskriftsartikel (refereegranskat)abstract
- Policies for handling cases of penicillin-non-susceptible Streptococcus pneumoniae (PNSP) in day-care groups vary between different counties in Sweden. The aim of this study was to evaluate the epidemiological effect of excluding PNSP-carriers from children's day-care centres (DCC). We followed the incidence in 14 DCC groups with ongoing PNSP-spread, by repeated group screens until no further cases could be identified. All identified carriers were excluded from DCC attendance in study area A (Skane region) while they remained in the group in study area B (Goteborg and Orebro), according to local policies. The intervention effect was evaluated by comparing the number of additional cases after the baseline screen (start of the intervention period) between the 2 study areas. All PNSP-isolates were characterized by resistance pattern, serotype and pulse-field gel electrophoresis. The relative risk for children in DCCs without active intervention was 6.4 (95% CI: 2.0-20.7). Each prevented case in area A can be estimated to have demanded the exclusion of 2 other children from day care for approximately 4 weeks each. The total cost-benefit outcome of this action has to be seen in the light of the local situation with regard to the population prevalence and the distribution of other risk factors.
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- Modigh, C M, et al.
(författare)
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Time to pregnancy among partners of men exposed to di(2-ethylhexyl)phthalate
- 2002
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Ingår i: Scandinavian Journal of Work, Environment and Health. - 0355-3140. ; 28:6, s. 418-428
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Tidskriftsartikel (refereegranskat)abstract
- Objectives This study assessed paternal occupational exposure to di(2-ethylhexyl)phthalate (DEHP) in association with reduced fertility. Methods Men working in three plants with DEHP exposure were studied retrospectively. Male and female employees and their partners were invited to participate if they had reported a pregnancy or an attempt to achieve a pregnancy. Postal questionnaires and telephone interviews were used to collect additional data from the men and women, respectively. Information on time to pregnancy was eligible for 326 pregnancies fathered by 193 men. Male exposure to DEHP during every month of their time to pregnancy was classified into one of three exposure categories. The exposure ranged from <0.1 to 2.1 mg/ml(3). The fathers of only four pregnancies had DEHP exposure of >0.5 mg/m(3) during the time to pregnancy. The pregnancies of employed women with unexposed partners or pregnancies of employed men unexposed during the time to pregnancy formed the reference group. Results The fecundability ratio for time to pregnancy was 1.07 [95% confidence interval (95% Cl) 0.84-1.351 for those with low exposure and 0.97 (95% CI 0.70-1.33) for the highly exposed after adjustment for the father's age, mother's age, and length of recall. When the analyses were restricted to first pregnancy, the fecundability ratio was 1.13 (95% Cl 0.83-1.56) for low exposure and 1.02 (95% Cl 0.66-1.59) for high exposure. Conclusions Time to pregnancy is not prolonged among couples with paternal exposure to DEHP at a mean exposure level of <0.5 mg/ml.
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- Sjostrom, A, et al.
(författare)
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Acquisition of external major histocompatibility complex class I molecules by natural killer cells expressing inhibitory Ly49 receptors
- 2001
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Ingår i: The Journal of experimental medicine. - : Rockefeller University Press. - 0022-1007 .- 1540-9538. ; 194:10, s. 1519-1530
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Tidskriftsartikel (refereegranskat)abstract
- Murine natural killer (NK) cells express inhibitory Ly49 receptors specific for major histocompatibility complex (MHC) class I molecules. We report that during interactions with cells in the environment, NK cells acquired MHC class I ligands from surrounding cells in a Ly49-specific fashion and displayed them at the cell surface. Ligand acquisition sometimes reached 20% of the MHC class I expression on surrounding cells, involved transfer of the entire MHC class I protein to the NK cell, and was independent of whether or not the NK cell expressed the MHC class I ligand itself. We also present indirect evidence for spontaneous MHC class I acquisition in vivo, as well as describe an in vitro coculture system with transfected cells in which the same phenomenon occurred. Functional studies in the latter model showed that uptake of H-2Dd by Ly49A+ NK cells was accompanied by a partial inactivation of cytotoxic activity in the NK cell, as tested against H-2Dd-negative target cells. In addition, ligand acquisition did not abrogate the ability of Ly49A+ NK cells to receive inhibitory signals from external H-2Dd molecules. This study is the first to describe ligand acquisition by NK cells, which parallels recently described phenomena in T and B cells.
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