Studies have shown that autologous hematopoietic SCT (HSCT) can be used as an intensive immunosuppressive therapy to treat refractory patients and to prevent the progression of multiple sclerosis (MS). This is a prospective multicentric Brazilian MS trial comparing two conditioning regimens: BEAM/horse ATG and CY/ rabbit ATG. Most (80.4%) of the 41 subjects in the study had the secondary progressive MS subtype and the mean age was 42 years. The baseline EDSS score in 58.5% of the subjects was 6.5 and 78% had a score of 6.0 or higher, respectively. The complication rate during the intratransplantation period was 56% for all patients: 71.4% of the patients in the BEAM/hATG group and 40% in the CY/rATG group (P ¼ 0.04). Three subjects (7.5%) died of cardiac toxicity, sepsis and alveolar hemorrhage, all of them in the BEAM/ATG group. EFS was 58.54% for a ll patients: 47% in the BEAM/hATG group and 70% in the CY/rATG group (P ¼ 0.288). In conclusion, the CY/rATG regimen seems to be associated with similar outcome results, but presented less toxicity when compared with the BEAM/hATG regimen. Long-term followup would be required to fully assess the differences in therapeutic effectiveness between the two regimens.
While cord blood levels of interleukin-6 appear to be related to pathological conditions in the perinatal period (infectious and non-infectious), interleukin-8 seems to be a good predictor of early bacterial neonatal infection.
Aim: To investigate whether cord blood levels of C‐reactive protein, interleukin‐1β, interleukin‐6, interleukin‐8, tumour necrosis factor‐α and the soluble receptor of interleukin‐2, are useful markers in the diagnosis of early neonatal sepsis. Design: Umbilical cord blood samples were obtained at birth from 261 neonates, but 5 of these newborns were excluded from the study. Group I included 10 newborns that developed early neonatal sepsis with a positive blood culture; Group II included 11 newborns with non‐infectious perinatal diseases; Group III, which served as the control group, included 10 randomly selected patients, matched for gestational age, among the 235 healthy newborn babies. Results: There were no differences among the three study groups in levels of C‐reactive protein, interleukin‐1 β, tumour necrosis factor‐α and the soluble receptor of interleukin‐2. Interleukin‐6 was significantly elevated in Group I (360.4 ± 157.8 pg/ml) and Group II (158.8 ± 122.3 pg/ml), when compared with Group III (8.6 ± 3.12 pg/ml) (p < 0.01), whereas interleukin‐8 was significantly elevated in Group I (389.3 ± 115.9 pg/ml) compared with Groups II (30.2 ± 5.1 pg/ml) (p < 0.05) and III (33.9 ± 8.6 pg/ml) (p < 0.05). A cut‐off of 100.8 pg/ml for interleukin‐6 obtained by the ROC (receiver operating characteristic) method gave a sensitivity of 50% and a specificity of 87%, and a cut‐off of 111.7 pg/ml for interleukin‐8 showed a sensitivity of 78% and a specificity of 91%.
Conclusion: While cord blood levels of interleukin‐6 appear to be related to pathological conditions in the perinatal period (infectious and non‐infectious), interleukin‐8 seems to be a good predictor of early bacterial neonatal infection.
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