Introduction. The interest of intravenous immunoglobulins (IgIV) in the treatment of pemphigus is discussed. Pemphigus is not a recognized indication for this treatment by the CEDIT (French Committee for the assessmen...Introduction. The interest of intravenous immunoglobulins (IgIV) in the treatment of pemphigus is discussed. Pemphigus is not a recognized indication for this treatment by the CEDIT (French Committee for the assessment and diffusion of technological innovations). The aim of this study was to assess the efficacy of IgIV in the treatment of severe corticosteroid-dependant or resistant pemphigus. Material and methods. A retrospective study using a standardized questionnaire was conducted in the various departments of dermatology among the "Groupe Bulles"of the French Society of Dermatology. The study collected the following information from 12 patients suffering from pemphigus and treated with IgIV: 1) general demographical data; 2) characteristics of the pemphigus; 3)different treatments applied, and 4) efficacy and side effects of treatments. Results. Among the 12 patients studied at the end of treatment with IgIV, 8 were in complete remission (1 fleetingly for 2 months and 1 preceding initiation of IgIV), and 2 were improved (1 temporarily for 4 months). A reduction in corticosteroid therapy was possible in 75 p. 100 of cases (9 patients). During treatment with IgIV, immunosuppressors were combined with oral corticosteroids in 3 cases. It was possible to reduce their dose 1 one case and to stop them in another case. No major side effect related to treatment with IgIV was observed. Six months and one year after the treat-ment, complete remission rates were respectively 6/10 and 5/8. One patient relapsed more than one year after the end of IgIV treatment. Conclusions. Although very expensive, treatment with IgIV appears of interest in the treatment of severe corticosteroid-dependant or resistant pemphigus. Moreover tolerance is excellent. The results of our study warrant confirmation in a prospective study.展开更多
Background:Kaposi’s sarcoma (KS) is a potentially life-threatening multifocal neoplasm. Despite the significant decline in the incidence of acquired immune deficiency syndrome(AIDS)related KS with the use of highly a...Background:Kaposi’s sarcoma (KS) is a potentially life-threatening multifocal neoplasm. Despite the significant decline in the incidence of acquired immune deficiency syndrome(AIDS)related KS with the use of highly active antiretroviral therapy (HAART), some patients, even those with a good immune restoration, still have aggressive disease. Liposomal anthracyclines or combination chemotherapy are widely used but adverse effects limit their utilization. Objectives:We studied the efficacy and tolerance of docetaxel in the treatment of AIDS-related KS after pretreatment with anthracycline. Patients/methods and main outcome measure:A retrospective cohort study was done. Nine human immunodeficiency virus (HIV)-infected patients were treated from 1997 to 2002 with docetaxel. Tumour response was evaluated using the AIDS Clinical Trial Group (ACTG) staging criteria. Clinical and biological toxicity was evaluated. AIDS status with HIV viral load and CD4T-cell count were measured at the beginning and at the end of the treatment. Results:A major (complete or partial)response and a stabilization of the disease were demonstrated in seven and two patients, respectively. Grade 4 neutropenia and thrombocytopenia were observed in four of nine and one of nine patients, respectively. One patient died after sepsis. Conclusions:Docetaxel has a good and rapid efficacy in anthracycline-pretreated patients with severe AIDS-related KS. Phase II/III trials should be done to compare docetaxel with liposomal anthracyclines as a first-line treatment.展开更多
文摘Introduction. The interest of intravenous immunoglobulins (IgIV) in the treatment of pemphigus is discussed. Pemphigus is not a recognized indication for this treatment by the CEDIT (French Committee for the assessment and diffusion of technological innovations). The aim of this study was to assess the efficacy of IgIV in the treatment of severe corticosteroid-dependant or resistant pemphigus. Material and methods. A retrospective study using a standardized questionnaire was conducted in the various departments of dermatology among the "Groupe Bulles"of the French Society of Dermatology. The study collected the following information from 12 patients suffering from pemphigus and treated with IgIV: 1) general demographical data; 2) characteristics of the pemphigus; 3)different treatments applied, and 4) efficacy and side effects of treatments. Results. Among the 12 patients studied at the end of treatment with IgIV, 8 were in complete remission (1 fleetingly for 2 months and 1 preceding initiation of IgIV), and 2 were improved (1 temporarily for 4 months). A reduction in corticosteroid therapy was possible in 75 p. 100 of cases (9 patients). During treatment with IgIV, immunosuppressors were combined with oral corticosteroids in 3 cases. It was possible to reduce their dose 1 one case and to stop them in another case. No major side effect related to treatment with IgIV was observed. Six months and one year after the treat-ment, complete remission rates were respectively 6/10 and 5/8. One patient relapsed more than one year after the end of IgIV treatment. Conclusions. Although very expensive, treatment with IgIV appears of interest in the treatment of severe corticosteroid-dependant or resistant pemphigus. Moreover tolerance is excellent. The results of our study warrant confirmation in a prospective study.
文摘Background:Kaposi’s sarcoma (KS) is a potentially life-threatening multifocal neoplasm. Despite the significant decline in the incidence of acquired immune deficiency syndrome(AIDS)related KS with the use of highly active antiretroviral therapy (HAART), some patients, even those with a good immune restoration, still have aggressive disease. Liposomal anthracyclines or combination chemotherapy are widely used but adverse effects limit their utilization. Objectives:We studied the efficacy and tolerance of docetaxel in the treatment of AIDS-related KS after pretreatment with anthracycline. Patients/methods and main outcome measure:A retrospective cohort study was done. Nine human immunodeficiency virus (HIV)-infected patients were treated from 1997 to 2002 with docetaxel. Tumour response was evaluated using the AIDS Clinical Trial Group (ACTG) staging criteria. Clinical and biological toxicity was evaluated. AIDS status with HIV viral load and CD4T-cell count were measured at the beginning and at the end of the treatment. Results:A major (complete or partial)response and a stabilization of the disease were demonstrated in seven and two patients, respectively. Grade 4 neutropenia and thrombocytopenia were observed in four of nine and one of nine patients, respectively. One patient died after sepsis. Conclusions:Docetaxel has a good and rapid efficacy in anthracycline-pretreated patients with severe AIDS-related KS. Phase II/III trials should be done to compare docetaxel with liposomal anthracyclines as a first-line treatment.
