Srp Ark Celok Lek
-
Following the transplantation of visceral organs, two populations of immunocytes survive which derived from the donor's and the recipient's bone marrow. The rejection process of transplanted organ or graft versus host reaction could result from their mutual stimulation. On the other hand, the immunocytes of the donor and recipient could deny the effects of their MHC antigen disparities directed against each other, to favor the transplant acceptance through the processes of the donor specific tolerance. ⋯ The frequency of chimerism is augmenting more than 1000 times following the combined and simultaneous transplantation of both kidney allograft and donor bone marrow cells. Theoretically, the continuous peroraly giving of high doses of synthetic peptides homologous to immunodominate epitope(s) of the donor MHC molecules could sustain the state of "stable chimerism" with donor immunocytes. This immunosuppressive protocol permits long-term survival of organ (kidney) allograft without diminishing the donor immune system that provokes the present immunosuppressives with non-specific effects.
-
The importance of the extent of surgery as a prognostic factor in multiform glioblastoma has been investigated for years. Some studies could not establish its influence on survival of patients treated with surgery, postoperative radiotherapy, with or without chemotherapy. On the other hand, there are data suggesting benefit for patients treated with more aggressive surgical approach. The aim of this study was to investigate the influence of the extent of surgery on survival/progression-free survival of patients with multiform glioblastoma treated with two consecutive protocols of a combined approach. ⋯ The benefit of a more radical surgery remains controversial in patients with multiform glioblastoma, although maximal tumour reduction should be supported from the cytokinetic point of view. Findings of various authors support this view. Results of this study add further evidence that the aggressive surgical approach carries significant benefit for patients with multiform glioblastoma regarding the survival and progression-free survival. These observations are confirmed with multivariate analyses that showed independent influence of this prognostic factor.