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Acute promyelocytic leukemia (APL) has now become the most curable of all subtypes of acute myeloid leukemia. A cure rate of 75-80% can be anticipated with a combination of all-trans retinoic acid (ATRA) and anthracyclines. In Tunisia, the ATRA era began in 1998 with the use, consecutively, of two regimens of a combination of ATRA with anthracycline and cytarabine (APL93), and without cytarabine (LPA99). From 2004, 39 patients with confirmed APL either by t(15;17) or PML/RARA were treated by the PETHEMA LPA 99 trial. The rationale of this protocol by avoiding cytarabine is to reduce death in complete remission (CR) without increasing the incidence of relapse. Thirty-three patients achieved CR (84.6%). The remaining six patients were considered as failure due to early death: three caused by differentiation syndrome (DS) and three died from central nervous system hemorrhage. Baseline blood cell count (WBC) >10 x 10(9)/l (P=0.26) and creatinine >1.4 mg/dl (P=0.42) were not predictive of mortality. DS was observed in 11 patients (30.5%) with a median onset time of 12 days (range: 3-23 days) and median WBC of 29 x 10(9)/L (range: 1.2 x 10(9)-82.7 x 10(9)/l). DS was severe in seven cases, moderate in four, and fatal in three cases. Body mass index > or =30 (P=0.044) and baseline WBC > or =20 x 10(9)/l (P=0.025) are independent predictors of DS. The median follow-up of this study is 36 months. Thirty patients are alive in continuous complete remission; two patients died in CR from septic shock and secondary myelodysplastic syndrome respectively; one patient died 47 months after achieving two relapses. Event free survival from diagnosis was 80% and overall survival was 82%. Our results are quite acceptable and can be improved by reducing mortality rate.

Ad hoc wireless networks are decentralized networks whose members join and leave the network in an asynchronous manner and for short periods of time. Each node participating in the network acts both as host and a router Ad hoc networks in theory, support missions of the Armed Forces in situations in which the infrastructure for wire-bound networks is not dependable, it is impractical to build and maintain the infrastructure, or the missions requires that the nodes have a high-degree of mobility. Ad hoc wireless networks require some level of semantic interoperability so that nodes in the network can 'understand' each other. In this thesis we discuss requirements for semantic interoperability in ad hoc wireless networks, and present a case study of how such requirements could be applied. We realized during our study that semantic interoperability components and functions are developed mostly for wired networks, and not taking in consideration the wireless issues such as: processing, power, and networking limitations. In this thesis we discuss wireless user infrastructure, mobile middleware, and wireless application protocols as a solution to realize semantic interoperability in wireless ad hoc networks. http://archive.org/details/semanticinterope1094510835