摘要:

Abstract: Hematologic abnormalities are commonly associated with infection by the human immunodeficiency virus (HIV) that is the etiologic agent of the acquired immunodeficiency syndrome (AIDS). Bone marrow examinations reveal frequent dysplasia, dyserythropoïesis, lymphocytic infiltration and plasmocytosis. These marrow morphologic characteristics are strongly associated with peripheral blood cytopenia of one or more lineage: anemia, granulocytopenia or thrombocytopenia are frequently described. The pathophysiology of these observed deficiencies is still unclear, although several mechanisms have been postulated as possible explanations for the hematological features of AIDS patients. The hematologic manifestations observed in patients with AIDS or AIDS‐related complex (ARC) and the postulated pathogenetic mechanisms are discussed in this re

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1992.tb01582.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract: We report a case of Ph1‐positive, bcr‐positive chronic myeloid leukemia blast crisis (CML‐BC) which at presentation showed a mixed myeloid/B‐lymphoid immunophenotype along with TdT positivity and, at the molecular level, an oligoclonal rearrangement of the immunoglobulin heavy chain (IgH) gene region. After obtaining a successful remission, at the time of relapse the patient underwent a phenotypic and genotypic switch from mixed to myeloid phenotype, characterized by the loss of the lymphoid markers and TdT expression and by a germline configuration of the IgH gene region. The same bcr rearrangement was, however, found in both phases of the disease, supporting the suggestion of a true phenotypic and genotypic conversion. This report confirms that the neoplastic event in CML may take place at an early multipotent stem‐cell level, prior to a well‐defined phenotypic and genotypic lineage expression. Moreover, it is suggested that different factors (chemotherapy? growth factors?) may have either eradicated the bcr+/IgH+clone and promoted the growth of bcr+/IgH−leukemic cells or, alternatively, supported the lymphoid differentiation program and induced a myeloi

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1992.tb01583.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract: We report on the occurrence of monoclonal components observed in a provincial hospital in northern Italy from 1987 to 1990. The monoclonal components were detected by visual inspection of high‐resolution acetate serum electrophoreses and typed by immunofixation. The percentage of monoclonal components increases steeply with age, and reaches a plateau of 7–8% in individuals over 55 years old. Besides the high percentage of monoclonal component, the other relevant finding of this study is that ˜80% of monoclonal components are of low concentration (<5 g/l). Most of these subjects with small monoclonal component passed undetected in the previous studies on the prognostic significance of monoclonal gammapathy. These findings indicate the need for a revision of the current concepts on the biological and clinical significance of MC discovered by

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1992.tb01584.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract: The effect of thrombin‐activated platelets and their release products on the intracellular free calcium concentration ([Ca2+]i) of human polymorphonuclear leukocytes (PMNs) was studied by loading PMNs with a fluorescent indicator of calcium, fura‐2. [Ca2+]i of PMNs was transiently elevated by thrombin‐activated platelets. The supernatant of thrombin‐activated platelets also elicited a transient elevation of [Ca2+]i in PMNs. Pretreatment of the supernatant with hexokinase caused a decrease in the transient [Ca2+]i elevation of PMNs, while hexokinase abrogated the [Ca2+]i elevation of PMNs elicited by 80 μmol/1 adenosine triphosphate (ATP). Pretreatment of the supernatant with trypsin also decreased the magnitude of the elevation, while trypsin had no effect on the response to ATP. These findings suggest that thrombin‐activated platelets induce a transient [Ca2+]i elevation in PMNs by releasing ATP and some trypsin‐sensi

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1992.tb01585.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract: Administration of both glycosylated and non‐glycosylated recombinant human granulocyte‐macrophage colony‐stimulating factor (rhGM‐CSF) induces an immediate transient granulocytopenia of 1–3 hours' duration. In order to explore this phenomenon, granulocytes were labelled with111Indium and the effect on the kinetics of granulocytes after administration of rhGM‐CSF was studied in 10 previously untreated patients with malignant lymphoma. For both types and doses of rhGM‐CSF, a significant and dramatic accumulation of the111Indium‐labelled granulocytes was observed in the lung within a few minutes after i.v. injection of rhGM‐CSF. The accumulation of radioactivity coincided with the pronounced and transient granulocytopenia in peripheral blood. The111Indium‐labelled granulocytes later reappeared in the peripheral blood, indicating reversible pulmonary vascular margination of the granulocytes. Half‐life of labelled granulocytes after reappearance was comparable to half‐life values under normal conditions. The transient accumulation of granulocytes in the pulmonary vessels seems not to be of clinical importance in the management of patients, but it may to some degree explain previously described side‐effects, such as transient hypoxemia (“first‐dose” reaction) fol

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1992.tb01586.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract: In a retrospective study of 352 patients with primary myelodysplastic syndromes, 61 (17.3%) revealed myelofibrosis in bone marrow biopsies. The fibrosis was observed to occur mostly focally (41/61 cases), and collagen deposits were found very rarely (4/61). The histopathology of bone marrow biopsies revealed hyperplasia and disturbed differentiation in megakaryopoiesis; the frequency and grade of dysplasia in megakaryopoiesis increased with advancing myelofibrosis. Reticulin fibrosis occurred in all subtypes of MDS; however, there was a higher incidence in chronic myelo‐monocytic leukaemia (CMMoL). The frequency of cytogenetic aberrations was significantly higher in the MDS cases with myelofibrosis, compared to the cases without fibrosis. Clinical data showed significantly lower values of haemoglobin and lower platelet counts in MDS with myelofibrosis. Life expectancy was reduced to 9.6 months, compared with 17.4 months in MDS without fibrosis. In refractory anaemia, the survival times were 10.0 months in MDS with myelofibrosis, compared to 28.9 months in MDS without myelofibrosis. 36.6% of the patients with MDS and myelofibrosis developed a transformation into ANLL during the course of the disease. Myelofibrosis therefore seems to herald a poor progno

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1992.tb01587.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract: Since the differentiating effect of high‐dose methylprednisolone (HDMP) on myeloid leukemic cells has been shown in one of our patients with acute myeloblastic leukemia (AML‐M4), 27 previously untreated children with AML were given HDMP (20–30 mg/kg per day) combined with cytosine arabinoside (Ara‐C; 3 mg/kg) for the first 2 weeks of induction therapy. Marked clinical improvement was observed in all patients with the exception of one who died within 24 hours of the treatment. Enlarged liver and spleen (>5 cm) became nonpalpable in 3 (37%) out of 8 and 5 (100%) out of 5 patients, respectively, and bone marrow blasts decreased below 5% in 7 patients (27%) within 2 wk of HDMP and Ara‐C treatment. Adriamycin (1 mg/kg) was added 2 wk after initiation of induction therapy. Twenty‐two (84.6%) of the 26 patients achieved complete remission, 3 (11.5%) had partial remission and no response was obtained in one. Treatment was well tolerated. The addition of HDMP as a differentiating and/or cytolytic agent to conventional anti‐leukemic chemotherapy increased the complete remission rate and prolonged the duration of remission of o

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1992.tb01588.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract: In an attempt to explore T‐cell functions shortly after allogeneic bone marrow transplantation more fully, IL2‐ and IL4‐dependent proliferation was assessed on CD4+TCRαβ+T‐cell clones derived 4–6 weeks after transplantation. Both allogeneic pooled peripheral blood mononuclear cells and Epstein‐Barr virus‐transformed B‐cell lines (BCL) could function as accessory cells (AC) for PHA activation of T‐cell clones. Although minimal clonal proliferation was seen when the T‐cell activation signal was BCL + PHA + IL4, a majority of the clones could undergo IL4‐dependent proliferation after previous activation with AC + PHA + IL2. For certain clones, IL4 also showed an additive effect with IL2. Thus, IL4 was a growth factor for a majority of the investigated posttransplant T‐cell clones, andin vivomodulation of IL4‐dependent T‐cell functions may thus become a future therapeutic possibility to enhance graft‐versus‐leukaemia effects i

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1992.tb01589.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract: P‐Cobalamins have been reported to be decreased in patients with HIV infection. Because of this, we found it of interest to examine both cobalamin‐saturated binding proteins (holo‐transcobalamin, holo‐TC and holo‐haptocorrin, holo‐HC) and cobalamin unsaturated binding proteins (apo‐transcobalamin, apo‐TC and apo‐haptocorrin, apo‐HC). The results are given as range and (median). Eighteen male HIV‐infected patients with plasma cobalamins below 200 pmol/1 were studied. We found low concentrations of holo‐TC (37–88 (47.5) pmol/1) and holo‐HC (64–184 (135.5) pmol/1). The concentration of apo‐TC and apo‐HC was increased (480–1730 (1025) pmol/1; 70–800 (235) pmol/1). It is concluded that, in HIV‐infected patients, low plasma cobalamin does not reflect a low concentration of transcobalamin or haptocorrin. In 20 HIV‐infected patients and 31 patients with malignant haematological diseases, the TC isopeptide patterns were determined. In the HIV group, an increased frequency of TC isopeptide X was found and the overall distribution of TC isopeptides was significantly different from the reference population (p<0.05). There was no difference between the group of patients with malignant haem

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1992.tb01590.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1992.tb01591.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY