ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1994.tb01317.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Abstract: We examined the effect of treatment with rHuEpo on platelet counts in 61 hemodialysis patients and correlated them with changes in erythropoietic activity, iron status and inflammation. Platelets (109/l) increased from 220 ±80 to 245 ±102 after 14 days and stabilized at that level up to day 90 (p<0.0001). The increment was similar in complete or partial responders but was not observed in failures. Serum transferrin receptor (sTfR, a measure of total erythropoiesis) and Hct rose much more progressively, but relative platelet increments correlated with relative increases in sTfR and Hct. Relative platelet increments correlated inversely with relative changes of SeFe or transferrin saturation, but not with their absolute values, nor with baseline ferritin or its progressive decrease. Although baseline platelet count was 12% higher in patients with inflammation and correlated with serum haptoglobin, relative increases were similar in patients with or without inflammation. In conclusion, rHuEpo produced a clinically minor but consistent elevation of platelet counts. These modifications were not related primarily to modifications in iron stores, functional iron deficiency, or inflammation, but paralleled the expansion of erythropoietic activity. The results suggest that rHuEpo has a small positive effect on platelet production, but it cannot be ruled out that this could be partially mediated through functional iron deficie

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1994.tb01318.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Abstract: The anaemia in hairy cell leukaemia (HCL) has been suggested to be mediated in part by T lymphocytes. Consequently, we have investigated the role of T lymphocytes in this disease by cloning pre‐treatment HCL T lymphocytes and testing their influence on the in vitro growth of BFU‐E from autologous post‐treatment and normal donors T‐lymphocyte depleted peripheral blood mononuclear cells (PBMNC‐T). Altogether, 24 CD4+/CD8‐and 17 CD4‐/CD8+T‐lymphocyte clones from 3 different HCL patients were tested. All were found to enhance the growth of BFU‐E, the degree of enhancement being independent of the length of IFN treatment at the time of the post‐treatment sampling. Likewise, no difference in the extent of enhancement was seen between CD4+/CD8‐and CD4‐/CD8+clones, or whether the clones were tested for modulation of BFU‐E from PBMNC‐T of autologous or allogeneic origin. Finally, no differences could be observed between different patients in the extent of clonal enhancement. These findings, which are in line with our previous ones in normal donors, indicate that the T‐lymphocyte function with regard to regulation of the erythropoiesis is normal in HCL, arguing against a T‐lymphocyte mediated suppres

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1994.tb01319.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Abstract: The retrospective evaluation of bone marrow biopsies of 569 patients with primary myelodysplastic syndrome ‐ pMDS ‐ revealed 256 refractory anemias ‐ RA ‐, 52 refractory anemias with ringed sideroblasts ‐RARS ‐, 133 refractory anemias with excess of blasts ‐ RAEB ‐, 52 refractory anemias with excess of blasts in transformation ‐ RAEB‐t ‐, and 53 chronic myelo‐monocytic leukemias ‐ CMMOL ‐ according to FAB‐criteria, 23 patients were not otherwise specified (myelodysplastic syndrome: not otherwise specified ‐ MDS.NOS ‐). RARS‐patients had the best prognosis (median survival 41.9 months, incidence of leukemia 3.8%), followed by RA‐patients (26.5 months, 16.4%), MDS.NOS‐patients (22.4 months, 21.7%), CMMOL‐patients (12.5 months, 49.1%). RAEB‐and RAEB‐t‐patients had the worst prognosis (median survival time 8.5 and 4.6 months, incidence of leukemia 42.1% and 57.7%, respectively). But the survival times showed a considerable range in each FAB‐subgroup with 0–154 months in RA or 0–52 months in CMMOL. To forecast life expectancy more precisely, a scoring system was developed using nine histopathological parameters, among which the three most important ones were determined: quantity of myeloblasts, myelofibrosis and ALIP's. The scoring system allows a determination of three risk groups with significantly different survival times. It is valid also for patients without increase of myeloblasts (<5% myeloblasts in the bone marrow) and identifies high‐risk MDS patients in this group. By this proposed scoring system, a prognostic approval in primary MDS can be achieved applying histopathology without regarding further methods herewith presenting a system which could be considered indep

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1994.tb01320.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Abstract: We report a 63‐year‐old woman with myelodysplastic syndrome (MDS), refractory anaemia with ring sideroblasts (RARS), and blood basophilia with pathological forms. Karyotype analysis revealed a complex rearrangement: 46,XX,del(3) (p13p25),del(5) (q13q33),der(16)t(1;16) (p 13;q 12)/47,idem,add(20) (?p1l)/49,idem, + add(1) (q32),add(20) (?p11), + mar/46,XX. Karyotype, immunophenotype and in situ hybridization studies by the MAC (morphology antibody chromosomes) combination technique revealed the chromosomal abnormality in granulocytic/monocytic and erythrocytic metaphase cells. Also mature basophils and other granulocytes were involved with the abnormality. We suggest that our patient with the MDS has a stem cell disorder affecting all myeloid cell lineages and that basophilia constitutes a part of the malignant pr

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1994.tb01321.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Abstract: The role of flow cytometric reticulocyte (RET) counting and the immature RET fractions (IRF) in the evaluation of hematopoietic recovery following chemoradiotherapy‐induced aplasia was studied. RET counts and IRF were studied using an automated flow cytometric reticulocyte counter (Sysmex R‐2000) in three groups of patients: 58 patients undergoing an autologous bone marrow transplantation (ABMT group), 28 of whom received granulocyte colony‐stimulating factor (G‐CSF); 28 patients undergoing an allogeneic bone marrow transplantation (BMT group); and 28 patients receiving remission‐induction chemotherapy for acute leukemia (CHEMO group). To evaluate the IRF the percentages of RET fractions with middle and high fluorescence reticulocyte (MFR and HFR, respectively) were used. A rising IRF (expressed as the percentage of MFR ± HFR) was the first sign of hematopoietic recovery (ABMT group, IRF 9 days versus 18 days for the absolute neutrophil count (ANC); BMT group, 15 versus 18 days; CHEMO group, 9 versus 11 days). When recovery of the ANC (>0.5 times 109/1) was compared with that of the IRF (MFR ± HFR>5%), statistically significant differences were found in all three groups. Additionally, 93.1% of the ABMT, 92% of the BMT and 91.2% of the CHEMO recovered the IRF before the ANC. In conclusion, an elevation in the percentage of IRF is the first sign of hematologic recovery in the majority of patients receiving remission‐induction chemotherapy and the first sign of engraftment in those submitted to ABMT or BMT. Serial automated flow cytometric quantitative reticulocyte counting provides a useful and early measure of erythropoiesis indicative of hematopoietic reconstitution or successful bone marrow engraftment following marrow

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1994.tb01322.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Abstract: Agranulocytosis developed in a 63‐year‐old patient with myelodysplasia 6 weeks after commencing treatment with the oral iron chelator deferiprone (L1, 1,2‐dimethyl‐3‐hydroxypyrid‐4‐one, CP20) at a daily dose of 79 mg/kg. This was the 3rd case of agranulocytosis (neutrophils 0 times 109/***1) in clinical trials of L1at the Royal Free Hospital. The neutrophil count recovered 7 days after stopping and commencing G‐CSF at a dose of 300 μg daily. Three other patients with milder degrees of neutropenia (neutrophils<1.5 times 109/1) have also been observed in our trials. The case histories of these 4 patients are described here; other reported cases of neutropenia or agranulocytosis are reviewed. Based on worldwide long‐term clinical trials the incidence of agranulocytosis is about 1.6% a

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1994.tb01323.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1994.tb01324.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1994.tb01325.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1994.tb01326.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY