ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1990.tb00418.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1990.tb00419.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

ABSTRACT:13 patients with idiopathic aplastic anaemia in remission for more than 2 years were examined to define the haemopoietic status by means of bone marrow scintigraphy, ferrokinetics and bone marrow culture for haemopoietic progenitor cells. Haemoglobin levels reached the normal range in all these patients although mild neutropenia and thrombocytopenia were still observed in 5 patients. Bone marrow scintigrams using indium‐111 showed normal distribution in 2, diffuse low accumulation in 3, patchy distribution in 7, and expanded distribution with patchy uptake in 1 patient. The defective haemopoiesis was also confirmed by ferrokinetic and bone marrow culture studies. The patchy haemopoiesis appears to characterize the residual marrow damage in remission of idiopathic aplastic anaemi

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1990.tb00420.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

In a previous study we characterized cancer procoagulant (CP), a 68 kd cysteine proteinase which directly activates coagulation factor X in various subtypes (from M1 to M5) of acute non‐lymphoblastic leukemia (ANLL). The aim of this study was to determine whether CP is also expressed by acute lymphoblastic leukemia (ALL) cells. Blasts from 25 ALL patients were extracted and tested for their procoagulant properties. 16 samples (64%) shortened the recalcification time of normal human plasma, and 9 (36%) did not. 8 of the 16 active samples showed properties compatible with CP, i.e. independence from factor VII in triggering blood coagulation and sensitivity to cysteine proteinase inhibitors. Selected samples also cross‐reacted with a polyclonal antibody raised against purified CP. The specific activity of CP in ALL extracts was significantly lower than in most ANLL types previously studied (all but M4). These finding indicate that CP can be a property of the lymphoid phenotype although its expression may be lower than in the myeloid phenot

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1990.tb00421.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

The records of 608 intravenous drug addicts and 124 hemophiliacs diagnosed in 1985 to be seropositive for HIV were reviewed to identify patients with thrombocytopenia. The records of 54 drug addicts (8.9%) and 14 hemophiliacs (11.2%) who had chronic thrombocytopenia were then followed through June 1989 to estimate the incidence of bleeding episodes. The records of 55 HIV‐seronegative patients with idiopathic thrombocytopenic purpura (ITP), comparable for age, platelet count at diagnosis and duration of follow‐up, were used for comparison. Patients with ITP were significantly different from those with HIV‐associated thrombocytopenia in having a higher proportion of females (M/F ratio 13/42 v 53/15, p<0.001) and more intensive treatment (treated: 62% v 21%, p<0.001; splenectomized 37% v 1.5%, p<0.001). The incidence of major bleeding was not significantly different in drug addicts, hemophiliacs and ITP patients (0.98, 1.82 and 1.17/100 patients/year). Among drug addicts, bleeding was significantly more frequent in women than in men (3.4v0/100 patients/year, p<0.05). Our results indicate that the incidence of major bleeding in patients with HIV‐associated thrombocytopenia is low and similar to that observed in more intensively treated ITP p

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1990.tb00422.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

We studied the clinical efficacy and safety of the antifibrinolytic drug tranexamic acid (TA) in patients undergoing chemotherapy for acute leukemia. 54 newley diagnosed AML patients were treated with 1g of TA every 6 hours until the platelet count rose to above 20 × 109/l. Platelet transfusions were given, irrespective of the count, only when oral, mucosal or significant skin bleeding manifestations were observed. During induction, the average number of days with thrombocytopenia below 20 × 109/l was 14.4 ±7.4 and 4.6 ±4.1 transfusions were given in each course. During consolidation, the average number of thrombocytopenic days was 8.4 ± 8.5 and only 1.7 ± 1.8 transfusions were administered. In 11.5% of the induction and 32.1% of the consolidation courses, no platelet support was required. TA was tolerated very well and no side effects or thromboembolic complications were observed. Only in 6 of the 78 induction courses did a major bleeding event occur and there were none in any of the 53 consolidation courses. Thus it seems that TA therapy allowed a significant reduction in the use of platelet transfusions without submitting the patients to greater bleeding

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1990.tb00423.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

We report our findings in 18 patients with acute lymphoblastic leukemia (ALL) aged 60 years or older. A preleukemic syndrome was observed in 2 patients. Compared to younger adults with ALL, L3 morphology was unexpectedly frequent (4/16) T‐ALL was not observed. Other criteria of poor prognosis (high white blood cell count, CNS involvement, organomegaly, high serum LDH) were similar to those reported in young adults. 12 patients were treated with an OPAL‐derived regimen, 4 with the MAV regimen, 1 with vincristine and prednisone, 1 with 6‐mercaptopurine. Complete remission was achieved in 8 patients but proved short‐lived. 5 patients died in aplasia and 5 failed to achieve remission. Median survival for the whole group was 3 months. ALL in the elderly raises the dilemma of an aggressive disease in patients with poor tolerance to intensive

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1990.tb00424.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

We analyzed the prognostic value of clinical, hematologic and bone marrow (BM) histologic findings at presentation in 94 patients with myelodysplastic syndromes (MDS) (28 RA; 2 RARS; 34 RAEB; 6 CMML; 24 RAEB‐t). With survival as the dependent variable, stepwise multivariate analysis indicated as the prognostically most important factors among the MDS taken as a whole: latency from the first symptoms to diagnosis, age, and percentage of BM blasts. In each main MDS group the most unfavorable initial characteristics were: l)low Hb, no macro‐megaloblastosis, male sex for RA/RARS; 2) low Hb and low platelet levels for RAEB/CMML; 3) granuloblastic hyperplasia and high BM blastosis for RAEB‐t. Of the BM histologic parameters, only the percentage of blasts had significant prognostic value. Histologic assessment of BM blastosis, however, did not differ statistically from that based on cytologic examination of BM smears, so that marrow histology seemed not essential for initial prognostic assessment in MDS patients. The finding of abnormal localization of immature precursors (ALIP) in BM biopsies was associated with a negative trend without reaching statistical significance. Using four objective parameters of proven significance (age, Hb, platelets, and BM blasts) we devised a staging system of immediate clinical utility for prognostic stratification and risk‐adapted therapeutic

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1990.tb00425.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Antibody class and subclass response to pneumococcal vaccination was monitored in 173 splenectomized individuals. The distribution according to indication for splenectomy was Hodgkin's disease (HD; n = 41), non‐Hodgkin lymphoma (NHL; n = 25), autoimmune hemolytic anemia or idiopathic thrombocytopenic purpura (n = 17), accidental splenectomy during abdominal surgery for malignant (AMA; n = 15) and benign (ABE; n = 42) disease and splenectomy due to splenic rupture caused by trauma (TRAUMA; n = 33). Pre‐vaccination total IgG pneumococcal antibody values (i.e. against the whole antigen = the vaccine) in the NHL patients were lower than in the ABE and TRAUMA groups (p<0.05). The response to vaccination in HD and NHL patients did not differ from that in the other patient groups. Furthermore, pre‐vaccination values did not differ between HD patients vaccinated before splenectomy and treatment and those vaccinated after, although

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1990.tb00426.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1990.tb00427.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY