摘要:

Abstract:Disseminated intravascular coagulation (DIC) commonly occurs in patients with acute promyelocytic leukemia (APL, FAB‐M3) but may also be seen in other subtypes of AML. DIC in patients with AML has been attributed to procoagulants released from granular fractions of leukemic blast cells. The present study was designed (i) to evaluate thrombin activity in patients with AML by measuring plasma levels of fibrinopeptide A (FPA) prior to chemotherapy, and (ii) to examine whether a relationship between FPA levels and the number of peripheral blast cells exists. Plasma levels of FPA were determined using a commercially available RIA kit. To remove fibrinogen and the majority of elastase‐induced fibrinopeptides (Aα 1–21) known to crossreact with the FPA (Aα 1–16) antiserum used in this assay, plasma samples were treated with bentonite prior to further processing. The study was conducted on 5 patients with APL and on 22 patients with other subtypes of AML. Peripheral blast cell counts at initial diagnosis ranged from 2100 to 56000/μl in patients with APL and from 1900 to 151000/μl in patients with other AML subtypes. The mean (± 1 SEM) pretreatment plasma level of FPA was significantly higher (p = 0.021) in the 5 patients with APL (38.2 ± 8.3 ng/ml) than in patients with other AML subtypes (8.1 ± 0.7 ng/ml). No relationship was found between peripheral blast cell counts and the corresponding FPA levels in the total group of 27 patients. However, when considering the 5 patients with APL separately, a significant correlation was observed between peripheral blast cell number and FPA plasma levels (r = 0.88, p = 0.050). This study confirms that thrombin generation is considerably greater in patients with acute promyelocytic leukemia than in other subtypes of AML. We conclude that type and number of circulating blast cells and their related capacity to express procoagulent activities appear to be major determinants of excessive fibrinogen degr

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1990.tb00394.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract:In order to evaluate the clinical significance of the timing of diagnosis in chronic lymphocytic leukemia (CLL), we studied the diagnostic latency (DL), a variable related both to lymphocyte count and to lymphocyte doubling time (LDT), which points out the interval between the date of CLL diagnosis and the time at which it could have been made (lymphocyte count in peripheral blood of at least 5.0 × 109/l). In two different series accounting for 221 previously untreated CLL patients the trends of the DL tended to decrease as the risk increased. In other words, the more advanced the clinical stage the shorter the DL. On the other hand, the values of lymphocyte accumulation rate (LAR), which defines the speed at which the number of lymphocytes increases over the time, were significantly lower in earlier stages of disease. Both DL and LAR had a significant impact on survival when investigated by means of univariate analysis. In a Cox's regression analysis applied to a training set of 122 patients, the combination of international clinical stages, LAR and age had the strongest value in predicting survival. The resulting model was validated in an independent subset of 99 patients (test‐set cases) leading to a classification of patients into low‐, intermediate‐, and high‐risk groups with 5‐year survival rates of 89%, 31% and 8%, respectively, and with distinctively different annual mortality rates (p<0.001). Finally, when multivariate analysis was applied to study disease progression, LAR was the first variable to enter the regression model (p

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1990.tb00395.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract:Interferon gamma (IFNγ) inhibits haematopoiesisin vitroand anin vivorole in bone marrow suppression has been implied from clinical studies. We investigated the capacity of three recombinant (r), human (h), haematopoietic growth factors to overcome thein vitroIFNγ inhibition of bone marrow progenitor cells in a methylcellulose culture system. Granulocyte macrophage‐colony stimulating factor (GM‐CSF) partially reversed IFNγ‐induced suppression of granulocyte‐macrophage colony formation, by increasing colony forming units‐granulocyte macrophage (CFU‐GM) in a proportion ranging from 54–101%. Interleukin‐3 (IL‐3) and granulocytecolony stimulating factor (G‐CSF) were much less effective. For erythropoiesis, IL‐3 was much more effective and partially reversed IFNγ‐mediated inhibition by increasing burst forming units‐erythroid (BFU‐E) in a proportion ranging from 52–138%. GM‐CSF and G‐CSF had no significant effect on IFNγ‐induced suppression of BFU‐E. In conclusion, haematopoietic growth factors have different capacity to overcome IFNγ‐induced suppression of marrow progenitor cellsin vitro.The findings may have therapeutic implications, as combinations of growth factors may be more effect

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1990.tb00396.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract:Marrow fibroblast colony formation was studied in patients with myeloproliferative disorders, using human serum or platelet‐derived growth factor plus plasma‐derived serum as growth‐stimulating factors. Colony numbers negatively correlated with the patient's age, but were not different from those of controls. However, both maximum and average cell numbers per colony were significantly increased in patients with chronic myelocytic leukemia (CML) as compared to controls. These results suggest that fibroblast colony‐forming cells with high sensitivity to human serum mitogen(s) exist in a CML bone marrow. These may possibly be involved in one of the mechanism concerned with promoting fibrosis in this

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1990.tb00397.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract:To evaluate whether local oral humoral immunity changes during remission‐induction therapy of newly diagnosed acute myeloid leukaemia, 10 consecutive adult patients were investigated during 4 weeks. The concentrations of the oral secretory immunoglobulins A and M were increased during the first 7 days but, when corrected for changes in the salivary flow rate, the secretion rates of S‐IgA and S‐IgM remained unchanged, relative to the values before chemotherapy. In comparison, the concentrations of the serum immunoglobulins A, G and M were decreased, like the leukocyte and thrombocyte counts, during the first 14 d. It is concluded that the chemotherapeutic agents appear to act differently upon the local plasma cells associated with oral secretory glands and plasma cells in the bone marrow, and that the secretion rate of oral immunoglobulins remains constant during remission‐induction

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1990.tb00398.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract:Orally administrated Na232PO4mainly accumulates in bone marrow where it emits β‐particles which may damage cells. Previously, we showed that32P treatment for polycythemia vera (PVC) increased the phytohemagglutinin reactivity and proportions of T cells in the blood. Now we have examined the effects of32P treatment for PCV on natural killer (NK) and B‐lymphocyte subsets which are considered to undergo their maturation in bone marrow. A mean isotope dose of 240 MBq given to 14 patients reduced the peripheral lymphocyte counts to 60% at 6 weeks. B cells and NK cells were reduced to the highest relative extent followed by HNK‐1 cells and T cells. Although the proportion of NK cells was reduced to 50% there was no concomitant reduction of NK activity against K562 cells. Pokeweed mitogen‐triggered secretion of IgM was significantly reduced, but not that of IgG or IgA. It is suggested that lymphocytes which mature in bone marrow may be affected to the highest extent by32P treatmen

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1990.tb00399.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract:We have compared the effect of alpha 2‐C and gamma recombinant interferons (rIFNs) on normal myeloid progenitors (N‐CFU‐GM), chronic myeloid leukemia (CML) progenitors (CML‐CFU‐GM) and leukemic progenitors (L‐CFU) of acute non‐lymphoblastic leukemia (ANLL) patients. Within 14 days of continuous exposure in culture, a dose‐dependent inhibition of CFU‐GM was seen for most normal subjects. Resistance to rIFNs was frequent in leukemic patients and even more in acute leukemia than in CML. Stimulation of clonogenic cell growth was seen for a minority of leukemic patients. When only the sensitive cases were considered, no difference in sensitivity was noticed between normal, CML and ANLL patients. A good correlation was observed between the activity or the lack of activity of alph

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1990.tb00400.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract:3 patients with acute nonlymphocytic leukemia (ANLL) and an isochromosome (17q) as the sole chromosomal defect are reported. Besides this cytogenetic pattern, they shared several clinical and hematological features such as male sex, advanced age, spleno‐ and/or hepatomegaly and a suspected preceding myeloproliferative syndrome. Bone marrow cytology was characterized by hypercellularity, prominent baso‐ and eosinophilia, decreased erythropoiesis and marked increase of dysmorphic megakarocytes. We suggest that some or most patients with ANLL and i(17q) as the sole cytogenetic defect represent blastic transformation of an underlying chronic myeloproliferative disorder rather thande novoA

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1990.tb00401.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.tb00402.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.tb00403.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY