摘要:

ABSTRACTA boy with acute lymphoblastic leukemia showed cerebrospinal fluid and blood eosinophilia and basophilia. No cause for the eosinophilia or basophilia was identified, but they preceded the appearance of leukemic lymphoblasts in both CSF and blood. The first appearance of basophils and eosinophils in the CSF was associated with acute symptomatology and responded completely to antileukemic therapy. Though treatment with intrathecal drugs reversed major neurological signs, there was evidence of generalized cerebral cortical atrophy. The possible mechanisms responsible for this unusual cellular reaction include: 1) reaction to antileukemic therapy; 2) immunological reaction to the lymphoblasts; 3) ectopic hormone production; 4) common stem cell origin of lymphoblasts, basophils, and eosinophils. The last explanation seems the most likely. This is a report of a boy with acute lymphoblastic leukemia (ALL) who developed central nervous system (CNS) and bone marrow relapse of leukemia following 2 years of remission. He showed marked eosinophilia and basophilia in the cerebrospinal fluid (CSF) associated with blood eosinophilia and basophilia. Only Budka et al.(1)have reported a similar patient with acute leukemia and CSF eosinophilia and basophilia; their patient showed no blood eosinophilia or basophilia. The gradual accumulation of case reports of eosinophilic or basophilic meningitis with Hodgkin's or non-Hodgkin's lymphoma(2,5)suggests that this finding is of some importance.

ISSN:0192-8562    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

ABSTRACTThe hematologic manifestations of neuroblastoma are numerous and varied. Bone marrow invasion by tumor cells may cause leukoerythroblastic changes or depression of one or more of the cell lines in the peripheral blood; occasionally bone marrow involvement may be so extensive that tumor cells may be released into the peripheral blood and lead to an erroneous diagnosis of leukemia. Anemia in neuroblastoma patients may result not only from bone marrow involvement, but also from bleeding into a tumor mass or from the hemolysis accompanying a consumption coagulopathy. A specific morphologic abnormality, the cogwheel erythrocyte, has been reported in patients with neuroblastoma. Neuroblastoma may also be associated with elevation of the platelet count or a hypercoagulable state. Recognition of these protean hematologic manifestations may facilitate diagnosis in children with atypical presentations of this highly malignant tumor.

ISSN:0192-8562    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

ABSTRACTThirty-three children with acute lymphocytic leukemia who were in remission and who did not have central nervous system (CNS) leukemia were studied in an effort to detect effects of CNS prophylaxis on brain function. Nineteen children had received intrathecal methotrexate plus cranial radiation, eight had intrathecal methotrexate alone, and six had intrathecal plus intravenous methotrexate. Intrathecal methotrexate, 12 mg/m2, was given six times over 2 months. The dosage of cranial irradiation was 2400 rads in 12 divided doses over 16 days. Intravenous methotrexate, 500 mg/m2, was given at 21-day intervals three times. All except two patients had been in remission for more than 1 year, 10 for 1–2 years, nine for 2–4 years, and 12 for more than 4 years. Computed tomography of the head, electroencephalograms, neurologic examination, and a modified form of the Halsted-Reitan neuropsychologic test battery revealed 13 patients with an abnormal finding, but only one of these patients had an abnormality in more than one area. There was thus no correlation between the observed structural and functional abnormalities. These preliminary results fail to confirm any significant difference in neuropsychologic function related to the various CNS regimens and do not indicate a need to modify presently accepted methods of CNS prophylaxis. A prospective longer-term follow-up study with a larger patient sample is needed to assess the long-range relationship of measurable abnormalities to CNS prophylaxis and to help establish a preferred method of prophylaxis.

ISSN:0192-8562    

出版商:OVID    

年代:1979

数据来源: OVID

ISSN:0192-8562    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

ABSTRACTWe describe a microtechnology for the study of the coagulation system in newborn infants. Interpretation of results demands an understanding of the techniques used and the nature of the control population from which normal values are drawn. We have examined two syndromes which represent the majority of hemostatic disorders of sick newborn infants. The first is thrombocytopenia resulting from bacterial infections in which there are minimal changes in the levels of blood coagulation factors and little tendency to bleed. The second is a syndrome of disseminated intravascular coagulation in which there is a profound disturbance in the coagulation mechanism, relatively little change in platelet counts, a severe hemorrhagic diathesis, and widespread ischemic necrosis.

ISSN:0192-8562    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

ABSTRACTImpairment of platelet function is well recognized in the neonate. The abnormalities include a reduction in platelet factor 3 activity and availability, a reduction in the release of nonmetabolic storage pool ADP and ATP, and platelet factor 4 following stimulation, decreased adhesiveness, and impaired aggregation with ADP, epinephrine, collagen, and thrombin. Whether the cause of the platelet abnormality and the impairment in platelet secretion is due to a “storage pool deficiency” or an “aspirin-like defect” has been unclear. However, recent data suggests that the neonatal platelet possesses neither a significant deficiency in prostaglandin synthesis nor a significant decrease in storage pool adenine nucleotides. The abnormalities noted appear most likely to be due to a membrane-related phenomenon.

ISSN:0192-8562    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

ABSTRACTAbnormalities in blood flow, in blood vessel walls, in procoagulants, in circulating anticoagulants, and in the reticuloendothelial system may contribute to the thrombotic tendency of newborns. However, the importance of the role of each of these factors or other unmeasured factors is largely unknown. Most infants may be protected by their physiologic platelet dysfunction, increased fibrinolysis, and deficiencies in coagulation factors.

ISSN:0192-8562    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

ABSTRACTHuman newborns have certain hemostatic “deficiencies” which seem to be peculiar to this period of life, such as reduced factors II, VII, IX, X, XI, and XII, reduced antithrombin III levels, and reduced plasminogen levels. However, they are capable of activating the coagulation mechanism to elicit either the entity of disseminated intravascular coagulation or the occurrence of localized and diffuse thrombotic events. The mechanisms involved have yet to be defined. Evidence has been presented to suggest that preterm infants may manifest a variant form of disseminated intravascular coagulation in which thrombocytopenia is not present.

ISSN:0192-8562    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

ABSTRACTThe fibrinolysin system is incomplete in newborn infants. Lack of serum plasminogen in premature newborn has an important role in the pathophysiology of the respiratory distress syndrome since alveolar fibrin deposits cannot be eliminated. Urokinase activated human plasmin has increased the survival rate of infants with respiratory distress syndrome. Plasminogen given I.V. at birth has reduced the incidence and the severity of respiratory distress syndrome, in a randomized double-blind study of 500 premature infants. Death in the plasminogen recipient group occurred only among infants born to mothers with bleeding complications of pregnancy. Plasmin inhibitors measured with a functional assay were the highest in this group of infants, serum plasminogen was the lowest; when activator and purified human plasminogen were added to the serum, fibrinolytic activity was elicited in excess of the plasminogen added. It is suggested that plasminogen and/or plasmin inhibitors may be abnormal fetal variants in infants born to mothers with bleeding complications.

ISSN:0192-8562    

出版商:OVID    

年代:1979

数据来源: OVID

ISSN:0192-8562    

出版商:OVID    

年代:1979

数据来源: OVID