摘要:

The clinical and hematological characteristics of 5 patients affected with both acute myeloid leukemia (AML) and diabetes insipidus (DI) are described. Banded chromosomal analysis demonstrated monosomy 7 in 2 patients and a complex cytogenetic rearrangement in another. No patient entered complete remission with standard induction chemotherapy. These data confirm that in patients with AML, the association of DI (with or without monosomy 7) is an unfavorable prognostic factor.

ISSN:0001-5792    

DOI:10.1159/000204080

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

It is well known that L-asparaginase (L-Ase) treatment may cause thrombotic events in patients with acute lymphoblastic leukemia (ALL). The mechanism of this effect is not well understood although a reduction in plasma antithrombin III (AT III) levels is observed. In our study, a group of patients treated with L-Ase received AT III concentrates as adjuvant treatment. This adjuvant treatment reduced the levels of plasma D-dimer and thrombin-antithrombin complex, which are considered as early markers of a hypercoagulability state. These preliminary data suggest that large randomized trials will have to be conducted to improve our understanding of the role of AT III concentrates in ALL therapy.

ISSN:0001-5792    

DOI:10.1159/000204081

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

This study evaluates the sensitivity and positive predictive value of some of the morphological flags supplied by the Technicon H-1 haematological analyser to detect circulating blasts. A total of 1,269 venous blood samples from 91 paediatric patients diagnosed of acute leukaemia were analysed in the Technicon H-1. A conventional microscopic manual method was used for reference. The prevalence was 17.7% for the presence of blasts. The results showed that all samples with more than 5% blasts were detected by some WBC morphological flag: only 5 samples (2.2%) with less than 5% blasts showed no morphological flag. In most cases (86%), the flags observed were either the ‘Atyp’ flag or the ‘Blast’ flag or both simultaneously. The positive predictive value obtained by the ‘Blast’ flag for the true presence of blasts was 66.8%, and for the ‘Atyp’ flag 34.9%; it was 75.8% when both flags were present simultaneously. False positives were associated with postchemotherapy monocytosis or sev

ISSN:0001-5792    

DOI:10.1159/000204082

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Twenty-five consecutive patients with multidrug-resistant enteric fever were evaluated and followed for haemostatic abnormalities. Twenty-one (84%) of the patients had evidence of disseminated intravascular coagulation (DIC) and 12 (48%) also had evidence of associated fibrinolysis. Clinical bleeding was observed in 3 (12%) cases, and did not bear any correlation with clotting abnormalities. Protein C activity was found to be decreased in 11 of the 15 cases with DIC, and a block in its activation, as previously postulated, could not be substantiated. DIC was reversed in most cases within 8 days of the institution of specific antibiotic therapy.

ISSN:0001-5792    

DOI:10.1159/000204083

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

The aim of this study was to evaluate the effects of calcitonin (CT) treatment on bone pain, osteoporosis, bone fractures and blood chemistry in thalassemic patients. Twenty-four patients with an age range of 10-24 years were included, 14 of whom received 100IU CT and 250 mg calcium 3 times a week. The others (n = 10) were followed up as a control group with only routine thalassemia therapy. After 1 year of treatment, bone pain disappeared and radiological signs of osteoporosis had improved significantly (p < 0.01) in the treatment group. CT has no important side effects.

ISSN:0001-5792    

DOI:10.1159/000204084

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

We investigated 90 autopsied cases with hematologic malignancy, including malignant lymphoma (ML), acute leukemia (AL), and adult T-cell leukemia (ATL) peculiar to our district, during the 10-year period 1982-1991 to determine the change in incidence of infection as a cause of death. We divided the cases into two groups representing the first half decade (1982-1986) and the second half decade (1987-1991) and compared the findings made in the two groups. Although infection was the major cause of death in those autopsied cases, the incidence of fatal infections decreased during the latter period. The incidence of fatal bacterial infections decreased, while fungal infections showed a relative increase. Pneumocystis carinii pneumonia and cytomegalovirus (CMV) infection occurred more frequently in patients with ATL than in those with ML or AL. Combined infection by more than three pathogens was observed in 2 cases of ATL. Our study revealed the characteristics of ATL specific to our district, and indicated the need to apply new strategies to prevent and treat fungal and viral infections in patients with hematologic malignancies.

ISSN:0001-5792    

DOI:10.1159/000204085

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

The widespread use of alpha-interferon (IFN-α) therapy in different diseases draws attention to its side effects, such as autoimmune-related diseases, especially thyroid autoimmune dysfunctions. Data about hepatitis and nonhematologic neoplasia are available, while data about hematologic malignancies are fragmentary. We studied the incidence of autoimmune-related disturbances and thyroid dysfunctions in 54 consecutive patients suffering from hematologic malignancies, treated with recombinant human IFN-α for a mean time of 15.9 ± 8.9 months. Our results minimize the incidence of autoimmune dysfunctions in hematologic malignancies as side effects of IFN-α therapy. We registered the appearance of autoantibodies in only 3 females (5% of total): 2 patients (1 affected with essential thrombocythemia and one with multiple myeloma) presented antithyroglobulin antibodies with no clinical symptoms; 1 patient, affected with essential thrombocythemia, developed antinuclear antibodies with arthralgia and myalgia. ARA criteria for systemic lupus erythematosus were not fulfilled but the therapy had to be interrupted. No patient developed thyroid dysfunction. In patients with hematologic malignancies, the dosage and the duration of IFN-α treatment do not seem to influence the appearance of autoantibodies, while female sex appears to be a risk fa

ISSN:0001-5792    

DOI:10.1159/000204086

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

A 2-year-old Sicilian boy was investigated because of chronic nonspherocytic hemolytic anemia (CNSHA) associated with hepatosplenomegaly. Appropriate studies revealed deficiency of glucose-6-phosphate dehydrogenase type Seattle (G6PD Seattle). In addition, bone marrow morphology, serological studies and analysis of red cell membrane proteins revealed congenital dyserythropoietic anemia (CDA) type II (or HEMPAS). Because G6PD Seattle on its own does not cause CNSHA, we believe that the clinical manifestations in this patient are essentially due to the CDA type II abnormality. However, the coexistence of these two different red cell abnormalities may affect the clinical picture specifically by making CDA type II more hemolytic than it would have been otherwise.

ISSN:0001-5792    

DOI:10.1159/000204087

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

A patient with acute adult T-cell leukemia (ATL) in whom spontaneous remission was observed without any specific treatment having been given is described. The abnormal cell phenotype was CD4+, CD45RO+ and CD8-. As the number of abnormal cells decreased, CD4+ cell count decreased and CD8+ cells and CD45RA+ cells increased to normal levels (45 and 77%, respectively). Further, the number of cells with CD45RO antigen of intermediate fluorescence intensity increased. Five months after admission, we assessed the patient as being in a state of complete clinical remission; no abnormal cells were detected in peripheral blood, lymph node enlargement had disappeared and the serum chemistry was normal. When the abnormal cells in peripheral blood had disappeared, Southern blot analysis for HTLV-I proviral DNA still revealed a weak monoclonal band with EcoRl digestion, and HTLV-I proviral DNA was detected by polymerase chain reaction analysis. Thus, it appeared that very few abnormal cells persisted although the laboratory findings for ATL were normal. Our case could contribute to the understanding of the mechanism that underlies spontaneous remission in ATL.

ISSN:0001-5792    

DOI:10.1159/000204089

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Transient regression in the lymphocyte count of a patient with B-cell chronic lymphocytic leukemia (B-CLL) after viral infection is reported. A similar event occurred under natural interferon-α (IFN-α) treatment. It was confirmed that the event was not caused by a direct cytotoxic effect of IFN-α by analyzing the DNA fragmentation to estimate apoptotic and necrotic cell death before and after the administration of IFN-α. The study also suggested that the event was not caused by a cytostatic effect of IF

ISSN:0001-5792    

DOI:10.1159/000204091

出版商:S. Karger AG    

年代:1995

数据来源: Karger