摘要:

AbstractWe reviewed the records of all patients with chronic myeloid leukemia (CML) seen in the CML Clinic of the University of Colorado Health Sciences Center between 1968 and 1987 for a history of cigarette smoking. Patients who smoked for five or more pack/years within the ten years preceding, or after the diagnosis of CML, were defined as smokers. Adequate smoking histories were obtained on 122 patients. Eighty‐seven of these were non‐smokers and 35 were smokers by the above criteria. The smoking group had a higher predominance of males, an older median age, and were diagnosed earlier in the course of the 20 year study. Seventy‐two patients had died at the time of analysis. All but one, a non‐smoker, died from the development of blast crisis. The overall median actuarial survival was significantly reduced for smokers (35 months) as compared to non‐smokers (47 months). This was particularly striking for patients who had succumbed to the disease, with a median survival of 30 months in smokers versus 46 months in non‐smokers. Although various explanations could explain the differences noted, we conclude that cigarette smoking has an adverse effect on the development of blast crisis and survival in chronic myelo

ISSN:0361-8609    

DOI:10.1002/ajh.2830340102

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

摘要:

AbstractMethemoglobin reduction was shown to proceed much more rapidly in erythroid cells from rat bone marrow than in rat erythrocytes. Methemoglobin reduction in suspensions of intact, nitrite‐treated bone marrow cells does not depend on the presence of glucose in the incubation mixture, even after the cells have been stored in substrate‐free medium. 2‐Deoxyglucose and iodoacetate prevent the reduction from proceeding to completion. The results suggest that, relative to erythrocytes, immature erythroid cells more efficiently catalyze methemoglobin reduction and more effectively store metabolites which provide electrons for this rea

ISSN:0361-8609    

DOI:10.1002/ajh.2830340103

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

摘要:

AbstractThe clinical features and red cell membrane characteristics of 20 patients with hereditary high red cell membrane phosphatidylcholine hemolytic anemia (HPCHA) were studied in relation to the effect of splenectomy. After splenectomy, anemia worsened and the extent of increased hemolysis in these patients was unchanged, indicating a contraindication for splenectomy. Concomitant with these results in clinical hematology, marked stomatocytic changes, increased red cell phosphatidylcholine content, and enhanced sodium transport, which were observed before splenectomy, were not improved by splenectomy.

ISSN:0361-8609    

DOI:10.1002/ajh.2830340104

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

摘要:

AbstractThe indolent follicular and diffuse lymphomas are neoplasms of B‐cell origin. In several other B‐cell neoplastic disorders, including multiple myeloma, hairy cell leukemia, and chronic lymphocytic leukemia, the light chain isotype of the surface immunoglobulin has been reported to have prognostic significance. Patients with tumors expressing λ light chains usually fare more poorly than those with k light chain‐bearing tumors. We analyzed the clinical data and immunologic phenotype of 101 patients with indolent lymphoma. Eighty‐nine of the 101 patients demonstrated surface immunoglobulin of only one light chain type (k‐47, λ‐42). Patients in both groups were matched for known prognostic factors. There were no significant differences in disease‐free survival or overall survival between the two groups or within histologic subtypes. These results indicate that the immunologic light chain phenotype in indolent lymphoma, unlike other B‐cell neoplasms, is not a prognostic indi

ISSN:0361-8609    

DOI:10.1002/ajh.2830340105

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

摘要:

AbstractThe effect of several iron chelators on iron uptake and release by mouse peritoneal macrophages has been investigated. The 1,2‐dimethyl (L1) and 1‐ethyl‐2‐methyl (L1NEt) derivatives of 3‐hydroxypyrid‐4‐one markedly enhanced iron mobilisation from macrophages pulsed with59Fe‐transferrin‐antitransferrin immune complexes and were more effective than desferrioxamine, maltol, or mimosine. Release increased with increasing chelator concentration. None of the chelators donated significant amounts of iron to macrophages, and none showed any cytotoxic effect. The synthetic α‐ketohydroxypyridine chelators may therefore be active in removing iron from the reticuloendothelial system as well as from hepatocytes, and indeed may be superio

ISSN:0361-8609    

DOI:10.1002/ajh.2830340106

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

摘要:

AbstractA study of surface markers and in vitro growth in semi‐solid and liquid medium was performed in 35 patients with newly diagnosed myelodysplastic syndrome (MDS). Surface markers were studied by CD34, CD13, CD14, CD15, and CD33 monoclonal antibodies. There was no strict correlation with the FAB typing, but CD34 was expressed only in refractory anemia with excess of blasts (RAEB) or RAEB in transformation (RAEB‐t). CD14 was markedly positive in the 4 cases of chronic myelomonocytic leukemia. Colony‐forming cells were assessed by culture in semi‐solid medium in the presence of HTB9 as growth factor. Four growth patterns were identified: a) normal growth (6 cases); b) no growth or low plating efficiency (10 cases); c) low colony and high cluster number (15 cases); and d) normal or high colony number with high number of clusters (4 cases). Expression of CD34 was associated with low colony and high cluster number. Finally we studied the proliferation and differentiation capacities in liquid culture without stimulating factor. Fifteen patients had a spontaneous proliferation. This was not correlated with any surface marker. Differentiation assessed by the loss of CD34 and/or the increase of CD15 by more than 20% at day 7 was observed in 21 cases. None of the surface markers or growth patterns was associated with a specific chromosomal abnormality, except the lack of growth in liquid culture observed in all 5q deletion cases. In univariate analysis, RAEB and RAEB‐t FAB subtypes, percentage of blasts higher than 5%, staining by CD33 and CD34, and lack of differentiation in liquid culture were significantly associated with progression to leukemia and shorter survival. In multivariate analysis, only CD34 expression (P= .002) and percentage of blasts (P= .05) remained independent significant variables. CD34 was the only significant variable for prediction of survival (P= .05). It is concluded that surface marker analysis at diagnosis and after liquid culture may be a useful tool for the initial evaluati

ISSN:0361-8609    

DOI:10.1002/ajh.2830340107

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

摘要:

AbstractForty‐eight patients with polycythemia vera (PV) were retrospectively studied for incidence of acute leukemia over a 12 year period. Initial clinical features, hemogram, RBC mass, B12 levels, neutrophil alkaline phosphatase (NAP), and therapy given were studied for association with development of acute leukemia. There were 25 males and mean age at diagnosis was 61.4 years. Initial Hg was 18.38 ± 1.86 g/dl, WBC 16.44 ± 12.92 (× 1,000/mm3), platelets 632.94 ± 303.81 (×1,000/mm3), B12 1,030.93 ± 445.20 pg/ml, and neutrophil alkaline phosphatase (NAP) score 136.63 ± 55.14. Twenty‐three patients were treated with phlebotomy alone and 25 received additional myelosuppressive therapy as follows—2 received p32 alone, 4 alkylating agents alone, 8 hydroxyurea (HU) alone, and 11 received 2 or more (multiple) of these agents. None of those treated with phlebotomy alone but 6 of 25 (24%) patients given myelosuppressive therapy developed acute leukemia (P= .03) after a mean period of 46.8 months from start of myelosuppressive therapy. Four of the 11 patients (36%) receiving multiple agent therapy developed acute leukemia (P= .019). Initial hemoglobin levels, but not the other clinical parameters, were significantly higher in patients who developed acute leukemia (P= .002), and this difference persisted in various subgroups receiving myelosuppressive therapy. Thus, high initial hemoglobin and use of any myelosuppressive therapy are associated with an increased risk of leukemic transformation in polycythemia vera. This risk becomes substantial with the use of two or more myelosuppressive agents. Since myelosuppressive therapy does not prolong survival, its role in the management of polycythemia vera should b

ISSN:0361-8609    

DOI:10.1002/ajh.2830340108

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

摘要:

AbstractWe studied by cytochemical means the distribution of 5′ nucleotidase (5′ NT), a purine degradative enzyme, in the circulating lymphocytes of 24 healthy donors and 41 cases of chronic lymphoid leukemias, classified according to morphological and immunological criteria. About half the normal circulating lymphocytes were 5′ NT positive and exhibited variable degrees of enzyme activity. Among chronic B lymphocytic leukemias we found high percentages of positive cells only in the phenotypically more mature cases. Moreover all cases of hairy cell, follicular cell, lymphoplasmacytic, and plasma cell leukemia showed moderate or weak 5′ NT reactivity. Also one case of chronic T lymphocytic leukemia, CD8 positive, was moderately positive, while another, with large granular lymphocyte morphology, was completely negative. Electron microscopy revealed a discontinuous, granular plasma membrane reaction pattern, varying in intensity from case to case. In conclusion, our results confirm the usefulness of the 5′ NT cytochemical reaction for identification of lymphoid populations at different stages of maturation in chronic B cell

ISSN:0361-8609    

DOI:10.1002/ajh.2830340109

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

摘要:

AbstractThe increased adhesiveness of sickle erythrocytes (SS RBC) to endothelial cells has been confirmed in a static system utilizing fresh umbilical vein endothelium. Adherence of SS RBC to the endothelium was as great in the presence of calcium‐containing buffer as when incubated in plasma. SS RBC suspended in autologous platelet‐rich plasma adhered to a greater extent than when suspended in autologous platelet poor plasma. Prostacyclin, thromboxane B2, and an inhibitor of collagen‐ and epinephrine‐induced platelet aggregation (B13.177) did not affect SS RBC adherence to endothelium. Aspirin in concentration of 5 μg/ml slightly decreased SS RBC adherence to endothelium in the presence of platelats may play a significant role in the increased adhesiveness of SS RBC to endothelium. To the extent that increasede SS RBC adhesiveness contributes to the genesis of painful crises and to the extent platelets augment this adhesiveness, agents affecting platelet function may prove useful in preventing painfu

ISSN:0361-8609    

DOI:10.1002/ajh.2830340110

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

摘要:

AbstractThe treatment of an adult patient with sickle cell disease whose clinical course is characterized by frequent painful crises creates a number of logistic problems in a tertiary care city hospital. Because such patients usually have no objective signs of painful crises, they are often considered to be malingerers and drug abusers. This paper reviews this controversial issue and presents one attempt at its resolution.

ISSN:0361-8609    

DOI:10.1002/ajh.2830340111

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY