摘要:

AbstractThe treatment of acute myelocytic leukemia in childhood and young adults has lagged behind that for acute lymphocytic leukemia. The studies described here were directed towards evaluating the role of intensive chemotherapy in the treatment of this illness. Intensive remission induction therapy combining cytosine arabinoside with an anthracycline antibiotic produced a complete remission rate comparable to that achieved in acute lymphocytic leukemia (45 of 49 patients or 92%). Intensive consolidation chemotherapy produced a median duration of complete remission of 160 weeks with 40% of patients projected to be in remission at 4 years. By contrast, the median duration of remission for patients treated with moderate consolidation/maintenance therapy was 23 weeks with only 10% of patients in remission at 4 years. These studies demonstrate that intensive chemotherapy can be administered to pediatric patients and young adults and that this approach to therapy produces a high remission rate with a 3 year median duration of remission.

ISSN:0361-8609    

DOI:10.1002/ajh.2830130302

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

年代:1982

数据来源: WILEY

摘要:

AbstractLeukemic cells from the peripheral blood of 52 patients with acute and chronic leukemias were incubated with 12‐0‐tetradecanoyl phorbol ester (TPA). Thirty‐one cases of lymphocytic leukemia (18 cases of acute lymphoblastic and 13 cases of chronic lymphocytic leukemia), 13 cases of acute nonlymphoblastic (myelo or myelomonoblastic) leukemia, and eight cases of blastic crisis of CGL (seven cases of predominantly myeloblastic crisis, and one case of lymphoblastic crisis) were studied. In all cases of lymphoid leukemia, cells formed clumps or aggregates after exposure to TPA, while in all cases of myeloid leukemia cells became adherent to the substrate. Seven of the eight cases of blastic crisis of CGL were predominantly myeloid in type and cells adhered to the substrate, while in a single case of lymphoid crisis in CGL cells formed clumps after TPA exposure. Functional, cytochemical, and ultrastructural studies showed altered cell differentiation and continuing in vitro maturation of leukemic cells after exposure to TPA. In the light of the above results, it is concluded that this simple test employing TPA exposure in vitro serves as a reliable means of distinguishing blasts from different origins in human leuk

ISSN:0361-8609    

DOI:10.1002/ajh.2830130303

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

年代:1982

数据来源: WILEY

摘要:

AbstractA large dose of equine antilymphocytic globulin (ALG, 120 mg/kg/day) was given intravenously to four patients with myeloblastic leukemia. Leukemic myeloblasts from each patient were lysed by the ALG in vitro, in the presence of the same patient's serum complement. In each patient, ALG infusion was followed by a reduction in the count of circulating leukemic myeloblasts, and a fall in the serum levels of C3 and C4 complement. It is likely that complement‐mediated lysis of circulating leukemic myeloblasts occurred in these patients, as a result of ALG administratio

ISSN:0361-8609    

DOI:10.1002/ajh.2830130304

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

年代:1982

数据来源: WILEY

摘要:

AbstractMean megakaryocyte ploidy, mean platelet volume, and platelet count were measured during 17 courses of chemotherapy for acute nonlymphocytic leukemia. During the myelosuppression from chemotherapy, all three variables fell; during recovery, megakaryocyte ploidy rose 1–2 days before platelet volume, which in turn rose 1–2 days before platelet count. Serial platelet volumes and counts of these patients were compared to the nomogram of the inverse nonlinear relation between platelet count and platelet size in reference subjects. Platelet volume became inappropriately small before platelet count fell substantially and remained small through most of the thrombocytopenic nadir. The end of the nadir was predictable 1–2 days after platelet volume increased to lie congruent with the reference nomogram. Changes in thrombopoiesis appear to occur sequentially in megakaryocyte ploidy, platelet volume, and platelet count. Changes in platelet count, and therefore the appearance of duration of the thrombocytopenic nadir, can be predicted by 1–2 days with platelet volume and 3–4 days with megakaryocyte ploidy. As platelet count rose, despite the continuing predominance of “young” platelets, MPV fell, suggesting that megakaryocyte stimulation as well as platelet age affects

ISSN:0361-8609    

DOI:10.1002/ajh.2830130305

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

年代:1982

数据来源: WILEY

摘要:

AbstractEffects of divalent cations on fibrinogen and its reaction with thrombin were re‐examined and correlated to improve definition of mechanisms underlying the acceleration of clot formation by the ions. The rate of release of fibrinopeptides from fibrinogen was not affected by any of the specific ions studied, but increased rates of fibrin monomer polymerization were obtained with all but magnesium ions. Maximal acceleration of monomer polymerization was observed with the divalent ions at concentration of 2.5–5 mM, and no added specific ion effects were observed with much higher levels. The acceleratory ions were found to have a corresponding effect on the solubility of fibrinogen, as judged from acceleration of its precipitation at low temperature. Although magnesium ions had no effect on fibrin monomer polymerization, they did have a low ranking effect on cryoprecipitation. These data confirm that the principal effect of divalent cations in the fibrinogen‐fibrin transformation is to accelerate fibrin monomer polymerization, and suggest that the acceleration is associated with effects on the solubility of fibri

ISSN:0361-8609    

DOI:10.1002/ajh.2830130306

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

年代:1982

数据来源: WILEY

摘要:

AbstractThe relationship between platelet buoyant density and platelet age was investigated in eight human subjects submitted to an autologous chromium labeled platelet survival study. Platelets were isolated after isopycnic centrifugation using either discontinuous isoosmotic stractan gradients (five subjects), or various continuous and linear isoosmolar gradients (three subjects). A paradoxical radioactivity enrichment of the dense platelets and a premature loss of radioactivity in the light platelets were observed. These results are explained by a shift of the radioactivity distribution curve toward higher densities during the 3–4 days after platelet injection, while the standard deviation of the distribution was conserved throughout the platelet life span. These results suggest that young platelets are heterogeneous and slightly less dense than the total platelet populatio

ISSN:0361-8609    

DOI:10.1002/ajh.2830130307

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

年代:1982

数据来源: WILEY

摘要:

AbstractIn a patient with amyloidosis involving the heart, kidneys, and skeletal muscles, a Tc 99m pyrophosphate “bone” scan demonstrated intense uptake of tracer by the skeletal muscles; but not by the heart or kidneys. Using the alizarin red stain, prominent calcium deposits were detected histologically in association with the skeletal muscle amyloid. These findings suggest that certain amyloid deposits will take up Tc 99m pyrophosphate, but only if sufficient amounts of calcium are associated with the amyl

ISSN:0361-8609    

DOI:10.1002/ajh.2830130308

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

年代:1982

数据来源: WILEY

摘要:

AbstractTwo patients with primary acquired sideroblastic anemia who eventually developed myelofibrosis with myeloid metaplasia are reported. Splenectomy was performed in one patient because of increasing blood transfusion requirements, and splenic histology revealed both myeloid metaplasia and ringed sideroblasts. The second patient showed a partial response of the sideroblastic anemia to pyridoxine therapy during the early stages of development of the myelofibrosis. Myelofibrosis with myeloid metaplasia may represent a nonspecific response of the marrow tissue to sideroblastic anemia as to other primary hematologic disorders.

ISSN:0361-8609    

DOI:10.1002/ajh.2830130309

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

年代:1982

数据来源: WILEY

摘要:

AbstractA young woman with recurring bouts of thrombotic thrombocytopenic purpura presented an opportunity to study a single patient serially and in depth. This patient underwent 12 remissions in response to fresh frozen plasma, and as little as 250 ml of plasma or plasma from which cryoprecipitate had been extracted was efficacious. Neither the Lian factor nor alterations in either cold‐insoluble globulin or protein C could be demonstrated. Evidence in support of the concept of “exhausted” platelets was generated, in that immediately before a thrombocytopenic relapse, platelet function was altered as manifested by bruising, prolongation of the bleeding time, and decreased platelet aggregation. The in vitro addition of normal plasma to such platelets did not improve aggregation. The antiplatelet agent sulfinpyrazone did not seem to add efficacy. Serial observations support the hypothesis that the progression of pathophysiologic events in this patient is: exhausted platelets, thrombocytopenia, hemolysis, renal perturbations, and central nervous system dysfun

ISSN:0361-8609    

DOI:10.1002/ajh.2830130310

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

年代:1982

数据来源: WILEY

ISSN:0361-8609    

DOI:10.1002/ajh.2830130301

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

年代:1982

数据来源: WILEY