摘要:

SummaryTwenty‐three cytopenic episodes in 18 patients undergoing ablative chemotherapy for the treatment of leukaemia or lymphoma were monitored from commencement of treatment until recovery, by automated differential counts using the Technicon H*1 Autoanalyser, with particular reference to abnormal white cell flags and large unstained cell (LUC) percentage. The blast flag was indicated in this recovery phase in 100% of patients and in 85% this preceded bone marrow recovery (defined as neutrophil count>0.5 × 109/1) by a mean of 10 days. On average the blast flag was indicated for 8 days in total. Bone marrow function continued to improve in all patients with no evidence of relapse. An increase in the LUC percentage on the differential count reached a maximum at 18 days, 6 days prior to marrow recovery. The ability to detect impending marrow recovery by means of the positive blast flag, may be of great value when patients have been cytopenic for many da

ISSN:0141-9854    

DOI:10.1111/j.1365-2257.1988.tb01146.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

SummaryTwo patients presented with co‐existing large cell immunoblastic and well‐differentiated lymphocytic lymphomas. Prolonged remissions from the large cell lymphomas were achieved following intensive combination chemotherapy but both patients suffered relapses after many years. Previous reports have grouped such patients with those developing classical Richter's syndrome implying a uniformly poor prognosis. This report suggests that this is not the case. It was not possible with immunohistochemical stains to prove or disprove that these tumours had the same stem cell orig

ISSN:0141-9854    

DOI:10.1111/j.1365-2257.1988.tb01147.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

SummaryAcute megakaryoblastic leukaemia, the M‐7 variant of acute leukaemia according to the French‐American‐British (FAB) co‐operative group, comprises 8.4% of all cases of acute leukaemia in the city of Puebla, Mexico. The malignancy can be identified by means of monoclonal antibodies or electron microscopy. Using two monoclonal antibodies, Hp1‐1d that binds the glycoprotein IIb/IIIa complex (CDw 41) and W1‐23 that recognizes the factor VIII: von Willebrand fraction, we have found 19 cases of M‐7 leukaemia. Fourteen of these were entered in a prospective therapeutic trial, seven were treated with low‐dose (LD) Ara‐C (10 mg/m2, delivered subcutaneously every 12 h in 21‐day courses). The median age was 14 years, four were female and three male. The remaining seven patients were treated with HOP (adriamycin 25 mg/m2+ vincristine 1.4 mg/m2delivered intravenously every 7 days for 42 days and prednisone 60 mg/m2orally, daily, for the same period. The median age was 20 years, three were females and four males. Patients were followed for periods of 1–24 months. Six of seven patients in each group achieved remission; however, 18‐month disease‐free survival was 14% for the LD Ara‐C group and 42% for the HOP‐treated group. All patients in the LD Ara‐C group were dead at 24 months; three patients in the HOP group survived at 12, 14 and 18 months. Differences between these two groups are probably not significant due to the sm

ISSN:0141-9854    

DOI:10.1111/j.1365-2257.1988.tb01148.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

SummaryTwo of three patients with bone pains and hydroxyprolinuria due to idiopathic myelofibrosis developed hypercalcaemia during periods of immobilization. This responded rapidly to cytotoxic therapy with busulphan. Hydroxyproline excretion in the urine was increased compared to ambulant patients with the same disease. These previously unreported findings suggest that immobilization can produce rapid, generalized bone resorption in patients with myelofibrosis.

ISSN:0141-9854    

DOI:10.1111/j.1365-2257.1988.tb01149.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

SummaryDuring a 2‐week period three unrelated children presented with severe aplastic anaemia at a general hospital serving a population of 25 000 children aged 0–15 years. The probability of this occuring by chance alone was 0.00009 (exact probability cluster analysis). Serology for common viral infections including hepatitis A&B and infectious mononucleosis was negative. It was not possible to demonstrate IgM antibodies to human parvovirus (HPV) by radioimmunoprecipitation or HPV virions by DNA hybridization in the patients or any members of their families. Epidemiological investigation failed to demonstrate a common environmental toxin. It did reveal, however, that all three patients had spent time, within the preceding 3 months in a swimming pool and its surrounding area in a region of Cardiff where none of them resided. Pool maintenance was satisfactory and water analysis showed no abnormality. The possibility must remain that the cluster was caused by an undisclosed environmental to

ISSN:0141-9854    

DOI:10.1111/j.1365-2257.1988.tb01150.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

SummaryThere was a wide variation in the number of BFUe and CFUe in the bone marrow of Gambian children with falciparum malaria and moderate or severe anaemia. However, such children were often not deficient in these erythroid progenitors. The number of BFUe in patients who had parasitaemias>1% was significantly lower than that in patients with parasitaemias<1%. There was also a statistically significant negative correlation between the number of BFUe and CFUe in the entire group of children studied. When autologous serum (30%, v/v) was used in the culture system, CFUe growth was observed even in the absence of added erythropoietin (EPO), indicating the presence of high levels of EPO or an EPO‐like substance in the anaemic sera. It is concluded that children withPlasmodium falciparummalaria show no major abnormality in their erythroid progenitor cells and that the perturbation of erythropoiesis in such children occurs mainly in the morphologically recognizable erythroid precursor cells. The wide variation observed in the number of CFUe and BFUe in different patients, and the correlations between the number of BFUe and parasitaemia and the number of BFUe and CFUe are all probably largely related to the changing clinicopathological situation in patients with malaria and anaemi

ISSN:0141-9854    

DOI:10.1111/j.1365-2257.1988.tb01151.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

SummaryThe clinical and laboratory features of 100 patients with lupus anticoagulant (LA) are reviewed. Subjects were divided into three groups according to their age (1–5, 15–35, 45–89 years). Female prevalence was observed in each group and overall F/M ratio was 3/1. An underlying autoimmune disease (principally lupus erythematosus) was found in 47 cases (10% of the children, 80% of the 15–35‐year‐old patients and 37% of the elderly patients). Biological criteria for the LA diagnosis were prolonged activated partial thromboplastin time and diluted thromboplastin time (1.3 × control), not corrected after addition of control to patient's plasma. Thromboplastin time was normal in 77 patients. Other types of coagulation inhibitors were eliminated by specific factor assays (with a 10‐fold increase of cephalin concentration when necessary). Twenty‐three thrombotic episodes were observed. No significant difference was found in the incidence of thrombosis between the autoimmune and non‐autoimmune disease group, but the age when first thrombosis occurred was clearly lower in the former. Fourteen obstetrical accidents were noted in eight women but 13 pregnancies terminated without accident. Four patients experienced haemorrhagic complications; they all presented with a severe thrombocytopenia associated with the LA. In our experience, LA is a frequent coagulation abnormality, associated in about half of the cases with a clearly defined autoimmune disease. Clinical presentation appears as notably different according to the patient's age; it is particularly noteworthy that in nine out of 10 children, LA disappeared spontaneous

ISSN:0141-9854    

DOI:10.1111/j.1365-2257.1988.tb01152.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

SummaryA family is described in which two brothers, with a significant haemorrhagic disorder, are affected by combined factor V/VIII deficiency. In one of these patients an abnormal decrease of von Willebrand factor was also observed. Family studies suggest that both of the brothers are homozygous for a recessive gene. Normal laboratory results were found in eight other family members although seven of them had reported a mild bleeding tendency. The results indicate that hereditary combined factor V/VIII deficiency is a heterogeneous disorder and that defects of von Willebrand factor might be involved in the aetiology of the disease in some families.

ISSN:0141-9854    

DOI:10.1111/j.1365-2257.1988.tb01153.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

SummaryThe reliability of the international normalized ratios (INR) system in the induction phase of coumarin administration has been studied in 15 serial patients over the first 7–40 days of treatment (mean 13.1). The INR results obtained with a variety of thromboplastin reagents have been compared with those obtained with the WHO second primary IRP, BCT/253. A wide divergence of INR values was observed with the various thromboplastins on each day of testing. INR values cannot therefore be relied upon with some of these reagents in the early days of anticoagulant treatment. This probably arises from the difference in responses of the thromboplastins to depression of vitamin Independent clotting factors. Consistent deviations from the IRP suggested that additional error may be due to inaccurate calibration of their products by the manufacturers. When the slopes of the sensitivity of the individual reagents to clotting factors II, VII and X were compared, however, results overall more closely approximated to those of the IRP when the INR were substituted for simple prothrombin ratio

ISSN:0141-9854    

DOI:10.1111/j.1365-2257.1988.tb01154.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

SummaryIn seven exercises of blood grouping the overall rates of major error were 0.19% and 0.25% in ABO and D grouping respectively. In ABO grouping this represents an increase in error rate over that observed in 1982–1983 but the increase was due to an unusually high error rate with one particular group A2B cell. An improvement in performance was observed in simple D grouping and was largely due to a lower incidence of false positive grouping of D‐negative cells in the antiglobulin test. An improvement in performance observed in D grouping IgG‐coated D‐negative cells appeared to be due to a better understanding of the problem rather than to any change in serological practice. Error rates in antibody screening were somewhat lower than in 1982–1983 but this may or may not represent an improvement in performance as the test materials were not the same in the two periods. The direct antiglobulin test with IgG‐coated cells was reliably performed with polyspccific and with anti‐IgG reagents but an excess of false positive results was obtained with anti‐C3d. Error rates in antibody identification varied from 0.6% for anti‐D to 7

ISSN:0141-9854    

DOI:10.1111/j.1365-2257.1988.tb01155.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY