摘要:

With traditional therapy of acute myelogenous leukemia, not more than 20% of patients achieve long-term survival. Efforts at intensifying postinduction chemotherapy have resulted in minor improvements only, but this limited progress has been hampered by increasing toxic-death rates. Eradication of the leukemia burden may be achieved by the introduction of more effective induction regimes and these may be rendered more effective by the application of ‘enhancers’. With a lower tumor burden, and with more appropriate timing for supralethal therapy, it may be possible to achieve cure with greater frequency. Measurement of ‘minimal residual disease’ permits more logical selection of postinduction

ISSN:0001-5792    

DOI:10.1159/000204842

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

The leukemic cells from 31 cases of acute myeloid leukemia were immunophenotyped by the alkaline phosphatase-antialkaline phosphatase (APAAP) technique, using 7 monoclonal antibodies reactive with cells of myeloid origin. We found a good correlation between the results obtained using the APAAP method and indirect immunofluorescence. In most cases, we observed a slight degree of variation in the percentages of reacting cells when comparing the two methods. Nevertheless, taking 20% of cells being immunolabelled as a threshold for defining a case as positive, we found no discrepancies in the final classification of each case. The main advantages of the APAAP method are: (1) its use with routinely prepared peripheral or blood marrow samples, and (2) the possibility of correlating immunological characterization with morphology. Since the results with the APAAP method were comparable with those obtained using indirect immunofluorescence, we suggest that this former technique can complement, and sometimes substitute, other methods of immunological evaluation.

ISSN:0001-5792    

DOI:10.1159/000204843

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

It has been postulated that platelet-derived growth factor and platelet factor 4 (PF4) are involved in the imbalance of the mechanism of medullar stroma maintenance which triggers off the bone marrow myelofibrotic process. In this work we compare the PF4 and the β-thromboglobulin (β-TG) and mitogenic activity in platelet-poor plasma (PPP) and platelet extracts (PE) from patients with myeloproliferative disorders (MPD) with those of secondary thrombocytosis (ST) and normal volunteers. Statistically significant differences were found between MPD and ST patients or controls, but none between ST and controls in all the parameters studied. Maximal differences in platelet-derived factors (PDFs) between MPD and control groups were found in polycythemia vera patients. However, the relationship between the presence of myelofibrosis and abnormal levels of β-TG, PF4 and mitogenic activity in PPP and PE was only observed in patients with agnogenic myeloid metaplasia (AMM). These results show that PDFs are specifically decreased in MPD platelets. Furthermore, no statistical correlation was found between PDFs and the number of platelets. However, other unknown factors or conditions would be necessary to develop myelofibrosis in MPD, which is present in A

ISSN:0001-5792    

DOI:10.1159/000204844

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

In a randomized clinical trial, the effects of standard doses of alpha-interferon (α-IFN) compared with the effects of half of these doses were evaluated in patients with hairy cell leukemia. There were 14 patients treated with standard-dose (3 MU/day i.m. for 6 months, then 3 MU three times/week for a further 6 months) and 10 patients with low-dose α-IFN (1.5 MU/day with the same schedule and for the same period). The overall response rate, the quality, and the duration of response were rather similar in both groups. The rapidity of response in normalizing the peripheral blood counts was similar, even increased in low-dose-treated patients, consisting mainly in clearing the number of circulating hairy cells (p < 0.03). Finally, the toxic effects of both regimens were minimal but less evident in patients treated with low-dose α-IFN. Despite the small number of patients, on the basis of this report, we can confirm that 1.5 MU/day of α-IFN is an adequate treatment for patients with hairy cell leuke

ISSN:0001-5792    

DOI:10.1159/000204845

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

We demonstrated the utility of dual parameter analysis of DNA and cytoplasmic immunoglobulin for the detection of minimal residual myeloma cells in bone marrow and peripheral blood. This method is sensitive: even 0.1% of contaminating myeloma cells could be detected in peripheral blood of myeloma patients and in the model experiments using cell lines. This method is useful for the selection of patients undergoing high-dose chemotherapy and autologous blood stem cell transplantation.

ISSN:0001-5792    

DOI:10.1159/000204846

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

In 16 patients with monoclonal gammopathies of undetermined significance (MGUS) and in 49 with multiple myeloma (MM, 43 untreated and 6 relapsed) we used immunocytochemistry to determine the percentages of bone marrow plasma cells (BMPC) that incorporate bromodeoxyuridine (BUDR-labeling index, BUDR-LI) in vitro and that label with the monoclonal antibody Ki-67 (which recognizes an antigen thought to identify the growth fraction of the population, Ki-67 GF). Both mean and range values were greater for Ki-67 GF than for BUDR-LI. Most patients with high Ki-67 GF also had high BUDR-LI, although a linear correlation was not found between the two parameters. MGUS has lower values than MM, and the difference was much greater for Ki-67 GF than for BUDR-LI (p < 0.005 vs. p < 0.05). Differences in Ki-67 GF but not in BUDR-LI were found between MGUS and stage I MM (p < 0.0005) and between grouped stage I and II MM and stage III MM (p < 0.025). Both Ki-67 GF and BUDR-LI were significantly (p < 0.005) greater in relapsed than in untreated MM. Determining Ki-67 GF as a proliferative parameter could be a better way of studying the kinetics of (BMPC) in MGUS and MM than determining the BUDR-LI, since a wider range of values is obtained and this allows patient groups with different clinical characteristics to be separated more easily.

ISSN:0001-5792    

DOI:10.1159/000204847

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

A patient with chronic lymphocytic leukemia (CLL) and essential thrombocythemia is described. The two disorders were diagnosed synchronously. This association was not treatment related. Review of the literature revealed an additional 9 case reports of CLL associated with myeloproliferative disorders, but none with essential thrombocythemia.

ISSN:0001-5792    

DOI:10.1159/000204848

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

Acquired amegakaryocytic thrombocytopenic purpura (AATP) is a haematological disorder characterized by severe thrombocytopenia due to an immunologically induced absence of megakaryocytes in an otherwise normal-appearing bone marrow. A 57-year-old male with a 6-month history of rectal and cutaneous bleeding is reported. Platelet count was 10 × 109/l, while other haematological values were within the normal range, except for the presence of hypogammaglobulinaemia with decreased IgA and IgG. Both platelet median volume and half-life span were normal, and antiplatelet IgG determinations were negative. Bone marrow aspiration and biopsy showed no megakaryocytes, with a normal appearance of erythroblastic and granulopoietic series. An in vitro culture for megakaryocytic progenitor cells did not show any growth of megakaryocyte colonies. No inhibitory effect on the growth of normal marrow megakaryocytic colonies was observed when serum and lymphocytes of the patient were added. Following 4 weeks of prednisone therapy, the platelet count rose to 127 × 109/l and the bone marrow aspirate showed some megakaryocytes. The possible pathogenetic mechanisms of this entity are discusse

ISSN:0001-5792    

DOI:10.1159/000204849

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

We describe 3 patients with thrombotic thrombocytopenic purpura (TTP) treated with vincristine. In 2 of them, multimodality treatment with plasmapheresis, acetylsalicylic acid, dipyridamole, corticosteroids, and plasma infusions did not achieve lasting remission, subsequent to which the administration of vincristine was followed by prompt and durable remission. In the third patient, 1 mg of intravenous vincristine as initial therapy in conjunction with multimodality treatment resulted in the prompt resolution of the disease. Our experience suggests that vincristine is effective in the treatment of TTP and can be used as initial treatment in combination with other modalities.

ISSN:0001-5792    

DOI:10.1159/000204850

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

A new case of IgE myeloma is described. A 77-year-old woman presented with bone pain and fatigue. Serum protein analysis revealed a paraprotein of the IgEκ type; bone marrow aspirate and immunofiuorescence confirmed the diagnosis; ultrastructural examination showed immature plasma cells. Treatment with prednisone, melphalan, cyclophosphamide and interferon alfa did not produce any improvement and the patient died 5 months after diagnosis. The patient’s clinical and laboratory data are compared with those of IgE myeloma cases reported in the literatu

ISSN:0001-5792    

DOI:10.1159/000204851

出版商:S. Karger AG    

年代:1991

数据来源: Karger