[Contribution of RT-PCR for diagnosis of chronic myeloid leukemia]

The molecular analysis of chromosomal abnormalities associated with hematological malignancies allowed the identification of genes involved in theses rearrangements as well as of some recurrent mechanisms. Polymerase chain reaction [PCR] tools are now available to detect these rearrangements, allowing a better follow-up of these diseases. Chronic myeloid leukemia is a myeloproliferative disorder characterized by a reciprocal translocation t[9;22][q34;q11] which results in a bcr-abl fusion gene. Retro-transcription polymerase chain reaction [RT-PCR] is used to detect bcr-abl to establish diagnosis and to monitor patients. We report here the results of 30 patients samples tested in the hematology laboratory at Pasteur Institute, diagnosed as chronic myeloid leukemia and monitored with RT-PCR. Our results highlight the interest of molecular tools to diagnose and monitor patients mainly when cytogenetic techniques are irrelevant such as cases with complex chromosomal rearrangements or when patients achieve Philadelphia negativity after treatment

Adult acute lymphoblastic leukemia. Report of 42 cases

Between 1989 and 1995, 42 cases with acute lymphoblastic leukemia [18 males and 24 females] were diagnosed in our institution. Median age was 38.5 years [range, 16-88 years]. Leukocyte count was more than 30.10 9/l in 54 percent of cases. According to the French-American-British [FAB] criteria, 67 percent were classified L1 and 33 percent L2. Sixteen patients were treated with 12LA80 protocol, 14 patients with LALA 85 protocol, 6 patients with LALA 87 protocol and 6 patients with EORTC protocol. Complete remission was achieved in 22 cases [52 percent], 8 cases [20 percent] failed to respond and 12 [28 percent] died during induction. Relapse was observed in 10 cases. The 4-year survival rate was 28 percent confirming the worse prognosis of this leukemia when treated with standard chemotherapy

Leucemies aigues myeloblastiques de l'enfant. A propos de 21 cas

Between 1989 and 1996,21 cases with acute non lymphoblastic leukemia [11 males and 10 females] were diagnosed in our institution. Median age was 9 years [range, 2-15 years]. leukocyte count was more than 50.109/1 in 47% of cases. According to the French-American-British [FAB] criteria, 7 cases were classified M 1, 10 cases were classified M2, 1 classified M4Eo and 3 classified M5. All patients were treated with" 7+3 " protocol and complete remission was achieved in 17 cases [80%], 2 cases [10%] Failed to respond and 2 [10%] died during induction. Relapse was observed in 15 cases. The 3-year survival rate was 20% and the relapse-free survival rate was 12% confirming the worse prognosis of this leukemia when treated with standard chemotherapy

Elderly acute leukemia: report of 40 cases

Between 1989 and 1996, 40 cases with acute leukemia [16 males and 24 females] were diagnosed in out institution. Median age was 65 years [range, 56- 88 years]. Leukocyte count was more than 30.109/1 in 42 percent of cases. According to the French-American-British [FAB] criteria, 11 cases were classified lymphoblastic and 29 myeloblastic. Sixteen patients have received palliative treatment because of there age and there bad performance status. Only 24 patients have received curative treatment. Complete remission was achieved in 12 cases [50 percent], 5 cases [20 percent] failed to respond and 7 [30 percent] died during induction. Relapse was observed in 8 cases. The 2-year survival rate was 10 percent confirming the worse prognosis of the acute leukemia in elderly

Myelodysplasie avec myelofibrose un eentite anatomo-clinique particuliere

Myelofibrosis is rarely associated with myelodysplastic syndrome. This association constitute a distinct clinicopathological entity which is difficult to be distinguished from other forms of myelofibrosis. We report six cases of this entity. Patients were aged between 50 and 79 years, with 3 males and 3 females. All these patients had similar clinical features consisting of pancytopenia and absent visceral enlargement. The analysis of bone marrow aspirate was difficult

Les septicemies a pseudomonas aeruginosa en onco-hematologie a propos de 22 cas

Pseudomonas aeruginosa is one of the most dangerous agents in neutropenic patients. Twenty two septicemia due to P. Aeruginosa occuring in neutropenic patients were analyzed. Fifty nine% of the patients had acute leukemia and more than two - thirds of the patients had severe neutropenia [less than 500 neutrophils / mm3]. The outcome was unfavorable with a high mortality rate