Post chemotherapy blood and bone marrow regenerative changes in childhood acute lymphoblastic leukemia a prospective study.

Context: This study was done to assess the Serial peripheral blood and bone marrow changes in patients of Acute Lymphoblastic Leukemia on chemotherapy. Aims:To assess the therapy related serial bone marrow changes in patients of Acute Lymphoblastic Leukemia. Settings and Design: Prospective study, carried out in Lymphoma- Leukemia Lab, Department of Pathology, K.G.M.U from March 2011 to March 2012. A total of 60 cases were studied Materials and Methods: History, complete hemogram, bone marrow examination at pretherapy (Day-0), intratherapy (Day-14), and end of induction chemotherapy (Day-28) were done. Peripheral blood smears were evaluated at regular interval to assess clearance of blast cells. Statistical analysis used:The statistical analysis was done using SPSS (Statistical Package for Social Sciences) Version 15.0 statistical Analysis Software. The values were represented in Number (%) and Mean ± SD. The following Statistical formulas were used: Mean, standard deviation, Chi square test, Paired “t” test, Student ‘t’ test, Level of signifi cance P Results: Incidence of ALL-L1 (46.7%) and ALL-L2 (53.3%) was equal. ALL-L2 patients had poor survival.Day 0 (D-0) bone marrow was hypercellular with fl ooding of marrow by leukemic cells. High levels of tumor load at D‘0’ were associated with poor survival. 14th day of Induction phase showed signifi cant decrease in hemoglobin and TLC as compared to D ‘0’ parameters. D28 showed marrow regeneration. Cellularity, Blast%, and Leukemic Index showed signifi cant drop from day ‘0’ to day 14 due to myelosupression, whereas regeneration refl ected by increased cellularity as per day 28 marrow. Lymphocytosis (>20%) at end of induction chemotherapy had better survival and longer remission.Risk of mortality was directly proportional to blast clearance and was a major independent prognostic factor for achievement of complete remission. Conclusions: A bone marrow examination at the end of induction chemotherapy provides information whether patient has achieved remission with regeneration of cells or still has residual leukemia. If the patient is in remission, maintenance treatment is started and if not more intensive chemotherapy or bone marrow transplantation may be embarked upon.

Hypogonadism in male Leprosy patients--a study from rural Uttar pradesh.

Hypogonadism in male patients with Leprosy is common and may identify patients with future risk for bone loss and osteoporosis. In the present study, we evaluated gonadal function in 71 male patients with Leprosy both clinically and by estimation of serum testosterone levels. The patients belonged to selected rural areas of Uttar pradesh, with majority aged less than 50 yrs (74.6%), Hindus (66.7%), illiterate (60.9%), and of low socioeconomic status (58% with per capita income < Rs.500 per month). Most patients had multibacillary Leprosy (83.1%), duration less than 2 years (75.4%) and had received antileprosy drugs for less than a year (95.6 %).Seven patients (9.9%) had clinical features of hypogonadism such as gynaecomastia, decreased sexual hair and infertility. Serum testosterone levels, estimated in 31 of the patients, revealed low values in 25.8% (8/31) patients (Mean 4.65+/-3.37 ng/ml). Age, duration of Leprosy and socioeconomic status but not type of Leprosy or treatment duration affected hypogonadism significantly. The results of the present study indicate a high frequency of hypogonadism among rural male Leprosy patients that warrants routine screening to identify patients at risk for osteoporosis and possible prevention with testosterone replacement therapy.

Histoid leprosy with filariasis.

A patient with filariasis, taking treatment in the form diethyl carbamazime citrate developing "de-novo" histoid leprosy during the course of the disease is being reported.