Immunophenotypic subsets in acute lymphoblastic leukemia from a single centre in North India: correlation with outcome to induction chemotherapy.

The poorer outcome of Indian patients with acute lymphoid leukemia (ALL) has been observed in earlier studies. However, little data is available on their immunophenotypic characteristics. The aim of the present study was thus to characterize the immunophenotypic subsets of Indian ALL patients and correlate with outcome at the end of induction chemotherapy. Immunophenotyping of 45 childhood and 25 adult ALL patients was performed by dual colour flow cytometry using a panel of B-lineage, T-lineage and Myeloid lineage specific monoclonal antibodies. Eighty and 17% of childhood and 92% and none of adults were B-lineage and T-lineage ALL, respectively. Aberrant myeloid marker expression was seen in 11% and 28% of childhood and adult groups, respectively. B-lineage ALL with aberrant T-lineage marker expression was observed in 4.4% and 8% of childhood and adult groups, respectively. Two each induction failures were observed in both childhood and adult groups. All of these were associated with aberrant expression of myeloid and/or T-lineage markers on B-lineage ALL. Aberrant expression of markers was associated with poorer outcome to induction chemotherapy in both childhood and adult ALL patients.

Effect of pH adjustment of bupivacaine on onset and duration of epidural anaesthesia.

The effect of pH adjustment of bupivacaine on onset and duration of sensory and motor block was studied in 45 patients undergoing lower abdominal and lower limb surgery. The study was done in 3 groups with the mean pH adjustment of 5.85, 7.14 and 7.21. Each patient was given 30 ml of 0.4% pH adjusted bupivacaine solution in epidural space. Onset of sensory block and duration were noticed by pin-prick method while motor block was observed by asking the patient to raise the thigh. It was observed that increase in pH of bupivacaine solution quickens the onset of sensory and motor block and increases the overall duration of neural blockade.