Childhood proptosis: the invaluable but overlooked peripheral blood smear.

Two cases of granulocytic sarcoma presenting as childhood proptosis are described. This highlights the significance of peripheral blood smear examination in establishing the diagnosis of Acute Myeloid Leukaemia (AML).

Role of serum ferritin in assessment of disease activity in acute & chronic leukemia.

Serum ferritin (SF) was estimated using double antibody sandwich ELISA in 83 patients of acute and chronic leukemia at various stages of the disease. In 35 patients of acute lymphoblastic leukemia (ALL) in remission, the SF levels fell significantly from 550.63 ng/ml at presentation to 319.56 ng/ml but remained significantly higher than the control values of 46.14 ng/ml. In 28 patients of acute myeloid leukemia (AML), the SF values at 775.0 ng/ml were much higher than those in ALL patients and showed no decline with remission. This pattern was also seen in patients of chronic myeloid leukemia in blast crisis (CML-BC) with SF levels of 804.03 ng/ml at presentation and 717.43 ng/ml at partial remission. The values of SF were lowest in patients of CML in chronic phase ranging from 271.5 ng/ml to 332.12 ng/ml and showed no relationship with variation in total leucocyte count. No correlation was found between SF values and various clinical and laboratory parameters such as age, sex, fever, organomegaly, haemoglobin and total leucocyte count. Thus, while there appeared to be a correlation between remission and SF values in ALL, no such correlation existed between the activity of the disease and SF in other types of leukemia.

Platelet function in chronic leukemias.

Bleeding time, clot retraction, platelet factor 3 availability and platelet aggregation in response to ADP, epinephrine, collagen and ristocetin were studied in 12 cases of chronic leukemia which included eight of chronic myeloid leukemia, two of chronic lymphatic leukemia and two of CLL related disorders. One or more abnormalities in platelet function were detected in all the cases. Among the cases of CML, bleeding time was prolonged in one, clot retraction was impaired in one and PF3 availability was decreased in one case. Defects in platelet aggregation were variable. Among the cases of CLL and CLL related disorders, bleeding time was prolonged in two, clot retraction was impaired in one and PF3 availability was decreased in three cases. Platelet aggregation responses were significantly impaired in all the cases.

Increased plasma removal of microemulsions resembling the lipid phase of low-density lipoproteins (LDL) in patients with acute myeloid leukemia: a possible new strategy for the treatment of the disease

A microemulsion of lipid composition resembling low-density lipoprotein (LDL), but devoid of apolipoproteins and labeled with [14C]-cholesteryl oleate was injected into 16 healthy subjects and into 15 patients with acute myeloid leukemia (AML). Removal from plasma of the lipid label was higher in the leukemic group compared to healthy subjects in terms of fractional clearance rate (0.185 +/- 0.205 and 0.080 +/- 0.030 h-1, respectively, P < 0.03). When the emulsion was again injected into 10 of the AML patients after complete hematological remission, the fractional clearance rate of cholesteryl ester was reduced to one third of the value observed prior to treatment (0.061 +/- 0.038 h-1) and was not different from that obtained for the healthy subjects. Also, in untreated AML patients, serum LDL-cholesterol levels inversely correlated with the values of fractional clearance rate of the microemulsion. This correlation was no longer observed after treatment. These data suggest that the LDL-like microemulsion was selectively taken up by the neoplastic cells presumably by interaction with LDL receptors. Therefore, microemulsions may function as potential carriers for anticancer drugs that are targeted to tumor cells for patients with acute myeloid leukemia. Unlike native LDL, microemulsions are suitable for utilization in routine clinical practice

Comparison of colony-stimulating activities for evaluating in vitro granulomonopoiesis in normal subjects and in patients with myeloid leukemias

El crecimiento in vitro de unidades formadoras de colonias granulomonocíticas (UFC-GM) en sangre periférica (SP) y médula ósea (MO) humana requiere de fractores estimuladores denominados actividad estimuladora de colonias (AEC). El ensayo de Pike & Robinson emplea como fuente de AEC capa alimentadora (CA) compuesta por leucocitos de SP inmovilizados en agar. No obstante que este ensayo de bicapa presenta desventajas técnicas es ampliamente utilizado. Los sobrenadantes tisulares y celulares con actividad biológica para la UFC-GM, también conocidos como medios condicionados (MC), eliminan lsos incovenientes teécnicos de la estimulación con CA. En el presente trabajo se prepararon dos MC, uno de CA (MC-CA) y otro de leucocitos estimulados con fitohemaglutinina (MC-LEF). La AEC de ambos MC se comparó con la producida por la CA. Las tres AEC, evaluadas por el número de racimos (agregados celulares con 3 a 39 células) y de colonias (agregados celulares con -> 40 células) presentes en el cultivo, se probaron en células obtenidas de SP de 17 individuos sanos, y en células de SP (17 muestras) y MO (12 muestras) de enfermos con leucemias mieloides. Se encontró que el MC-CA indujo un número significativamente menor de agregados celulares tanto en muestras de sujetos normales como de enfermos leucémicos al compararlo con el ensayo de CA. En muestras de pacientes con leucemia, el crecimiento clonal mediado por el MC-LEF fue similar al encontrado con CA. En cambio, la adición de MC-LEF a muestras de sujetos sanos dio como resultado un número promedio de colonias significativamente menor al observado con CA. Estos resultados indican que el MC-CA es una fuente inapropiada de AEC para muestras provenientes de sujetos normales y de pacientes leucémicos, mientras que la AEC derivada del MC-LEF mantiene adecuadamente el crecimiento de UFC-GM en muestras de enfermos con leucemia, pero no en muestras de personas normales. Basados en estos hallazgos y en los incovenientes técnicos del ensayo de Pike & Robinson, se concluye que el MC-LEF permite una mejor evaluación de la granulomonopoyesis in vitro en pacientes con leucemias mieloides