ABSTRACT
A 48-year-old man was treated by allogeneic bone marrow transplantation (BMT) in first remission of M4 acute myelogenous leukaemia (AML). He experienced no graft-versus-host disease (GVHD) and 7 months later he relapsed. Following further chemotherapy, he entered a second complete remission; however, he refused a further allogeneic or autologous BMT but agreed to immunotherapy with interleukin-2 and autologous lymphokine-activated killer (LAK) cells. He tolerated this treatment well but went on to develop grade II skin GVHD. Polymerase chain reaction studies of DNA microsatellites of the autologous LAK cells showed that they were of donor origin. The patient remained well for 9 months until, immediately following the introduction of prednisolone for his persistent GVHD, he relapsed. He declined further active treatment and died 5 months later. The case shows that IL-2/LAK cells can be safely given to patients who have experienced no GVHD following allo-BMT and are likely to be effective through an ongoing graft-versus-leukaemia effect.
Subject(s)
Bone Marrow Transplantation/pathology , Graft vs Host Disease/immunology , Interleukin-2/therapeutic use , Killer Cells, Lymphokine-Activated/immunology , Leukemia, Myeloid, Acute/therapy , Genetic Markers , Graft vs Host Disease/pathology , Humans , Immunotherapy , Male , Middle Aged , Tissue DonorsSubject(s)
Leukemia, Lymphoid/complications , Skin Diseases/etiology , Humans , Male , Middle Aged , Skin/pathology , Skin Diseases/pathology , SyndromeABSTRACT
The clinical, hematologic, and histological characteristics of two patients who progressed from refractory anemia to acute leukemia are described. When first studied, nuclear bridging of erythroblasts, similar to that seen in congenital dyserythropoietic anemia type I and megakaryocytic dysplasia, were the only abnormalities. Within 6 years, both patients died, the first of acute nonlymphocytic leukemia, the second of erythroleukemia. Nuclear bridging of erythroblasts in the marrow of these patients was an early and transient phenomenon and was not observed during the terminal phase of leukemia.
Subject(s)
Erythroblasts/ultrastructure , Erythropoiesis , Preleukemia/diagnosis , Adult , Aged , Anemia/complications , Bone Marrow/pathology , Female , Humans , Male , Preleukemia/bloodABSTRACT
A number of unusual features have been described in patients who have peripheral neuropathy in association with plasma cell neoplasia. Amongst these features are raised haemoglobins and increased platelet counts. We have measured the red cell mass in one such patient and have shown that the raised haemoglobin was due to a pseudoerythrocytosis. Our patient is also of interest because of his youth being only 19 years old at presentation.
