Loss of blast cell procoagulant activity and improvement of hemostatic variables in patients with acute promyelocytic leukemia administered all-trans-retinoic acid.

All-trans-retinoic acid (ATRA) induces complete remission (CR) in up to 90% of acute promyelocytic leukemia (APL) patients with rapid amelioration of the bleeding syndrome. Previous studies indicate that ATRA treatment in vitro of the APL NB4 cell line can affect their procoagulant activity (PCA). To assess whether ATRA has this effect also in vivo, we prospectively studied the PCA of bone marrow blasts from APL patients on therapy with ATRA alone or associated with chemotherapy. Samples were obtained before, during, and after ATRA. To characterize the coagulopathy, we measured a series of plasma hemostatic variables before and during the first two weeks of therapy, as follows: (1) markers of hypercoagulability; (2) natural anticoagulants; (3) fibrinolysis proteins; and (4) elastase. The results by enzymatic and immunologic methods show that both total (tissue factor-like) and factor VII-independent (cancer procoagulant-like) blast cell PCAs, present before therapy, were reduced during (69% and 65% decrement, respectively) and virtually undetectable after ATRA. The plasma hemostatic assessment of patients before treatment was elevated hypercoagulability markers, low mean protein C, normal fibrinolysis proteins, and increased elastase. After starting ATRA, hypercoagulability markers were reduced within 4 to 8 days, protein C augmented, the overall fibrinolytic balance was unmodified, and elastase remained elevated. These results were not different either with or without chemotherapy and are consistent with the clinical findings of rapid improvement of the coagulopathy.

Multicentre evaluation of the Serono SR1 assay for prostate specific antigen.

This report describes the findings of an evaluation of the validity of the new, highly automated Serono SR1 enzyme immunoassay for prostate specific antigen performed at three European sites. Within-run precision was below 5.5% at the clinically important decision point of 4 micrograms/l, less than 10% below 3 micrograms/l and less than 5% above 4 micrograms/l. Between-run precision was below 12% at each site and between-site precision was less than 14%. Dilution series were shown to be parallel to the standard curve on 12 samples with neat prostate specific antigen concentrations ranging from 20 to 88 micrograms/l (linear regression slopes and correlation coefficients of 1.00 to 1.06 and 0.972 to 1.000 respectively). Comparisons with Hybritech Tandem-E and -R and Roche Cobas Core prostate specific antigen methods used routinely at the three sites were good (linear regression slopes 1.04 to 1.13, correlation coefficients 0.96 to 0.99), but results were significantly lower than the Ciba Corning ACS180 (slope 0.66, correlation coefficient 0.99). The assay presents a precise, robust and valid diagnostic tool offering additional advantages of non-isotope automation.

[Emerging pathologies and correlates of drug abuse in 2 therapeutic communities in Bergamo]. / Patologie emergenti e correlate alle droghe d'abuso in due comunità terapeutiche di Bergamo.

The authors monitored for 1 year 96 cases of ex-opiate addicts, belonging to two therapeutic Communities from Bergamo, a male and a female group, and a group of subjects living close to them (operators) or relatives and of laboratory technicians (51 cases on the whole). Protocols were set up with all the biochemical, hematological and serological parameters, to study the alterations connected with possible pathologies related to drug addiction, with repeated controls during the observation year. Only one LAS case was pointed out, at present markedly improved, a high incidence of hepatic involvement, due to previous hepatitis (type B or non A and non B), no alterations of kidney functions, while alterations of lymphocyte populations and subsets, thrombocytopenia, cross reactions with VDRL and negative TPHA, 45% of anti HTLV III antibody positive cases, were pointed out. Concerning the technicians and people living close to the examined subjects, no positivity for anti-HTLV III antibody, due to horizontal transmission of infection, was observed.