ABSTRACT
The myelodysplastic syndromes (MDS) are a group of closely related disorders characterized by chronic cytopenias with cellular marrow, poor prognosis and refractoriness to treatment. We studied 101 consecutive cases of MDS diagnosed over a 7-year period. Peripheral blood (PB) and bone marrow (BM) samples were reviewed and classified according to the proposals of the French-American-British (FAB) cooperative group for MDS. The combined analysis of the initial laboratory features and qualitative haematological abnormalities readily allowed the distinction between the different subgroups. Thirty-two of 79 cases (40.5%) evolved towards other diseases, frequently acute leukaemia (24/79, 30%), or transformed into other MDS (7/79, 9%). In five cases, initially classified as refractory anaemia (RA) or refractory anaemia with ring sideroblasts (RAS), a transitory change to another type of MDS--two chronic myelomonocytic leukaemias (CMML), two refractory anaemias with excess of blasts (RAEB) and one refractory anaemia with excess of blasts 'in transformation' (RAEB-t)--was observed before the evolution towards acute leukaemia. This provides a new link between all these syndromes and increases the number of transitions to other MDS. Overall prognosis was very poor, with differences between subgroups. RA had the best prognosis whereas RAEB-t had the worst one. This study shows that the FAB classification is readily usable and defines well-characterized subgroups of MDS, although there are frequent transitional forms, and as the natural history of the MDS unfolds they may convert into another. The actual poor prognosis and the frequent evolution towards acute leukaemia makes necessary to investigate new methods of treatment for these disorders.
Subject(s)
Myelodysplastic Syndromes/classification , Adult , Age Factors , Aged , Anemia, Aplastic/classification , Blood Cell Count , Bone Marrow/pathology , Female , Follow-Up Studies , Humans , Leukemia, Myeloid/classification , Male , Middle Aged , Preleukemia/classification , Prognosis , Sex FactorsSubject(s)
Antibodies, Viral/analysis , Deltaretrovirus/immunology , Hemophilia A/immunology , Adolescent , Adult , Blood Transfusion , Child , Child, Preschool , Hemophilia A/therapy , Humans , Infant , Middle Aged , SpainSubject(s)
Blood Coagulation Factors/therapeutic use , Hemophilia A/immunology , T-Lymphocytes/classification , Adolescent , Adult , Antibodies/analysis , Child , Child, Preschool , Enzymes/blood , Hemophilia A/blood , Hemophilia A/therapy , Humans , Immunoglobulins/analysis , Leukocyte Count , Male , Middle Aged , T-Lymphocytes, Helper-Inducer , T-Lymphocytes, RegulatoryABSTRACT
The incidence of posttransfusion hepatitis was prospectively investigated in 230 cardiac surgery patients, 40 patients (17.4%) developed clinical and/or biological signs of hepatitis. In 10 cases (25%), the illness was due to hepatitis B virus infection. 1 patient (2.5%) had serological evidence of cytomegalovirus infection with clinical signs of hepatitis. In 29 cases (72.5%), the hepatitis was considered to be due to non-A, non-B agent(s). Of the 29 patients in this latter group, 16 have persistent transaminase elevations after 1 year, thus suggesting the development of chronic liver disease.
Subject(s)
Hepatitis, Viral, Human/etiology , Transfusion Reaction , Cytomegalovirus Infections/complications , Hepatitis A/epidemiology , Hepatitis B/epidemiology , Hepatitis C/epidemiology , Hepatitis, Viral, Human/epidemiology , Humans , Immunization, Passive , SpainABSTRACT
The study of the specificity of platelet autoantibodies has made it possible to expand our knowledge about the immune characterization of idiopathic thrombocytopenic purpura. We report on a study of eluates obtained from 10 patients' platelets with autoimmune thrombocytopenia. They were tested with platelets obtained from healthy donors (Zw a + and Zw a-) and with type I Glanzmann platelets. Our results, as those reported by van Leeuwen et al. in 1982, suggest that the autoantibodies recognize one or more antigenic markers probably carried by glycoproteins IIb and IIIa.
Subject(s)
Autoantibodies/immunology , Blood Platelets/immunology , Purpura, Thrombocytopenic/immunology , Antigen-Antibody Reactions , Humans , Lupus Erythematosus, Systemic/immunologyABSTRACT
Antibody elution by chloroform and trichloroethylene was compared with the Rubin ether method modified by Hughes-Jones for IgG antibodies and the Landsteiner and Miller heat method for IgM antibodies. After washing the cells, the chloroform and trichloroethylene method was done at 37 degrees C for 10 minutes. With this technique the eluate remained on the upper layer above the red blood cell stroma layer, while with Rubin's method the eluate remained below the cell stroma. The reported technique was as effective as the Landsteiner and Miller heat method for IgM antibodies, and a double volume of eluate was obtained.
Subject(s)
Blood Group Antigens/immunology , Chloroform/pharmacology , Immunologic Techniques , Isoantibodies/analysis , Hot Temperature , Humans , Immunoglobulin G , Immunoglobulin M , Infant, Newborn , Trichloroethylene/pharmacologySubject(s)
Autoantibodies/immunology , Blood Coagulation Factors/immunology , Adult , Female , Humans , Hydrochloric Acid/poisoning , Immunoglobulin G/analysis , Immunoglobulin M/analysis , Infectious Mononucleosis/immunology , Lupus Erythematosus, Systemic/immunology , Male , Middle Aged , Pneumonia/immunology , Pregnancy , Urinary Bladder Neoplasms/immunologyABSTRACT
A circulating anticoagulant against factor XII was detected in a patient with smoldering leukemia. Despite severe associated thrombocytopenia the patient suffered two thromboembolic episodes, besides mucosal bleeding. The circulating anticoagulant was demonstrated not only in the plasma but also in the serum. Its activity was not affected by heating at 56 degrees C for 30 min and it was not adsorbed by SO4Ba or A1(OH)3. The circulating anticoagulant was not dializable and demonstrated to be an IgG. This is apparently the first reported association of smoldering leukemia and a circulating anticoagulant against factor XII.