Subject(s)
Carcinoma, Bronchogenic/drug therapy , Cisplatin/administration & dosage , Etoposide/administration & dosage , Lung Neoplasms/drug therapy , Podophyllotoxin/analogs & derivatives , Cisplatin/adverse effects , Drug Therapy, Combination , Etoposide/adverse effects , Humans , Male , Middle AgedABSTRACT
In ten patients with IRSA, chromosome analysis and bone marrow cytology were performed once or several times during 24 months. Bone marrow chromosomes from eight patients showed a normal karyotype. Two patients were found to have stable clonal chromosome aberrations (45, X,-Y[male] and 46, XX,+mar). In a median duration of 6.8 years of IRSA no patient has yet developed acute leukemia. In another ten deceased patients with IRSA no evidence of leukemia, but a carcinoma of colon and prostate were observed in a latency of 7.7 years. Three patients with symptomatic SA developed in 1-15 months an acute leukemia. Two of them showed severe instable clonal chromosome abnormalities. Distinct bone marrow abnormalities (increase of blasts, normal cellularity, reversed M:E ratio, PAS-pos. erythroblasts), thrombocytopenia, and major clonal chromosome aberrations may help to differentiate IRSA from preleukemic states with symptomatic SA.
Subject(s)
Anemia, Sideroblastic/diagnosis , Aged , Anemia, Sideroblastic/complications , Bone Marrow Examination , Chromosome Aberrations , Colonic Neoplasms/complications , Female , Humans , Karyotyping , Male , Middle Aged , Preleukemia/pathology , Prostatic Neoplasms/complications , Thrombocytopenia/complications , Time FactorsABSTRACT
44 patients suffering from myelomonocytic leukemia (MML) have been observed over the last four years. They have been subclassified in acute myelomonocytic and acute monoblastic leukemias (AMML, n = 12; AMoL, n = 10), subacute myelomonocytic leukemias (SMML, n = 13), and chronic myelomonocytic leukemias (CMML, n = 9) on the basis of bone marrow cytology(blast and promonocyte counts, maturation of granulopoesis) and cytochemical findings (peroxydase and unspecific esterase reaction). This subclassification has been proved to be of prognostic relevance by its good correlation with the mean survival times (AMML : 4.5 months, AMoL : 2.4 months, SMML : 8 months, CMML : 18 months). The acute forms have been treated in general with combined cytostatic chemotherapy, whereas SMML and CMML have been treated this way only in case of progression to an acute phase. These progressions to an AMML have been observed more often and earlier in subacute forms than in chronic forms. The diagnosis of SMML and CMML is supported by the finding of sea-blue histiocytes in the bone marrow, increased lysozyme levels in serum and urine and by the absence of the Philadelphia-Chromosome.
Subject(s)
Leukemia, Myeloid/diagnosis , Acute Disease , Adolescent , Adult , Aged , Bone Marrow Examination , Chronic Disease , Female , Histiocytes , Humans , Leukemia, Monocytic, Acute/diagnosis , Leukemia, Myeloid/pathology , Male , Middle Aged , Muramidase/blood , Muramidase/urine , PrognosisABSTRACT
The course of spontaneous vitamin B6 deficiency anemia in a 57-year-old woman is reported. The anemia was characterized by hypochromasia of the erythrocytes, hyperferricemia, absence of hemolysis, and hyperplastic, ineffective, sideroblastic erythropoiesis of the bone marrow. It was corrected by oral vitamin B6 therapy. On interruption of the vitamin B6 therapy the anemia relapsed. On resumption of vitamin B6 medication it responded again with normalization of the hemoglobin and erythrocytes values. The hematological remission could be maintained under longterm vitamin B6 medication. The nosological significant of this rare anemia and its differentiation from other forms of anemia are discussed.
Subject(s)
Pyridoxine , Vitamin B Deficiency , Anemia, Hypochromic/etiology , Anemia, Sideroblastic/drug therapy , Erythropoiesis , Female , Humans , Middle Aged , Pyridoxine/therapeutic use , Vitamin B Deficiency/complicationsABSTRACT
On account of 2 own observations, main clinical and diagnostic features of Hairy cell leukemia (HCL) will be discussed. HCL is a rare, unusual type of chronic leukemia and is predominantly particular of middle-aged men. The occurrence of middle-sized lymphoid cells having a hairy cytoplasmic edge, and a tartrate-resistant acid PHOsphatase isoenzyme are the characteristic criteria of the HCL. The diffuse infiltration by hairy cells affecting primarily the spleen and bone marrow results in anaemia, granulocytopenia, thrombocytopenia and splenomegaly. Differential diagnosis have to be made in relation to other lymphatic leukemias, leukemic malignant lymphomas and monoclonal gammopathies as well as lymphotropic viral infections. Immunologic behaviour of hairy cells is like that of B-lymphocytes. Therefore, the term "leukemic reticuloendotheliosis" should no longer be applied.
