[Childhood acute lymphoid leukemia relapsing in adult age?]. / Gyermekkori akut lymphoid leukaemia felnöttkori relapsusa?

A 30-years-old woman developed an acute lymphoblastic leukemia 16 years after a successfully treated childhood acute lymphoblastic leukemia. The developed second malignancy unexpectedly seemed identical to her previous malignant disease. That's why and because of the literature doesn't mention acute lymphoblastic leukemia as a second neoplasm after an acute lymphoblastic leukemia we considered the disease unusual late relaps of the original childhood malignancy.

Pregnancies and offspring in survivors of acute lymphoid leukemia and lymphoma.

Since few data on the reproductive outlook of patients successfully treated for lymphoproliferative disease are available, further experiences on the pregnancy outcome and offspring follow-up of 12 women treated for acute lymphoid leukemia and 7 women treated for malignant lymphoma are reported. Of the 20 pregnancies of leukemic patients in remission, 14 ended in live births, one in spontaneous abortion, and 5 in elective abortions among which one was performed during relapse. One minor (hip dysplasia) and one major birth defect (Apert syndrome) were seen. The Apert syndrome baby is considered as a new mutation. Of the 9 pregnancies of lymphoma patients 5 ended in normal births and 4 in elective abortions. Neither relapse nor malformation was encountered. One leukemic patient had gestational edema and one lymphoma patient had puerperal thrombophlebitis of lower extremity. The offspring of the above patients appropriately developed and had no complication except for one with cephalhematoma and for another one with epilepsy attributed to birth injury.

Age dependency of the progression of HIV disease in haemophiliacs; predictive value of T cell subset and neopterin measurements.

Sixteen HIV-seropositive haemophiliacs were followed up for 42 months and 9 other patients for 24 months. All patients were infected in 1983 or 1984. T cell subsets and serum neopterin levels were measured twice a year. The patients were divided into three groups according to their age in 1989: group A (children) less than 14 years old (n = 6); group B (adolescents) 14-20 years old (n = 8); group C (adults) greater than 20 years old (n = 11). At the last measurement performed in November, 1989, patients of group A had significantly higher absolute number and percentage of CD4+ lymphocytes and significantly lower serum neopterin levels than patients of group B and C. In addition, the percentage of the activated, CD3+ DR+ lymphocytes was also significantly higher in the adult-adolescent group than in the children group. Until the end of December, 1989, AIDS developed in 0, 1 and 2 patients and ARC was diagnosed in 0, 5, and 2 patients of groups A, B, and C, respectively. The progression of the HIV disease towards AIDS in these patients was predicted by the T cell subset and neopterin measurements performed in 1987. Only those 3 patients who progressed to AIDS had CD4+ cells less than 350/microliters and a neopterin value of more than 20 nmol/l. These findings confirm previous observations indicating that in patients with haemophilia the progression of HIV disease is influenced by age: a relatively slow progression can be expected in prepuberty children.(ABSTRACT TRUNCATED AT 250 WORDS)

[Pregnancy in acute lymphoid leukemia]. / Akut lymphoid leukaemiában szenvedök terhességei.

Authors followed up 5 girls, aged 7 to 13 years suffered of acute lymphoid leukemia, who got into complete remission due to induction therapy with multiple cytostatic agents and who became pregnant after the maintenance treatment lasting two and a half years. Of 8 pregnancies of the 5 women 4 pregnancies were terminated by spontaneous deliveries with mature newborns, and 4 ones were interrupted in gestational weeks 7 to 14. Except for one patient who died one year after the termination of pregnancy the other remained in complete remission during and after the pregnancy, and at present their survival times range between 12.5 and 15 years. Among the newborns one had dysplasia coxae congenita of mild grade. Progenies developed healthily in the course of follow-up ranging between 1.5 and 6 years.

Prevalence of HIV-antibodies in patients with haemophilia in Hungary.

Incidence of HIV antibodies have been studied in 617 patients with congenital bleeding disorders. Screening was performed with the Organon ELISA test, repeatedly positive samples were tested with four different confirmatory assays. HIV antibodies were found in 3/356 patients with haemophilia A, 21/114 patients with haemophilia B, 3/123 patients with von Willebrand disease and in 1/24 patients with other types of congenital coagulation disorders. All the 28 seropositive patients were treated with imported coagulation factor, mostly with factor IX concentrates. No patient treated exclusively with nationally produced factor preparations between 1981 and 1985 was found to be anti-HIV positive.

Studies of the sensitivity and reproducibility of commercial kits to detect antibodies to the human immunodeficiency virus.

Nine serial three-fold dilutions (1:1 to 1:6561) were prepared from 18 sera obtained from hemophiliacs confirmed to have antibodies to the human immunodeficiency virus. The dilutions were tested with five different commercial enzyme immunoassay kits and twelve sera were retested 5 to 7 months later by different lots of three kits. The dilution that gave an absorbance (OD) equal to the cut-off OD was considered as the titer of antibody. Sensitivities of the kits were compared by statistical and regression analysis; the same approach was used for studying reproducibility from the results of retesting. The highest titers were found with the Wellcome kit, the lowest with Organon and Pasteur kits, whereas intermediate values were found with the Sorin/Biomedica and Electronucleonics kits. With the Organon and Wellcome kits, excellent reproducibility was observed on later retesting; however, a significant change in titers was seen on retesting the Sorin kit.

Prognostic factors in acute lymphoid leukaemia of childhood. I. Cytogenetic studies.

The results of chromosonal analysis of bone-marrow cells of 30 children with untreated acute lymphoid leukaemia are reported. On the basis of the modal chromosome number found in the cell clone showing the most frequent aberration, the patients could be classified into hypodiploid, pseudodiploid, hyperploid and normal groups. Pseudodiploidy predicted a poor prognosis while the survival rate of patients with normal or hyperploid chromosome counts was favourable.

Prognostic factors in acute lymphoid leukaemia of childhood. II. Cell surface markers.

Monoclonal sera have been used to determine the surface phaenotype of leukaemic cells during the last three years. Bone-marrow specimens of 57 children with recently diagnosed acute lymphoid leukaemia were examined; four cases were classified as T-cell leukaemia, 2 cases as B-cell leukaemia, in 37 cases cALLa was positive and fourteen children were classified as O-cell type, based on the absence of markers. Analysis of symptom-free survival revealed a very poor prognosis in B-cell leukaemia; there was no significant difference between the remaining groups. Within the cALLa positive cases L1 exhibited a markedly more favourable prognosis than L2.

In vitro proliferation of normal and leukaemic human leukocytes controlled by an inhibitory endopeptide.

GI-3, an endogenous inhibitory fraction isolated from leukocytes, selectively inhibits the proliferation of granuloid precursor cells in a non-toxic manner. Its active principle was determined as an acidic chlor-tolidine positive decapeptide [ 3 ]. The in vitro effect on normal and acute leukaemic human bone marrow and blood cells was examined. A dose dependent inhibition by GI-3 of 3H-TdR incorporation into myeloid cells of normal bone marrow was found, the sensitivity of human cells being higher than that of rat cells. The proliferation of the target leukaemic bone marrow and blood cells (AML, AMMoL) was also decreased by the endogenous inhibitor in a dose dependent manner in untreated subjects as well as in patients in remission or relapse. The rate of inhibition of leukaemic of well-known cytostatics (adriamycin hydrochloride, dianhydrogalactitol) applied for comparison. Beyond its direct cytostatic effect, GI-3 could be used in the differential diagnosis of blastic leukaemias, complementing the routine cytochemical methods.

Therapeutic results: report of the Hungarian children's leukaemia study group.

In Hungary, the morbidity of leukaemia in children aged 0 to 15 years is 3.6/100,000. The rate of complete remission was 88.5% in ALL and 57.1% in AML. The most important factors limiting survival were infections acquired during induction therapy in 91.3% and during Co irradiation in 66.3% of the patients.