RESUMO
The incidence of aplastic anemia appears to be relatively high in some parts of the world, including Pakistan. Since some of the etiological factors are shared by aplastic anemia and the preleukemic syndrome, there is a strong possibility that a proportion of cases of aplastic anemia may in fact be preleukemia. The study of chromosomes offers a relatively easy method of detecting cases of preleukemia, because some chromosomal abnormalities are frequently observed in this condition. Chromosomal studies were carried out in peripheral blood cell cultures of 31 patients with otherwise typical aplastic anemia. Chromosomal abnormalities were detected in 7 (22.5%) cases. The most common chromosomal abnormality detected was trisomy 8, seen in four cases. Other abnormalities detected were 22q-, t(14;22) and t(15;21), in one case each. These abnormalities have been found to be associated with AML, MDS, ALL, and NHL as well. We hypothesize that a proportion of cases of otherwise typical aplastic anemia may in fact be due to a leukemic process in evolution.
Assuntos
Anemia Aplástica/genética , Aberrações Cromossômicas , Transtornos Cromossômicos , Síndromes Mielodisplásicas/genética , Translocação Genética , Trissomia , Adolescente , Adulto , Anemia Aplástica/diagnóstico , Criança , Cromossomos Humanos Par 14 , Cromossomos Humanos Par 15 , Cromossomos Humanos Par 21 , Cromossomos Humanos Par 22 , Cromossomos Humanos Par 8 , Feminino , Humanos , Lactente , Cariotipagem , Masculino , Pessoa de Meia-Idade , Síndromes Mielodisplásicas/diagnósticoRESUMO
Haemorrhagic diathesis is the commonest cause of morbidity and mortality in acute leukaemias (AL). It is most commonly due to thrombocytopenia resulting from bone marrow failure. However, in a significant number of cases, disseminated intravascular coagulation (DIC) plays an important part. Previously it was thought that this mechanism was mainly confined to acute promyelocytic leukaemia (APL), but recently it has also been reported to occur in other subtypes of acute leukaemia. We report the results of a study carried out to find the incidence of DIC in various types of AL at the time of first diagnosis and in the absence of other recognisable causes. DIC was observed in 14(13.4%) cases out of 104 cases of AL studied. Nine out of 49(18.4%) cases of AML and 5 out of 55(9.1%) cases of acute lymphoblastic leukaemia (ALL) showed coagulation abnormalities consistent with DIC. Out of the 9 cases of AML showing DIC, 63 (66.67%) belonged to APL (FAB ME) subtype. Three (60%) out of 5 cases of ALL with DIC had T-cell immunophenotype. The results indicate that DIC may also occur in types of AL other than APL, particularly in T-ALL, and should be looked for.
Assuntos
Coagulação Intravascular Disseminada/epidemiologia , Leucemia Mieloide Aguda/complicações , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicações , Adolescente , Adulto , Envelhecimento , Criança , Coagulação Intravascular Disseminada/complicações , Feminino , Humanos , Masculino , Estudos Prospectivos , Fatores de Risco , Caracteres SexuaisRESUMO
Granulocytic sarcoma is an unusual variant of myeloid malignancy most commonly encountered in the course of chronic or acute myeloid leukaemia. Of 60 patients of chronic myeloid leukaemia studied over 21 months, we encountered 6 (10%) cases of granulocytic sarcoma. Four of these had granulocytic sarcoma on their first presentation. All those who were receiving hydroxyurea did not fare well but one who was put on DAT (daunorubicin, cyftosine arabinocide, 6 thioguanine)regimen went into remission with complete disappearance of lesions.
