Bone marrow patterns in chronic lymphocytic leukaemia related to various clinical and haematological findings. A preliminary report.

In a retrospective study of 55 CLL cases subjected to bone-marrow biopsy, the histological pattern of the bone-marrow was correlated to the clinical and haematological data. Instead of the four histological patterns described by Rozman et al., five patterns have been established. The clinical staging according to the Montserrat score, compared with the bone-marrow pattern, showed a good correlation, when maintenance or replacement of normal haematopoiesis was considered. The bone-marrow pattern with maintained haematopoiesis was predicting a favourable clinical correlation; those with replaced haematopoiesis corresponded to a poor prognosis. The correlation is a useful index of severity and prognosis of CLL.

Detection of monoclonal gammapathies by the presence of certain peculiar changes on the Giemsa-stained blood smear.

Certain changes in the morphological and tinctorial features of the panoptically stained blood-smears suggest the diagnosis of monoclonal gammopathies in cases in which these are not even supposed. The mechanism of such alterations is discussed and emphasis is laid on the practical value of these findings in the detection of myeloma and other related syndromes in patients without clinical symptomatology or followed up for years for other diseases.

[Blood histamine level in chronic myeloproliferative diseases; a review]. / Der Bluthistaminspiegel bei chronischen myeloproliferativen Erkrankungen; Ein Uberblick.

Since the discovery of a very high blood histamine level in chronic myelocytic leukemia (CML) 1936, the author could ascertain that this parameter is very useful in the differential diagnosis between CML and various "leukemoid" reactions; in the early diagnosis of CML and in the differential diagnosis between CML and other myeloproliferative disorders. Recent researches proved that no correlation exists between blood histamine level and basophil count in the peripheral blood. Further investigations in this field have to clear up the questions whether it is possible by means of repeated controls of the blood histamine level to predict the development of a polycythemia vera into CML or to establish in a case of osteomyelosclerosis that this disease has been Preceeded by A CML.

A preventive therapy of the central nervous system complications in acute leukemias. Preliminary report.

A new therapeutic schedule for preventive therapy of the central nervous system (CNS) complications by intrathecal (i.t.) injections of methotrexate (MTX) was applied in two groups of 6 and respectively 13 adults with acute lymphoblastic or non-lymphoblastic leukemias. Instead of starting this treatment only in the remission stage, i.t. MTX was given from the very beginning of cytostatic therapy. In most of the patients this drug proved to be effective in preventing CNS involvement. In some cases, however, it was not well, tolerated owing probably to a neurotoxic effect. This suggested continuation of the study with Ara-C.

Ph1-positive polycythemia vera.

The rare presence of the ph1 chromosome in chronic myeloproliferative disorders other than chronic granulocytic leukemia (CGL), i.e. polycythemia vera (PV), myeloid metaplasia with myelofibrosis (MMM) and hemorrhagic thrombocytopenia (HT) raised the question whether or not the Ph1 chromosome is peculiar to CGL. In an attempt to answer this question, the authors reports six cases of positive-Ph1 of which two are from their personal experience and four from the literature. Three of these six cases converted to CGL. The authors conclude that the cases of Ph1-positive PV and HT are transition forms to CGL, and the cases of Ph1-positive MMM are in fact secondary forms derived from CGL.