[The use of cyclophosphane in the immunodepressive therapy of severe aplastic anemia]. / Ispol'zovanie tsiklofosfana v immunodepressivnoi terapii tiazheloi aplasticheskoi anemii.

Low course doses of cyclophosphamide (1.9 +/- 0.2 g) were given to postsplenectomy patients with grave aplastic anemia (GAA). A total of 27 patients aged 14-42 years were treated, 27 control GAA patients did not receive cyclophosphamide. The cyclophosphamide therapy was controlled by T-lymphocyte functional activity assessed in active rosette formation test with levamisole in vitro. 19 (70.3%) patients were treated twice. The remission was achieved in 22 patients (81.5%), partial response was in 1 patient (3.7%), 4 patients died (14.8%). In control subjects the remission was recorded only in 4 subjects, 23 patients died 3 to 12 months after splenectomy. It is evident that low-dose courses of cyclophosphamide are highly effective in case of control over immunological activity of the pathological process.

The monitoring of acute leukemia patients: Part 1. Basic morphometric characteristics of bone marrow blast cells in acute lymphoblastic leukemia.

Morphologic types L1 and L2 (FAB) of acute lymphoblastic leukemia were classified by computer morphometry of bone marrow blast cells in 57 patients. Measurements were made on MOP-Videoplan Analyser (Reichert) by means of cell image contouring. The decision rule that had been deduced by us on the basis of multidimensional analysis of variance in two-cell training sets, and the selection of the following combination of the best discriminating features [the discriminant coefficients are in brackets: maximal nuclear diameter (-0.338), nuclear perimeter (-6.145), cell area (-0.044), nuclear area (1.007), relative nucleoli eccentricity (-0.279), cytoplasmic/nuclear relation (-5.920) and integral nucleoli area (-0.640)] were used for computer classification of L1 and L2 blast cells. The threshold score for discriminant function in this case was -117.766. Complete clinical remission rates in L1 ALL appeared to be higher than in L2 but remission duration in those groups did not differ significantly. The morphometric parameters of leukemic cells seem to characterize their maturity or their position in cell cycle phases and may be used in acute leukemia patient monitoring.

[The prognostic significance of parameters of bone marrow blast cell proliferation in patients with acute leukemia]. / Prognosticheskoe znachenie parametrov proliferatsii blastnykh kletok kostnogo mozga u bol'nykh ostrym leikozom.

Percentage of bone marrow blasts in S-phase (S%) in acute leukemia patients was evaluated by 3H-thymidine autoradiography or Feulgen cytophotometry at the initial acute period before chemotherapy. In acute lymphoid leukemia (ALL) patients who showed complete remission (CR) S% was 8.6 +/- 1.8% versus 2.1 +/- 0.4% in cases without CR (p less than 0.001). In acute non-lymphoid leukemia (ANLL) the corresponding values were 11.4 +/- 1.4% and 8.3 +/- 1.8%, p greater than 0.05. A negative correlation was observed between S% and the duration of CR in ALL: S% was 13.0 +/- 0.7% in CR, more than 12 months, and 6.9 +/- 1.1% in CR less than 12 months (p less than 0.01). The duration of life also correlated negatively with S%. In ALL S% was 9.5 +/- 1.5% for patients with survival less than 12 months versus 6.2 +/- 0.6% for patients with survival more than 12 months (p less than 0.05). In ANLL the difference (10.3 +/- 1.6% and 6.8 +/- 1.2, respectively) was not significant (p greater than 0.05). Thus in ALL the correlations between S% and the probability to achieve CR is positive, while the correlations between S% and survival and remission duration are negative. In ANLL these correlations are statistically insignificant.