Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0002871 (anemia)
 52,094 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fifty four cases of CLLB were studied from 1st of April. 1990 to October 30, 1993; 35 male and 19 female (M:F = 1.8:1) in age 39-76 years (median age = 62 years). 81% patients had lymphadenopathy, 30%--hepatomegaly, 31% splenomegaly, 24% had allergic symptoms, 24% had anaemia (7% AINH). 13% thrombopoenia (2% autoimmunologic thrombopoenia). In all cases immunological phenotype of peripheral blood lymphocytes was determined, 100% patients had B cells CD5+, 70% lymphocytes sIg+, 97%-CD19+, 73%-CD23+, 67%-CD22+, 82%-HLADr, 10%-71(TR90), CD10 was negative. There was negative correlation between B CD5+ cells and life span (p < 0.03). There was positive correlation, between CD23 and bulky diseases (p < 0.01). Percentage of T cells with CD2+, CD3+, CD4+, CD8+ and CD4:CD8 was diminished. Lymphocytosis T with antigens CD2+, CD3+, CD4+, CD8+ was enhanced. There was found a positive correlation between lymphocytosis CD2+ (p < 0.00009), CD4+ (p < 0.008), CD8+ (p < 0.0008) and blood lymphocytosis and positive correlation between T lymphocytosis CD2+ (p < 0.02), CD4+ (p < 0.002) and lymphocytosis bone marrow.
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PMID:[Chronic lymphatic leukemia from B CD5+ cells: characteristics, clinical and laboratory features, and immunophenotyping]. 865 49

The transgenic (tg) expression of interleukin (IL)-4 under the control of a major histocompatibility complex (MHC) class I promoter leads to B cell hyperactivity in mice, characterized by increased B cell surface MHC class II and CD23 expression, elevated responsiveness of the B cells to polyclonal ex vivo stimulation, and increased immunoglobulin (Ig)G1 and IgE serum levels. Tg mice develop anemia, glomerulonephritis with complement and immune deposition in the glomeruli, and show increased production of autoantibodies. Treatment of IL-4 tg mice with anti-IL-4 neutralizing antibodies protected the mice from disease development, showing that IL-4 was responsible for the observed disorders. Deletion of superantigen responsive autoreactive T cells in the IL-4 tg mice was normal and treatment of mutant mice with deleting anti-CD4 antibodies failed to ablate the onset of autoimmune-like disease, suggesting that CD4+ T cells were not the primary cause of the disorders. Furthermore, the deletion of B cells reacting against MHC class I molecules was also normal in the IL-4 tg mice. Therefore the most likely explanation for the increased production of autoantibodies and the autoimmunelike disorders is that IL-4 acts directly on autoreactive B cells by expanding them in a polyclonal manner. Taken together our results show that inappropriate multi-organ expression of IL-4 in vivo leads to autoimmune-type disease in mice.
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PMID:Constitutive expression of interleukin (IL)-4 in vivo causes autoimmune-type disorders in mice. 901 81

The present study was designed to investigate the possible relationships of hemoglobin concentrations with serum levels of soluble CD23 molecules (sCD23) and soluble tumor necrosis factor receptors I and II (sTNF-RI and sTNF-RII) in rheumatoid arthritis (RA) patients. Fifty-six patients, eight males and 48 females, and 20 age and sex matched healthy volunteers were enrolled in the study. Patients were classified in two groups on the basis of disease activity: group A included 43 patients with active, and group B 13 patients with non-active RA. Serum sCD23 and sTNF-Rs levels were measured using commercially available micro-ELISA kits. It was found that patients of group A had lower hemoglobin concentrations than patients of group B or normal controls, whereas hemoglobin levels in patients of group B did not differ statistically from the controls. Patients of group A had also significantly higher serum sCD23, sTNF-RI and sTNF-RII concentrations than patients of group B or control subjects. Serum levels of all three cytokines did not differ statistically between patients of group B and normal controls. In the entire group of subjects studied, hemoglobin concentrations correlated inversely with the levels of serum sCD23, sTNF-RI and sTNF-RII, and also with the values of the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) reflecting disease activity. We concluded that anemia and elevated concentrations of sCD23, sTNF-RI and sTNF-RII in RA patients are two biological expressions of the same underlying inflammatory process, although a causal relationship between themselves cannot be excluded and needs further investigation.
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PMID:Hemoglobin levels correlate with serum soluble CD23 and TNF-Rs concentrations in patients with rheumatoid arthritis. 972 1

We report a case of mantle cell lymphoma in leukemic phase, which was diagnosed by a bone marrow biopsy performed as part of a workup for chronic anemia in a patient without lymphadenopathy. The patient, a 79-year-old man with diabetes mellitus, hypertension, chronic renal failure, congestive heart failure, and atherosclerosis, presented with claudication. On admission, he also had an 8-month history of anemia, during which time he experienced a 18-kg weight loss. On presentation, the patient had normal vital signs, anemia, leukocytosis (as well as an absolute lymphocytosis), and splenomegaly; as mentioned, lymphadenopathy was absent. A bone marrow biopsy showed an increase in small to intermediate-sized, slightly irregular lymphocytes in interstitial nodules. Flow cytometric immunophenotyping of the bone marrow identified a monoclonal population of cells, representing 25% of cells within the bone marrow, with expression of CD19, CD20, immunoglobulin M/D, lambda light chain, HLA-DR, and CD5; reactions for CD10 and CD23 were absent. Based on morphologic and immunophenotypic analysis of the bone marrow, as well as morphologic review of the peripheral blood smear, a diagnosis of mantle cell lymphoma involving the bone marrow and in leukemic phase was made. Subsequent polymerase chain reaction analysis of DNA from peripheral blood identified a population of cells with the bcl-1 rearrangement. This case is unique in that the diagnosis of mantle cell lymphoma was made without lymph node or spleen analysis and the patient, although exhibiting bone marrow and peripheral blood involvement by mantle cell lymphoma at presentation, did not have lymphadenopathy.
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PMID:Leukemic phase of mantle cell lymphoma presenting as anemia: diagnosis by combining flow cytometry and cytomorphology. 982 32

Chronic lymphocytic leukaemia (CLL) is the most common form of adult leukaemia in Western countries. The diagnosis requires mature-appearing lymphocytes in the peripheral blood to >5 x 10(9)/L. The immunophenotype typically includes B cell antigens CD19, CD20 and CD23, low expression of surface immunoglobulin and CD5+, with other T cell antigens absent. Bone marrow biopsy, although not required for diagnosis, must show at least 30% lymphocytes. Cytogenetic abnormalities are frequent in patients with CLL, and may be associated with poor prognosis. Clinically, most patients are asymptomatic at presentation, with incidental lymphadenopathy and/or hepatosplenomegaly in the routine physical examination. Infections by opportunistic pathogens are the major cause of death. Aggressive transformation occurs in 10% of patients with CLL, most commonly prolymphocytic leukaemia (PLL) and Richter's syndrome. PLL de novo must be differentiated from PLL of an aggressive transformation. The incidences of autoimmune diseases and solid or haemopoietic secondary malignancies are increased in patients with CLL. Clinical stage is the strongest prognostic factor in CLL. There is no indication for early intervention. The current recommendation to start treatment includes disease-related symptoms, massive and/or progressive hepatosplenomegaly or lymphadenopathy, increasing bone marrow failure, autoimmune disease, and recurrent infections. Alkylating agents (e.g. chlorambucil) and nucleoside analogues (e.g. fludarabine) are the most active agents for CLL. Fludarabine induces higher response rates, but no improvement in overall survival has been observed. Fludarabine is the drug of choice for the majority of patients with CLL. Chlorambucil may be helpful for elderly patients with poor performance, and for patients who do not tolerate fludarabine. No drug combination is better than single agents. For patients refractory to initial treatment, referral to a clinical trial is the best choice. Other salvage therapy includes retreatment with the same initial agent (chlorambucil or fludarabine) if initial response was observed, or fludarabine for patients refractory to chlorambucil. Promising new approaches include cycle-active agents, nelarabine, biological therapy such as anti-CD52 monoclonal antibody, bone marrow transplantation, including the use of submyeloablative preparative regimens ('minitransplant') to induce graft-versus-leukaemia effect, and gene therapy. Prophylactic antibacterials and intravenous immunoglobulin should not be used routinely during supportive care. Epoetin may be helpful for patients who have anaemia without obvious cause. Assessment of response to therapy in CLL has been updated by the National Cancer Institute Working Group, and these guidelines are used worldwide for clinical trials.
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PMID:Management of chronic lymphocytic leukaemia. 1073 61

Diffuse large B-cell lymphoma with haemophagocytic syndrome (BCL-HS) has been reported mainly in Asia and is regarded as a distinct variant of intravascular lymphoma (IVL). However, it is unclear whether all cases of BCL-HS fall within the framework of IVL and available clinical information is limited. We analysed 25 cases with BCL-HS, including 11 autopsied cases (median, 66 years; male-female ratio, 1.1:1). The patients presented with fever, anaemia, thrombocytopenia, hepatosplenomegaly, haemophagocytosis, bone marrow invasion, respiratory disturbance and disseminated intravascular coagulopathy, but usually lacked lymphadenopathy, mass formation, neurological abnormalities and skin lesions. The clinical course was aggressive with a median survival of 7 months. The morphological findings were uniform: large lymphoid cells infiltrated vessels and/or sinusoids of the liver, marrow, lung, kidney and other organs. They were positive for CD19, CD20, CD79a and HLA-DR, but negative for CD10, CD23 and CD30. CD5 was positive in five out of 17 cases. Our critical review indicates that BCL-HS is the equivalent of the Asian variant of IVL.
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PMID:An Asian variant of intravascular large B-cell lymphoma: clinical, pathological and cytogenetic approaches to diffuse large B-cell lymphoma associated with haemophagocytic syndrome. 1112 44

We present the case of a 9-year-old girl from northwestern Greece admitted to our Hospital because of malaise, low-grade fever, intermittent hip joint pain, anemia, leukopenia and thrombocytopenia. The examination of a bone marrow aspirate revealed the predominance of blast cells (97%) with FAB L1 morphology, immunopheno-typically positive for CD19 (95%), CD10 (95%), CD22 (95%), CD13 (82%), CD34 (95%) and CD38 (72%), with dim expression of CD45 and of the intracellular antigen terminal deoxynucleotidyl transferase (Tdt). Only 10% of the blasts expressed HLA-DR. Staining for CD2, CD3, CD5, CD7, CD20, CD23, CD33, CD14, CD15, AC133 and KOR-SA3544 was negative. Blast cells were lacking surface immunoglobulin expression and bcr/abl rearrangements were not detected. Cell cycle analysis revealed a diploid cell population. Karyotypic abnormalities were not identified. The lack of expression of HLA-DR and the presence of myeloid antigen CD13 indicated that it was a rare case of B-precursor ALL with aberrant immunophenotypic characteristics.
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PMID:A case of HLA-DR negative B-precursor acute lymphoblastic leukemia. 1505 8

Helminths are the most prevalent parasitic infections and malaria is the deadliest parasitic disease. Helminths have been reported to be protective against the severe forms of malaria but they were also possibly linked to increased malaria-incidence and gametocyte carriage. Connecting the dots between observations suggests that statistical regularities throughout the evolution of worms and malaria parasites in the same hosts, may have led to the emergence of non-zero interactions as observed in iterated prisoners dilemma games. Thus by protecting the host, helminths protect themselves and their reproductive potential, but also favor the dissemination and reproduction of Plasmodium falciparum. The proximate causes of this evolutionarily stable strategy might be mediated by IgE and the CD23/NO pathway, the protective role of IL10 in helminth-infected patients, and possibly the hematological consequences of worms. The chronic activation of the CD23/NO pathway might be instrumental in downregulating the expression of cytoadherence receptors thus reducing sequestration of parasitized red blood cells in the deep organs. Mild anemia in helminth-infected patients might favor gametocytogenesis and send attractive cues to the vector. This framework leads to numerous testable hypotheses and could explain certain singularities regarding the double edged role of IgE and NO. Among these hypotheses, there are 2 practical ones: the impact of helminths on malaria vaccine candidates, and the theoretical risk of increasing the severity of malaria after anthelmintics. The capacity for increased IgE responses could thus have been vital in our ancestor's wormy and malarious past. Allergies may be what remains of it in the modern world.
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PMID:Interactions between worm infections and malaria. 1514 5

This case report describes a hairy B cell lymphoproliferative disorder (HBLD) with clinical and hematological features resembling hairy cell leukemia. The patient was a 29-year-old female who demonstrated atypical lymphocytes in her peripheral blood. Physical examination demonstrated splenomegaly, but there were no palpable superficial lymph nodes. Hematological examination showed a leukocyte count of 10.6 x 10(3)/mm3 with 41% atypical lymphocytes. Bone marrow examination showed a normal cellular and an atypical lymphocyte count of 42%. The atypical lymphocytes had microvilli and prominent membranous ruffles on their surfaces. Atypical lymphocytes expressed CD5- CD10- CD11c+ CD19+ CD20+ CD23- CD25- on the surface of the cells on examination by with a fluorescence activated cell sorter. Although these findings were similar to hairy cell leukemia, Japanese variant, the surface marker of the kappa chain and lambda chain was unbiased and studies of immunoglobulin gene rearrangements and expression showed polyclonal proliferation of B cells. Therefore, we diagnosed this patient as having HBLD. Because she did not demonstrate anemia or thrombocytopenia, she is not currently receiving medication. To date, the atypical lymphocyte count has not changed.
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PMID:[A hairy B cell lymphoproliferative disorder resembling hairy cell leukemia]. 1516 48

Mantle-cell lymphoma (MCL) is a B-cell malignancy with distinct molecular genetics and pathological features. Peripheral blood involvement has been reported with variable frequency, but information on the natural history of cases presenting with leukemia is lacking. This study aimed to determine the clinical and prognostic features of such cases. We studied clinical features, tumor characteristics, prognostic factors and outcome in 58 patients with leukemic presentation of MCL. Diagnosis was based on morphology, immunophenotype, presence of t(11;14), histology and cyclin D1 expression. The median age was 62 years and male:female 2.4:1. Presenting features included splenomegaly (74%), lymphadenopathy (45%), hepatomegaly (17%) and, in a minority, gastro-intestinal involvement or involvement of Waldeyer's ring; 10% had lymphocytosis alone. Six patients developed central nervous system disease. Median lymphocyte count was 58 x 10(9)/l, 55% had anemia and 17% had thrombocytopenia. Morphology of peripheral blood showed small-cell MCL in 15% of cases, typical MCL in 46% and blastoid MCL in 39%. Immunological markers showed a typical phenotype (CD5+ CD23 -) in 68%, and atypical phenotypes, CD5- CD23- in 17% or CD5+ CD23+ in 15%. CLL scores were 0, 1 or 2 in 96%. Median overall survival was 36 months. Good response to first-line treatment (P = 0.0008) and splenomegaly (P = 0.03) were favorable prognostic factors, while other features including morphology and CD38 expression had no impact on survival or treatment response. This analysis demonstrates that except for splenomegaly, survival of MCL patients presenting with leukemia is not significantly influenced by clinical or tumor characteristics. Splenectomy is a useful treatment option in this group of patients.
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PMID:The leukemic presentation of mantle-cell lymphoma: disease features and prognostic factors in 58 patients. 1537 Feb 45


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