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)

Two cases of T-cell chronic lymphoid leukaemia in adults were classified by recently developed immunological methods. Clinically there was splenomegaly, hepatomegaly, marked anaemia, para-aortic lymph nodes, cutaneous infiltration, little peripheral lymph-node enlargement and significant marrow infiltration. Immunological tests of membrane antigens revealed T-cell determinants. T-CLL may differ in its course and prognosis from B-CLL and may require different treatment.
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PMID:[T-cell leukaemia in adults: report of two cases (author's transl)]. 30 81

A 74-year-old Japanese male was admitted because of anemia. Hepatosplenomegaly, lymphoadenopathy, and purpura were not found. The laboratory data on admission revealed that the white-cell count was 9,400/microliters, the hemoglobin 11.1 g/dl, and the platelet count 17,000/microliters. Platelet-associated IgG was 794.2 ng/10(7) cells. The patient was diagnosed as having autoimmune thrombocytopenic purpura (ATP) at this time. He was treated with prednisolone, but his thrombocytopenia not improve. In addition to prednisolone, azathioprine was given to him. During the course of treatment, leukocytosis gradually appeared and the white-cell count reached more than 30,000/microliters with over 70% lymphocytes. A bone marrow aspiration revealed 70% of small lymphocytes, and surface marker analysis showed that CD19 and HLA-DR were positive on these lymphocytes. Southern blotting analysis demonstrated rearrangements of JH and JK. He was finally diagnosed as B-CLL complicated by ATP. One month after the azathioprine administration, the platelet count increased more than 30,000/microliters and the white-cell count decreased less than 10,000/microliters. About 2% of patients with CLL are known to be complicated by ATP. To our knowledge, the present case is the first case of B-CLL complicated by ATP in Japan.
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PMID:[B-cell chronic lymphocytic leukemia complicated by autoimmune thrombocytopenic purpura]. 163 69

The anaemia accompanying chronic lymphocytic leukaemia (CLL) may have different causes (bone marrow infiltration, hypersplenism, immune haemolysis, haemorrhages) and is one of the poor-prognosis features of the disease. Treatment of advanced CLL patients with tumoral-infiltrative anaemia is based on chemotherapy. Nevertheless, some proofs seem to stress the important role played by suppressor T cells on the mechanism of the anaemia in such patients. As a result of these observations, cyclosporin A, a drug with proven efficacy in autoimmune diseases and bone marrow insufficiency, is being used in these cases. Three patients with advanced B-CLL and anaemia, refractory to treatment, received cyclosporin A (8-10 mg/kg, p.o. daily for 2-4 months). One of them recovered from anaemia and thrombocytopenia and is still in this situation after 11 months of suppression of therapy. Two other such cases are revised from the literature, as well as the role played by cyclosporin A in the therapy of CLL.
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PMID:[Treatment with cyclosporin A of the anemia associated with chronic lymphatic leukemia]. 214 38

In vitro studies were performed in a patient with B-cell chronic lymphocytic leukemia who developed pure red cell aplasia (CLL-PRCA). The patient's irradiated circulating mononuclear blood cells and supernatant markedly inhibited normal marrow erythroid (but not granulocyte-monocyte) progenitor colony proliferation. In contrast, irradiated peripheral blood mononuclear cells and supernatant obtained from a B-CLL patient (Rai stage III) and from a hematologically normal donor, did not affect hematopoietic progenitor colony growth. These findings suggest that the anemia of CLL-PRCA evolves different mechanisms of those causing anemia in CLL, and is mediated through cellular and secretory mechanisms.
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PMID:Circulating mononuclear cells from pure red cell aplasia of chronic lymphocytic leukemia suppress in vitro erythropoiesis. 250 95

A 78-year-old woman, who had axillary lymphadenopathy but no hepatosplenomegaly, was admitted because of lymphocytosis. The leukocyte count was 18.1 x 10(9)/l with 72% abnormal cells. Neither anemia nor thrombocytopenia was present. Many abnormal cells and erythroblasts were seen in the bone marrow. These abnormal cells had irregular nuclei but no granules in the cytoplasm. The surface markers of these cells were positive for E-rosette, CD 2, CD 3, and Leu 7 but negative for CD 4, CD 8, CD 11 (OKM 1), CD 16 (Leu 11), and HLA-DR. The DNA analysis revealed the rearrangement of T-cell receptor beta-chain genes. Direct Coombs test was positive and red-cell life-span (51Cr) was T 1/2 = 19.5 days. The patient was diagnosed as having T-CLL with mild autoimmune hemolysis and was followed without treatment. Seven months later, the leukemia cells of peripheral blood increased to 62.6 X 10(9)/l and the frank autoimmune hemolytic anemia developed. After prednisolone, vincristine and cyclophosphamide were administered, leukemia cells of blood decreased. Anemia with reticulocytopenia, however, persisted and direct Coombs test became negative. In the bone marrow at that time, many neutrophils and megakaryocytes besides leukemia cells were preserved, but erythroblasts were hardly seen, namely a pattern of red cell hypoplasia was observed. The patient deteriorated rapidly and died 26 months after initial recognition of lymphocytosis. When complement was added, the patient's serum obtained during red cell hypoplasia but not during autoimmune hemolysis inhibited BFU-E and CFU-GM in in vitro colony assays. This case indicates that not only B-CLL but also T-CLL is accompanied by immune hematocytopenia.
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PMID:[Red cell hypoplasia following autoimmune hemolytic anemia associated with T-CLL: report of a case and review of the literature]. 250 1

Clinical and biological data have been evaluated, using both univariate and Cox's multivariate statistical analyses, in a series of 133 Chronic Lymphocytic Leukemia (CLL) patients with a mean age of 46.6 years (range 31-50). In univariate analyses, anemia (Hb less than 13 g/dl), peripheral blood (PB) lymphocytosis (greater than 40 x 10(9)/l) and bone marrow (BM) lymphocytosis (greater than 80 per cent) were shown to be of significant prognostic value. Multivariate analysis, through a forward stepwise procedure, showed that the most important and independent variable is the BM lymphocytosis. These results are different from those obtained in previous studies and particularly in a recent identical study performed by the same Cooperative Group on 1777 patients with a mean age of 64.2 years (Mandelli et al., 1987). No significance can be demonstrated in stratifying this series of younger patients according to different staging methods (Rai et al., 1975; Binet et al., 1981b; Mandelli et al., 1987). Therefore this population of CLL patients, with less than 50 years of age, has risk factors quite different from classical CLL. The results of the present study show that the diagnostic approach to B-CLL in younger adults must be more complete: using the common diagnostic criteria, established staging systems appear to be inadequate in this series of younger patients.
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PMID:Chronic lymphocytic leukemia (CLL) in younger adults: a retrospective study of 133 cases. 292 Oct 8

The clinical and laboratory findings as well as the immunological cell phenotype of nine patients with chronic T-cell lymphocytosis (T-CL) are presented. The clinical course was stable in most patients and only one patient died. Splenic enlargement was the main clinical finding and in contrast to B-CLL the age at presentation was lower; T-CL predominated in females and lymphadenopathy was rare. The lymphocyte count was moderate (range 4.1-23.8 X 10(9)/L). Six patients displayed neutropenia; in contrast, anaemia was only observed in one patient and thrombopenia in another. The immunological cell phenotype was heterogeneous: four cases exhibited a cytotoxic/suppressor phenotype, two a helper phenotype and in the remaining three cases mixed OKT4+ and OKT8+ lymphocytes were observed; these results suggest that T-CL may originate from different T-cell subsets. Although the question of the benign or neoplastic nature of the T-CL remains open, some of the characteristics of the immunological phenotype could provide additional evidence to demonstrate the malignant condition of the process: in contrast to normal lymphocytes (CD5+, CD7+) the lymphocytes in T-CL were generally CD5 +/-, CD7-, and one patient showed an aberrant phenotype (OKT3+, OKT6+), an occasional finding in other T lymphoproliferative disorders.
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PMID:Heterogeneity of chronic T-cell lymphocytosis: immunological and clinical aspects. 349 59

In Taiwan, as in other areas of Asia, the incidence of chronic lymphocytic leukemia (CLL) is low. A retrospective analysis was conducted to elucidate the clinicopathologic features of CLL patients in Taiwan. Of the 47 cases of CLL enrolled in this study, 45 were immunophenotyped as B-CLL; the other 2 were T-CLL. It was found that the lower the Binet and Rai stages of the B-CLL, the longer patients survive (p = 0.0131 and 0.0142, respectively). Univariate analysis showed that fatigue, splenomegaly, hepatomegaly and anemia are associated with poor survival with p values of 0.0203, 0.0184, 0.0001 and 0.171, respectively. By multivariate analysis with Cox's proportional hazard model, hepatomegaly and decrease in body weight were the two most significant predictors of survival. However, molecular parameters of kappa or lambda immunoglobulin (Ig) gene rearrangement or double allele rearrangement of Ig gene did not significantly increase the predictability of the prognosis.
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PMID:Genotypic characterization and multivariate survival analysis of chronic lymphocytic leukemia in Taiwan. 915 61

B-CLL is the most common adult leukemia in the Western world. It is a neoplasia of mature looking B-monoclonal lymphocytes co-expressing the CD5 antigen (involving the blood, the bone marrow, the lymph nodes and related organs). Much new information about the nature of the neoplastic cells, including chromosomal and molecular changes as well as mechanisms participating in the survival of the leukemic clone have been published recently, in an attempt to elucidate the biology of the disease and identify prognostic subgroups. For the time being, clinical stage based on Rai and Binet staging systems remains the strongest predictor of prognosis and patients' survival, and therefore it affects treatment decisions. In the early stages treatment may be delayed until progression. When treatment is necessary according to well-established criteria, there are nowadays many different options. Chlorambucil has been the standard regimen for many years. During the last decade novel modalities have been tried with the emphasis on fludarabine and 2-chlorodeoxyadenosine and their combinations with other drugs. Such an approach offers greater probability of a durable complete remission but no effect on overall survival has been clearly proven so far. Other modalities, included in the therapeutic armamentarium, are monoclonal antibodies, stem cell transplantation (autologous or allogeneic) and new experimental drugs. Supportive care is an important part of patient management and it involves restoring hypogammaglobulinemia and disease-related anemia by polyvalent immunoglobulin administration and erythropoietin respectively.
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PMID:B-chronic lymphocytic leukemia: practical aspects. 1220 55

B cells in chronic lymphocytic leukaemia (CLL) usually express the CD5 antigen, which appears to participate in the pathogenesis of autoimmune phenomena. However, 7-20% of B-CLL patients are CD5-. The aim of this study was to assess whether CD5 expression could be used as a discriminating factor for two subgroups of B-CLL. Twenty-nine CD5- B-CLL patients were compared in terms of clinico-biological characteristics and survival with a control group of 29 sex- and age-matched, consecutive CD5+ B-CLL subjects. B-CLL was considered to be CD5- when less than 5% of mononuclear cells expressed CD5 after subtraction of the number of T cells. Splenomegaly, lymph node involvement, and haemolytic anemia were found in CD5+ patients in a significantly higher proportion than in their CD5- counterparts, who presented with an earlier stage of disease. CD5- patients had a median survival of 97.2 (22-130) months, exceeding CD5+ subjects significantly [84.0 (19-120) months, p = 0.0025]. CD5- patients seemingly present with milder disease and have a favourable prognosis compared with the vast majority of B-CLL patients who express CD5.
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PMID:The prognostic role of CD5 negativity in B-cell chronic lymphocytic leukaemia: a case-control study. 1261 81


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