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Query: UMLS:C0002871 (anemia)
 52,094 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We have studied the clinical and laboratory features of 53 cases of chronic myelomonocytic leukaemia (CMML) defined according to the FAB criteria. A granulocyte count of greater than 16 X 10(9)/l or a monocyte count of greater than 2.6 X 10(9)/l correlated with a poorer survival, but the best predictor of poor survival was the modified 'Bournemouth' score in which one point each was allocated for Hb less than 10 g/dl, neutrophils less than 2.5 X 10(9)/l or greater than 16 X 10(9)/l, platelets less than 100 X 10(9)/l and bone marrow blasts greater than 5%. A score of 2 or more was predictive of poor survival (Chi2 = 10.25; P less than 0.001). Those patients with low monocyte and neutrophil counts and a low modified Bournemouth score tended to have a clinical course similar to refractory anaemia (RA) with an indolent course not requiring treatment and long survival whereas those with high monocyte and neutrophil counts and a high modified 'Bournemouth' score have a clinical course resembling that of refractory anaemia with excess of blasts (RAEB).
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PMID:Prognostic features of chronic myelomonocytic leukaemia: a modified Bournemouth score gives the best prediction of survival. 342 15

In 27 patients initially diagnosed as refractory anaemia (RA) or RA with sideroblasts (RA-S) according to the FAB-classification a number of clinical, morphological and cytogenetic parameters were correlated for prognostic significance. From these correlations it emerged that severe cytopenia is centrally positioned with regard to clinical course in RA and RA-S. Positive correlations were found to initial diagnosis, clonal cytogenetic abnormalities, progression to RA with an excess of blasts (RAEB) or acute myeloid leukaemia (AML), the percentage of bone marrow blast cells and prolonged half life for radioactively labeled iron. The degree of peripheral blood granulocytopenia, alone, was correlated to bone marrow hypoplasia. Moreover, the frequency of abnormal karyotypes was inversely correlated to bone marrow cellularity and proportional to the frequency of bone marrow blast cells. From these relationships it may be proposed that chromosome abnormalities are associated with prolonged blast cell generation times and inhibition of blast cell maturation resulting in reduced marrow cellularity and blast cell accumulation, and, in the peripheral blood, falling percentages of neutrophil granulocytes. With the blast cell accumulation the bone marrow cellularity again becomes hyperplastic and the preleukaemic condition is transformed into RAEB or AML.
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PMID:Prognostic significance of some clinical, morphological and cytogenetic findings in refractory anaemia (RA) and RA with sideroblasts. 345 30

A 79-year-old patient with acute myeloblastic leukemia (M2 type in FAB), who has survived more than 5 years, is reported. She was admitted because of fever and anemia. Her white blood cell count was 6200/mm3 with 58% blasts. Bone marrow aspiration showed a nucleated cell count of 26 X 10(4)/mm with 84% blasts, Complete remission was achieved within one month by DCMP two-step method therapy. She relapsed in the third and fifth years after initial therapy. Because leukemic change is atypical, she was treated with a low dose of Ara-C therapy, resulting in complete remission. In cases of acute myelobastic leukemia in elderly patients, long-term survival is rare. However in this case, follow-up has succeeded for 5 years. This patient is the oldest case of acute myeloblastic leukemia ever reported in Japan.
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PMID:[Long-term survival in an elderly patient with acute myeloblastic leukemia]. 347 33

Two independent observers performed a double review of cytological and histological bone marrow material obtained at diagnosis and during follow up in 34 patients with the myelodysplastic syndrome (MDS), subtypes refractory anaemia (RA) and RA with ringed sideroblasts (RA-S) (26 and 8 patients, respectively). Average values were used for the analyses. Data obtained at diagnosis confirmed earlier observations that a worse prognosis was indicated by high blast cell counts (P less than 0.01), presence of blast foci and clonal cytogenetic abnormalities (P = 0.08). Data obtained during follow up, in addition, showed that an increased probability of progression to FAB-subtype RA with an excess of blasts was related to both the occurrence of blast foci (P less than 0.05) and the occurrence of new or additional clonal abnormalities (karyotype shift) (P less than 0.01). The relationship between parameters investigated at diagnosis, during follow up, and in the pooled material, points to RA-S being a separate entity having a better prognosis than RA, and further substantiates an earlier observed relationship between blast cell accumulation and the frequency of cytogenetically abnormal metaphases.
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PMID:The prognostic significance of cytological, histological and cytogenetic findings in refractory anaemia (RA) and RA with sideroblasts. A follow up study. 382 39

An analysis of clinical, haematological, histological and cytogenetic data was performed in 85 consecutive patients with myelodysplastic syndromes (MDS). The criteria for diagnosis of refractory anaemia (RA), acquired idiopathic sideroblastic anaemia (AISA) and chronic myelomonocytic leukaemia (CMML) were clearly defined, since the inclusion criteria provided by the FAB co-operative group are imprecise. None of these patients has received chemotherapy during the follow-up period. The median survival of the whole group was only 15 months, with less than 10% of the patients surviving after 5 years. Fifteen patients (17.6%) were still alive at time of analysis, 31 (36.5%) have developed acute myeloid leukaemia (AML) and only one of them is still alive; 30 (35.3%) died of infectious and/or haemorrhagic complications. Patients who developed AML had a shorter survival (median survival time 9.5 versus 15 months) but this difference was not significant (P = 0.10). Factors with prognostic value are in order of significance: abnormal localized immature myeloid precursors (= ALIP) in the trephine biopsy, circulating myeloblasts, excess of blasts in the bone marrow smears, age, FAB classification and granulocyte count. In comparison to refractory anaemia with excess of blasts (RAEB), CMML and RAEB in transformation (RAEBt), patients with RA and AISA had a lower incidence of evolution to AML (11% versus 56%), but a higher mortality rate from infections and/or bleeding (59.2% versus 29%). ALIP negative cases were only found among patients with RA and AISA, whereas ALIP positivity was observed in all cases of RAEB and RAEBt, in 10/11 patients with CMML and in almost half the cases of RA and AISA. In RA and AISA patients survival was significantly different between ALIP positive and ALIP negative cases (P = 0.009). Among MDS patients, ALIP negative cases developed significantly less AML than ALIP positive cases (5% versus 44%), but a similar percentage of mortality from infectious and/or haemorrhagic complications was seen in both groups (33% versus 36.5%). Chromosomal analysis proved to be of no significant prognostic value, although a trend for shorter survival was observed in patients with complex karyotype anomalies or without mitoses. Because of their prolonged survival, antileukaemic chemotherapy is contra-indicated in ALIP negative patients (median survival 50 months). Nevertheless they only constitute a minor subgroup of MDS cases. Prognosis in ALIP positive patients is poor (median survival 12.5 months); in these patients therapeutic trials with cytostatic drugs or with inducers of differentiation of myeloid precursor cells seem to be justified.
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PMID:Prognostic factors in the myelodysplastic syndromes: importance of initial data on peripheral blood counts, bone marrow cytology, trephine biopsy and chromosomal analysis. 385 19

The authors write their personal experience in 205 children with lymphoblastic leukemia. The disease has its peak incidence between 5 and 14 years, showing a preference for females and white individuals. The clinical form of presentation was "complete" (66.8%) or "incomplete" (33.2%). Most of the symptoms were due to leukemic infiltration of bone marrow and some other tissues. The amount of leukocytes was variable; most of the cases showed anemia and thrombocytopenia. However, a few patients had normal values of hemoglobin and platelets, whose prognostic significance is discussed. After the FAB classification, the L1 variety predominated. About 3.9% of the patients showed radiological bone alterations suggesting acute leukemia.
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PMID:[Clinico-hematic study of lymphoblastic leukemia of childhood]. 387 Apr 23

An identical translocation between the long arm of chromosome no. 1 and the short arm of chromosome no. 15 was found in two unrelated patients with refractory anaemia type I, according to the FAB classification of myelodysplastic syndromes. In the first patient the typical translocation was associated with anomalies commonly found in preleukaemic states, i.e. a 5q- and a 20q- chromosome. Furthermore, in both patients the long arm of chromosome no. 1 was trisomic. Cytogenetic follow-up in the second patient demonstrated a proliferative advantage of the cells bearing a t(1;15) translocation over the cells with trisomy 8 as well as over normal cells. This karyotypic evolution, however, was not accompanied by a transformation of the haematological disorder into acute leukaemia.
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PMID:An identical translocation between chromosome 1 and 15 in two patients with myelodysplastic syndromes. 395 64

72 patients were diagnosed as suffering from myelodysplastic syndromes (MDS) according to the FAB classification: 16 patients with refractory anaemia (RA), 11 patients with acquired idiopathic sideroblastic anaemia (AISA), 14 patients with refractory anaemia with an excess of blast cells (RAEB), 7 patients with RAEB in transformation (RAEB/t) and 24 patients with chronic myelomonocytic leukaemia (CMML). The duration of the preleukaemic phase was between 2 and 189 months (median: 15 months); RAEB in transformation and CMML showed a median phase of less than 12 months. Transformation into acute leukaemia (AL) occurred in 46 patients (64%). Of the clinical signs only thrombocytopenia was a significant poor prognostic factor (p less than 0.01). Cytogenetic studies were made in 31 patients. 14 had clonal aneuploidy: these patients had a higher risk of AL, but not a significantly shorter preleukaemic phase (p greater than 0.1). Stem cell cultures (CFUc) were carried out in 31 patients. Patients without colony growth or only cluster growth showed a high incidence (10/11 and 8/8) of transformation into AL; preleukaemic phases were significantly shorter than in patients with normal colony growth or cluster + colony growth in all FAB subgroups (p less than 0.001). The bone marrow blast cell count was indirectly proportional to the duration of the preleukaemic phase: thrombocytopenia, cytogenic aberrations and failure of in vitro colony growth are additional poor prognostic factors in MDS.
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PMID:[Prognostic factors in myelodysplastic syndromes: analysis of 72 cases]. 398 46

Three children with myelodysplastic syndromes (MDS) are described following the diagnostic criteria proposed by the FAB-cooperative group. Two of the children were of Turkish origin. Two cases fit the criteria for 'refractory anaemia with excess of blasts in transformation'. The other one is most consistent with 'chronic myelomonocytic leukaemia'. The patients received 'ANLL type' induction. One died during induction, two were grafted, of whom one survives.
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PMID:Myelodysplastic syndromes in childhood: three case reports. 400 74

A 79 year old man with a history of myocardial infarction and cerebral infarction was admitted to our hospital in August, 1982. The hematological examination showed anemia and leukopenia (myeloblast 12%), and bone marrow aspiration confirmed the diagnosis of acute myeloblastic leukemia (FAB, M2). Because his general condition was poor, he was treated with small dose of Ara-C (10 mg/m2/12 hr, subcutaneous injections), obtaining complete remission. In cases of acute myeloblastic leukemia in elderly patients where other intensive treatments are contraindicated, it appears to be useful to employ a method of small dose of Ara-C therapy.
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PMID:[Small dose of ARA-C in the treatment of an elderly patient with acute myeloblastic leukemia]. 657 83


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