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Query: UMLS:C0023418 (leukemia)
 93,477 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Therapy-related acute nonlymphocytic leukemias occur with increasing frequency owing to modern aggressive antineoplastic therapies. Out of 3,138 bone marrow trephine biopsies, there were 148 cases of acute nonlymphocytic leukemias. Of these, 14 cases occurred 30-156 months following chemotherapy or radiotherapy or both for malignant disease. The male/female ratio was 0.27 (vs. 1.6 of "de novo" leukemias). Primary malignancies (7 Hodgkin's disease, 1 fibrosarcoma and 6 carcinomas) had been treated with chemotherapy+radiotherapy (10 cases), with chemotherapy alone (3 cases) or with radiotherapy alone (1 case) and were apparently cured. All therapy-related leukemias were heralded by a preleukemic cytopenic phase. Response to therapy was poor (mean survival 3.9 months). Bone marrow histopathological findings showed in 13 cases acute myelo- or monoblastic leukemia and in 1 case erythroleukemia. Out of 21 biopsies, there were increased numbers of abnormal megakaryocytes in 10, megaloblastic dyserythropoiesis in 7, and fibrosis in 13 (moderate in 11 cases and severe in 2, with dry tap). Therapy-related acute leukemia appears to be a distinct clinical-pathological entity. Bone marrow trephine biopsy is useful because of the frequency of fibrosis, the possibility of dry tap, and the characteristic histopathological findings that make diagnosis possible also in the preleukemic phase.
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PMID:Bone marrow histopathology of acute nonlymphocytic leukemia following therapy for primary malignancies. 647 85

To determine how alterations of megakaryocyte proliferation will affect platelet production, we measured mean platelet volume (MPV), platelet volume heterogeneity, platelet count, and mean megakaryocyte ploidy in 42 patients. In normal subjects, mean platelet volume and megakaryocyte ploidy were related inversely but nonlinearly to platelet count, whereas mean platelet volume and platelet volume heterogeneity were related directly. In patients with immune thrombocytopenic purpura (low platelet count, MPV above normal, and increased megakaryocyte ploidy), and in those with reactive thrombocytosis (high platelet count, low MPV and megakaryocyte ploidy), the relation of MPV to megakaryocyte ploidy, platelet volume heterogeneity, and platelet count resembled or extended the relations found in normal subjects. By contrast, in patients with aplastic anemia or megaloblastic anemia, or in patients who were undergoing chemotherapy for leukemia, heterogeneity was increased abnormally at any MPV, and both MPV and megakaryocyte ploidy were substantially lower, at any platelet volume, than in normals or the above other groups. The most common ploidy class was 8N in all patients, and the mean megakaryocyte ploidy correlated directly and linearly with mean platelet volume. The data show that bone marrow with megakaryocytes of higher ploidy produces platelets that are both larger and more heterogeneous.
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PMID:The relation of megakaryocyte ploidy to platelet volume. 653 64

A patient is described who appeared to demonstrate modulation of acute myelogenous leukaemia with vitamin B12 deprivation. Support for this observation was obtained via an in vitro bone marrow blast cell assay. The addition of B12 to this patient's bone marrow in vitro significantly stimulated the colony forming ability of the blast cells. Patients with B12 deficiency have an increased incidence of haematopoietic malignancies and excessive replacement of B12 may in some cases have the potential of accelerating such disorders. Intensive B12 replacement in refractory megaloblastic anaemias should be done with caution.
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PMID:Acute myelogenous leukaemia modulated by B12 deficiency: a case with bone marrow blast cell assay corroboration. 659 92

The morphologic and clinical features of four patients who developed significant bone marrow and blood dyspoiesis after successful chemotherapy for acute nonlymphocytic leukemia (ANLL) are described. This postleukemic dyspoiesis developed 1-6 months after leukemia induction therapy and persisted for 5-20 months in a relatively stable state. This period of prolonged dyspoiesis was not associated with rising myeloblast counts or clinical evidence of relapse. Dyspoietic abnormalities developed while two patients were receiving maintenance chemotherapy; the other two patients received no maintenance therapy. The dyspoietic changes in these four patients greatly exceeded those noted in a control group of ANLL patients on maintenance chemotherapy. The morphologic features of postleukemic dysmyelopoiesis were similar to those described in preleukemic dysmyelopoietic disorders. Erythroid abnormalities included hyperplasia with ring sideroblasts, megaloblastic changes, and cytoplasmic PAS reactivity. Myeloid abnormalities consisted of left-shifted granulopoiesis with hyper- and hyposegmentation; megakaryocytic abnormalities included hyperplasia with a predominance of hypolobulated forms. Three of the four patients eventually suffered relapse and have died. The fourth patient died of sepsis after 20 months of pancytopenia and dysmyelopoiesis. Theories to explain the development of postleukemic dysmyelopoiesis are presented which emphasize the possibility of drug-induced leukemia cell differentiation. Cytogenetic studies will be necessary to establish any relationship between ANLL and the subsequent postleukemic dysmyelopoiesis.
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PMID:Postleukemic dysmyelopoiesis. 665 Apr 93

Acute nonlymphocytic leukemia developed in a 57-year-old woman following adjuvant therapy with melphalan for ovarian carcinoma. Maturation of differentiating marrow myeloid and erythroid precursors was megaloblastic. The serum vitamin B12 level was low, and Schilling test revealed vitamin B12 malabsorption correctable with intrinsic factor. Megaloblastic maturation of the marrow cells was converted to normoblastic following treatment with vitamin B12 and folic acid. However, blast cells persisted in the marrow, and cytogenetic analysis revealed aneuploidy and trisomy 18. In contrast to the marrow blast cells, there was a decline in circulating blast cells following vitamin replacement, suggesting that these cells were capable of maturation but required vitamin B12 for this purpose.
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PMID:Unusual case of acute leukemia. Coexisting acute leukemia and pernicious anemia. 673 67

Three types of experiments have been used to study the metabolism of thymine nucleotides by human cells. (1) Cells were labelled continuously with [3H]thymidine and the incorporation of label into DNA compared with the specific radioactivities of pools of individual thymine nucleotides separated by chromatography on polyethylene-imine-cellulose. (2) Cellular thymine nucleotides were labelled with [3H]thymidine at 13 degrees C, followed by incubation at 37 degrees C in unlabelled medium. Incorporation of label into DNA and loss of label from the nucleotide pools were monitored during the 'chase' period at 37 degrees C. (3) The experiments described in (2) above were repeated in the presence of the DNA-synthesis inhibitor cytosine arabinoside, in order to demonstrate more clearly and to quantify degradative pathways for thymine nucleotides. In phytohaemagglutinin-stimulated lymphocytes and in bone-marrow cells, only a proportion (25-60%) of labelled thymine nucleotide was incorporated into DNA, the rest being rapidly degraded and lost from the cell. In contrast, an established cell line (HPB-ALL) from a patient with acute lymphoblastic leukaemia of thymic origin incorporated 100% of its exogenously labelled thymine nucleotides into DNA. These results indicated that alternative metabolic routes are open to thymine nucleotides in human cells. In lymphocytes from patients with megaloblastic anaemia and in normal lymphocytes treated with methotrexate, the utilization of labelled thymine nucleotides for DNA synthesis was more efficient than in controls. These results offer an explanation for the observation of a normal pool of thymidine triphosphate in the cells of patients with untreated megaloblastic anaemia even though the amount of this compound available for DNA synthesis appears to be decreased.
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PMID:Alternative metabolic fates of thymine nucleotides in human cells. 694 67

Chromosomes of bone marrow from 28 patients with acute nonlymphocytic leukemia (ANLL) (26 with AML, 2 with AMMoL), 19 of whom had chromosome abnormalities, were studied; 11 cases exhibited previously unreported karyotypic abnormalities. The marrows of two cases had 8-21 translocations associated with an iso-X chromosome in the female patient and with 9q13- and a missing Y in the male patient. Usually, AML patients with a 8-21 translocation have been considered to have a good prognosis; however, our cases had rather short survival times. Therefore, the prognosis of AML with an 8-21 translocation but associated with other abnormalities is still not clear. Centromere spreading (CS), which was originally reported in marrow cells of megaloblastic anemia (B12 and folic acid deficiency), was detected in leukemic cells, disappeared during remission, and reappeared on relapse. These findings suggest that CS may be a new type of abnormality in AML. In two patients with atypical hypoplastic anemia and hemolytic anemia, chromosome abnormalities were detected at the anemic stage. One case with CS was associated with atypical hypoplastic anemia and developed AML after 1 year; the other with 48,XY,+i(1q),+3,/12 and -14 had hemolytic anemia and developed AMMoL 3 weeks later. Interestingly, identical clones were detected both before and after the clinical diagnosis of leukemia. These cases strongly support the concept that some chromosome abnormalities precede the clinical manifestations of leukemia. The present study also revealed that lymphocytes in ANLL respond poorly to PHA in the presence of high numbers of blasts but do respond well to mitogens during remission. Therefore, the response of lymphocytes to PHA may serve as one criterion for determining remission.
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PMID:Diagnostic and prognostic significance of chromosome abnormalities in marrow and mitogen response of lymphocytes of acute nonlymphocytic leukemia. 695 Aug 4

Quantitative and qualitative investigations of the erythropoiesis in the sternal marrow of untreated 52 patients with a plasmacytoma and 46 patients with a chronic lymphatic leukaemia resulted in about half the cases in an indicated or more distinct megaloblastic disturbance of maturation in a part of the erythroblasts. These changes of the erythroblastic cells might be the expression of a neoplastic transformation and of a disturbance of the differentiation of the pluripotent stem cells in these diseases.
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PMID:[Megaloblastic maturation disorder of erythropoiesis in plasmacytoma and chronic lymphatic leukemia]. 708 May 58

This report describes a patient referred at 14 years in 1971, after one year's surveillance by the family physician, for a persistently elevated erythrocyte sedimentation rate, leukopenia, and relative lymphocytosis. Despite the documented myeloproliferative syndrome of seven years, significant physiologic impairment precluding strenuous ranching and rodeo work appeared only in the last six to nine months. Throughout the clinical course characterized by pancytopenia, refractory and somewhat megaloblastic anemia partially responsive to oxymetholone, and subacute myeloblastic leukemia, he showed a persistent double trisomy--48, XY, +8, +21 in bone marrow. This report reiterates the value of chromosome analysis in the study of hematologic disorders and, in addition, emphasizes the need to individualize each patient's prognosis.
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PMID:Myeloproliferative disorder with unusual marrow chromosome constitution. 727 50

Increased numbers of bone marrow mast cells were found in 45 (2.2%) of 2,000 bone marrow specimens obtained from patients who had hematologic disorders. Mast cells were most frequently seen in the marrows of patients who had preleukemic syndromes, lymphoproliferative disorders, and acute leukemia. The 16 patients who had preleukemic syndromes included those with refractory sideroblastic and megaloblastic anemia (with or without an excess of blasts), idiopathic pancytopenia or pure erythrocytic aplasia, paroxysmal nocturnal hemoglobinuria, idiopathic refractory neutropenia, agranulocytosis or thrombocytopenia, and persistent eosinophilia. Five of the seven patients who had acute leukemia had nonlymphoblastic leukemia; two had blastic crisis of chronic granulocytic leukemia. Of the 13 patients who had lymphoproliferative disorders, eight had chronic lymphocytic leukemia, three had macroglobulinemia, and two had non-Hodgkin's lymphoma. Three patients who had chronic renal failure associated with severe anemia and two who had chronic liver disease, splenomegaly, or hypersplenism were also encountered. In this study there appeared to be a consistent relationship between the presence of increased numbers of mast cells and the lymphocyte and plasma cell counts in the bone marrow. The significance of the presence of secondary mastocytosis in premalignant lesions, neoplasia, and, in particular, lympho- and myeloproliferative disorders, is still unclear.
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PMID:Increased bone marrow mast cells in preleukemic syndromes, acute leukemia, and lymphoproliferative disorders. 745 27


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