Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023418 (leukemia)
 93,477 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Experience with CNS prophylaxis in 35 children with acute lymphatic leukaemia is reported. Before prophylactic irradiation of the skull was given the average survival time in 36 children was 2,8 (2,7) years. Menigeal leukaemia preceeded bone marrow relapse in 9 cases and followed relapse in a further 5 cases (39%). Between 1971 and 1973 Pinkel's treatment scheme VII was given to 35 children. This included prophylactic skull irradiation and intraspinal MTX injections. 29 children are still in their first remissions which range from 10 - 35 months in length. Meningeal leukaemia has not so far been observed, in this latter group.
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PMID:Prevention of meningeal leukaemia and relapses by cranial irradiation and intrathecal MTX in acute lymphatic leukaemia. 105 42

A 57-year-old man was diagnosed to have essential thrombocythemia (ET) in July 1977. He was doing well with continual medication of carboquone but was hospitalized because of slight unconsciousness and gait disturbance in May, 1988. His laboratory data were as follows: WBC count 81,600/microliters with 55% of blasts with cytoplasmic blebs, Hb 10.2 g/dl, and platelet count 2.6 x 10(4)/microliters. Bone marrow aspiration revealed hypercellular marrow with 72.8% blasts. Chromosomal analysis showed tetraploidy with 7p+ and 19p+. Cytochemistry of blasts showed the positivity for platelet peroxidase and CDw 41. The diagnosis of acute megakaryoblastic leukemia was made. Meningeal leukemia was also suspected by the cerebrospinal fluid data, and cytarabine was intrathecally injected. Then the percent of blasts of peripheral blood gradually decreased and the data of cerebrospinal fluid improved. However, several days later the patient became comatose probably due to cerebral bleeding, and died. In this case, two possibilities were considered (1) that a blastic transformation to acute leukemia from ET, and (2) that a secondary leukemia developed as a result of the chemotherapy, independently of ET. Since there was no evidence of myelodysplastic syndrome, it was concluded that this case represented a blastic transformation of ET.
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PMID:[Acute megakaryoblastic leukemia developing 11 years after diagnosis of essential thrombocythemia]. 194 27

By use of prophylactic CNS therapy, the incidence of meningeal relapse has been dramatically reduced and the length of the initial bone marrow remission has been greatly prolonged in children with acute lymphoblastic leukemia. Pinkel performed a controlled study in which 94 patients were randomized to one of two regimens of presymptomatic CNS therapy, or received no prophylactic CNS therapy. This crucial study showed that prophylactic CNS therapy was very useful both in preventing meningeal relapse and in prolonging the duration of complete remission. Then, many additional regimens for prophylactic CNS therapy were tried on thousands of children worldwide in an effort to improve upon these results. Among the many CNS therapy regimens that were tried, none gave results better than the original St. Jude regimen. Our knowledge of CNS leukemia in general has greatly increased, but the last 20 years have brought us no further significant progress as to improved results in preventing meningeal leukemia. The many novel and innovative CNS therapy regimens that have been tried have yielded essentially the same results as to prevention of meningeal leukemia and as to duration of disease-free survival. Five to ten percent, or fewer in patients at low risk, still show meningeal relapse, and nearly one half of children with ALL still have hematologic relapse within the first 5 years following initiation of therapy. The goal now is to reduce neurotoxicity. Thus, progress has been stymied and we now await some new addition to therapy that will dramatically improve our results. Nonetheless, there are still many promising avenues of research yet to be explored. Meningeal leukemia remains a fascinating and satisfying field of clinical research.
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PMID:Prevention of meningeal leukemia. Review of 20 years of research and current recommendations. 226 87

A three-and-a-half-year-old boy presented in the blastic phase of chronic myelocytic leukaemia (CML) with lymphoblastic infiltration of CNS and testes. The clinical signs and symptoms and also blood and bone marrow findings were otherwise compatible with the chronic phase of the disease, and none of the factors predictive of early transformation were present. Cytogenetic analysis revealed that the Ph1 chromosome, with no additional chromosomal abnormalities, was present in 85% of the bone marrow cells. Meningeal leukaemia is almost unknown in the chronic phase of CML. However, the incidence in the blastic phase may resemble the incidence of CNS leukaemia at diagnosis in children with acute leukaemias. Testicular involvement appears to be extremely rare even in the blastic phase of CML; the "true" incidence may, however, also resemble that of acute leukaemias. This raises the question of the need for testicular and meningeal surveillance and prophylaxis, at least during the blastic phase of CML. One should consider whether the simultaneous meningeal and testicular lymphoblastic leukaemia in this patient was the result of blastic transformation at two independent sites, or whether the testes were seeded from the meninges without identifiable spread to blood and bone marrow.
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PMID:Simultaneous meningeal and testicular lymphoblastic transformation of Ph1-positive chronic myelocytic leukaemia in a three-year-old boy. 228 52

Meningeal leukaemia, developed in 4 female patients with M4 or M5 leukaemia during a period of haematological remission. Polyradicular symptoms and signs dominated neurologically, but 3 patients also exhibited cranial nerve palsies. The neurological findings showed no reversal following intrathecal chemotherapy with normalization of liquor cytology. Patchy demyelinization in the region of the anterior spinal roots and of the proximal segments of the affected cranial nerves were responsible for the neurological features. Peripherally located streaky demyelinization of the olfactory bulb and of the optic chiasm were not found to cause any neurological manifestations.
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PMID:[Acute myelomonocytic and monoblastic leukemia with polyradicular symptoms]. 386 14

The case of a 53-year-old female with a Philadelphia-chromosome (Ph')-positive chronic myeloid leukemia (CML) is reported. In this patient, a first lymphoid blast crisis developed after a chronic period of 20 months. Treatment with vincristine and prednisone was successful. A few weeks later she presented with meningeal leukemia with lymphoid blastic cells in CSF and a facial nerve palsy, while the peripheral blood showed the typical picture of CML. Meningeal leukemia was successfully treated with cranial irradiation and intrathecal chemotherapy. Later on, a second lymphoid blast crisis (blasts of "common acute leukemia" type) was observed. Again, chemotherapy with vincristine and prednisone was successful. After 2 1/2 weeks, however, a third lymphoid blast crisis developed. At this moment, Ph'-chromosome was undetectable in unstimulated cells of the peripheral blood. The question of an additional leukemia is discussed.
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PMID:[Philadelphia chromosome-positive chronic myeloid leukemia with washing out of Ph'-negative lymphoid blasts and with meningiosis: atypical blast crisis or a 2d leukemia?]. 658 70

Seventeen adult patients with previously untreated acute lymphoblastic leukaemia (ALL) were entered into a schedule of chemotherapy in which 3 combinations, each of 4 drugs, were administered in a predetermined cyclical rotation in combination with cranial irradiation and intrathecal injections of methotrexate. Of the 17 patients, 16 completed induction therapy and 15 (94%) entered remission. The only patient with T-ALL died before receiving any therapy. The median survival for all patients (17) was 22 months. Meningeal leukaemia did not occur during the haematological remission phase although 3 patients developed this complication following relapse. The authors conclude that the addition of cyclophosphamide and cytosine arabinoside to vincristine/prednisone provides excellent remission induction but the aggressive maintenance schedule employed has not led to significant long-term survival.
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PMID:Treatment of adult lymphoblastic leukaemia using cyclical chemotherapy with three combinations of four drugs (COAP, POMP, TRAP schedule). 694 94

Meningeal leukemia is a common, often fatal complication of leukemia. Efforts to devise better prophylactic or therapeutic regimens have been limited by large gaps in knowledge regarding the pathogenesis of the process. This report describes a new experimental model of meningeal leukemia that should facilitate its study and fill some of the gaps. T-cell lymphomas, originally induced in C3H mice by Gross murine leukemia virus, were established as transplantable tumor lines in syngeneic mice. Three of ten tumor lines produced meningeal leukemia when injected i.v. into normal recipient animals. The others produced predominantly visceral lymphomas.
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PMID:New experimental model of meningeal leukemia. 742 31

Between 1971 and 1992 neuropathological examinations were performed in 316 patients having died of leukaemia. Among them 73 had acute lymphoid leukaemia, 134 acute myeloid leukaemia, 49 chronic lymphoid leukaemia and 60 chronic myeloid leukaemia. Meningeal leukaemia, which had been a frequent pathological complication at the beginning of the examination period, later had become rarer. The study made it possible to define further neurologic complications, the characteristic neuropathological changes of the different types and some subtypes of leukaemia and to draw clinical consequences. The incidence of cerebral "leukaemic nodules" was twelve times higher in the myeloid than in the lymphoid leukaemias, this may be the explanation for the fact that central nervous system haemorrhage was more frequent in the myeloid types. Subdural haematoma can primarily be expected in acute myeloid leukaemia. The neuropathologic features of chronic lymphoid leukaemia were particular, as no "leukaemic nodules" developed, and meningeal leukaemia was a rare event; at the same time, it was related with the highest incidence of infiltration of the dura mater and the sciatic nerve.
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PMID:[Pathological features of neuroleukemia. Changes and lessons]. 801 23

Sezary cell leukemia (SCL) is a rare T cell neoplasia that has been suggested to be a variant of T-prolymphocytic leukemia (T-PLL). Both disorders have an aggressive clinical course, lymphocytosis with characteristic morphology, lymphadenopathy, hepatomegaly, characteristic cytogenetic abnormalities and mature T cell phenotypes. Skin lesions, however, are mainly found in T-PLL. We describe a patient with T-PLL/SCL, who atypically presented with severe seropositive polyarthritis and skin lesions, responding to treatment with human CD52 antibody, CAMPATH-1H and pentostatin. Meningeal leukemia and an assumed myocardial infiltration subsequently developed. Polyarthritis is common in T large granular lymphocyte leukemia and adult T cell lymphoma-leukemia, but both entities could be ruled out in the present case. In rheumatoid arthritis, an expansion of CD4+ and/or CD8+ T lymphocytes is well documented and this phenomenon is believed to be of pathogenetic importance. We speculate that the T cell clone in the present case had special homing properties or cytokine effects resulting in synovitis.
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PMID:Seropositive polyarthritis and skin manifestations in T-prolymphocytic leukemia/Sezary cell leukemia variant. 1075 96


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