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

Three children with ALL having poor prognostic features developed clinical and laboratory evidence of disseminated intravascular coagulation (DIC). Two developed a bleeding diathesis associated temporally with a rapid drop in blast cell counts during induction therapy with L-asparaginase, prednisone, and vincristine. One of these children died of massive cerebral hemorrhage. The third patient developed episodes of superficial thrombophlebitis associated with relapses and rising blast cell counts which responded to chemotherapy and treatment with heparin. The unusual association of ALL with DIC and the fact that all 3 patients had multiple poor prognostic signs have led us to monitor carefully the coagulation system and withhold L-asparaginase in patients with massive disease until the white cell count and organomegaly have responded to prednisone and vincristine. The more common association of DIC with non-lymphocytic leukemia and recent reports of the presence of the Ph' chromosome in children with leukemia morphologically resembling ALL suggest that chromosomal evaluation be done in selected leukemic patients.
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PMID:Disseminated intravascular coagulation in childhood acute lymphocytic leukemia with poor prognostic features. 27 70

The clinical course of a patient with chronic granulocytic leukemia cutis associated with myeloid metaplasia is described. Cutaneous manifestations of leukemia appeared only at the sites of bone marrow aspiration and vena puncture. Radiotherapy to both spleen and skin and chemotherapy with busulfan failed to control spreading cutaneous lesions. Treatment with hydroxyurea was followed by a marked reduction in spleen size, a decrease in white cell count and healing of the skin lesions.
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PMID:Chronic granulocytic leukemia cutis treated with hydroxyurea. Report of a case. 27 47

The use of electronic pulse spectroscopy to determine the volume distribution of a white blood cell fraction isolated by sedimentation from anticoagulated whole blood permits a rapid quantitative measure of size and dispersion of white blood cells in suspension. In patients without apparent hematologic diseases the white cell volume distribution presents as a broad peak. In patients with a large percentage of circulatory malignant cells, a single narrow volume peak is observed in acute leukemias and a broad and sometimes bimodal curve is observed in chronic leukemias. The volume of the leukemic cells is observed to shift in vivo after the start of effective chemotherapy as was predicted on the basis of a tissue culture model. The prognostic significance of the white cell volume distribution in leukemia and the use of a shift in size of leukemic cells after the start of therapy as a means of monitoring therapy are discussed.
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PMID:The significance of leukemic cell volume distribution. 27 91

Diagnostic bone marrow smears from 132 patients with acute lymphoblastic leukaemia, (ALL) were stained simultaneously by the periodic acid-Schiff (PAS) reaction, and the blast cell positivity was assessed quantitatively. The patients fell naturally into two unequal groups: those with more than 20% PAS-positive blast cells (44 patients) and those with less (88 patients). There was no relation between the degree of positivity and age, sex, or presenting leucocyte count. Actuarial survival studies showed that the group with more than 20% PAS-positive blast cells survived longer, but that this difference assumed statistical significance only after the exclusion of patients over 14 years old and those with high white cell counts at the time of diagnosis. It appears that the PAS reaction can identify long survivors among patients with ALL, but not in the absence of features strongly associated with a poor prognosis.
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PMID:Periodic acid-Schiff reaction and prognosis in lymphoblastic leukaemia. 28 41

Full skeletal survey was performed on 193 consecutive children presenting over a 6-year period with acute lymphoblastic leukaemia (ALL). A record was made of the degree of bone pain in these patients and 60 others presenting immediately prior to the availability of skeletal surveys. Bone pain was present in 76 out of 253 patients (30%) and radiological bone changes characteristic of leukaemia in 125 out of 193 (65%). A significant correlation was found between the severity of bone pain and the number of bones involved on X ray (r = 0.25, P = less than 0.001), but not between initial white cell counts and bone score (r = -0.14, P = 0.08). There was no significant correlation between the degree of bone pain and survival or length of first remission (P = 0.29 and 0.86). Similarly, the extent of radiological bone disease was of no prognostic significance with relation to survival (P = 0.41) or length of first remission (P = 0.21).
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PMID:The prognostic significance of radiological and symptomatic bone involvement in childhood acute lymphoblastic leukaemia. 28 56

Biological symptoms of D.I.C. were investigated in 43 patients with acute leukemia. Ten of them were found to be positive either at the onset or at the relapse of the disease and in some cases D.I.C. was triggered by chemotherapy. Among the ten positive cases 3 patients had an acute promyelocytic leukemia, 4 had an acute lymphoblastic leukemia, 2 a myeloblastic and 1 a monoblastic leukemia. D.I.C. was found either in patients with an hypercellular form of the disease or in patients with a normal or low white cell count. Symptoms of D.I.C. in acute leukemia must be systematicaly sought at the onset and during treatment by chemotherapy and treated with heparin and platelet transfusions as it is now admitted for acute promyelocytic leukemia.
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PMID:[Disseminated intravascular coagulation (D.I.C.) and fibrinolysis in patients with acute leukemia (author's transl)]. 28 87

Results of treatment in 72 children with a relapse of acute lymphoblastic leukaemia were analysed. A second remission was induced in 57 children (79%). Remission rates were significantly higher in males, and in patients with white cell counts less than 30 X 10(9)/L. The median duration of the second remission was only four months, and the median duration of survival from the time of relapse was nine months. The median duration of survival from the time of diagnosis was 27 months. Among children who suffered a relapse was a small group who had prolonged survival and prolonged second remissions. It is uncertain whether some of these may have a chance of "cure".
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PMID:Poor outlook for childhood acute lymphoblastic leukaemia with relapse. 29 27

In the five year period 1973-77, 278 children in Goroka Hospital paediatric ward were found to have a white cell count (W.C.C.) over 30,000/mm3. Of those with a W.C.C. over 40,000/mm3 in 1977 where the outcome was known, 13 of the 17 (76%) died. It is suggested that "leukaemoid reaction" in Highlands children be defined as a total W.C. over 40,000/mm3 that is not due to leukaemia. A leukaemoid reaction is a useful, but grave, prognostic sign. Such children comprise a quarter of all deaths in the Goroka paediatric ward.
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PMID:Leukaemoid reaction in Eastern Highlands children. 29 30

One hundred consecutive newly diagnosed cases of leukemia and lymphoma in children from 0 to 16 years of age presenting at the University of Minnesota from 1973 to 1977 were studied. Clinical features were correlated with phenotypic features of blast cells, including surface markers and cytomorphology. Four groups with distinct clinical and pathologic features emerged from the study: a) The acute leukemias of the "null" or "undifferentiated" group were those in which the malignant cells carried distinctive null leukemia surface antigen and lacked features of either T cells (E-rosette positivity) or B cells (surface immunoglobulin positivity). These cases occurred most frequently in the series (56% of total cases), peaked in incidence at 6 years, were associated with extensive bone marrow involvement, lacked distinguishing cytomorphologic features, and had the best response to therapy of all groups. b) The acute myelogenous leukemias, including those with myeloid, monocytoid, or erythroid features or a combination of the above, had extensive bone marrow involvement and the characteristic morphology. This group was seen with intermediate frequency and showed an intermediate response to therapy. c) Leukemia-lymphomas of the T-cell group were frequently associated with mediastinal masses and other masses, a cytomorphology which was different from the B-cell group but similar to the null group, and high white cell counts. These cases occurred with intermediate frequency (14%) and had a worse prognosis than the null group. d) Leukemia-lymphomas of the B-cell group had monoclonal surface immunoglobulin with mu-heavy and either kappa or lambda light chain. These patients were least frequent in the series, frequently presented with abdominal masses, and had a characteristic Burkitt cell morphology. Prognosis was the worst of all patients in our series. These data suggest that the major phenotypic groups of childhood leukemia and lymphoma have differing prognoses and should receive differing forms of therapy. Clinical and pathologic features of each group are sufficiently distinctive to suggest that they may have different causes.
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PMID:The nature of childhood leukemia and lymphoma. 30 75

Acute lymphoblastic leukemia (ALL) patients could be subclassified into two groups depending on whether or not their leukemia cells expressed a B-lymphocyte antigen. The antigen was detected by an indirect immunofluorescence test using rabbit antisera. In the positive group, consisting of 26 of 32 patients, the leukemia cells were of the "null"-cell type, i.e., they did not appear to express currently recognized T- and -b-cell markers. Absroption studies indicated that the positive null-cell group expressed a common antigen which was not expressed on the negative group. Of the 6 negative cases,, 5 expressed complement receptors and 3 expressed T-cell markers. The negative group was also characterized by high white cell counts and the pressence of a mediastinal mass.
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PMID:Immunofluorescent method for positive identification of null-cell type acute lymphocytic leukemias: use of heterologous antiserum. 33 57


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