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Query: UMLS:C0023467 (acute myeloid leukemia)
35,200 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The prognosis for patients with AML is improving, but mortality due to bleeding and infection remains significant. HLA compatibility has been the cornerstone of matching for prophylactic platelet transfusion; while HLA matched platelets are often of benefit, we have observed that HLA matching does not reliably predict transfusion responses. The platelet migration inhibition assay is, however, consistently predictive. The matching problem may be circumvented by the use of frozen autologous platelets, which circulate and function hemostatically. In the granulocytopenic patient with de novo fever (frequently due to bacterial sepsis), the immediate empiric use of broad spectrum antibiotics is mandatory. If the marrow begins to recover from chemotherapy shortly after the onset of infection, such that the peripheral granulocyte count will approach normal within 10 days, the likelihood of survival from an episode of septicemia after antibiosis now approaches 80%. If the marrow does not recover shortly, however, the likelihood of survival with antibiosis alone is poor. In this setting, survival is improved if patients are given granulocyte transfusions in addition to antibiotics. Patients who receive chemotherapy in a laminar air-flow room (LAFR) experience fewer severe infections than do patients in a conventional ward. However, most patients who are unresponsive to initial chemotherapy remain so in spite of protection from infection. Thus, the available results do not suggest that the LAFR is likely to improve appreciably the rate or duration of remission. Using malignant lymphoma as a model, we have found that cryopreserved autologous marrow infusions can hasten hematopoietic recovery in man after high-dose chemotherapy, and earlier reconstitution may be of clinical benefit to the patient; techniques are at hand that might permit the application of this concept to AML.
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PMID:Recent developments in the supportive therapy of acute myelogenous leukemia. 2 27

Human B lymphocyte antigens analogous to the murine Ia determinants were found on myeloblasts and promyelocytes but not on more mature granulocytes. This was apparent by fluorescent staining with both human alloantisera and rabbit antisera to the isolated Ia-like proteins. The cells of patients with chronic myelocytic leukemia showed this difference especially clearly. Separation of the myeloblasts and promyelocytes by multistep density gradient fractionation produced a marked enrichment of the positive cells. The remaining cells from higher density fractions were more-mature neutrophils that were essentially negative. In acute myeloid leukemia, in which myeloid cells early in differentiation predominate, the vast majority of cells were strongly positive. Similar results were obtained with normal bone marrow cells. Here also, only the early forms of the myeloid series separated by gradient centrifugation had Ia antigens. Evidence was also obtained for the presence of Ia determinants on cells with the appearance of early erythroid precursors. Support for the presence of the Ia determinants on granulocyte-macrophage committed stem cells was provided by the inhibition of granulocyte colony formation in agar cultures following preincubation of normal bone marrow with antiserum and complement. Cross absorptions with purified preparations of immature cells provided evidence for the close similarity of the antigenic determinants on both myeloblasts and B cells. A 28,000-37,000-dalton bimolecular complex obtained from myeloblast membranes contained the Ia determinants and was similar to that obtained from peripheral blood B cell membranes.
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PMID:Expression of Ia-like antigen molecules on human granulocytes during early phases of differentiation. 7 38

Normal human granulocyte alloantigens were found on chronic myelogenous, acute myeloblastic leukemia cells, and a cell line of chronic myeloblastic origin (K562). Antigens were detected by human antisera positive for normal peripheral blood granulocytes but devoid of HLA activity. Very few acute lymphoblastic leukemia cells reacted positively, and none of the chronic lymphocytic leukemia cells seemed to bear granulocyte surface antigens. The recognition of these normal tissue isoantigens on myeloblastic leukemia cells is a necessary prerequisite for the identification of "leukemia-specific" of "leukemia-associated" antigens.
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PMID:Human granulocyte antigens detected on leukemia cells and a chronic myelogenous cell line. 7 3

Blood and bone-marrow smears from adult patients with acute leukemias were stained for esterase reaction, consecutively with naphthol AS D-chloracetate (chloracetate esterase) followed by alpha naphthyl butyrate (nonspecific esterase). The two substrates were, respectively, granulocyte- and monocyte-specific. By this method three subgroups of acute nonlymphocytic leukemias could be distinguished. Leukemic cells may be positive for either chloracetate esterase or nonspecific esterases, and the authors believe these two subgroups represent "true" granulocytic and "pure" monocytic leukemias. In a third group, leukemic cells contained both esterases in the same cell, and it is believed this group may represent "true" myelomonocytic leukemias. In the majority of patients in this group, leukemia evolved from a preleukemic phase. When only Romanowsky-stained smears are used, the monocytoid feature and absolute elevated monocyte counts in acute granulocytic leukemia may lead to an erroneous diagnosis of the leukemia as acute myelomonocytic leukemia. This happened in five of the 13 cases in the study. The presence of granulocyte- and monocyte-specific esterases in a single cell supports the concept of a common origin of granulocytes and monocytes. The authors conclude that the combined esterase reaction can distinguish among acute granulocytic leukemia, acute monocytic leukemia, and acute myelomonocytic leukemia.
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PMID:Cytochemical diagnosis of acute myelomonocytic leukemia. 8 77

To determine the mechanism by which acute myelogenous leukemia (AML) cells suppress normal marrow granulopoiesis, diffusion chambers containing Wistar/Furth (W/Fu) rat marrow cells, peritoneal exudate (PE) macrophages or W/Fu AML clone-3 cells were implanted intraperitoneally into syngeneic irradiated rats. Growth of each population over 21 days in single or double diffusion chambers (in which cell populations were separated by a Nucleopore filter) was compared to that of mixed populations. Double diffusion chamber culture of homologous or heterologous combinations had no detectable effect on growth kinetics of any of the three cell populations compared to single chambers. In contrast, normal granulocyte proliferation was significantly depressed by single chamber co-cultivation with one tenth the number of PE macrophages or AML cells. Mixing PE macrophages with AML cells produced no preferential population suppression. AML cells differentiation was not detected under any set of conditions. These studies demonstrate that physical contact with proliferating normal macrophages as well as AML cells will suppress granulopoiesis in diffusion chambers.
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PMID:Suppression of granulopoiesis in diffusion chambers by syngeneic clonal acute myelogenous leukemia cells or peritoneal exudate macrophages. 11 3

Unique fusiform or spindle-shaped particles (Phi bodies) and rods with hydroperoxidase (catalase and/or peroxidase) activity are present in human granulocyte precursors only in acute myelogenous leukemia (AML). These newly recognized particles are much more numerous and prominent than Auer rods. They may be rapidly and readily identified using the microscope in marrow or peripheral blood films when the procedures recommended in this paper for fixation, incubation for hydroperoxidase demonstration in 3,3'-diaminobenzidine (DAB)/H2O2 medium, copper salt treatment and counterstaining (optional) with the Papanicolaou method are employed. Films prepared in the same manner but treated with benzidine/H2O2 medium for myeloperoxidase did not reveal these particles. We believe that Phi bodies are pathognomonic of AML since they are almost invariably present in AML patients with active disease. Their presence serves to distinguish AML from acute lymphocytic leukemia and from chronic granulocytic leukemia in blast crisis. Since the particles disappear in disease remission and reappear upon relapse, the recommended procedure is not only useful in diagnosis but in guiding therapy. When a very rapid diagnosis is needed, it is not necessary to counterstain the preparations, but the nuclei, cytoplasm and plasmalemma can readily be observed in the granulocyte precursors when they are counterstained by the Papanicolaou method. This treatment does not diminish the clarity of the Phi bodies and rods which stain by virtue of their peroxidatic activity. This cytochemical diagnostic procedure should be considered for adoption by hematology laboratories.
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PMID:The light microscopic demonstration of hydroperoxidase-positive Phi bodies and rods in leukocytes in acute myeloid leukemia. 21 54

A study of granulocyte functions in acute myeloblastic leukemia is reported. Functions were assessed by the ability of polymorphonuclear to migrate in Boyden's chamber, to ingest and kill staphylococcus aureus. Chemotaxis was grossly impaired. Cellular imparirment of phagocytosis and bactericidal capacity was observed in 5 and 9 patients. An inhibitor of phagocytosis and bactericidal capacity was observed in 9 and 4 patients. Results improved in complete remission.
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PMID:Polymorphonuclear function in acute myeloblastic leukemia. 26 22

Twenty-seven patients receiving a standard cytosine arabinoside and daunorubicin regimen as induction of reinduction therapy of acute myelogenous leukemia were randomly assigned to receive lithium carbonate, 300 mg t.i.d., or no lithium. Treatment groups were comparable with respect to age and baseline granulocyte counts. All patients developed granulocyte nadirs below 100/cu mm. By actuarial analysis, the median duration of granulocytopenia, less than 1000/cu mm, was 16.0 days in the lithium group and 24.6 days in the no-lithium group, p = 0.013. The median duration of granulocytes less than 500/cu mm also favored the lithium group but only approached statistical significance: 14.0 days versus 20.5 days, p = 0.054. Lithium levels between 0.5 and 1.0 meq/liter were easily maintained in 11 of 12 patients receiving lithium, 300 mg t.i.d., and toxicity directly attributable to lithium was not observed. Despite the shortened duration of neutropenia, the incidence of infections and the rate of remission were not affected.
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PMID:Lithium and granulocytopenia during induction therapy of acute myelogenous leukemia. 28 86

The sensitivity of populations of human granulocyte precursors to factors with colony stimulating activity (CSA) was assessed in agar culture in vitro. The mean threshold of stimulation was estimated by analysis of dose-response curves of clone growth against concentration of CSA. This method of assessment has the advantage that CSA production by cells contaminating the population under test does not affect results. Marrow cells from patients with acute myeloid leukaemia were less sensitive to CSA than marrow cells from normal individuals. Sensitivities of cells from chronic granulocytic leukaemia and from chronic myelomonocytic leukaemia were within the normal range, but this group also tended to require more CSA than controls. In addition, sensitivities of granulocyte precursors from patients with acute myeloid leukemia were closely related to the culture pattern, and thus to the remission probability. The significance of this relationship is discussed.
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PMID:Stimulation of human haemopoietic cells by colony stimulating factors: sensitivity of leukaemia cells. 31 10

Androgen therapy prolongs complete remission in acute myeloid leukaemia (AML). (1,2) In vitro studies of clone formation by myeloid leukaemia cells in semi-solid agar cultures have revealed a relationship between culture findings and response to chemotherapy. (3) These seemingly unrelated findings may be explained by the hypothesis proposed here which relates clone size in culture and sensitivity to regulators of granulopoiesis with level of differentiation in the granulocyte-monocyte pathway. This hypothesis not only suggests other means of therapy which may be equally or more effective while lacking the side effects of androgen therapy, but also predicts which patients are most likely to benefit from such therapy.
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PMID:Response to therapy in acute myeloid leukaemia: an explanation of two unrelated findings. 31 95


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