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Query: UMLS:C0023473 (chronic myeloid leukemia)
 18,916 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Chronic myelomonocytic leukemia (CMML) is a polymorphous malignant hematological stem cell disorder, characterized by abnormal hyperplasia of mature or immature cells of both monocytic and granulocytic series and with abnormal cellular morphology. It is an independent entity of chronic leukemia, as its prestage course is manifested by refractory anemia with monocytosis and the disease gradually evolves to CMML. In some cases, it finally becomes acute leukemia. In this study, the average white cell count of the patients was 29.3 x 10(9)/L.14 cases had leucocytosis, 7 leucopenia and 5 normal count. The absolute value of monocytes was 19 x 10(9)/L and the proportion of monocytes was 10-87%, with an average of 49%. In the leukopenic group with white cell count less than 4 x 10(9)/L, the absolute value of monocytes was less than 1 x 10(9)/L in 5 of the 7 cases. However, it was noticed that all the 5 cases had a proportion of monocytes greater than or equal to 10%. The authors would like to take this percentage as the diagnostic criteria for CMML, which is different from that adopted in FAB classification of 1982 as well as in the literatures. Statistics showed that P value of M/E, Mo/E, Mo/M were of apparent significance in the differentiation of CMML from normal controls and patients with other hematological diseases such as RA, RAEB, CML, CNL, M4 and M5.
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PMID:[An analysis of 26 cases of chronic myelomonocytic leukemia]. 226 33

The chronic leukemias are associated with significant morbidity from splenic enlargement and hyperfunction. Although some patients with chronic leukemia benefit from splenectomy, the indications for operation are unclear. To identify those patients who benefit most from splenectomy, nine patients with chronic lymphocytic leukemia (CLL) and eight patients with chronic granulocytic leukemia (CGL) who had splenectomy to palliate the symptoms of massive splenic bulk or to improve the hematologic sequelae of splenic hyperfunction were studied. Splenectomy for bulk symptoms provided good palliation of symptoms, but the duration of the benefit was limited by the stage of the disease. Five of eight patients with CGL with bulk symptoms died within 6 months of operation. Splenectomy for hyperfunction was limited to a short-term hematologic response. In three of four patients with CLL who were Coombs positive, the presence of autoantibodies correlated with a recurrent transfusion requirement within 3 months of splenectomy. Thus, the benefit of splenectomy for bulk symptoms must be weighed against the risk of surgery and the patient's limited life expectancy. The benefit of splenectomy for treatment of splenic hyperfunction depends on the stimulus to hyperfunction and may not be beneficial for patients with refractory autoimmune anemias.
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PMID:Splenic enlargement and hyperfunction as indications for splenectomy in chronic leukemia. 243 41

Patients with acute (2,569) and chronic (957) leukemia diagnosed at 19 institutes took part in the study on the "Multidisciplinary Treatment of Leukemia" between 1971 and 1985 and were investigated retrospectively. By dividing the 15 years into three five-year periods, we were able to compare patient ratios in the different periods. The proportions of acute to chronic leukemia cases showed no obvious change; however, the proportions of cases diagnosed as acute lymphocytic leukemia in acute leukemia showed a significant increase. The main chemotherapeutic drugs used during the three time periods were cytarabine or its analogues, the anthracyclines, 6-mercaputopurine and prednisolone, against acute myelogenous leukemia, and the vinca alkaloids, prednisolone and the anthracyclines against acute lymphocytic leukemia. The rate of complete remission from acute myelogenous leukemia made marked progress, from 45.1% during 1971-1975 to 62.3% during 1981-1985, but that of acute lymphocytic leukemia showed no significant progress, being 65% during 1971-1975 and 69.7% during 1981-1985. The durations of remission, however, and the survival times for patients with acute lymphocytic leukemia, as well as for those with acute myelogenous leukemia, became significantly longer over the three periods. Median survival times from chronic myelocytic leukemia were 37-40 mo in all three periods, showing no progress. There was a better prognosis in cases of chronic myelocytic leukemia with, than without, Philadelphia chromosome. Except for a low incidence of chronic lymphocytic leukemia in Japan, adult leukemia patients' characteristics and prognoses seem to be almost the same in Japan as in the U.S.A. and Europe.
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PMID:Recent trends in the treatment and prognosis of adult leukemia with characteristics of patients in Japan: transition during the fifteen years from 1971 to 1985. 260 37

This paper presents an analysis of data collected from 242 cases of acute and chronic leukemia observed during a 10-year period. The incidence of childhood leukemia was 26.45%. In the present series, it was 35.95% for ALL, 21.9% AML, 38.4% CML and 2.89% CLL. The incidences of ALL and CML were found comparable to other series from Bombay. The geographical variations in the pattern of leukemias as observed in India are discussed.
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PMID:Pattern of leukemias: a ten-year incidence study of 242 cases. 264 17

Point mutations within codon 12 of the Harvey (H-) ras proto-oncogene have recently been implicated in the progression of hemopoietic malignancy, particularly chronic myeloid leukemia. We have analyzed DNA from 170 cases of acute and chronic leukemia by using a restriction fragment length polymorphism. No evidence for clonal allelic H-ras codon 12 activation was found among these cases, which included 23 cases of chronic myeloid leukemia, 12 of which were in accelerated phase or blastic transformation. These data suggest that H-ras codon 12 mutations occur infrequently in hemopoietic neoplasms generally and may be less important in disease progression than has been previously suggested.
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PMID:Activation of Harvey ras oncogene by mutation at codon 12 is very rare in hemopoietic malignancies. 264 80

Criteria for the evaluation of chemotherapy for acute leukemia, chronic leukemia, Myelodysplastic syndrome and polycythemia vera were discussed. In leukemia patients the changes in the number of leukemic and normal cells are easily quantitatively evaluated. The criteria depends on the reduction and recovery of leukemic cells and normal cells. In acute leukemia because considerable parts of complete remissions ended with relapse, the evaluation seems necessarily to differentiate good remission from standard remission. For such purpose 5,000 leukocyte differential seemed effective. In the phase II study of anti-leukemia drugs, however, it seemed necessary to find efficacy less than remission, to avoid underestimation of drug efficacy because pretreated patients are usually studied in the phase II study. In the evaluation of chronic myelogenous leukemia, chronic myelomonocytic leukemia or polycythemia vera, short term judgment needs to be further studied about the correlation with longterm efficacy such as survival. The treatment of myelodysplastic syndrome is very hard to evaluate, reduction of blasts and increase of normal cells may be necessary for the improvement of symptoms. The relation of the efficacy and survival seemed necessary to be studied.
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PMID:[Evaluation of chemotherapy of hematological malignancies]. 264 5

As compared with advances in the treatment of acute leukemia, we have made little progress in chronic leukemia. Recently we have attempted some new treatments for chronic phase of CML, and confirmed those effectiveness. But for blastic crisis, we still grope in the dark. In this paper, we review the chemotherapy of CML and CLL including new treatments except bone marrow transplantation.
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PMID:[Chronic leukemia]. 265 37

Twenty-two patients with chronic lymphocytic leukemia (CLL) and 14 patients with chronic myelogenous leukemia (CML) were studied with respect to natural killer (NK) cell activity and related cell markers (Leu 7 and Leu 11b). Significantly reduced NK cell activity was detected in peripheral blood from the patients with CLL. Similarly, a reduced number of cells with the markers Leu 7 and Leu 11b (CD 16) were detected in the same patients. Removal of the leukemic cells by centrifugation of cells forming rosettes with mouse erythrocytes led to an augmented, but not fully normalized, NK activity. This indicates that the low NK activity in CLL partly may be due to overgrowth of leukemic cells. However, in spite of the lymphocytic infiltration, the NK cell activity in the bone marrow of CLL patients did not differ significantly from that of normal controls. The patients with CML in the chronic phase as well as patients in the accelerated or blast phase also had a reduced NK activity. The finding that patients in the chronic phase had a reduced NK activity and normal numbers of Leu 11b (CD 16) positive cells, together with no detectable blasts in the peripheral blood, indicates that patients with CML may have an inherent NK cell defect. The highly reduced activity found in patients with the accelerated/blast form may in addition partly be due to overgrowth of leukemic cells. This low NK activity may be of importance in the development of chronic leukemia.
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PMID:Natural killer cells in chronic leukemia. Function and markers. 297 42

The mechanisms responsible for the massive hyperplasia and for the blastic crisis in chronic myelocytic leukemia are poorly understood. The most generally accepted hypothesis proposes that this progression is due to the development of genetic instability in the leukemic cells. In particular, the two phases of the disease are believed to reflect different, discrete genetic events. Such events remain undefined as yet, and the causal significance of observed genetic aberrations is not clear. An alternative hypothesis is presented here. It is assumed that the feedback interactions adjust the relative probabilities of maturation and replication of the 'committed' as well as the pluripotent cells, and further that mitotic cells at all stages possess considerable phenotypic adaptability; in particular their self-renewal capacity can vary in response to changes in the cellular composition of the tissue even within a conventionally defined compartment. On this basis, it is shown that chronic leukemia can arise and evolve into the blastic crisis from a progressive decline in a single clonal characteristic--inducibility to maturation. It is shown, with the help of mathematical considerations, how an initial hereditable event in an early hemopoietic cell can cause a disturbance of the tissue which feeds back onto the individual members of the clone, resulting in a cascade of dynamic changes which can lead to blast cell dominance.
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PMID:A new approach to the evolution of the blastic crisis from chronic myelocytic leukemia: dynamic interplay of cellular alterations and a changing microenvironment. 345 86

Tetraploid populations have been observed in various types of leukemia, but relatively few reports exist of triploid cell populations in acute or chronic leukemia. We report two cases of Ph-positive leukemia with a modal triploid cell population. Examination of peripheral blood from a 3-year-old boy with Ph-positive acute lymphoblastic leukemia (ALL) and a 68-year-old male with Ph-positive chronic myelocytic leukemia (CML) in blastic crisis revealed modal populations of 72 and 63 chromosomes, respectively. G-banding analysis of both cases revealed the following: karyotypic instability (no clonality), dominant trisomy, and the random association of the Ph chromosome with gains and losses of chromosomes involved in this translocation. The cytogenetic evidence obtained suggests that the triploid cell populations were not derived from a duplication of a hypodiploid cell population, but resulted from random loss of chromosomes from tetraploid cell populations derived from duplication of pseudodiploid cells.
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PMID:Near-triploid Ph-positive leukemia. 386 95


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