Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023473 (chronic myeloid leukemia)
 18,916 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We experienced a case of demyelinating, inflammatory cervical myelopathy after bone marrow transplantation for chronic myelocytic leukemia (CML). A 28 years-old man who had been having skin and liver graft versus host disease (GVHD), developed paresthesia in the legs, and then, difficulty in walking. At the time of admission, weakness of the hands also appeared. There was no evidence of CML recurrence after bone marrow transplantation. The myelopathy was characterized by multiple abnormal spotty signal intensities in the cervical spinal cord on MRI and these were in part Gd-enhanced. A course of pulse-dose methylprednisolone was given, followed by prednisolone. The neurological deficits were improved to the degree of full recovery. The inflammatory myelopathy together with a plaque in the cerebral hemisphere, moderately delayed p-100 latency of VEP and elevation of myelin basic protein of the spinal fluid, is difficult to distinguish from that of multiple sclerosis. Although the precise mechanism of GVHD-myelopathy is not known, it is likely that the donor myelin-reactive T-lymphocytes were non-specifically activated with GVHD reaction and directed to a central nervous system. Tacrolimus might have precipitated the focal immune reaction by way of cytotoxic effects on brain capillaries. The "GVHD-myelopathy" presented here may thus be akin to multiple sclerosis in its immune mechanism.
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PMID:[A case of inflammatory demyelinative myelopathy after bone marrow transplantation]. 1108 92

In an attempt to identify novel mHas that induce GVL effect on chronic myeloid leukemia (CML), we analyzed peripheral blood T cells of 4 CML patients who relapsed after allogeneic stem cell transplantation and received donor leukocyte infusion (DLI), for the presence of antigen-specific T-cell proliferation. When peripheral blood lymphocyte collected from patients every 2-4 weeks after DLI were subjected to complementarity determining region (CDR) 3 size distribution analysis of T-cell receptor beta chain, clonal proliferation of a limited number of CD4+ T cells was detected in all patients 2-4 months after DLI in association with the occurrence of GVL effect. To identify an epitope of the T-cell clone that probably mediates GVL effect, we determined nucleotide sequence of CDR3 of the T cells and screened the database for the presence of T cells with a CDR3 sequence similar to that of the GVL-mediating T cells. In one of 4 patients who showed clonal proliferation of a BV16+ T cell, a CDR3 motif QDR was shared by a T-cell clone that recognized an 85-99 peptide of myelin basic protein presented by HLA-DRB1*1501. When the I domain of CD49b, a candidate peptides that could bind to this CDR3 motif in the context of DRB1*1501, was studied, codon 256 in the I domain of the recipient was ATT (Ile) while that of the donor was GTT (Val). The BV16+ T cells showed proliferative response to DRB1*1501 L-cell transfectant pulsed with the recipient type CD49b. Thus, identification of a clonotype of T cells that mediate GVL effect in patients receiving DLI and a search for T-cell clones with a similar clonotype to the GVL-mediating T cells followed by screening of polymorphic peptides that could stimulate the T cells appears to be useful in identifying novel mHas serving a target antigens of GVL effect.
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PMID:Identification of novel minor histocompatibility antigens responsible for graft-versus-leukemia (GVL) effect on chronic myeloid leukemia: usefulness of determining the clonotype of T cells associated with GVL effect after donor leukocyte infusion. 1243 Aug 63

Astroglia-rich primary cultures from rat brain were used to investigate the presence in glial cells of Nepsilon-(carboxymethyl)lysine (CML), an advanced glycation endproduct. Westernblot analysis of homogenates of rat brain as well as of astroglia-rich cultures demonstrated the presence of CML-modified proteins in these samples. Immunocytochemical staining of astroglia-rich cultures revealed that only a minority of the cells in these cultures were intensively stained for CML. The staining intensity of CML-positive cells was strongly reduced, if the cells were not permeabilized, indicating that intracellular proteins were CML-modified. The CML-positive cells were identified as astrocytes and oligodendrocytes by double-labelling immunocytochemical staining for CML and the cellular markers galactocerebroside, myelin basic protein and glial fibrillary acidic protein. In contrast to other glial cells, microglial cells in astroglia-rich cultures were CML-negative. The finding that only a minority of cells in astroglia-rich cultures contains high amounts of intracellular CML-modified proteins indicates that specific properties of these CML-positive cells are responsible for the CML-formation in these cells.
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PMID:Identification of Nepsilon-(carboxymethyl)lysine-positive cells in astroglia-rich primary cultures. 1452 21

Methotrexate and cytarabine arabinoside are frequently administered intrathecally in the prophylaxis and treatment of patients with hematological malignancies. Myelopathy as a complication of intrathecal (IT) chemotherapy is rare in adults, with most of the cases described in the literature occurring in the pediatric population. Between January 2010 and March 2014, 587 newly diagnosed B cell acute lymphoblastic leukemia and 24 chronic myeloid leukemia lymphoid blast phase patients were seen at The University of Texas MD Anderson Cancer Center. This case series discusses seven adult cases deemed to have IT chemotherapy-induced myelopathy between 2010 and 2014 at MD Anderson Cancer Center. Five out of the seven patients had T2 abnormalities involving the dorsal columns of the spinal cord. An elevated myelin basic protein level was noted in the two patients in whom it was checked. The wide range of dosage and timing with respect to IT chemotherapy administration suggests an idiosyncratic reaction or individual threshold to the development of myelopathy. By describing the largest case series of myelopathy in adults, we aim to raise awareness about this rare albeit devastating complication. Based on the seven cases described we would recommend-MRI of the spine with T2-weighted imaging in the sagittal and axial planes in leukemia patients with unexplained myelopathy and consideration to delay IT chemotherapy until after an extensive work-up to rule out CNS leukemia. Though more data are needed on the use of folate metabolites, preliminary results have shown some promise in the treatment of methotrexate-induced myelopathy and may be a potential consideration for future patients suspected to have chemotherapy induced myelopathy.
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PMID:Myelopathy following intrathecal chemotherapy in adults: a single institution experience. 2566 82