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Query: UMLS:C0027947 (neutropenia)
 17,527 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The toxicity produced by two courses of methotrexate separated by different intervals has been studied in matched groups of rats. The maximum degree of neutropenia reached when courses were separated by 8 days or more was no greater than that seen after a single course of methotrexate. However, when courses of neutropenia following the second course of methotrexate was directly related to the level of depression of bone marrow cell numbers at the time of the second course. Conversely the anti-leukaemic effects of 2 courses of methotrexate, in terms of time of onset of leukaemia and time of death in rats transplanted with a syngeneic T-cell leukaemia, are shown to be similar when courses of methotrexate are separated by between 2 and 12 days. Thus in this system, chemotherapeutic schedules using methotrexate may be designed on the basis of minimal host toxicity without prejudicing anti-leukaemic effects. These results are discussed in relation to toxicity and anti-leukaemic effects observed during UKALL trials of treatment in acute lymphoblastic leukaemia.
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PMID:Effects of varying the interval between courses of methotrexate on its myelotoxic and anti-leukaemic activities. 83 60

Within six months of the introduction of the new antipsychotic drug clozapine in Finalnd, 17 cases of neutropenia or agranulocytosis were recorded amongst about 3000 patients treated. Agranulocytosis was fatal in eight patients, and in addition, two patients developed thrombocytopenia, and one patient leukaemia. As additional cases might well have been overlooked as banal infections, the risk of developing agranulocytosis during clozapine treatment was at least 0.5%. Impaired elimination of the drug or increased susceptibility of granulocyte precursors to clozapine, possibly due to some inherited characteristic, might explain the high incidence of complications.
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PMID:Agranulocytosis during treatment with chlozapine. 85 3

Pulmonary aspergillosis in patients with leukemia or lymphoma is usually a fatal infection. However, difficulty in obtaining a premortem diagnosis has often prevented an adequate trial of anti-fungal chemotherapy. In this report, nine cases of aspergillus pneumonia in patients with hematologic malignancy were diagnosed during a one-year period. Five of nine patients had a premortem diagnosis (56%) and eight of nine (89%) received a premortem trial of amphotericin B. Two of nine patients survived infection, including one patient with prolonged neutropenia. Better diagnostic methods and wider use of antifungal chemotherapy may improve prognosis for aspergillus infection in patients with hematologic malignancy.
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PMID:Aspergillus pneumonia in hematologic malignancy. Improvements in diagnosis and therapy. 86 47

The mechanisms of haemopoietic cellular proliferation are more clearly understood when the granylocytic, monocytic and macrophagic elements of the bone marrow are studied by means of in vitro cultures. Better physiological insight into stimulating and inhibitory factors is obtained in this way. These studies are of diagnostic, therapeutic and prognostic importance in the clinical handling of myeloid leukaemia dn neutropenia. It can be accepted today that the concept of myeloid leukaemia as a neoplastic process with an increased production of autonomous cell populations is to a large extent outdated, and these cells can be induced in vitro to differentiate into mature polymorphs. In the past it has been demonstrated that in vitro successes are followed by in vivo results, and in particular it is hoped that with the development of techniques for concentration of colony-stimulating factor, that this might be of therapeutic advantage in selected leukaemia patients in the future.
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PMID:[Myelopoiesis--a kinetic approach]. 108 Aug 85

A case of a woman suffering of hairy cells leukemia (tricholeucocytes) is described. The diagnosis of this leukemia was set two years after a splemectomy, due to the enlargement of the spleen. The patient was treated for a period of two years as a refractory anaemia and leucopenia (neutropenia). After admission the diagnosis was confirmed by the examination of periferal blood, cytologic and histologic examination of the bone marrow and after a subsequent examination of the spleen tissue. All these examinations showed the presence of typical hairy cells--tricholeucocytes in the periferal blood, bone marrow and spleen. On account of their own cytochemical examinations, and especialy immunological examinations by other authors, the authors of this presentation suppose that the tricholeucocytes most probably belong to B lymphocytes and that, therefore, this leukemia should be placed in the group of malignant lymphocytoproliferative diseases.
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PMID:[Hairy-leukocyte leukemia (tricholeukocyte). Report of a case]. 108 56

The degree of drug-induced neutropenia resulting from a controlled trial (UKALL I) of treatment in acute lymphoblastic leukaemia was analysed. The main agent associated with severe neutropenia was methotrexate, and methotrexate-induced neutropenia was significantly greater in patients who had received craniospinal irradiation. The synergistic toxic effect of irradiation followed by methotrexate treatment seems to have contributed to three of the five deaths which occurred in complete remission in this trial; all deaths in remission occurred in patients who had received central nervous system prophylaxis. Analysis of patients who subsequently relapsed compared with those still in remission after 18 months of treatment indicated that the former, on average, had slightly lower neutrophil counts. This suggests that the children who relapsed did not receive any less aggressive treatment than those who remained in remission.
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PMID:Analysis of treatment in childhood leukaemia. I. Predisposition to methotrexate-induced neutropenia after craniospinal irradiation. Report to the Medical Research Council of the Working Party on Leukaemia in Childhood. 110 Jan 79

A gnotobiotic isolation system based on those developed in veterinary research has been constructed for hospital use. Fifteen patients with leukaemia and neutropenia spent a total of 110 weeks in plastic isolators, and none acquired any infection. Endogenous flora was effectively suppressed by topical antiseptics and gastrointestinal decontamination effected with nonabsorbable antibiotics. The isolator system was acceptable to patients and staff and much cheaper than the use of sterile rooms. Other advantages of the system are portability, easy storage, and use on ordinary open wards without prejudice to the microbiological protection afforded. It is as yet uncertain whether protective environments of this type will substantially improve the outcome of treatment for the acute leukaemias.
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PMID:Plastic isolators for treatment of acute leukaemia patients under "germ-free" conditions. 120 66

Granulopoiesis was studied simultaneously by three methods in normal subjects and in subjects with neutropenia of various aetiologies: in vitro labelling of autologous and homologous granulocytes for the study of peripheral kinetics, in vivo labelling with DF32P (di-isopropyl-flourophosphate 32P) or 75Se-selenomethionine, and bone marrow autoradiography after in vitro labelling with 3H-thymidine for the study of bone marrow granulopoiesis. Three main mechanisms of neutropenia can be distinguished: a) peripheral hyperdestruction, corpuscular or extra-corpuscular, and false leukopenias (change in the distribution of peripheral granulocytes from the circulating to the marginal granulocyte pool; b) quantitative bone marrow insufficiency without qualitative abnormality; c) qualitative abnormality in bone marrow granulopoiesis with cell death in either the maturation stage or the proliferative stage. There is no exact correlation between clinical and kinetic classifications, but most cases of post-infection chronic neutropenias and idiopathic neutropenias fall into the first two categories, and most cases of benzol intoxication and bone marrow insufficiency due to X-irradiation fall into the last category. Some of these last patients developed an acute myeloblastic leukaemia in the two following years and can be considered as preleukaemic states.
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PMID:Studies of granulocyte kinetics in normal and granulocytopenic subjects. 121 98

Colony stimulating factors (CSFs) are glycoprotein hormones that regulate growth and differentiation of hematopoietic progenitor cells. Their use to stimulate granulocyte precursors during periods of neutropenia in patients with acute myeloid leukemia (AML) is limited by their concomitant stimulation of the proliferation of myeloblasts. The effects of these agents on leukemic lymphoblasts is not entirely known. We have investigated the in vitro effects of granulocyte-CSF (G-CSF) and granulocyte/macrophage-CSF (GM-CSF) on leukemic cells from children with acute lymphoblastic leukemia (ALL). DNA synthesis of bone marrow cells from 22 children with ALL, either at diagnosis or in relapse, was examined with and without CSFs. Proliferative potential was also tested in a clonogenic assay with 13 bone marrow specimens. These factors did not stimulate the growth of ALL cells in either assay. Our results indicate that G-CSF and GM-CSF should be able to stimulate granulocyte proliferation without enhancing leukemic proliferation during periods of neutropenia in children with ALL.
Leukemia 1992 Nov
PMID:The effect of recombinant GM-CSF and G-CSF on the bone marrow cells of children with acute lymphoblastic leukemia. 127 25

The syndrome of CD8 hyperlymphocytosis with neutropenia is a heterogeneous disorder ranging from reactive benign state to neoplastic pathology. The prognosis for LGL (Large Granular Lymphocyte) leukemia depends likely on its phenotype:-NK phenotype, extremely poor prognosis and rapidly fatal-T phenotype (CD8+), chronic disease with slow progression. Here, we report four cases of CD8+ hyperlymphocytosis with neutropenia, which are CD2+/-, CD3+, CD4-, CD8+, CD16-, CD56+/-, CD57+ phenotype. These lymphocytic proliferations were associated with clonal rearrangement of T-cell receptor b gene. In two cases, characteristic blood hyperlymphocytosis appeared only after splenectomy, but retrospective bone marrow analysis showed that the CD8+, CD57+ lymphocyte proliferation previously existed. These lymphocytes had a low natural killer activity against K562 cell line. HTLV1 proviral sequence was not integrated in leukemic cell DNA. This monoclonal pathology has a chronic clinical course, with a thirteen year evolution in one case. Splenectomy did not correct neutropenia but allowed the control of hemolytic anemia and auto-immune thrombocytopenia in one case.
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PMID:[Lymphoproliferative syndrome with granular lymphocytes of CD8+ phenotype: a clonal pathology with a chronic course]. 128 65


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