Biomedical subjects
Publications and source records attributed to B Leszko.
Pseudothrombocytopenia in four patients has been described. It was due to platelet "++EDTA-dependent" antibodies. The number of platelets was described only in EDTA blood while the number was normal when platelet were evaluated in citrate blood. The importance of distinguishing pseudothrombocytopenia from thrombocytopenia is discussed, especially in view of unnecessary treatment, delayed operation etc.
8 patients with severe and 4 with non-severe aplastic anaemia, aged 7 to 46 years, whose suppressor lymphocyte activity was in most cases elevated and who had no histocompatible sibling donor, underwent 1-2 courses of ALG/ATG treatment. 6 patients got CR and 1 PR and during 1-4 years they live with sustaining haemopoiesis, independent of blood transfusion (except one in PR). Among these seven responders increased suppressor lymphocyte activity normalized in 6. The adverse effects of the treatment were granulocyto- and thrombocytopenia, subfebrile states, hepatotoxicity, serum sickness and skin allergy. Five patients died because of early or late complications of the treatment or it's failure. Our results, similar to other authors', are like after BMT and supports the immunological mechanism of A.A. Immunosuppressive treatment with ALG/ATG has many advantages: no need to have identical bone marrow donor, no GVHD, possibility of treatment of patients over 30, even pretreated with blood transfusions, and finally much lower costs and efforts.
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Using the fluorescence technique the presence of various immunoglobulin classes (IgG, IgA, IgM) was determined on the surface of peripheral blood lymphocytes obtained from healthy subjects (10 cases) and from patients with chronic lymphatic leukaemia (65 cases). In the investigations the effect of treatment and clinical course on the values of these parameters was taken into consideration. Nearly in all cases of this leukaemia the percent of lymphocytes binding immunoglobulins on their surface was raised in comparison with the lymphocytes of healthy subjects. Presence of one or more classes of immunoglobulins was demonstrated on the surface of leukaemic lymphocytes.
In 23 patients with polycythaemia vera and symptomatic erythrocytosis, glomerular filtration rate and urine concentration ability see article were determined under conditions of antidiuresis. The restriction of fluid intake caused a significant reduction of GFR and modified the osmotic function of the kidneys. The results were similar in both types of polycythaemia.
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In 22 patients with phase IV of Hodgkin's disease refractory to treatment by the programmes MOPP and/or CVPP, and ABCD and/or BACOP, and in patients with recurrences after this treatment the ABDIC and/or BVCPP programmes were applied. In 5 cases this treatment was associated with radiotherapy. Complete remission lasting 30 months was achieved in one case. In 9 cases only clinical improvement was noted. Twelve patients failed to respond to this treatment. Ten patients died. The mean survival time of all patients from the beginning of treatment by ABDIC and BVCPP programmes to the end of the observation was 14 months, and the time from the diagnosis to the end of the observation was 69 months. The results of this treatment are not satisfactory.
Clinical analysis of 300 cases of secondary pancytopenia treated in a period of 10 years is reported. The disease was more frequent in women than in men. The most frequent single cause were drugs, among them chloramphenicol. Most patients had pancytopenia and hypoplastic bone marrow. The mortality was 37%. Death occurred most frequently in the first 6 months of the disease due to infection or thrombocytopenic heamorrhagic diathesis. The results of treatment with corticosteroids and androgenic steroids were unsatisfactory.