Biomedical subjects
Publications and source records attributed to B Zdziarska.
Two rare cases of spurious macrocytosis are reported: in a patient with lymphocytic lymphoma and in another patient with pneumonia caused by Klebsiella pneumoniae. High blood titer of cold agglutinins resulted in appearing of microagglutination in vitro and false erythrocyte indices as measured by automatic blood cell counting.
The management of stomatitis, commonly complicating intensive chemotherapy in patients with acute leukemias and malignant lymphomas has been presented. The hydrotherapy equipment of our own construction was designed to wash the oral cavity with large amounts of fluid given at low pressure and constant temperature. This washing solution contained the addition of drugs; its pH was adjusted to the pH of the patients saliva. Preliminary results of this treatment modality have been reported.
The authors report the clinical course and neuropathological findings in the case of hemiballismus due to leukemic infiltration of the subthalamic nucleus. The symptoms were observed in a 19-year-old patient with blastic phase of chronic myelogenous leukemia, two weeks before death, when what is called the "critical point" developed (white cell count beyond 100 G/l and thrombocytopenia less than 50 G/l). The investigation are considered to confirm the role of the "critical point" in the development of central nervous system leukemic complications.
The frequency and distribution of intravascular coagulation (IVC) were studied in brains of 121 patients who had died due to acute myeloblastic leukemias type M1 or M2. The IVC within the brain was observed in 59% of cases, more frequently in patients treated with polychemotherapy, especially according to TAD or VAPA protocols. The microthrombi were found predominantly in capillaries and small venous vessels. IVC was more frequent in cerebral and cerebellar white matter and in the neighbourhood of lateral ventricles (hippocampus, thalamus). In patients who had developed brain hemorrhage in the course of primary neoplasmic disease IVC was very frequent phenomenon, thus IVC is considered to be an important factor in the development of CNS hemorrhages in myeloblastic leukemias, irrespective of thrombocytopenia related to bone marrow involvement.
Clinical and neuropathological investigations have been performed on 29 patients deceased due to blastic phase of chronic myelogenous leukemia. The authors tried to determine if the risk of death due to hemorrhagic complications in the central nervous system (CNS) increased in the period of blastic phase with simultaneous hyperleukocytosis above 100 G/l and thrombocytopenia below 25 G/l. The results have revealed that in the above mentioned period named "critical point" the probability of death due to hemorrhages is over 7 times as high as during hyperleukocytosis without thrombocytopenia and almost twice as high as during thrombocytopenia without hyperleukocytosis.
Parameters of unspecific immunity (absolute numbers of peripheral blood lymphocytes and their subpopulations, monocytes, blood concentrations of G, A, M immunoglobulins and skin tests with recall-antigens) were evaluated in 25 patients with high grade malignancy non-Hodgkin lymphomas at diagnosis. The frequency, site and gravidity of infections were recorded during the cytostatic treatment with the use of CHOP or CBVPP/ABVD regimens. The same immunological parameters were reevaluated in 9 patients in remission, within 6-52 months following treatment's cessation. Disturbances in at least 2 out of 10 studied parameters were found in all 25 patients at diagnosis. While on treatment, 19 out of 25 patients suffered from various bacterial, viral or fungal infections. The diminished frequency of infections was observed after treatment cessation, in contrast to persisting immunological disturbances. The usefulness of the immunological status monitoring and of immunomodulatory treatment during the remission phase of NHL is postulated.
The performed clinical analysis covered 80 patients with multiple myeloma, treated at Hematological Clinic of PMA in the years from 1974 to 1984. The following prognostic factors were analyzed: age, sex, living place, clinical advancement period of the disease, functional state according to Karnofsky (Karnofsky's index), monoclonal protein type, the concentration of urea, creatinine, calcium in blood serum, hemoglobin concentration as well as the neoplastic tumour mass. These factors were considered to indicate poor prognosis: severe anemia, hypercalcemia, renal failure, and Karnofsky's index being below 70 points.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The neurological and electroneurographic assessment was carried out in 56 patients with high-grade non-Hodgkin lymphomas. In 37 patients the neuropathological examination was also done. Polyneuropathy was the most frequent sign of nervous system involvement, observed in 40% of patients before chemotherapy and markedly enhanced by cytostatics. The signs of the central nervous system involvement were usually caused by lymphomatous infiltrations within leptomeninges, especially in lymphoblastic and immunoblastic lymphomas. The authors stress that cerebro-spinal fluid should be investigated several times for avoiding of false negative results. Signs of lymphomatous infiltrations disappeared after treatment, while signs of polyneuropathy due to chemotherapy increased during cytostatic treatment.
In 1979-1987, 570 patients with non-Hodgkin's lymphomas (226 female and 344 male patients) were treated at the Department of Hematology of the Pomeranian Medical Academy and hematological outpatient clinic. The second malignant tumors were diagnosed in 25 (4.4%) patients. Two patients suffered from three malignant tumors. The most frequent combination of 2 tumors were: non-Hodgkin lymphoma and cancer of the lungs in 8 patients, non-Hodgkin lymphoma and cancer of the skin in 6 patients, non-Hodgkin lymphoma and cancer of the larynx in 4 patients, non-Hodgkin lymphoma combined with cancer of the stomach in 2 patients, and non-Hodgkin lymphoma together with cancer of the bladder in 2 patients. Moreover, non-Hodgkin lymphoma coexisted with cancer of the colon, cervix and prostate (one case of each). The authors stress the possibility of other malignant tumors in patients with non-Hodgkin lymphomas and occurrence of the subsequent neoplasms without preceding chemo- or radiotherapy.
Explore the source record for details and available documents.
Clinical and neuropathological examinations were carried out in 32 cases of chronic myeloid leukaemia dying in the blast phase. The hypothesis is put forward that in chronic myeloid leukaemia lower age of the patient (below 45 years) is a risk factor for development of central nervous system involvement which may be related possibly to high leucocytosis occurring more frequently in these cases in the blast phase leading to leucostasis and leukaemic infiltrations in the brain. The duration of the chronic phase and blast phase, and the pattern of leucocytosis in the chronic phase were similar in younger and older patients.