[Acute monocytic leukemia with chromosome 11 anomalies].
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Biomedical subjects
Publications and source records attributed to G Flandrin.
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Between 1959 and 1978, 150 patients with tricholeucocytic leukaemia were seen, 5 having radiological bone lesions. This has been reported only once in the literature, its significance and therapeutic consequences remaining ill-defined. One of the commonest sites of bone involvement is the neck of the femur. The usual appearances are those of demineralisation, lysis and pathological fracture. The true prevalence of such lesions could be determined only by routine studies for the presence of such lesions.
Two cases of infantile acute lymphoblastic leukaemia, Burkitt type, are reported. The cytogenetic study revealed a translocation t(8;14) similar to that of Burkitt's lymphoma. This chromosomal rearrangement is considered as a further argument which favours uniqueness of the two diseases.
Three cases of a new variety of acute leukemia have been reported. The main features were: hyperleukocytosis made of large-sized blasts with a double shaped nucleus, few or no granulations in the cytoplasm, and in a few cell faggots or unique Auer rods; mycloperoxydase reaction was positive. This feature was associated with disseminated intravascular coagulation syndrome and t(15;17)(q22;q21) translocation in the majority of mitoses.
A 15-year-old female was treated for malignant histiocytosis. The occurrence of a leukemic phase (178,000 blasts/cu mm) during the follow up provided the opportunity of studying a large number of malignant cells by cytochemical electron microscopic, and cell membrane markers techniques. Acid phosphatase reaction was strongly positive and totally inhibited by tartaric acid. Nonspecific esterase reaction was moderately positive with inhibition by sodium fluorid. Electron microscopy revealed the presence of surface membrane pseudopods and the phagocytic activity of the cells. The leukemic cells had a receptor for the Fc fragment of IgG. These findings support the histiomonocytic origin of the abnormal cells in malignant histiocytosis.
A t(8;22)(q24;q11) translocation was found in blood, bone marrow, and ascites cells from a European Burkitt's lymphoma. Cell surface markers were identified as monoclonal IgG. The relationship between these two unusual findings is questionable in this cytologically typical Burkitt's lymphoma.
Erythrokinetics were studied in 29 patients with hairy-cell leukaemia. In all cases there was an increase in plasma volume, closely correlated to the size of the spleen, indicating that the true degree of anaemia can only be appreciated by red cell volume measurement. Moderately increased haemolysis was observed in most cases, which did not correlate with the spleen size. Simultaneous study of autologous and isologous red cell life-span suggested an extra-corpuscular mechanism for the haemolysis in most patients. A quantitative erythropoietic defect, either relative or absolute, was found in half the cases, without any qualitative defect. Only one case showed erythroid metaplasia of the spleen. Thus marrow failure appears to be largely responsible for the anaemia and granulocytopenia in hairy-cell leukaemia. A clear correlation was shown between the short-term prognosis after splenectomy and the degree of hypersplenism. However, long-term survival correlated chiefly with the degree of bone marrow failure, whether splenectomy had been carried out or not. The results indicate that isotope studies in hairy-cell leukaemia are useful both in determining the best form of treatment and predicting survival.
Cytogenetic findings on five patients with ALL Burkitt's type are reported. A t(8;14) (q23;q32) translocation identical to that found in Burkitt's lymphoma cells was found in each case. The relationship between ALL, L3 type and Burkitt's tumours is discussed.
Seven acute promyelocytic leukemias (APL) were compared with three atypical acute myeloblastic leukemias (AML). These three AML were characterized by high hyperleukocytosis, mostly formed of monocytelike myeloblasts, disseminated intravascular coagulation syndrome, and a t (15;17) translocation in the majority of leukemic cell mitoses. This translocation was inconsistently found in typical APL defined as M3, according to the FAB classification.
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A malignant histiocytosis in a newborn was found at the same time than a preleukemic syndrome in his mother (less than 10% myeloblasts with Auer rods). An overt myeloblastic leukemia occurs in the mother in the next four months. This uncommon association was presented and discussed.
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Two thousand consecutive white blood cell counts were simultaneously studied by the LARC system and the traditional manual method. This comparison enables the following four couclusions to be drawn.--The reproducibility of the LARC differential is superior to the traditional method;--The similarity between results obtained by the LARC and the manual method are good, as indicated by scatter-plots and calculated correlation coefficients;--The LARC system can be substituted for the traditional manual method, also for markedly pathologic samples, but in this case at the price of a slowing down of the through-put rate of the system;--The detection of abnormal white cell types is as good or better with the LARC system as compared with the manual method.
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The complete hematological remission (CHR) rate, duration of remission and survival were studied in relation to age, peripheral blast cell (PBC) count, presence or absence of tumor masses, cytological type, and treatment in 650 patients with acute lymphoblastic leukemia. Prognostic factors were considered separately and divided into prognostic classes. Age and PCB count correlated with both the rate and the duration of CHR. This correlation was still observed for more recent treatment schedules though it appears to be becoming progressively less significant. Meningeal relapses were more common in patients less than 1 year old and in those with a high PCB count. It is suggested that stratification of patients according to such factors as age, PCB count, presence or absence of tumor, and cytological type might be necessary for the design of new treatment protocols and for the evaluation of their results.