[Side effects of cefoperazone (third-generation cephalosporin) in a child with acute lymphoblastic leukemia].
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Biomedical subjects
Publications and source records attributed to H Bubała.
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From January 1987 to April 1988 six children we studied cytologically with the use of alkaline phosphatase-anti-alkaline phosphatase (APAAP) method and monoclonal antibodies (MoP) in order to establish the diagnosis of Non-Hodgkin Lymphoma. (NHL). Cytologic studies concerned pleural fluid (3 patients) imprints of the lymph node (3 patients), bone marrow smears (2 patients) and cerebrospinal fluid (1 patient). We performed simultaneously routine cytologic and histopathologic studies of the lymph nodes. Antigen T6 (thymocytes) was present in blasts of all patients, which permitted us to classify the blasts as common stage II group according to Reinherz. In all cases we found at least two positive antigen detected by MoP pan T (CD2, CD3, CD5, CD7) in one case--no expression of antigen T3 (CD3) and in two cases no antigen detected by an antibody CD2. Antigen Ia was found in one patient, and weak expression of antigen CALLA (CD10) in one patients. In three patients we showed a simultaneous expression of antigens T4, T8, whereas in two patients they were not observed. One child possessed mature phenotype T4, T6. By using APAAP method with MoP in cytologic studies it was possible to diagnose T-lymphoblastic lymphoma in six children before the results of histopathologic examination of the lymph nodes.
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To optimalize the diagnosis of meningeal involvement in ALL we adapted the alkaline-phosphatase-anti-alkaline-phosphatase procedure (APAAP) to be used for cerebrospinal fluid (CSF) examination. The study was performed on 19 patients (9 children with leukemia) with CSF hypercellularity. 490 determinations with a panel of 12 monoclonal antibodies were performed. This method was convenient, cell morphology was preserved so that combined morphological and immunological characterization of specific cells was possible in mixed cell populations. The combined study of immunological and morphological criteria produced more accurate results than those based on morphological criteria alone. The APAAP technique is useful for small numbers of cells. The preservation of antigenic reactivity in frozen CSF smears may be of use in reevaluation studies.
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Four children with the acute leukemia are presented. Their blasts shown the presence of 2 cellular lines markers. Coexistence of markers in the blasts was detected with the technique of double staining the blasts from the bone marrow with: alkaline phosphatase-anti-alkaline phosphatase, and peroxidase with the use of monoclonal antibodies series. Analysis of blasts phenotype with monoclonal antibodies confirm the occurrence of leukemias different from the normally programmed cellular line. Deviations of leukemic cells phenotype may be explained with the fact that leukemogenesis is not an absolute block of cells differentiation but combines maturation disorders and proliferation enabling expression normally absent antigens. It confirms the concept of line preservation and presentation of "earlier frozen" phenotype, and explains the occurrence of leukemias in which blasts present phenotype of one line which does not comply with cell differentiation pattern. Further genotypic studies are necessary to clarify pathogenesis and origin of such blasts. Consequently examination of the larger group of patients with hybrid leukemias will enable conclusions concerning prognostic value of such findings and necessity of introduction of the special therapies.
A case is presented of a rare T-phenotype acute lymphoblastic leukaemia. The blast cells were negative in the rosette test and demonstrated expression of the Ia antigen.
Efficacy of the ceftazidime monotherapy in 120 febrile children with neoplastic diseases and granulocytopenia was compared with that of tobramycin combined with amoxycillin/ampicillin. The obtained results were similar in both types of antibiotic therapy. However, granulocytopenia was higher and septicemia was more frequent in children treated with ceftazidime. Isolated bacteria were more sensitive to ceftazidime than to tobramycin with amoxycillin/ampicillin. Both regimens were tolerated well. Despite a low number of patients in both groups, one may conclude that ceftazidime is more efficient in patients with granulocytopenia. Less adverse reactions, lower number of infections, less frequent medical procedures, elimination of the potentially toxic aminoglycosides and lower cost of therapy advocate the use of ceftazidime monotherapy.
Blasts phenotype was determined in 61 children with the acute lymphoblastic leukemia. Non-T-cell acute lymphoblastic leukemia was diagnosed in 51 children. Stages of blasts differentiation were determined with the aid of monoclonal antibodies set using alkaline phosphatase-anti-alkaline phosphatase technique. Blasts in 50 patients belonged to B subpopulation confirmed by the presence of panB CD19 and CD22 antigens. Common antigen was seen in 76.5% of the examined patients with non-T-cell acute lymphoblastic leukemia. Cases of non-T-cell acute lymphoblastic leukemia were divided into 8 subgroups depending on the antigens of B-cells differentiation. An identification of pre-B subgroups of the acute lymphoblastic leukemia indicates heterogenicity of the acute lymphoblastic leukemias in childhood and enables their classification into groups corresponding to the early stages of lymphoblasts maturation.
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In 47 children after a 5 year remission of treated acute lymphoblastic leukemia respiratory function was assessed. In 11 a decrease of VC was found, while in 12 signs of obturation of lower airways were present. These results imply the presence of restrictive changes suggesting an interstitial lung disease. These children are at risk of developing a chronic pneumopathy.