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K Wutke

Publications and source records attributed to K Wutke.

31 records · Page 2Linked to original sources
PubMed1981

Cytological and histological classification of multiple myeloma.

In a retrospective study of 202 cases of multiple myeloma (MM) were studied cyto- and histomorphologically. In 62 cases only bone marrow smears, in 60 only histological preparations and in 80 both types of material were available. According to the differentiation of myeloma cells, a plasmocytic (n = 127), a mixed cellular (n = 35) and a plasmoblastic type (n = 32) could be distinguished. Besides, 8 cases with predominance of giant cells were found (giant cell MM). The comparative cytological and histological typing into the four types of MM proved to be reproducible. The medium survival time and survival curves of the described types showed a statistically significant difference. The survival times were 39.7 months with the plasmocytic type, 16.1 months with the mixed cellular type, and 9.8 months with the plasmoblastic type. The prognostic relevance of the morphological classification was supported by the frequency of extramedullary infiltrates (20% in the plasmocytic, 67% in the mixed cell, 69% in the plasmoblastic and 100% in the giant cell type).

Aged↗
PubMed1980

[Demonstration of Epstein-Barr virus genome in european Burkitt lymphoma (author's transl)].

A 6-year-old European boy with a tumour in the head and neck region died 86 days after the first occurrence of symptoms despite chemo- and radiotherapy. An epipharyngeal biopsy at the beginning of the disease and a cytological investigation of biopsy and autopsy material showed non-Hodgkin lymphoma with a high degree of malignancy of the Burkitt type. High antibody titres against Epstein-Barr virus (EBV)-specific virus capsid antigen, nuclear antigen and the R component of the EBV-early-antigen-complex as well as the approximately 27 EBV genome equivalents per tumour cell, demonstrated by DNA-DNA hybridisation, characterised the tumour as true Burkitt lymphoma which is observed extremely seldom outside Africa.

Antigens, Viral↗
PubMed1979

[Prognosis of lymphogranulomatosis (stage III B-IV) treated with drugs--results of a retrospective 10 year study].

With the help of survival curves of 91 patients with histologically ascertained lymphogranulomatosis a report on experiences concerning the prognostic importance of different factors is given. The examination is based on a retrospective analysis of a well documented number of patients who were chemotherapeutically treated from 1967--1976 in the medical outpatient department and the medical clinic of the Erfurt Academy of Medicine. We found on the basis of the retrospective study that the following factors deteriorate the prognosis: Clinical stage IV, presence of general symptoms, type poor in lymphocytes. Older age at making the diagnosis as well as male sex also reveal a worse prognosis as to the 3-year-survival rate than the comparative groups. Furthermore it was shown that the quality of remission after initial chemotherapy is of decisive prognostic valency. When cytostatic combination schemata were used for the induction of the remission the survival rates could be improved. The problems of the remission-keeping chemotherapy are entered.

Adult↗
PubMed1979

[Morphological and immuno-cytological classification of secretory immunoglobulin producing malignant lymphomas (author's transl)].

After an introduction about the frequency of "secretory" immunoglobulin producing malignant lymphomas and the histological equivalent of intracytoplasmatic immunoglobulin the results of a co-operative retrospective study on 102 cases of immunocytoma and 28 cases of immunoblastoma are discussed. According to the different types of physiological plasma cell reaction lymphoplasmacytoid immunocytoma might be functionally interpreted as "parafollicular" immunocytoma, whereas lymphoplasmacytic and polymorphous immunocytoma might be functionally considered as a "transfollicular" one. These subtypes of the immunocytoma show differences in morphology, immunocytology, primary localization and occurrence of leukemia.

Humans↗
PubMed1979

[Prognostic clinical and morphological classification of multiple myeloma (author's transl)].

Clinical staging has been widely accepted as essential for optimal treatment of many types of cancer. Various groups of workers have investigated factors which influence prognosis in multiple myeloma. Important factors which have been indentified include the performance status, the presence or absence of renal insufficiency, the quantity of the monoclonal protein fraction in the serum, the extent of bone lesions, the serum concentration of albumin and calcium, and the hemoglobin level. Since our findings agreed with the staging, previously proposed by Salmon, this procedure was used to stage myeloma cases in a retrospective study. Survival was statistically significant shorter in stage III than in stage I and in subtype B shorter than in subtype A. In addition to the clinical findings we propose a system for the cytological and histological staging of multiple myeloma which is based on differences in maturity of myeloma cells and have tested its validity in predicting survival in a retrospective follow-up study. 202 cases of multiple myeloma have been analysed by cytological and histological methods. On the basis of the findings the following types were distinguished: 1. plasmocytic myeloma (127 cases), 2. plasmoblastic-plasmocytic myeloma (35 cases), and 3. plasmoblastic myeloma (32 cases). In 8 cases predominance of giant cells were seen. In types 2 and 3 involvement of extraskeletal sites (lymph node, liver, spleen) was significantly higher than in type 1, just as survival was significantly higher (39,7 months) in this type than in type 3 (9,8 months). There seemed to be no correlation between morphological type and class specificity of monoclonal immunoglobulins. Use of the clinical and morphological staging system should provide better initial assessment and follow-up of individual patients, and should lead to improved study design and analysis in large clinical trials of diagnosis and therapy for multiple myeloma.

Cell Cycle↗
PubMed1978

[The coincidence of visceral lupus erythematosus and epilepsy].

It is reported on course and problems of the diagnosis of a lupus erythematodes visceralis with epilepsy. In the demonstrated case the initial stage was characterized by the nearly simultaneous appearance of relapsing arthritides and epilepsy. The diagnosis was made in the stage of an acute exacerbation with cardiac symptomatology which began after the medicamentous treatment with diphenylhydantoin. Up to this moment an oligosymptomatic lupus erythematodes visceralis had not yet been diagnosed. Anamnestic data and the laboratory-clinical findings of the further course of the disease proved the actual lupus erythematodes visceralis. It is referred to the necessity of an aimed anamnesis and a determination of the antinuclear factors before every application ofhydantoin derivations when an epilepsy and joint symptomatology are present.

Adolescent↗
PubMed1978

[The appearance of immature cell leukemias after radiologic and cytostatic intensive therapy of Hodgkin's lymphoma].

Among 106 patients with Hodgkin's lymphoma in stage IIIB and IVB treated from September 1969 to June 1977 by a working team for hematology and oncology at the clinic and outpatients clinic of the Medical School of Erfurt, there were two cases (=1.9%) showing a final transition to leukaemia with immature cells. A third neoplasia which had developed in a former field of irradiation was additionally observed in one patient. The various possibilities arising from an oncologic effect of ionizing rays and those substances having a cytostatic effect are discussed. After frequent reports on the occurrence of secondary tumours following intensive radiological and cytostatic therapy of advanced Hodgkin's lymphoma the enhanced risk of a secondary tumour being induced by this combined therapy cannot be excluded. Various conclusions are drawn from that by the authors.

Cyclophosphamide↗
PubMed1977

[Strategy of antineoplastic chemotherapy].

After introductory remarks on the present state of the antineoplastic chemotherapy the experiences of the Erfurt treatment centre are described. In close cooperation between the haematologico-oncological department of the Medical clinic and the haematologico-oncological special ambulatory of the Medical policlinic of the Medical Academy Erfurt including the general practitioners from 1969 to 1977 altogether 745 patients with tumours, out of them 580 cases with haemoblastoses and malignant systemic diseases, underwent an intensive care. The Erfurt model well proved in practice and is a constructive basis for the further development of a complex strategy of the antineoplastic chemotherapy.

Ambulatory Care↗
PubMed1977

[Stem-cell leukoses in the adult age--a clinical study].

The cytochemical differentiation of 86 stem cell leucoses of adults resulted with 74% of the cases in a clear prevalence of PAS-negative forms at this age. PAS-positive leucoses were observed only in 11%. The survival time of the patients revealed a clear dependence of the degree of the remission achieved. Also for the cases of PAS-negative leucoses, which achieved a complete remission, it was not worse than the survival time of acute lymphoplastic leucoses. However, the remission coefficient of the PAS-negative leucoses was essentially below the value of lymphoblastic forms. Multiple cytostatic combinations reached the best remission rates. Above all the combination of ribidomycin, cytosine arabinosid (Alexan), 6-mercaptopurine (Mercaleukin), prednisolone and vincristine (Oncovin), called RAMPO-scheme by the authors, seemed to give much success according to the results of this study. The number of complete and good partial remissions was calculated with 62% for the ViDaP-scheme, with 51% for the COAP-scheme. For all cases of treatment the coefficient of remission was 54%.

Adolescent↗
PubMed1977

[Pararheumatic diseases in leukoses].

Pararheumatic complaints may be the leading clinical symptom in the individual case also in leucoses and may lead to diagnostic errors. They are caused by leucotic infiltrates in juxta-articular bone segments, sporadically also by blast infiltrates of the synovial membrane, by secondary osteoporoses or osteoscleroses and by articular haemorrhages. In altogether 254 patients with leucosis there were rheumatoid symptoms in 21% of the cases with undifferentiated cell leucoses, in 37% of the cases with chronic myelosis, and in 12% of the cases with chronic lymphadenosis. Diagnostic errors are deplorable above all in the undifferentiated cell leucosis, as every temporary retardation of the beginning of the therapy furthermore deteriorated the prognosis of the disease.

Diagnosis, Differential↗
PubMed1976

[Problems in the treatment of stem cell leukemias in aged patients].

Stem-cell leukemias will reveal a second peak of frequency at old age. The cytochemical differentiation in 26 patients of old age revealed a preponderance of myeloblastic forms. Moreover, a slight accumulation of monocytic and myelo-monocytic types could also be observed. In spite of this apparently unfavourable cytochemical differentiation the relatively good capability of myeloblastic leukemias of responding to cytostatic treatment was surprising. However, no cytostatic maximum programmes should be chosen in view of the low regenerating ability of the bone marrow in old patients.

Aged↗
PubMed1975

[Immature-cell leukosis as a chance finding].

It is reported on a 35-year-old man in whom by chance was made the diagnosis of an undifferentiated cell leucosis during a routine investigation of the blood before an haemorrhoidectomy. In a number of leucozytes of 234.000/mul 96% of paraleucoblasts were found. Haemoglobin and thrombozytes were normal. Cytochemically a lymphoblast leucosis was concerned. By means of a cytostatic combination therapy (ViDaP-scheme) the clinically latent leucosis was brought into a very good partial remission. A recidivation appearing five month later led in form of a haemorrhagic diathesis to the first symptoms recognizable for the patient.

Adult↗