Biomedical subjects
Publications and source records attributed to L I Iavorkovskiĭ.
The author reviews the discovery of parvovirus B19, its characteristics, epidemiology, clinical and hematological features of acute and chronic forms of the infection in children and adults, diagnostic techniques, treatment of most severe forms.
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A case of typical Ph-positive chronic myelogenous leukemia developed in a 58-year old female with a 7-year history of chronic lymphoproliferative disease is described. With the second disease progression, the features of lymphoid proliferation disappeared almost completely. Possible causes of this rare combination of two diseases are discussed.
The data from literature on chromosome abnormalities in various subgroups of the myelodysplastic syndrome (according to FAB-classification) are presented. Special attention is paid to information about changes in the number and structure of chromosomes during the disease and their prognostic significance. The relation of definite chromosome aberrations to the clinical course and prognosis of the disease, in particular to its transformation into acute leukosis is under discussion.
A total of 5 patients with a clinicohematological picture resembling hairy-cell leukemia (HCL) have been described. However, the morphological features of leukemic lymphocytes, the absence of acid phosphatase in them, the nodular character of the bone marrow lesion combined with an unusual phenotype have permitted the authors to distinguish these cases as a separate variant of B-cell malignant lymphoma. Paraprotein (M-class) was detected in the blood of two of the patients. A conclusion has been made that the combination of splenomegaly with hairy lymphocytes in the blood is characteristic of not only HCL, but it can be also observed in different variants of malignant lymphoma.
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The authors have presented the current data on so-called Ph'-negative chronic myeloleukemia (CML). A detailed clinico-hematologic analysis has proved that most of patients with unchanged chromosome 22 have other myeloproliferative disease, most often it is chronic myelomonocytic leukemia. In some CML patients Ph'-chromosome is masked as a result of translocations, in other patients, although chromosome 22 is unchanged, the molecular-genetic marker of CML--chimera bcr/c-abl-gene, is detected on chromosome 22 or some other chromosome. It has been noted that only in rare cases of typical CML characteristic cytogenetic and molecular-genetic changes are absent. Further investigations should be conducted in the group of patients studied.
The analysis has been presented of the treatment of 35 patients (mainly middle-aged) with acute non-lymphoblastic leukemia, 27 of them untreated. Repeated 2-3-week courses of subcutaneous injections of cytarabine were used (10 mg/m2, twice a day). A total of 5 complete and 4 partial remissions were recorded. The frequency of complete remissions among the patients who received 2 and more courses of the drug therapy comprised 38.8%. Complete remissions were observed in primary patients with initially lowered or normal leucocyte count in the blood, with partially retained granulocytopoiesis, and a relatively slow progressing of the disease. The mechanisms of action of low doses of cytarabine has been considered.
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The blot-hybridization method for detecting gene rearrangement of Ig and T-cell receptor for antigen is briefly described. The results obtained by this method in various lymphoproliferative diseases offer new insights in the diagnosis of monoclonal lymphocyte expansion and in the determination of the lineage of proliferating cells. The ability of revealing oligoclonal lymphocyte proliferation and discriminating benign and malignant forms of angioimmunoblastic lymphadenopathy, T gamma-lymphocytosis, and some other disorders makes this method a useful tool for investigating diseases with lymphocyte proliferation.
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Improved cytogenetic techniques allow for the identification of subtle chromosomal rearrangements associated with particular subgroups of monocytic leukemias. A detailed assessment of both quantitative and structural chromosomal defects is presented and clinical and prognostic value of the karyotypic pattern is discussed.
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The contents of T-lymphocytes and their basic subpopulations (T-helpers and T-suppressors) in peripheral blood of 40 patients with B-cellular chronic lymphatic leukemia was studied (CLL) using monoclonal antibodies. It is shown that an imbalance of T-helpers and T-suppressors is observed in many patients (a ratio of helpers/suppressors less than 1.29 in 24 patients) at the expense of a decrease in the relative content of T-helpers in patients at stage I-III of CLL and an increase in the contents of T-suppressors in patients at stage IV. A correlation is revealed between the ratio of T-helpers and T-suppressors, on the one hand, and the stage of the disease, on the other hand.
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