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N Smadja

Publications and source records attributed to N Smadja.

At least 37 records · Page 2Linked to original sources

Acquisition of a Philadelphia chromosome concomitant with transformation of a refractory anemia into an acute leukemia.

The authors present a case of Philadelphia (Ph1) positive acute myeloblastic leukemia (AML) following a refractory anemia with excess of blasts (RAEB) that had been Ph1-negative for 17 months. During the transformation of RAEB into AML, the Ph1 was discovered in 100% of the examined cells. With therapy a partial remission was obtained, during which some 46,XY cells reappeared mixed with Ph1 cells along with a new clone: 47,XY,+11 originating from a Ph1-negative cell. During the terminal blast crisis, the karyotype returned to 46,XY,Ph1. The AML lasted 21 months. The authors discuss: (1) the significance of Ph1-positive AML with a review of the literature; (2) the de novo acquisition of a Ph1 during the course of a blood disorder; and (3) the meaning of a second abnormal clone originating from 46,XY cells.

Anemia, Aplastic↗

Translocation 1;7 in preleukemic states.

A translocation t(1;7) interpreted as t(1;7)(p11;p11) was first reported by Scheres et al. in eight patients with various hematologic disorders. The karyotype of the abnormal cells was trisomic for 1q and monosomic for 7q. Those investigators reported having found four other cases in the literature. We report herein studies of two patients with the same t(1;7).

Adult↗

Quantification of bone lytic lesions and prognosis in myelomatosis.

Degree and extent of lytic bone lesions were quantified at diagnosis in 69 patients with myelomatosis (MM). longest survival was found in patients with minimal lytic lesions and shortest survival was found in those either without bone lesions or with severe and extensive lesions. Among the 12 patients without bone lesions only 6 were Durie & Salmon stage I and only 1 later developed a single lesion. Based on these data, bone involvement in MM does not seem to be a reliable predictive factor of survival in all cases. This suggests the existence of 2 distinct types of MM: 1 with tumour and 1 without. Lytic lesions could have a prognostic value only in the 1st type.

Aged↗

[Abnormality of chromosome number 1 in 3 cases of acute transformation of chronic myeloid leukemia].

The authors report three cases of Ph1-positive chronic myelogenous leukemia (CML) with chromosome no 1 abnormalities. Such abnormalities have seldom been reported: three cases out of 42 in blast crisis and none of the 70 patients in the chronic phase in our series. In case no 1 a translocation: (t(1q;14q) was noted. In case no 2 the rearrangement was more complex: partial duplication of the long arm of chromosome no 1 and presence of a 21q+ corresponding to chromosome no 21 on which a part of the long arm of chromosome no 1 was transferred. In case no 3 a double translocation was noted between chromosomes no 1 and no 11, involving either the p or q arm. A review of the literature shows that abnormalities of chromosome no 1 are more frequent during the blast crisis that in the chronic phase of CML. Chromosome no 1 abnormalities are found in a number of myeloproliferative syndromes but even more frequently in solid tumors. The rearrangement sites are reviewed by the authors. Such rearrangements of chromosome no 1 may indicate an increased potential of malignancy.

Adult↗

Two cases of acute leukemia following treatment of malignant glioma.

Two female patients, 42 and 30 years old, respectively, died of acute nonlymphocytic leukemia 43 and 38 months, respectively, after a subsequent treatment: chemotherapy for one and irradiation and chemotherapy for the other, following excision of a malignant glioma. At the time of death, both seemed to be in complete remission of their brain tumor. Both had been treated with procarbazine and nitrosoureas. The latter were responsible for severe myelosuppressive episodes and seem to have played an essential role in the induction of the leukemia. In one case, a myelodysplasia was observed before the onset of the AL and the diagnosis of refractory anemia with excess of blasts seemed warranted. Secondary acute leukemias are rare in the evolution of malignant gliomas and the usefulness of subsequent radiochemotherapy cannot be questioned at the present time. The risks involved in this therapy are minor when compared to the short-term fatal prognosis of this type of tumor.

Acute Disease↗

[Hematologic and cytogenetic study of 7 cases of preleukemic state or acute leukemia following the treatment of a first malignancy].

The authors present 7 cases of preleukemic state and/or acute leukemia following the treatment of a first malignancy (3 malignant lymphomas, 3 epithelial cancers and one polycythemia vera). A preleukemic state was found in all patients. In 6 cases it was followed by an acute non-lymphoblastic leukemia which was rapidly fatal; in one case, death occurred during the preleukemic phase. A karyotype was prepared during the preleukemic phase in 6 out of 7 patients and in 4 out of 6 during the leukemia. Karyotypes prepared during the preleukemic state presented at least one of the abnormalities which are characteristic of secondary hematopoietic disorders: -5/5q; -7/7q; involvement of 17. The same major clone was found in 3 of the 6 patients who were karyotyped during the acute leukemic phase. These karyotype abnormalities are not only characteristic of secondary acute leukemias but also of secondary dysmyelopoietic syndromes.

Adult↗

[Association of Kaposi's sarcoma with acute myeloblastic leukemia. Apropos of a case].

The authors report the case of a 73-year-old woman from Central Europe with acute myeloid leukemia and Kaposi's sarcoma. The two diseases were discovered simultaneously. The inefficacy of leukemia chemotherapy and the widespread cutaneous diffusion of the Kaposi's sarcoma explain the unfavorable outcome. The different pathogenic hypotheses which can account for the association of these two different malignancies are reviewed.

Aged↗

Hematologic and cytogenetic study of two cases of acute leukemia associated with breast cancer.

The authors present two cases of patients with breast cancer with lymph node extension and who both had surgery. As a pancytopenia with hypercellular bone marrow was discovered at the same time in the first patient, she received no complementary treatment; 4 months later, she presented with an acute lymphocytic leukemia (ALL) for which a remission was easily induced, but she died of a pulmonary infection. The second patient received local radiotherapy (50 grays) and adjuvant chemotherapy (Alkeran for 26 months). Forty-seven months after the diagnosis of breast cancer and 16 months after the end of the treatment, an acute nonlymphoblastic leukemia (ANLL; M6) was diagnosed after 8 months of a preleukemic state. Treatment did not produce any results and death occurred on the 17th day. Cytogenetic studies on the bone marrow cells of both patients were performed. In the first patient in the ALL phase normal cells coexisted with a 47 chromosome clone, the extra chromosome being a D (+ 13?). In the second patient, several karyotype abnormalities were already present in the preleukemic state and also during the acute leukemic phase. No normal mitoses were found; hypodiploidy was present as well as major abnormalities such as markers, rings, and, among others, the systematic loss of a #5 and a #7. The first patient seems to have presented with a de novo ALL, associated with the malignant tumor; whereas, the second patient showed all the characteristics of an induced ANLL. The clinical, hematologic, and cytogenetic characteristics of these two patients are analyzed and compared to those of other cases in the literature.

Adenocarcinoma↗

Chronic myelogenous leukemia with a Philadelphia chromosome resulting from a complex translocation (2; 9; 22), following an undifferentiated acute leukemia.

This case report concerns a patient with acute leukemia considered at diagnosis to be undifferentiated. Unfortunately, because of the failure of the culture, a cytogenetic evaluation was not possible at that stage. A full remission was induced, but 17 months after the onset of the disease the patient developed chronic myelogenous leukemia. The karyotypes prepared at that time and during the follow-up revealed the presence of a Philadelphia chromosome (Ph1) in all examined cells. This Ph1 resulted from a complex translocation involving chromosomes No. 2, 9, and 22.

Adult↗

[Acute leukemia associated with breast cancer (author's transl)].

Two cases of acute leukemia in patients with breast cancer are reported. In the first patient, erythroleukemia occurred three years after breast cancer was treated by mastectomy, followed by local radiotherapy ; complementary chemotherapy (melphalan) has been given for twenty-six months. The second patient had onset of acute lymphoblastic leukemia four months after breast cancer was treated by surgery only. This patient subsequently has complete remission. Both patients died shortly after onset of leukemia. In the first patient, bone marrow cytogenetic studies evidenced major abnormalities at an early stage of the disease, with abnormal mitoses in all the cells, whereas, in the second patient, only minor abnormalities were found. A review of previously published cases of breast cancer with acute leukemia was done. Our findings suggest that the association of leukemia with breast cancer may result from therapy is some cases (secondary induced acute leukemias) while in others it may occur spontaneously.

Aged↗

[Cytogenetic study of preleukemic phases and of acute leukemia secondary to chemo-and/or radiotherapy. Review of the literature (102 cases)].

A review of the literature upon 102 cases with cytogenetic study of preleukemic states (Prel.) and/or acute secondary leukemia (ASL) following chemotherapy and/or radiotherapy treatment has been made. The karyotype was almost always abnormal (91%) of cases). There was a predominance of hypodiploidy with abnormalities including chromosome number 5 (-5 ou 5q-) and/or number 7 (7- or 7q-) (chromosomes studied with banding). The abnormalities were present in preleukemia state. The pattern of the acute secondary leukemia was particularly different from that acute leukemia de novo: high frequency of preleukemia state, ANLL type of leukemia, very bad prognosis, importance of cytogenetic abnormalities. There was a great interest in the study of the karyotype for the previous detection in ASL: this allowed their discovery as soon as the preleukemia state.

Acute Disease↗

[Study of caryotype in pre-leukaemic states (author's transl)].

Twenty-four patients, in a condition considered to be pre-leukaemic underwent study of marrow caryotype. Nine of them (37.5%) had an abnormal caryotype. The prevalence of abnormalities varied according to the type of pre-leukaemic state: 17% in acquired idiopathic sideroblastic anaemia, 33% in refractory anaemias with excessive myeloblasts, 100% in 3 cases of simple refractory anaemia. The abnormalities were non-systematised. However, in one case there was an abnormality already described in the literature and considered to be specific: deletion of the long branch of chromosome 5. In refractory anaemias with excess myeloblasts transformation to acute leukaemia appeared to be more frequent in patients with an abnormality (4/5) than in patients with a normal caryotype (0/10).

Aged↗

[Inagural lymphoblatic transformation in chronic myeloid leukemia. Clinical and cytogenetic study of one case].

A fifty-year old patient was treated for acute lymphoblastic leukemia. One month after a complete remission, a syndrome suggesting chronic myeloid leukemia led the authors to study the marrow karyotype which revealed the existence of a Philadelphia chromosome. A second lymphoblastic attack occurred rapidly and a second complete remission was easily obtained. A few weeks later, occurred lymphoblastic meningitis. A new cytogenetic study then showed duplication of the Philadelphia chromosome. One may imagine that the initial attack represented acute lymphoid transformation of chronic myloid leukemia. The theoretical and practical significance of this case is discussed.

Bone Marrow↗