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P Fessas

Publications and source records attributed to P Fessas.

At least 37 records · Page 2Linked to original sources

Monoclonal and oligoclonal immunoglobulins in the serum of patients with B-chronic lymphocytic leukemia.

The incidence of monoclonal and oligoclonal immunoglobulins (paraproteins) was determined in serum samples of 45 chronic lymphocytic leukemia (B-CLL) patients using the high-resolution agarose gel electrophoresis technique combined with immunofixation. Paraproteins were identified in 25 of the 45 patients tested. Twelve paraproteins were monoclonal and 13 oligoclonal. IgG kappa and/or lambda immunoglobulin isotypes were found in 17/25 of these patients. No correlation of the lymphocyte cell morphology and the presence of paraproteins was demonstrated. The high frequency of serum oligoclonal immunoglobulins in B-CLL indicates that more than one lymphocyte clone may be present in this disease.

B-Lymphocytes↗

B-chronic lymphocytic leukemia. Prognostic implication of bone marrow histology in 120 patients experience from a single hematology unit.

The available staging systems for B-chronic lymphocytic leukemia (B-CLL) do not always predict the clinical course and the prognosis of the disease. In these systems, the pattern of bone marrow histology is not incorporated. In the current report we investigate the prognostic value of the diffuse or nondiffuse pattern of bone marrow involvement in 120 B-CLL patients in relation to their actuarial survival, and we compare these results with the actuarial survival based on the International Workshop system. In addition, we analyze the influence of the diffuse or nondiffuse pattern on the actuarial survival, in relation to the individual clinical stages (A, B, C). All patients were diagnosed and followed-up in the same Unit. Our patients were divided into Stage A (64), Stage B (22), and Stage C (34). They were also subdivided into those with a diffuse (46) and those with a nondiffuse (74) pattern of bone marrow histology. The difference in the actuarial survival in relation to their clinical stage (A, B, C) was statistically significant (P less than 0.025). A greater statistical difference (P less than 0.005) was found when the actuarial survival was analyzed in relation to the diffuse or nondiffuse pattern of bone marrow histology. No statistically significant differences could be found (P greater than 0.1), when the actuarial survival was calculated in every stage (A, B, C), on the basis of the diffuse or nondiffuse pattern of bone marrow histology. When our Stage A and B patients were analyzed for disease progression, in relation to the diffuse or nondiffuse bone marrow histology, it was found that 66.6% of the diffuse Stage A patients and 88% of the diffuse Stage B patients had disease progression as compared to only 8.6% for the nondiffuse Stage A patients and 33% for the nondiffuse Stage B patients. Our findings indicate that: the pattern of bone marrow histology in B-CLL patients is the single most important prognostic parameter in this disease; a clinicopathologic staging system for B-CLL may be justified; and the diffuse pattern of bone marrow histology could be considered as the best criterion for initiation of therapy in these patients.

Adult↗

The anemia of childhood revisited.

The question of the mechanism of the physiological anemia of childhood was reexamined; we took into consideration the fact that microcytosis is a feature of this anemia as well as the evidence suggesting that the 2,3 DPG/hemoglobin ratio may depend in part on red cell size. In a group of normal, not-iron deficient children a high inverse correlation was obtained between the MCV and the 2,3 DPG/Hb ratio; this latter ratio did not correlate with serum phosphorus levels, previously incriminated in the indirect causation of the anemia of childhood.

2,3-Diphosphoglycerate↗

Quantitation of hemoglobin in single erythrocytes with and without fetal hemoglobin.

The hemoglobin content was determined by microspectrophotometry in single erythrocytes with and without fetal hemoglobin (Hb F) from 16 normal subjects, 30 patients with anemia of different etiology and severity and 20 individuals with thalassemic disorders. Hb F-containing cells were identified by an indirect immunofluorescent method. The relative single cell value: total extinction (TE) at 415 nm, cell size (A) and the ratio TE/A, were used to indicate single cell values of MCH, MCV and MCHC respectively. The TE (MCH) and/or TE/A (MCHC) did not differ significantly between Hb F-containing (F-cells) and non-F cells in normal subjects and in cases with various forms of acquired anemia. On the contrary, the TE and/or TE/A of F-cells was found significantly higher in F compared to non-F cells in 11 of 20 (55%) of the cases with thalassemia. The results suggest that, in some cases of thalassemia, hemoglobin F is an important substitute for hemoglobin A and may improve the level of hemoglobinization.

Erythrocytes↗

Prevention of thalassaemia and haemoglobin S syndromes in Greece.

Clinically severe thalassaemia and Hb S syndromes are a major public health problem in Greece. A wide programme aiming at reducing the births of new cases is under way; it comprises (a) carrier identification either at a premarital stage or prior to the birth of first child and (b) prenatal diagnosis. Participation is voluntary and free of charge. Reduction of births of affected children has been obtained to a very large extent.

Anemia, Sickle Cell↗

Hairy cell leukemia: bone marrow changes following splenectomy and alpha-interferon therapy.

Thirty hairy cell leukemia patients were evaluated repeatedly for their bone marrow (BM) histology. At the time of diagnosis, 18 (60%) had diffuse, 9 (30%) had interstitial, and 2 (10%) had a mixed (diffuse and interstitial) pattern of BM disease. The follow-up BM specimens were obtained at intervals of 3-24 months, and the follow-up observation period was 12-94 months. In patients who were nontreated or only splenectomized, no significant changes were observed except of a persistent megaloblastoid picture of the red cell series and an increase of BM fibrosis. In the alpha-interferon treated patients a complete disappearance of hairy cells was observed in one and a dramatic reduction in five. The hairy cell index was reduced from a mean of 0.8 before to 0.1 after alpha-interferon therapy; most patients displayed megaloblastoid erythropoiesis. In the complete responder features of myelodysplasia were present.

Bone Marrow↗

Hemoglobin Knossos: a clinical, laboratory, and epidemiological study.

Hb Knossos is a beta-chain variant (beta 27 Ser----Ala) that is unrecognizable by conventional separation methods but detectable by globin electrophoresis on urea-Triton X-acrylamide gels or by IEF. Hb Knossos is characterized by reduced synthesis and by interaction with beta-thalassemia, in which the double heterozygotes display typical features of thalassemia intermedia. The present paper summarizes the salient genetic, clinical, and biochemical characteristics of five such cases hitherto identified in three families along with the same features on 12 heterozygous Hb Knossos carriers. Hb Knossos displays a slightly decreased oxygen affinity; this factor may compensate in part for the severe anemia of the double heterozygotes. Hb Knossos is relatively rare in our population, since a prospective survey on 610 individuals has failed to disclose any heterozygotes. However, the mutation appears to have spread over the Mediterranean countries and may be more common elsewhere.

Adolescent↗

Hemoglobin San Diego/beta zero thalassemia in a Greek adult.

Interaction of beta zero thalassemia with Hb San Diego [a high affinity hemoglobin variant, alpha 2 beta (2)109(G11)Val----Met] in a 29-year-old Greek male is described. A marked polycythemia with low MCH and MCV, but minor clinical problems were observed. Functional properties of the isolated variant are described.

Adult↗

Hemoglobin content of single erythrocytes from fetuses with parents having heterozygous beta-thalassemia.

The hemoglobin content of single erythrocytes was determined by microspectrophotometry as total extinction (TE) at 415 nm in subjects with a wide spectrum of hemoglobin levels and erythrocyte indices. Precise measurements of the cellular area (A) and the ratio TE/A were also recorded. A significant correlation was found between TE and mean corpuscular hemoglobin (MCH), A and mean corpuscular volume, and TE/A and mean cell hemoglobin concentration (MCHC) for the cases studied. In addition, TE, A and TE/A were determined in fetal erythrocytes obtained by fetoscopy at the 20th week of gestation for prenatal diagnosis of beta-thalassemia. The mean red cell TE and TE/A of the group of fetuses diagnosed to have thalassemia major were significantly lower than those of the group of normal controls and with heterozygous beta-thalassemia. The significant differences of TE, A and TE/A between maternal and fetal blood allowed a safe distinction of the latter. The calculated MCH of the fetuses with thalassemia major was 12% less than that of the normal controls; the respective difference of the mean cell size was 5% and that of MCHC 3% lower than normal.

Erythrocyte Indices↗

Patterns of bone marrow involvement in chronic lymphocytic leukemia and small lymphocytic (well differentiated) non-Hodgkin's lymphoma. Its clinical significance in relation to their differential diagnosis and prognosis.

Forty-eight patients with chronic lymphocytic leukemia (CLL), and 12 patients with small (well differentiated) lymphocytic lymphoma (WDL) were histologically evaluated for their pattern of bone marrow (BM) involvement. Four different types of BM infiltration were recognized: nodular (N), interstitial (I), nodular and interstitial (mixed) and diffuse (D). The pattern of BM involvement was compared with the clinical, laboratory, and survival status in all patients. The extent of the disease in CLL patients, was determined by the Rai and the International Workshop on CLL Staging Systems, while in WDL patients the Ann Arbor staging system was used. In the CLL group the N pattern was found in 8%, the I in 33%, the mixed in 31%, and the D in 27% of the patients. Based on the International Workshop on CLL Staging System, the I pattern of BM involvement was more frequently found in Stage A (56%), the mixed in Stage B (68%), and the D in Stage C disease (90%). All CLL patients with D pattern required treatment from the beginning, contrary to CLL patients with the other patterns, in whom therapy was required in less than 50%. Similarly, deaths were more common in the D pattern in whom therapy pattern than in the other patterns. In the WDL patients BM involvement was found in 4 of 12, (33%) and its pattern of positivity was always nodular, although most patients (10 of 12) had advanced disease. It is concluded that the frequency of BM involvement may contribute in the differential diagnosis of WDL from CLL. In addition, the pattern of BM infiltration correlates very well with the International Staging System for CLL, and the pattern of BM positivity in CLL patients also has prognostic significance.

Adult↗