The nature of the leukemic process is discussed with respect to the possible in vitro transformation of the leukemic blast cells into myeloid differentiated cells. During the period 1968-1970 we noticed this process in bone marrow cultures in fluid medium. The differentiation was established on morphologic and cytochemical criteria; the proportion of mature cells or those undergoing maturation with peroxidase positive reaction increased over 50% reaching even 70-80%. Our recent observations can be discussed from several points of view but leukemic blast cell reversibility is now a phenomenon with therapeutical applications. The phenomenon of malignant cells growth enhancement has been considered as an antibody mediated immune process. In a previous paper we have demonstrated in AKR mice the possibility of achieving the growth enhancement of lymphoblastic cells in mixed cultures with normal autologous or isologous splenic cells. Other investigations have been carried out by means of mixed cultures in human leukemias and malignant lymphomas. The intensity of blast-cell proliferation was followed up by comparing the number of colonies and TH3 incorporation in simple cultures with those in mixed cultures. The observations made in the 20 culture systems followed-up over 3-5 and 8-10 days proved the "malignant cell growth enhancement" by the immune mononuclear cells (lymphocytes and macrophages).

Blood Cells↗

PubMedDate not supplied

Changes of the cellular immunity tests during the evolution of Hodgkin's disease.

To detect the changes of cellular immunity which occur at the same time as the pathological process and to find out the possible biologic indicators with prognostic value, a study was carried out on 140 patients with Hodgkin's disease (HD) in different clinical periods: onset, under therapy (cytostatics and/or irradiations), remission, after splenectomy and under immunotherapy. The study of cellular immunity included the determination of lymphocytes subpopulations by the rosette tests and their functional estimation by tests of blastic transformation to mitogens and antigens. Though the values obtained presented a wide dispersion, the rosette tests showed variations in correlation with the clinical stage, therefore with the severity of disease. It was observed that therapy and splenectomy change the cellular immunity tests. The only test with a certain prognostic value was found to be the in vitro lymphocyte response to PPD which became positive after therapy, particularly in the group of patients who showed good response to treatment. A dynamic follow-up of the cellular immunity tests might give an indication on the mechanisms of production of the immune deficit in HD.

Hodgkin Disease↗

PubMedDate not supplied

Present-day problems of diagnosis and treatment in the idiopathic thrombocytopenic purpura.

A review is made of the data in the literature and of the authors' experience regarding the etiology and pathogenesis, diagnosis and therapy of the chronic form of idiopathic thrombocytopenic purpura (ITP). The mechanisms of production (after McMillan et al.) are presented schematically and the five criteria of ITP diagnosis suggested by Karpatkin are discussed: 1) decreased blood platelet count with direct or indirect signs of thrombocytolysis; 2) increased number of megakaryocytes in the bone marrow and/or signs of intramedullary thrombocytolysis; 3) direct or indirect signs of antiplatelet autoantibody presence in the plasma; 4) exclusion of a primary disorder and 5) absence of splenomegaly. The results of corticotherapy, splenectomy, platelet transfusion and immunosuppression (including "target" immunosuppressive therapy) in 188 patients with ITP, admitted to the clinic of Hematology--Bucharest between 1966 and 1978, are presented and analysed.

Adrenal Cortex Hormones↗

PubMedDate not supplied

Polycythemic blood perfusions in severe aplastic anemia.

The course of two cases of severe aplastic anemia (AA) was followed up in two young male patients who, besides the conventional therapy, received perfusions with blood obtained from patients with polycythemia vera (PV). Case 1 received 4 units of PV blood from a unique donor. During the following week an obvious clinical relief, as well as increase of the peripheral blood values were recorded. Subsequently, the bone marrow was progressively repopulated with normal precursors and the peripheral blood picture reverted to normal. In case 2, 9 units of PV blood, obtained from two donors, were administered. During the next week a transient clinical and hematological improvement was obtained, but later on the progressive granulocytopenia and the infections led to exitus through a toxic-septic shock. It is assumed that PV blood may be a good replacing and a possible stimulatory therapeutic material, useful to overcome the early critical stage of severe AA.

Adolescent↗

PubMedDate not supplied

The role of spleen in the pathogeny of aplastic anemia related to increased number of CD3+ CD8+ FcR+ cells.

The role of spleen in the pathogeny of aplastic anemia (A.A.) related to excessive suppression, and the value of splenectomy in the treatment of this disorder is still debated and unclear. In an attempt to find out why some patients respond to surgery and others do not, an immunologic study was carried out in 16 patients with aplastic anemia. Lymphocytes surface markers CD3, CD4, CD8, HLA-DR, Fc receptors (FcR) and CD4/CD8 ratio were determined before and after splenectomy in the patients' peripheral blood, and in the spleen. In addition, the number of granulo-monocytic colony forming cells (GM-CFC) before and after splenectomy was estimated. Nine of the cases showed increased CD3+ CD8+ FcR+ cells, reversed CD4/CD8 ratios (both, in peripheral blood and in spleen), and a low number of GM-CFC. In all these cases, splenectomy induced an improvement of the clinical, hematological, and immunological parameters, thus suggesting that spleen represents an important "reservoir" for CD3+ CD8+ FcR+ cells, which seem to exert a suppressor effect on the hematopoietic progenitors. In splenectomized patients who did not respond to surgery, the pathogenic mechanism was probably related to defective help (3 cases with low values of CD4+ cells), to defective suppression (2 cases with decreased number of CD8+ cells), to a stem cell defect or a deficiency in the stem cell microenvironment (2 cases with normal helper/suppressor ratio). These observations support the conclusion that splenectomy is indicated and may be successful only when the phenotypic markers show an increased number of CD3+ CD8+ FcR+ cells.

Anemia, Aplastic↗

PubMedDate not supplied

The test of spontaneous rosettes with sheep erythrocytes in lymphocytoses.

The test of spontaneous rosettes with sheep erythrocytes was used to estimate the rosette forming lymphocytes (RFL) in the peripheral blood from normal subjects and from patients with various lymphocytoses. The test was performed in 65 patients with: chronic leukemia (CLL), lymphocytic lymphosarcoma, Waldenström's macroglobulinemia, infectious mononucleosis, pulmonary tuberculosis, hyperthyroidism and pertussis as well as in 25 normal controls. The percentage of RFL was constantly and significantly low in all the cases of CLL. However, in absolute values the RFL count was found within normal limits or increased. Trying to establish a correlation between the number of T lymphocytes and the clinical forms of disease (aggressive and non-aggressive) on the one hand, and on the other hand to find the effect of cytostatic therapy, on this lymphocytic population, we observed that in the aggressive form the absolute values of RFL were obviously increased as compared with the other form and that cytostatic therapy reduced the number of RFL. The cellular immune deficit in CLL is discussed as well as the clinical utility of the rosette test with sheep erythrocytes for the estimation of the immune status in patients with malignant or reactive lymphoproliferations.

Humans↗

PubMedDate not supplied

The test of spontaneous rosettes with sheep erythrocytes in lymphocytoses.

The test of spontaneous rosettes with sheep erythrocytes was used to estimate the rosette forming lymphocytes (RFL) in the peripheral blood from normal subjects and from patients with various lymphocytoses. The test was performed in 65 patients with : chronic leukemia (CLL), lymphocytic lymphosarcoma, Waldenström's macroglobulinemia, infectious mononucleosis, pulmonary tuberculosis, hyperthyroidism and pertussis as well as in 25 normal controls. The percentage of RFL was constantly and significantly low in all the cases of CLL. However, in absolute values the RFL count was found within normal limits or increased. Trying to establish a correlation between the number of T lymphocytes and the clinical forms of disease (aggressive and non-aggressive) on the one hand, and on the other hand to find the effect of cytostatic therapy, on this lymphocytic population, we observed that in the aggressive form the absolute values of RFL were obviously increased as compared with the other form and that cytostatic therapy reduced the number of RFL. The cellular immune deficit in CLL is discussed as well as the clinical utility of the rosette test with sheep erythrocytes for the estimation of the immune status in patients with malignant or reactive lymphoprpliferations.

Humans↗

PubMedDate not supplied

Congenital dyserythropoietic anemia type II. Radioautographic, ultrastructural and cytogenetical study in two familial cases.

The case of two sisters is reported in whom morphological (multinucleated erythroblasts in the bone marrow) and serological (positive Ham test, negative sucrose and water-sugar tests) characteristics of a congenital dyserythropoietic anemia type II were found. Radioautographic, cytogenetic and electron microscope studies confirmed the presence of an inefficient erythropoiesis and of a membrane defect, common in this disease. The finding of a nil LAP score has never been reported so far.

Adolescent↗