Immune-mediated thrombocytopenic purpura associated with Toxoplasma gondii infection in an immunocompetent patient.

Infection with Toxoplasma gondii (T. gondii) in immunocompetent adults is usually asymptomatic and needs no specific therapy. We report the case of a 16-year-old previous healthy adolescent who presented with bleeding due to immune-mediated thrombocytopenic purpura during an acute acquired T.

A randomized trial comparing intensified CNOP vs. CHOP in patients with aggressive non-Hodgkin's lymphoma.

The standard CHOP regimen may cure 30-40% of patients with advanced aggressive non-Hodgkin's lymphoma (ANHL). Mitoxantrone is an anthracenedione, which is active in NHL and its toxicity profile may be more favorable than doxorubicin with respect to alopecia, mucositis and cardiotoxicity. This study was designed to compare the effectiveness of an escalated dose of mitoxantrone with that of standard doxorubicin, used in the CHOP regimen in patients with ANHL.

One-year follow-up of a patient with reversible tricuspid valve stenosis due to lymphomatic mass into the right atrioventricular wall.

We present the case of a 66-year-old man with a history of coronary artery disease and chronic lymphocytic leukemia (CLL) who was admitted to the hospital complaining of chest discomfort and shortness of breath on exertion. The echocardiogram revealed a severe pericardial effusion and a large echogenic mass that infiltrated the lateral wall of the right atrium and ventricle and created a moderate tricuspid valve stenosis. B cell intracardiac non-Hodgkin lymphoma/CLL was diagnosed, and the patient was treated with six courses of CHOP chemotherapy.

Evaluation of the clinical relevance of the expression and function of P-glycoprotein, multidrug resistance protein and lung resistance protein in patients with primary acute myelogenous leukemia.

The multidrug resistance (MDR) transporter-proteins P-glycoprotein (Pgp), multidrug resistance protein (MRP) and lung resistance protein (LRP) have been associated with treatment failure. The aim of this study was to investigate prospectively the clinical significance of expression and function of the MDR proteins, considering other prognostic factors, such as age, immunophenotype, and cytogenetics. Mononuclear cells of peripheral blood or bone marrow from 61 patients with de novo acute myelogenous leukemia (AML) were analyzed.

Oral hairy leukoplakia in a patient with acute lymphocytic leukemia.

The first case of oral hairy leukoplakia (OHL) in an HIV-negative 56-year-old patient with acute lymphocytic leukemia (ALL) is reported. A white plaque was observed while the patient was in complete remission which followed the chemotherapeutic scheme. The clinical and histopathologic findings were typical for OHL and the polymerase chain reaction method was positive for Epstein-Barr virus DNA.

Treatment with recombinant human erythropoietin in children with malignancies.

The effect of recombinant human erythropoietin (rHuEPO) on the anemia of cancer was examined in 15 children with hematologic malignancies (group I) and solid tumors (group II), whose hemoglobin (Hb) was under the third percentile for sex and age. The response to rHuEPO was defined as an increase of Hb to above the 10th percentile following 8 weeks of therapy. The rHuEPO caused an increase in the Hb and hematocrit (Hct) in 46% of children of both groups at a dose of 150 IU/L, in 28.

Efficacy of recombinant human granulocyte colony-stimulating factor and recombinant human granulocyte-macrophage colony-stimulating factor in neutropenic children with malignancies.

The difference between the effects of administration of recombinant human granulocyte colony-stimulating factor (rhG-CSF) and recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) was studied in 39 children with neutropenia secondary to chemotherapy (absolute neutrophil count (ANC) less than 1,500/microliters. The children were divided into two groups. The first group (G-CSF) included 25 children (12 with acute lymphoblastic leukemia [ALL]-non-Hodgkin's lymphoma [NHL] and 13 with solid tumors) and the second group (GM-CSF) included 14 children (5 with ALL-NHL and 9 with solid tumors).

Reverse transcription polymerase chain reaction for the diagnosis and molecular monitoring of the PML/RAR alpha fusion gene in acute promyelocytic leukemia.

Acute promyelocytic leukemia (APL) is characterized by a specific t(15;17) translocation and a high rate of response to all-trans retinoic acid. The translocation generates a PML/RAR alpha chimeric gene which is transcribed in a fusion PML/RAR alpha mRNA. In this study, by using RT-PCR, we examined 14 APL patients for PML/RAR alpha fusion gene transcripts.

Effect of granulocyte colony-stimulating factor on chemotherapy-induced neutropenia in children with cancer.

We investigated the effects of recombinant granulocyte colony-stimulating factor (G-CSF) administration on duration of neutropenia, antibiotic therapy, and hospitalization days in 25 children with malignancies (Group A: 12 leukemia and lymphoma; Group B: 13 tumors) who were undergoing chemotherapy. We compared the effect of G-CSF with a control group of 21 children with equivalent diseases and chemotherapy that did not receive G-CSF treatment. All 25 children received 5 micrograms/kg/day of G-CSF at the end of chemotherapy courses when absolute neutrophil counts were < or = 1000/mm3.

Cord blood erythropoietin in the presence and absence of labor in normal infants.

To evaluate erythropoietin (Ep) levels in normal labor and cesarean section we studied the cord serum of 111 term pregnancies, divided into three groups: (i) those born by normal vaginal delivery (n = 69); (ii) those delivered vaginally from mothers who were smokers (n = 20); and (iii) those delivered by elective cesarean section (n = 22). The three groups did not differ in maternal age, gestational age, birthweight, infant sex and Apgar scores. No correlation was found between Ep and hematocrit in all three groups of normal terms studied.

Analysis of immunohistochemical results of the ras oncogene product p21 in myelodysplastic syndromes.

Mutation of the ras oncogenes is the most commonly detected molecular abnormality in acute myelogenous leukemia and myelodysplastic syndromes (MDS). This molecular event may either be acquired by different subclones or by all malignant cells. The availability of the ras p21 monoclonal antibody Y13 259 makes possible the direct study of the distribution of the ras gene product in human malignant cells.

Serum levels of tumor necrosis factor and soluble interleukin 2 receptor as markers of disease activity and prognosis in childhood leukemia and lymphoma.

The serum levels of soluble interleukin 2 receptor (SIL-2R) and tumor necrosis factor (TNF) were assessed in 69 children from 6 months to 14 years old who suffered from acute lymphoblastic leukemia (39), Hodgkin's disease (15), non-Hodgkin's lymphoma (15) and in 54 normal age-matched controls prior to any therapy and at remission. Both SIL-2R and TNF levels were significantly higher at diagnosis compared with normal controls (P < 0.001), but decreased significantly at remission.

Correlation of in vitro enhancement of erythropoiesis and clinical response to steroids in Diamond-Blackfan anaemia.

To investigate whether the clinical response to steroids in Diamond-Blackfan anaemia (DBA) can be predicted in vitro, erythroid cultures from six patients was performed. The increment of burst forming unit erythroid (BFU-E) and colony forming unit erythroid (CFU-E) derived colonies had been studied with the in vitro addition of steroids. Our results showed: 1) a relative insensitivity to low and optimum concentration of erythropoietin (Epo) in cultures, and 2) lower CFU-E and BFU-E colony formation in all cases studied.

The expression of the ras p21 oncoprotein in the bone marrow smears of children with acute leukemia.

Point mutations of the ras genes have been detected in various hematologic malignancies. This genetic event may either occur in all malignant cells or be acquired by different subclones, which however, cannot be demonstrated adequately by analyzing only DNA derived from patient specimens. The availability of the ras p21 monoclonal antibody (MoAb) Y 13259 makes possible the direct study of the distribution of the ras gene product in human malignant cells.

Expression of the Epstein-Barr virus encoded latent membrane protein in tumor cells of Hodgkin's disease occurring in childhood.

Paraffin sections from 21 cases of Hodgkin's disease (HD), 28 cases of non-Hodgkin's lymphomas (NHL) and 34 cases of non-specific reactive lymphadenitides occurring in childhood were examined for the presence of the Epstein-Barr Virus (EBV)-encoded Latent Membrane Protein (LMP) using a double layer immunohistochemical method. LMP was detected in 12/21 (57%) cases of HD but not in NHL or reactive lymph nodes. LMP reactivity was restricted to Reed-Sternberg and Hodgkin's (HRS) cells in 4 of 9 (45%) cases of nodular sclerosis (NS), 6 of 9 (66%) cases of mixed cellularity (MC) and 2 of 2 (100%) cases of lymphocyte depletion (LD) while it was undetectable in the single case of lymphocyte predominance (LD) subtype.

Proliferating cell nuclear antigen (PCNA) expression in childhood lymphomas.

Paraffin sections from 21 cases of Hodgkin's disease (HD) and 28 cases (26 high-grade and 2 low-grade) of non-Hodgkin's lymphomas (NHL) occurring in childhood were examined for the presence of proliferating cell nuclear antigen using an anti-PCNA antibody. All cases of HD and NHL showed PCNA reactivity. In HD 50.

Primary benign erythrocytosis with high erythropoietin levels and an early erythropoietin-sensitive population in the peripheral blood.

Primary erythrocytosis diagnosed in a 10-month-old female and followed for 12 years is described. The erythrocytosis was associated with an abnormally elevated set point of erythropoietin production in which the sensitivity fluctuated independently, but corresponded to the alterations in the oxygen-carrying capacity of the blood, when the hematocrit was lowered by phlebotomies. Extensive work for secondary erythrocytoses failed to demonstrate a recognizable cause for this abnormal erythropoietin production.

Ocular granulocytic sarcoma in childhood acute myelogenous leukemia.

We report two children of Greek origin with granulocytic sarcoma of the orbit and acute myelogenous leukemia. In the first case the orbital tumor was the initial manifestation of the disease, while the other occurred during hematological remission.

Serum erythropoietin in regularly transfused thalassemic patients.

Serum erythropoietin levels were measured in 67 regularly transfused thalassemic patients with pre-transfusion hematocrit ranging from 25-32% and in 40 normal individuals. In patients, mean erythropoietin levels were slightly increased (mean 91.5 miu/ml) as compared to normal individuals (mean 42 miu/ml).

Committed erythroid progenitors and erythropoietin levels in anemic children with lymphomas and tumors.

In order to investigate the pathogenesis of anemia in childhood malignancy, we studied erythroid cell proliferation responses with bone marrow erythroid cultures and serum erythropoietin (Ep) levels in 32 children with lymphomas and malignant tumors. The erythroid colony formation from 20 normal controls (mean 68.8 colony-forming-unit erythroid [CFU-E] and 32 burst-forming-unit erythroid [BFU-E] derived colonies/10(5) mononuclear cells), was higher than that seen in children with lymphomas (mean 45.

Plasmapheresis in paroxysmal nocturnal hemoglobinuria aplastic crisis: clinical improvement and in vitro demonstration of plasma inhibitory activity on erythroid stem cells.

Plasmapheresis was used in a 51 year old woman with known PNH and aplastic crisis unresponsive to conventional treatment. A clinical and laboratory improvement was noted and an in vitro inhibition of BFU-E's obtained from patient's peripheral blood mononuclear cells was observed when autologous plasma or serum were added to cultures. The beneficial effect of plasmapheresis is though to be to the elimination of a plasma inhibitory factor responsible for the aplastic crisis in this PNH case that exerts its action to the committed erythroid progenitors as well.