"Smouldering" Chronic Lymphocytic Leukemia.

Although clinical staging systems are useful to assess the prognosis of chronic lymphocyctic leukemia (CLL), for the large majority (up to 60%) of patients in early clinical stage no system is able to predict those who will progress ("active" disease) and those who will remain at the same stage ("smouldering" disease). To identify the latter subset of patients is important since in these patients treatment should be withhold until progression occurs. In the past few years, there have been several attempts to define "smouldering" CLL.

Chronic Lymphocytic Leukemia in Younger Adults: Preliminary Results of a Study Based on 454 Patients-IWCLL/Working Group.

Whether all younger adult patients with chronic lymphocytic leukemia (CLL) should be offered intensive and/or experimental treatments is currently undecided. In order to investigate the natural history and prognosis of CLL in younger adults, information on 454 B-CLL patients less than 50 yrs old, from 13 different International groups was collected and analyzed. The male/female proportion is 1.

Clinical features and response to treatment of infradiaphragmatic Hodgkin's disease.

Among 247 patients with Hodgkin's disease, initial disease presentation was restricted to infradiaphragmatic sites in 17 (6.9%). Advanced age, B symptoms, increased ESR, low lymphocyte and platelet counts, as well as advanced pathological stage and lymphocyte depletion histology were common presenting features of these patients.

Characteristics of the external quality assessment (EQA) scheme for haematology in Spain.

Ensuring reliable results of the tests which are performed in large haematology laboratories is essential because of the problems resulting from the use of complex automated instruments and the ever increasing workload. The Spanish Haematology EQA Scheme started in 1984 with 56 laboratories, a number which rose to 332 in 1989. The general scheme follows the guidelines established by the International Committee for Standardization in Haematology (ICSH) with participants from Public Health (57.

Occurrence of hereditary leaky red cell syndrome and partial coagulation factor VII deficiency in a Spanish family.

A Spanish family was found to have the coexistence of a hereditary haemolytic syndrome associated with excessively leaky RBC membrane to sodium (Na+) and potassium (K+) cations and a partial coagulation factor VII deficiency. Haemolysis was mild in the propositus and the RBC membrane leak included a marked increase in passive permeability to Na+ and K+. This was associated with an increase in active Na+,K(+)-pump activity and in the ouabain-resistant fluxes: Na+, K(+)-cotransport and Na+, Li(+)-countertransport.

[Effects of the treatment with human recombinant erythropoietin on primary hemostasis in uremic patients].

The effect of human recombinant erythropoietin (r-EPO) on primary hemostasia was studied in 9 patients undergoing hemodialysis. The analysis was performed before and after the hematocrit reached a value of 30%. The most important complications observed during the study period were a death for acute myocardial infarction in a patient with previous severe ischemic cardiopathy and a thrombosis of the venous line.

Variations of fat tissue fraction in abnormal human bone marrow depend both on size and number of adipocytes: a stereologic study.

Studies dealing with the number or size of individual adipose cells in abnormal human bone marrow are lacking. To ascertain whether variations in fat tissue fraction depend on the size of individual adipocytes or their number or both, a stereologic study of 30 human bone marrow specimens (10 with aplasia, 10 with hyperplasia, and 10 with dysplasia) was performed. A total of 23,435 adipocyte profiles were measured and two stereologic parameters were obtained in each specimen: mean diameter and number of cells per mm3 of bone marrow.

Timing of diagnosis and lymphocyte accumulation patterns in chronic lymphocytic leukemia: analysis of their clinical significance.

In order to evaluate the clinical significance of the timing of diagnosis in chronic lymphocytic leukemia (CLL), we studied the diagnostic latency (DL), a variable related both to lymphocyte count and to lymphocyte doubling time (LDT), which points out the interval between the date of CLL diagnosis and the time at which it could have been made (lymphocyte count in peripheral blood of at least 5.0 x 10(9)/l). In two different series accounting for 221 previously untreated CLL patients the trends of the DL tended to decrease as the risk increased.

Efficacy of ABVD Therapy in Resistant Hodgkin's Disease.

Between January 1979 and June 1987, 46 patients with Hodgkin's disease '(HD) resistant to first-line combination chemotherapy or in early relapse were treated with ABVD (doxorubicin, bleomycin, vinblastine and dacarbazine). Twenty-two of 42 patients (52%) evaluable for response achieved a complete remission (CR), and eight (19%) a partial remission (PR). Median survival was 42.

Investigation of plasma von Willebrand factor and circulating platelet aggregating activity in mitomycin C-related hemolytic-uremic syndrome.

We have studied the ability of the plasma to induce aggregation of both homologous and heterologous platelets in four patients with hemolytic-uremic syndrome (HUS) associated with chemotherapy with mitomycin C (MMC). Neither platelet aggregation was elicited by patients' plasmas nor the in vitro addition of purified von Willebrand factor (vWF) had any effect on the aggregation pattern. In addition, ristocetin-induced binding of patients' vWF to formaldehyde-fixed platelets was normal, and multimeric vWF analysis revealed a normal structure of patients' plasmatic vWF whatever the clinical stage in which it was studied.

Effect of chronic clonidine treatment on urinary growth hormone excretion and linear growth in children with short stature.

Eleven prepubertal children with short stature were treated with clonidine (0.15 mg/m2 daily) for a period of 1 year. The effect of this drug was evaluated on both clinical (growth velocity, height standard deviation scores for chronological age and bone age) and hormonal (urinary growth hormone excretion and insulin-like growth factor I) parameters.

[Neoplasms associated with chronic lymphatic leukemia. Incidence and characteristics in a series of 232 patients].

The frequency and features of associated neoplastic diseases and their impact on survival were evaluated in a series of 232 patients with chronic lymphocytic leukemia (CLL) who had been diagnosed during an 18 year period. Thirty-two patients (13.8%) had overall 38 neoplasias, 27 of which were diagnosed after CLL.

A new prognostic system for multiple myeloma based on easily available parameters.

The prognostic significance of different presenting features in 180 patients with multiple myeloma (MM) from a single institution was analysed. Out of eight variables isolated from the univariate analysis only two (blood urea and serum albumin), were significant in the multivariate model. Derived from these two simple variables, the relative risk of each patient was calculated, and subsequently two subpopulations of patients could be recognized.

Anti-K1 of the IgA class associated with Morganella morganii infection.

An anti-K1 alloantibody developed in a patient infected with Morganella morganii. The serologic behavior and response to dithiothreitol initially suggested that the alloantibody was an IgM. However, flow cytometry and the separation of immunoglobulin classes by serum chromatography revealed that the anti-K1 was constituted solely of IgA.

Hypertriglyceridemia in bone marrow transplant recipients: another side effect of cyclosporine A.

The incidence and duration of hypertriglyceridemia (HTG) associated with allogeneic HLA-identical bone marrow transplantation (BMT) were investigated in 38 patients with normal triglyceride levels (TG) before BMT and without any evidence of prior liver disorder. Twenty-two (58%) patients developed HTG. The median of TG peak values was 350 mg/dl (range 215-908) and the median actuarial time for HTG appearance was 7 weeks (range 1-12).

[Chronic myelomonocytic leukemia and solid neoplasms: is it a causal or a fortuitous association?].

Out of a series of 36 patients with chronic myelomonocytic leukaemia (CMML), five cases are reported with the association of this hemopathy to solid neoplasms. In two patients this last was a cutaneous tumour, while the remainders had, respectively, papilloma of the bladder, carcinoma of the sigma, and cutaneous T-cell lymphoma. These neoplasms were diagnosed in all cases prior to the discovery of CMML.

Acute transformation of chronic myelomonocytic leukaemia: a multivariate study of predictive factors.

In an attempt to determine the possible predictive value of the main clinical and haematological initial features of chronic myelomonocytic leukaemia (CMML) on the evolution to acute leukaemia, as well as the real impact of such an event on survival, 35 such patients were submitted to multiple regression analyses. At the time of the study 30 out of the 35 patients had died, with a median survival of 8.2 months for the whole series.

Age-related variations of fat tissue fraction in normal human bone marrow depend both on size and number of adipocytes: a stereological study.

Studies dealing with the number or size of individual adipose cells in human bone marrow are lacking. To ascertain whether the age-related variations in fat tissue fraction depend on the size of individual adipocytes or their number or both, a stereological study of 20 normal human bone marrow specimens was performed. A total number of 17,039 adipose cell profiles was measured and two stereological parameters were obtained in each specimen: mean diameter and number of cells per mm3 of bone marrow.

Hypocholesterolemia in acute myelogenous leukemia.

Plasma-cholesterol concentrations were determined in 85 acute myelogenous leukemia patients. Measurements were repeated in 28 cases during remission. Mean plasma-cholesterol concentration (+/- SD) at diagnosis was 3.