Establishment and validation of a novel risk model for estimating time to first treatment in 120 patients with chronic myelomonocytic leukaemia.

Chronic myelomonocytic leukaemia is a rare disease and data on the treatment are often extrapolated from myelodysplastic syndrome studies. Although several scores exist for the prognosis of overall survival in chronic myelomonocytic leukaemia, so far there is no designated score for the prediction of the time to first treatment. We tested clinical parameters and cytogenetic information for their ability to predict the time to first treatment in our single center cohort of 55 unselected consecutive chronic myelomonocytic leukaemia patients.

An uncommon cause of anaemia: Sheehan's syndrome.

Ischemic pituitary necrosis due to severe postpartum haemorrhage called Sheehan's syndrome is a rare cause of hypopituitarism in the western world, but much more common in developing countries. A 45-year-old female patient being a war refugee from Chechnya with severe anaemia and fatigue was diagnosed at our outpatient department with Sheehan's syndrome after severe postpartum haemorrhage and emergency hysterectomy 15 years ago. Panhypopituitarism was adequately treated with substitution of hydrocortisone, thyroxine and transdermal oestrogen which resulted in haemoglobin increase to nearly normal levels and symptoms improved immediately.

Differential diagnostic challenge of chronic neutrophilic leukemia in a patient with prolonged leukocytosis.

Our interesting case deals with the clinical and morphological aspects of a chronic neutrophilic leukemia and the critical evaluation of differential diagnosis of leukemoid reaction in bone marrow biopsies.

Massive infiltration of bone marrow in colon carcinoma after treatment with activated protein C.

We present an unusual case of localized colorectal carcinoma complicated by sepsis which was treated with activated protein C (APC). Shortly after treatment the patient developed symptomatic metastases to the bone marrow (BM). Destruction of bones by colorectal cancer (CRC) is rare, although BM micrometastases are frequently observed.

[Palliative therapy in glioblastoma multiforme: a multimodal concept].

We report on a 72-year-old patient with a glioblastoma multiforme, who after initial operation underwent concomitant radiation (60 Gy) and chemotherapy (CCNU), which had to be stopped due to toxicity. After an interval without antineoplastic therapy lasting for several months, disease progressed. In this situation we decided to start second-line chemotherapy (Temozolomid).