Myeloid regeneration after bone-marrow transplantation monitored by serum measurements of myeloperoxidase, lysozyme and lactoferrin

Bone-marrow regeneration after chemo- and radiotherapy-induced aplasia can be monitored by serum levels of myeloperoxidase (MPO), lysozyme (LYS) and lactoferrin (LF). In 10 patients with leukemia, serum measurements were performed before and after bone-marrow transplantation. Bone-marrow regeneration was suggested by increments in serum MPO and LYS 5 and 4 days prior to the increase in mononuclear cells (Mono) and 10 and 9 d before the increase in polymorphonuclear leukocytes (PMN) in the peripheral blood. LF started to rise 4.5 d before detectable circulating PMNs. 2 patients with early relapses of leukemia post transplantation are shown to display atypical patterns of serum MPO and LYS. We conclude that serum measurements of MPO, LYS and LF may be used as early and sensitive means to monitor bone-marrow activity during hematological regeneration. However, the findings also strongly support the earlier proposal that MPO alone may be used to reflect myeloid activity in the bone-marrow in general.     

A long-term time course of colorimetric assessment of the effects of imatinib mesylate on skin pigmentation: a study of five patients

BACKGROUND: Imatinib mesylate (IM), the first-line treatment of chronic myeloid leukaemia (CML), is a tyrosine kinase inhibitor that targets those proteins involved in BCR-ABL signal transduction in CML, c-kit (KIT) and platelet-derived growth-factor (PDGFR) receptor. The use of IM has been associated with cutaneous reactions. In the last 2 years numerous studies have focused the attention on hypopigmentations, depigmentations and photosensitivity developing after the initiation of IM therapy. OBJECTIVE: The aim of this study is to evaluate the effects of IM therapy on the skin pigmentation of five patients affected by CML. METHODS: Skin pigmentation measurements were performed with a Minolta CR-200 Chromameter. results: All the studied patients show the gradual lightening of the skin on unexposed areas over the treatment with IM. In particular, this explorative colorimetric study indicates the association between IM and skin depigmentation with a significant increase of luminance value (L*) (P = 0.001) and a significant decrease of the pigmentation value (b*) (P = 0.028). CONCLUSION: Even if we do not know the clinical significance of the skin depigmentation caused by IM, the regulatory role of KIT and its ligand stem cell factor in melanocyte development and survival seems to suggest an objective mechanism of action for IM in the pathogenesis of this cutaneous depigmentation.     

慢性髓性白血病细胞来源的树突状细胞大容量诱导及其功能的实验研究

目的　探索大容量诱导慢性髓性白血病 (CML)细胞来源的树突状细胞 (DCs)的适宜方法 ;研究CML DCs刺激自体T淋巴细胞增殖并分泌γ 干扰素 (IFN γ)的能力。方法　用CS 30 0 0 plus血细胞分离机采集初诊CML病人的外周血单个核细胞 (PBMNCs) ;单采的CML PBMNCS转入组织培养袋 ,加入重组人粒 巨细胞集落刺激因子 (rhGM CSF)和重组人白介素 4 (rhIL 4 ) ,培养诱导 7d ;在诱导前后 ,用流式细胞仪分别检测细胞表面HLA DR、CD1a、CD80和CD86的表达水平 ;用3 H TdR掺入法检测CML DCs和CML PBMNCs刺激自体和异体T细胞增殖的能力 ;用ELISA法检测在自体混合淋巴细胞培养 (MLR)时T细胞分泌的IFN γ浓度。结果　用血细胞分离机收集的CML PBMNCs ,在组织培养袋内经细胞因子培养诱导 ,HLA DR、CD1a、CD80、CD86的表达均有明显上调 ,细胞形态也表现典型的DC特征 ;CML DCs能显著刺激自体和异体T细胞增殖 ,而CML PBM NCs仅能刺激异体T细胞的增殖 ,刺激自体T细胞增殖的能力很弱 ;刺激自体T细胞增殖时分泌的IFN γ浓度 ,CML DCs组为 (877± 2 14 )pg/mL ;CML BPMNCs组仅为 (14± 1.7) pg/mL。 结论　单采的CML PBMNCs转入组织培养袋 ,加入rhGM CSF和rhIL 4 ,可收获大容量的CML DCs;CML DCs在体外具有显著刺激自体T细胞增殖     

Outcome of a multicenter treatment program including autologous or allogeneic bone marrow transplantation for de novo acute myeloid leukemia

Abstract: The results of an intensive treatment program for patients 16–60 yr of age with de novo acute myeloid leukemia are presented. The patients were given conventional induction treatment with daunorubicin and cytarabine. Patients not entering complete remission (CR) after 1 course of daunorubicin/cytarabine were given 1 course of amsacrine/etoposide/cytarabine. Those entering complete remission received 3 consolidation courses using mitoxantrone, etoposide, amsacrine and cytarabine. One hundred and eighteen patients were enrolled. Complete remission was attained after 1–2 courses in 90 patients (76%). Another 6 patients reached CR after 3–4 induction courses for a total CR rate of 81%. If feasible, patients were offered either allogeneic or unpurged autologous bone marrow transplantation. Twenty-four patients underwent allogeneic bone marrow transplantation; 15 in first remission, 8 in second remission, 1 in early relapse. Thirty patients below 56 yr of age underwent autologous bone marrow transplantation in first remission. The overall probability of survival at 4 yr was 34%, and for patients below 40 yr of age 50%. Leukemia-free survival was 35% for the whole cohort of patients; 52% for patients below 40 yr of age. Patients undergoing allogeneic or autologous bone marrow transplantation in first remission had an overall survival of 86% and 47%, respectively, while the probability of leukemia-free survival in these groups was 87% vs. 40% at 4 yr. The CR rate and long-term results of this intensive treatment program compare favorably with other recent studies using intensive consolidation with allogeneic or autologous bone marrow transplantation or high dose cytarabine.     

慢性粒细胞白血病100例骨髓组织病理学Hannover分类法意义探讨

本文对100例慢性粒细胞白血病(CML)患者进行组织病理学研究,应用Hannover国际分类法进行分类,观察到骨髓组织病理学中巨核细胞增多者临床症状较重,中位生存时间较短,认为该分类法对临床及预后判断有指导意义,比既往应用的Bartl及Frisch分类法优越。     

Pulmonary Sequestration In A Child With Acute Myelold Leukemia

The article describes a relatively rare congenital anomaly that was difficult to diagnose in a 10-year-old child with acute nonlymphoblastic leukemia. Just at diagnosis of leukemia, the patient showed a pathologic chest radiograph because of a parenchymal thickening at the right lung apex. The presence of bronchopneumonia was suspected, and broad-spectrum antibiotic therapy was started with subsequent antifungal treatment for persistent fever and concurrent chemotherapy-induced marrow aplasia, which did not favor pulmonary infiltrate recovery. Continuous culture tests, including bronchial swab, proved negative for Koch-Weeks bacillus, fungal organisms, and other pathogens. Computed tomography, however, was suggestive of Aspergillus lung involvement, and apical sepmentectomy was performed. The anatomic pathologist suggested the diagnosis of intralobar sequestration. In summary, when pulmonary pathology with an excavation is found in a leukemic child, one must consider the possibility of pulmonary sequestration complicated by an infectious disease.     

白血病bcr/abl融合基因的定量检测及临床意义

目的探讨慢性粒细胞性白血病(ehron ic myeloid leukem ia CML)ber/ab l融合基因检测及意义。方法采用荧光定量PCR(FQ-PCR)检测56例慢性粒细胞性白血病中ber/ab l融合基因的表达。结果对照组bcr/ab l基因表达均为阴性。56例慢性粒细胞性白血病病人bcr/ab l基因表达阳性率为87.5%(49/56),表达值范围3.0×107-7.9×107基因拷贝/L;33例CML患者Ph染色体分析结果中25例为Ph( )/bcr(十),2例为Ph(-)/bcr( ),4例Ph( )/bcr(-),1例Ph(-)/bcr(-);8例CML患者治疗前ber/ab l基因表达均值为(2.60±0.9)×107基因拷贝/L,治疗后为(1.78±0.6)×107基因拷贝/L,两者具有显著性差异(P<0.05=。结论bcr/ab l融合基因表达水平的定量检测及动态观察,对CML的临床诊断、疗效观察和预后具有重要意义。