1/104. The preleukemic syndrome: clinical and laboratory features, natural course, and management.The clinical and laboratory features of the stages in the evolution of acute nonlymphocytic leukemia are reviewed. Based on a retrospective analysis of 34 patients who died with an acute myelomonoblastic leukemia, the "preleukemic syndrome" has been shown to display a clinical picture sufficiently specific to permit its recognition prospectively (i.e., before the development of overt leukemia). The results to date of a variety of prospective studies are reviewed, and the approach(es) to the management of these cases is considered.- - - - - - - - - - ranking = 1keywords = nonlymphocytic, nonlymphocytic leukemia, leukemia (Clic here for more details about this article) |
2/104. Acute myeloblastic leukemia after immunodepressive therapy for primary nonmalignant disease.Three patients treated with immunodepressive chemotherapy over a period of 43, 60, 38 months respectively, for primary nonmalignant disease, developed AML after cessation of chemotherapy. During the months preceding the AML outbreak, there were hematologic changes with seemed to reveal a preleukemic state. Our 3 patients, and 8 previously published cases, making a total of 11 patients, developed AML after chemical immunodepression for reasons which were neither hematologic nor neoplastic.- - - - - - - - - - ranking = 0.21727016285199keywords = leukemia (Clic here for more details about this article) |
3/104. Proliferative behavior of hemopoietic cells in preleukemia and overt leukemia observed in one patient.Hemopoietic cell proliferation was studied in a patient suffering from preleukemia characterized by peripheral pancytopenia and hypercellular bone marrow with ineffective erythropoiesis. Two years later when overt acute myelogenous leukemia had developed the study was repeated. The kinetics of proliferation were investigated by a new method which allows evaluation of the rate and time of dna synthesis in individual morphologically defined cells. erythropoiesis was found ineffective to the same degree in both stages of disease. The rate of erythroid cell proliferation, however, was reduced in overt leukemia only. The myeloid system showed a grossly reduced production rate of myeloblasts in preleukemia whilst the same parameter was strongly increased in leukemia. This high production rate of myeloblasts in overt leukemia was interpreted as indication of a far-reaching self-maintenance of the myeloblast pool in this stage of disease. The proliferative activity of the individual myeloblasts was reduced already in preleukemia, and even more so in leukemia. In order to explain the amplification of the myeloblast pool with the onset of overt leukemia a change in the mode of myeloblast divisions is assumed. For this a transition from steady state to some degree of exponential growth gives the most plausible explanation.- - - - - - - - - - ranking = 0.92462031737085keywords = leukemia, myelogenous (Clic here for more details about this article) |
4/104. Idiopathic hypereosinophilic syndrome terminating in acute lymphoblastic leukemia.Idiopathic hypereosinophilic syndrome (IHES) is a heterogeneous group of disorders characterized by multisystem dysfunction and persistent, extreme eosinophilia of unknown cause. We describe a 9-1/2-year-old boy whose course included several unusual clinical features and terminated 2 years after diagnosis in acute lymphoblastic leukemia (ALL). Serial studies suggest that leukemia was not present earlier in his course. We speculate that this child may have had an evolving lymphoproliferative syndrome with a terminal blast crisis to which the eosinophilia was a nonmalignant leukemoid reaction.- - - - - - - - - - ranking = 0.32590524427799keywords = leukemia (Clic here for more details about this article) |
5/104. trisomy 4 and ring chromosome in a patient with acute myelomonocytic leukemia.We describe a patient with acute myelomonocytic leukemia (AMML) in whom cytogenetic analysis revealed trisomy 4 associated with a ring chromosome. In addition, in a cytogenetically unrelated clone, trisomy 8 and 5q- abnormalities were detectable. The possibility of a subclinical myelodysplastic syndrome preceding the onset of AML is discussed on the basis of the morphological and cytogenetic findings.- - - - - - - - - - ranking = 0.27158770356499keywords = leukemia (Clic here for more details about this article) |
6/104. bcr-abl-positive T-cell acute lymphoblastic leukemia associated with parvovirus B19 infection.The authors report an unusual presentation of a philadelphia chromosome-positive acute lymphoblastic leukemia with two unusual features: a bcr-abl fusion mRNA coding for p210 protein and a T-cell immunophenotype. The patient was a 16-year-old boy who presented with septic shock and pancytopenia, likely precipitated by an acute parvovirus B19 infection. Management consisted of supportive therapy, followed by chemotherapy for T-cell acute lymphoblastic leukemia and stem cell transplantation. He died 8 months after transplant due to idiopathic pneumonia syndrome, but without evidence of relapsed disease.- - - - - - - - - - ranking = 0.32590524427799keywords = leukemia (Clic here for more details about this article) |
7/104. Unusual extramedullary recurrences and breast relapse despite hepatic GVHD after allografting in Ph -ALL.Extramedullary recurrences with or without bone marrow involvement are reported in up to a half of leukemic relapses after BMT. Our report describes a case of an extramedullary recurrence and breast relapse after second-allografting in a female patient with Ph -acute lymphoblastic leukemia (ALL), occurring when there was active hepatic GHVD. This case illustrates the complex relationship between graft-versus-host disease (GVHD) and graft-versus-leukemia since she had no evidence of leukemia in her marrow demonstrating 100% full-donor chimerism while she had ALL relapse in her breast.- - - - - - - - - - ranking = 0.16295262213899keywords = leukemia (Clic here for more details about this article) |
8/104. fever of unknown origin due to preleukemia/myelodysplastic syndrome: the diagnostic importance of monocytosis with elevated serum ferritin levels.fever of unknown origin (FUO) is a common clinical diagnostic dilemma. In the elderly, causes of FUO most commonly include malignancy or infection, and less commonly include collagen vascular diseases. Among the collagen vascular diseases causing FUO in the elderly, polymyalgia rheumatica/temporal arteritis, and adult Still's disease (adult juvenile rheumatoid arthritis) are difficult diagnoses to prove. Among the infectious causes of FUO in the elderly are subacute bacterial endocarditis, intra-abdominal abscesses, and extrapulmonary tuberculosis. In the elderly, neoplastic causes of FUO include lymphomas, hepatomas, renal cell carcinomas, and hepatic or central nervous system metastases. Acute leukemias, particularly during "blast" transformation, may present as acute fevers in the absence of infection, but are rare causes of FUO. preleukemia/myelodysplastic syndromes are exceedingly rare causes of FUO. We present a case of an elderly man who presented with findings that initially suggested adult Still's disease. Prolonged and profound monocytosis provided the key clue to his subsequent diagnosis of preleukemia/myelodysplastic syndrome. In this patient, a positive Naprosyn test result also suggested a neoplastic cause for his FUO. After months of prolonged fevers, myelocytes/metamyelocytes were eventually demonstrated in his peripheral smear during hospital evaluation. These findings, in concert with the persistent monocytosis, highly elevated ferritin levels, polyclonal gammopathy on serum protein electrophoresis, and eventual presence of myelocytes/metamyelocytes on peripheral smear, prompted a bone marrow test that demonstrated blast cells confirming the diagnosis of preleukemia myelodysplastic syndrome as the cause of this patient's FUO.- - - - - - - - - - ranking = 0.43454032570398keywords = leukemia (Clic here for more details about this article) |
9/104. monosomy 7 syndrome in an infant with neurofibromatosis.A 9-month-old boy with known familial neurofibromatosis type I (NF-1) presented with a clinical and laboratory picture suggestive of juvenile chronic myelomonocytic leukemia (JCMMoL). Chromosomal studies obtained from the bone marrow indicated, however, that he had monosomy 7 syndrome. We believe this is the first reported case of monosomy 7 syndrome in a child with NF in the united states, and that this case complements a recent report of two cases of NF, JCMMoL, and monosomy 7 in Japanese children. Since monosomy 7 syndrome is very difficult to differentiate from JCMMoL or acute nonlymphocytic leukemia (ANLL) unless appropriate chromosomal studies are obtained, we believe it is possible that monosomy 7 may occur with increased frequency in patients with NF-1. monosomy 7 syndrome might therefore be a significant cause of the known association between NF-1 and nonlymphoid leukemia.- - - - - - - - - - ranking = 1keywords = nonlymphocytic, nonlymphocytic leukemia, leukemia (Clic here for more details about this article) |
10/104. Chromosome 7 abnormalities in children with down syndrome and preleukemia.Three children, two boys and one girl, with down syndrome (DS) who presented with preleukemia and loss of all or part of chromosome 7 were studied. Initial presentation, with cytopenias and less than 25% blasts in the bone marrow, was between 13 and 30 months of age. Progression to acute nonlymphocytic leukemia occurred 1-8 months after initial presentation. The morphologic type was megakaryoblastic in two, and undifferentiated in one. Two children achieved remission with intensive therapy, and one continues in remission off therapy; the other child died in remission of accidental causes. The third child died of respiratory distress and leukemia after no intervention was chosen. These cases represent the first examples of chromosome 7 abnormalities associated with DS and leukemia, and suggest differences from the "monosomy 7" syndrome seen in children without DS.- - - - - - - - - - ranking = 1.271587703565keywords = nonlymphocytic, nonlymphocytic leukemia, leukemia (Clic here for more details about this article) |
| | Next -> |