Within the last two years, the development of acute leukaemia after long‐continued treatment with alkylating cytostatic agents has repeatedly been reported. A watch is therefore kept for the possible leukaemogenic action of these drugs. In view of this, it will be of interest to report a case in which erythroleukaemia developed in an 81‐year‐old man with macroglobulinaemia who had been treated with melphalan for 3 1/2 years.
Even though most cases of M‐globulinaemia reveal low serum cholesterol values, a few cases are on record in which hypercholesterolaemia and/or xanthomatosis have been associated with IgG or IgA para‐proteinaemia. In most of the latter cases a familial origin of the disease was not disclosed, and a causal relationship between the paraproteinaemia and the lipoid disease was therefore assumed. A report is presented of a case associated with Waldenström's macroglobulinaemia—a combination which does not seem to have been described before. This case probably represents a fortuitous coincidence of the two diseases, as electrophoresis of the serum lipoproteins in the patient's sister revealed lipoid changes, although this sister had no xanthomata and her serum cholesterol level was only at the upper limit of normal. Thus a familial genesis can be excluded only by an analysis of serum lipoids in members of the family.
A case of benign idiopathic monoclonal gammapathy with cold sensitivity due to Donath‐Landsteiner antibody is reported. At the age of 42, the patient noticed a tendency to urticarial wheals after exposure to cold. Two years later, he began to have typical attacks of cold haemoglobinuria. At the age of 46, a haemolysin of the Donath‐Landsteiner type and increased amounts of IgG were disclosed. As the eluted M‐protein gave a positive Donath‐Landsteiner reaction, this was probably identical with the haemolysin. That the gammapathy was of the benign type was supported by the fact that no rise was seen in the M‐protein level or plasma‐cell count at a follow‐up examination 6 1/2 years after the onset of the cold sensitivity. The case is remarkable because Donath‐Landsteiner antibody has not previously been described together with a monoclonal gammapathy. The benign idiopathic monoclonal gammapathy is usually an asymptomatic condition.
As there may, perhaps, be a tendency to disregard a diagnosis of acute erythraemic myelosis when there are no erythroblasts in the peripheral blood, such a case observed in a 69‐year‐old man with pancytopenia and hypercellular bone marrow is reported. Of the bone marrow cells 85% were erythroblasts, most of which were basophilic. Many of the cells were megaloblastoid, often multilobular or multinuclear with a strongly positive PAS reaction. No erythroblasts were observed in the peripheral blood. The case must be classified as one of anerythraemic, aleukaemic Di Guglielmo syndrome.
Nuclear arylsulphatase activity was estimated in 82 cases of leukaemia and in 27 cases of bone marrow plasmocytosis. Smears from patients with other haematological disorders and from normal individuals were also studied. The nuclear staining reaction was always positive in lymphocytic cells including lymphoblasts, whereas it was negative in about one third of the cases of acute myeloblastic leukaemia. Promyelocytes and all more mature granulocytes always showed a negative staining reaction. As erythroblasts were invariably positive, this method cannot be used in the differentiation of megaloblasts in folic acid or vitamin‐B12 deficiency from the megaloblastoid erythroblasts in the Di Guglielmo syndrome. It is also without value in the differentiation between normal and neoplastic plasma cells. Storage in a desiccator for 4–8 weeks does not seem to exert any appreciable influence on the staining reaction.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.