Our results show that age, hemorrhagic diathesis, and initial leukocyte count are prognostic factors for APL treated with ATRA followed by intensive chemotherapy.

Background: Cutaneous plasmacytosis is a rare disease characterized by peculiar multiple eruptions and hypergammaglobulinemia. More than 40 cases have been reported, mainly in Japan, although information concerning the disorder was limited to individual case reports. Objective and Methods: To clarify the clinicopathological and laboratory features, we reviewed 41 cases. Results: All patients were Japanese and the male-to-female ratio was 1:0.6. The onset ages ranged from 20 to 62 years, with a mean and median of 37 and 37 years. A superficial lymphadenopathy was detected in 58% (22/38), and polyclonal hypergammaglobulinemia was found in 93% (38/41). No cases were associated with any apparent underlying diseases. The course was chronic without spontaneous remission. Four patients died, 3 of whom succumbed to leukemia, respiratory failure or renal failure, respectively. Conclusion: The results suggest that the condition appears to be a variant of reactive plasmacytic disorders of unknown origin.

No abstract

SummaryTo clarify the regulatory mechanism of thrombopoietin (TPO, c-Mpl ligand) in chronic thrombocytopenic conditions, we determined TPO levels in the sera of patients with aplastic anaemia (AA; n = 26) and idiopathic thrombocytopenic purpura (ITP; n = 32) by an enzyme-linked immunosorbent assay. Despite a similarity in platelet counts, serum TPO levels in the AA group were markedly higher than those in the ITP group: 20.41 ± 9.71 f mol/ml (mean ± SD) and 1.66 ± 0.55 f mol/ml, respectively, both of which were significantly elevated compared to normal subjects (n = 41; 1.22 ± 0.37). In both groups, serum TPO level showed an inverse correlation with the platelet count. We determined the megakaryocyte volume using bone marrow clot section and found that it was markedly small in the AA group; while in the ITP group it was augmented with a correlation to serum TPO level. Our findings suggest that TPO levels may be regulated not only by platelets but also megakaryocytes in AA and ITP.

To examine the role of the fibrinogen ␥ chain in the assembly and secretion of this multichain protein, we synthesized a series of fibrinogen variants with truncated ␥ chains, terminating between residues ␥379 and the C-terminus, ␥411. The variant fibrinogens were synthesized from altered ␥-chain complementary DNAs in cultured Chinese hamster ovary cells. Immunoassays of the culture media demonstrated that only those variants with ␥ chain longer than 386 residues were secreted and that the concentration of fibrinogen decreased with the length of the ␥ chain, from 1.4 g/mL for normal fibrinogen to 0.39 g/mL for ␥ 387 fibrinogen. Immunoassays of cell lysates showed that all variant ␥ chains were synthesized, although the levels varied significantly. For variants longer than 386 residues, levels decreased with length but remained near normal. In contrast, expression of the 4 variants with 386 residues or less was about 20-fold reduced. Quantitative reverse transcription-polymerase chain reaction demonstrated that the ␥-chain messenger RNA level was independent from chain length. Western blot analyses showed that lysates expressing variants with 387 residues or more contained species comparable to the known intermediates in fibrinogen assembly, including half-molecules. For shorter variants, these intermediates were not evident. We conclude that residues near the C-terminus of the ␥ chain are essential for fibrinogen assembly, and more specifically, that ␥387 is critical. We propose that the loss of residue ␥387 destabilized the structure of ␥ chain, preventing assembly of ␣␥ and ␤␥ dimers, essential intermediates in the assembly of normal fibrinogen. IntroductionFibrinogen is a 340-kd plasma glycoprotein consisting of 2 copies of 3 polypeptide chains, A␣, B␤, and ␥, linked by an extensive network of 29 intrachain and interchain disulfide bonds. 1,2 A separate gene encodes each polypeptide chain. The 3 chains are synthesized, assembled into the 6-chain molecule, and secreted from hepatocytes into the plasma. Studies of fibrinogen expressed from the endogenous genes in human hepatocytes or from transfected complementary DNAs (cDNAs) in baby hamster kidney (BHK) cells have shown that assembly occurs through specific intermediates. 3,4 These intermediates, ␣␥ dimers, ␤␥ dimers, and ␣␤␥ half-molecules, all include the ␥ chain.Normal fibrinogen levels are 2 to 4 mg/mL in plasma. Hypofibrinogenemia or afibrinogenemia, defined as reduced or immeasurable levels of fibrinogen in plasma, can be hereditary. Although the first case of afibrinogenemia was reported in 1920, 5 the genetic basis of these abnormalities was first demonstrated in 1999. 6 Since that time, 26 different mutations have been identified in cases of afibrinogenemia or hypofibrinogenemia. [7][8][9][10][11][12][13][14][15][16][17][18][19] These mutations were found in all 3 genes, and include missense, nonsense, and frameshift mutations; splice-site abnormalities; and large deletions. Thus, fibrinogen deficiencies are associated with a variety of genetic chan...