Die megakaryozytäre Myelose — Klinik, Morphologie und Plättchenfunktion

Hochhaus, Andreas; Höche, D; Mindner, K; Ostermann, G; Meyer, M.

doi:10.1007/bf01735652

Cited by 2 publications

(1 citation statement)

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“…Medizinische Klinik Mannheim, University of Heidelberg; Medizinische Poliklinik and Abteilung fü r Knochenmarksdiagnostik, Medizinische Klinik Innenstadt, University of Munich; Medizinische Klinik, Klinikum Erfurt). The data of 84 patients previously described Hochhaus et al, 1989) were updated.…”

Section: Methodsunclassified

Should a platelet limit of 600 × 10⁹/l be used as a diagnostic criterion in essential thrombocythaemia? An analysis of the natural course including early stages

Lengfelder

Hochhaus

Kronawitter³

et al. 1998

Br J Haematol

120

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Summary. In order to evaluate the natural history of essential thrombocythaemia (ET), clinical data and prognostic factors of 143 patients with ET were retrospectively analysed (mean observation time 6·1 Ϯ 4·6 years). In 42 patients the early phase of the disease with initial platelet counts between 250 and 600 × 10 9 /l was assessed. In most early cases, ET was suggested by clinical symptoms (79%) and increased megakaryopoiesis (95%) with abnormal megakaryocytes in bone marrow histology (n ¼ 34) and cytology (n ¼ 5). Other myeloproliferative disorders and reactive thrombocytosis were excluded according to the diagnostic criteria of the Polycythemia Vera Study Group. During follow-up of the 38 early cases not treated cytoreductively at diagnosis, the platelet counts increased to >600 × 10 9 /l in 28 patients (74%) and remained between 450 and 600 × 10 9 /l in 10 patients (26%). In primarily asymptomatic patients (n ¼ 46) with initial platelet counts above (n ¼ 37) and below 600 × 10 9 /l (n ¼ 9) the rates of increase of symptomatic patients were similar at about 7% per year. No influence of the initial platelet count on survival was seen in multivariate analysis of prognostic factors which included all 143 cases. Survival was mainly influenced by the rate of ET-related complications during follow-up (P ¼ 0·002). Analysing the influence of cytoreductive therapy on symptom-free survival, platelet reduction benefited patients under 60 years (19 cytoreductively treated v 65 untreated patients, P ¼ 0·075). The results demonstrate the possible clinical relevance of the early stages of ET and suggest that the features of pathologic megakaryopoiesis in the bone marrow are a more reliable diagnostic criterion than a definite platelet limit. Therefore, further therapeutic studies should include all stages of the disease and all age groups.Keywords: myeloproliferative disorder, early essential thrombocythaemia, prognostic factors, diagnostic criteria, bone marrow histology.Due to the lack of a specific diagnostic marker, the diagnostic criteria of essential thrombocythaemia (ET) established by the Polycythemia Vera Study Group (PVSG) were directed primarily at the exclusion of other myeloproliferative disorders and of reactive thrombocytosis. For diagnosis of ET, a platelet count of 600 × 10 9 /l was considered as an absolute requirement (Murphy et al, 1986). For protocols involving myelosuppressive agents a platelet count of 1000 × 10 9 /l was determined to restrict the erroneous inclusion of cases with reactive thrombocytosis and to avoid possible overtreatment of cases with a mild course of ET (Murphy et al, 1986(Murphy et al, , 1997. In most of the following studies, patients with lower platelet counts were excluded according to the criteria of the PVSG. Such selectivity is acceptable for therapeutic studies. But in the evaluation of the natural course of ET the exclusion of early stages with moderate thrombocytosis below the limit of 600 × 10 9 /l may lead to incomplete recognition of characteristic features of the di...

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Section: Methodsunclassified

Should a platelet limit of 600 × 10⁹/l be used as a diagnostic criterion in essential thrombocythaemia? An analysis of the natural course including early stages

Lengfelder

Hochhaus

Kronawitter³

et al. 1998

Br J Haematol

120

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Helicobacter pylori adheres selectively to Fusobacterium spp

Andersen

Ganeshkumar²,

Kolenbrander

1998

Oral Microbiology and Immunology

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Helicobacter pylori strains ATCC 43504 and ATCC 43629 were tested for their ability to coaggregate with 79 strains of bacteria representing 16 genera. All except two of the strains were of human origin, and most of the strains were isolated from the oral cavity. The helicobacters failed to coaggregate with all strains except the fusobacteria. Several coaggregations were partially or completely inhibited by lactose. Strong coaggregation was seen with each of four subspecies of Fusobacterium nucleatum and with Fusobacterium periodonticum ATCC 33693, all of human dental plaque origin. In contrast, the helicobacters failed to coaggregate with non-plaque isolates, Fusobacterium mortiferum ATCC 25557 and Fusobacterium ulcerans ATCC 49185. Heat treatment of the fusobacteria inactivated their ability to coaggregate, whereas heating of the Helicobacter partners had no effect, suggesting the presence of an adhesin on the fusobacteria and a corresponding receptor on the helicobacters. The potential ability of H. pylori to colonize the oral cavity by adhering selectively to the ubiquitous fusobacteria gives credence to the possibility that dental plaque may serve as a reservoir for this pathogen outside of the stomach.

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Die megakaryozytäre Myelose — Klinik, Morphologie und Plättchenfunktion

Cited by 2 publications

References 33 publications

Should a platelet limit of 600 × 10⁹/l be used as a diagnostic criterion in essential thrombocythaemia? An analysis of the natural course including early stages

Should a platelet limit of 600 × 10⁹/l be used as a diagnostic criterion in essential thrombocythaemia? An analysis of the natural course including early stages

Helicobacter pylori adheres selectively to Fusobacterium spp

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Die megakaryozytäre Myelose — Klinik, Morphologie und Plättchenfunktion

Cited by 2 publications

References 33 publications

Should a platelet limit of 600 × 109/l be used as a diagnostic criterion in essential thrombocythaemia? An analysis of the natural course including early stages

Should a platelet limit of 600 × 109/l be used as a diagnostic criterion in essential thrombocythaemia? An analysis of the natural course including early stages

Helicobacter pylori adheres selectively to Fusobacterium spp

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Product

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Should a platelet limit of 600 × 10⁹/l be used as a diagnostic criterion in essential thrombocythaemia? An analysis of the natural course including early stages

Should a platelet limit of 600 × 10⁹/l be used as a diagnostic criterion in essential thrombocythaemia? An analysis of the natural course including early stages