Natural history of smouldering leukaemia

Joseph, Annie; Cinkotai, K. I.; Hunt, Leigh H.; Geary, C. G.

doi:10.1038/bjc.1982.179

Cited by 49 publications

(15 citation statements)

References 13 publications

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“…Our study suggests that these "high risk" leukemic states can be addressed by this mode of therapy. The combined response (PR and CR) rate of 67% (8/12; CR rate of 42% and PR rate of 25 %) compares favorably with previously reported studies treating ANLL in the elderly (2847%) [14,20,21] or secondary ANLL (2043%) [5,6].…”

Section: Discussionsupporting

confidence: 84%

Treatment of “poor risk” acute nonlymphocytic leukemia with continuously infused low‐dose cytosine arabinoside

et al. 1988

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There is currently little experience using a continuous intravenous infusion of low-dose cytosine arabinoside (LDARA-C) in the treatment of acute nonlymphocytic leukemia (ANLL). We report the results in 12 patients with ANLL described as either relapsed ANLL, ANLL with a preceding myelodysplastic phase, or ANLL in the elderly treated with 14 days of continuous intravenous LDARA-C (20 mg/m2/day). Complete responses (CR) were seen in five patients (42%) and partial responses (PR) in three patients (25%). Treatment resulted in overall and clonal cytoreduction, which was evident by serial bone marrow exams and bone marrow cytogenetic analysis. The ability to obtain a CR correlated with the finding of a low initial marrow cellularity (P less than .05). This study finds that continuous intravenous infusion of LDARA-C for ANLL can achieve response rates comparable to standard induction programs in a subset of patients traditionally defined as having a poor prognosis.

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Section: Discussionsupporting

confidence: 84%

Treatment of “poor risk” acute nonlymphocytic leukemia with continuously infused low‐dose cytosine arabinoside

et al. 1988

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“…Mahmoud et al [16] believe that unexplained macrocytosis in the elderly (C75 years) could be an early sign of Myelodysplastic syndrome. Joseph et al [26] have observed that refractory, unexplained macrocytosis may be an early sign of smoldering leukemia. Therefore regardless of the hemoglobin levels, close attention should be paid to MCV [27,28].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Macrocytosis in Routine Hemograms

Veda

2012

Indian J Hematol Blood Transfus

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Macrocytosis, a condition in which erythrocytes are larger than normal manifests as an increase in mean corpuscular volume (MCV) more than 100 fl. The aim of this study was to identify the underlying causes of macrocytosis, detected in routine hemograms and to evaluate the hematological features in different etiologies. This study included 178 adult patients whose detailed medical history was recorded, and Vitamin B12 assay, folate assay, thyroid function tests, liver function tests, complete blood counts and peripheral smear evaluation was performed. Alcoholism was identified as the etiological factor in 65 cases (36.5%), Vitamin B12 deficiency in 43 cases (24.1%) and drug related in 23 cases (12.9%). These three conditions accounted for 73.6% of macrocytosis. Other causes identified were folate deficiency, liver disease, Myelodysplastic syndrome, chronic renal failure and Aplastic anemia. In 41 cases, the cause of macrocytosis could not be explained. Anemia was observed in 95 cases (53.3%) being most common in Vitamin B12 deficiency. 9 cases (20.9%) of Vitamin B12 deficiency presented with isolated macrocytosis without anemia. It was observed that mean hemoglobin was lower and red cell distribution width (RDW) higher in megaloblastic conditions. Peripheral smear revealed hypersegmented neutrophils in 86% and macroovalocytes in 72% of the megaloblastic cases. Complete medical history, red cell parameters and peripheral blood smear are simple, inexpensive tools which assist in identifying the underlying cause of macrocytosis, particularly in resource limited settings. Macrocytosis needs to be evaluated even in the absence of anemia, as it may be the first clue to an underlying pathology.

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“…The FAB classifica tion has divided these disorders into distinct diseases [2, 3], but there is evidence that they may also repre sent different stages of an evolving process that can eventually develop into acute nonlymphocytic leu kemia [6,11,15], Moreover, many studies support the idea that the MDSs are clonal disorders of a pluripotent stem cell [1] and leukemic transformation has a multistep pathogenesis [7.9, 14, 25, 26, 28].…”

Section: Discussionmentioning

confidence: 99%

Qualitative and Quantitative Study of Dihydrofolate Reductase in Myelodysplastic Syndromes

et al. 1988

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Dihydrofolate reductase (FH₂-R) was studied cytochemically in the bone marrow erythroblasts of 20 normal controls and 46 patients with myelodysplastic syndromes (MDSs) classified according to FAB, prior to therapy. The reaction product was quantified for the same samples with a Vickers M86 microdensitometer. The enzyme activity progressively decreased during the normal differentiation of the erythroid cells and persisted at high levels in MDS cells. The high level of FH₂-R may be related to the malignant transformation of the cells, or to increased compensatory erythropoietic activity of ineffective erythropoiesis, or to both.

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Natural history of smouldering leukaemia

Cited by 49 publications

References 13 publications

Treatment of “poor risk” acute nonlymphocytic leukemia with continuously infused low‐dose cytosine arabinoside

Treatment of “poor risk” acute nonlymphocytic leukemia with continuously infused low‐dose cytosine arabinoside

Evaluation of Macrocytosis in Routine Hemograms

Qualitative and Quantitative Study of Dihydrofolate Reductase in Myelodysplastic Syndromes

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