Pure red cell anemia with erythropoietic maturation arrest and spontaneous recovery.

We report the case of a 21-year-old male who presented with severe anemia and hypercellular bone marrow, without known cause. The dominant feature of the bone marrow was that of a maturation arrest in the erythroid series, with absolute reticulocytopenia in the peripheral blood. Immunosuppressive therapy was withheld, but transfusions were given to maintain his hemoglobin prior to full recovery. The patient had features of both pure red cell anemia and of transient erythroblastopenia of childhood.

Coexistence of hereditary spherocytosis and beta-thalassemia: case report of severe hemolytic anemia in an American black.

The first reported case of hereditary spherocytosis (HS) and beta-thalassemia in an American black is presented. The diagnosis rested on clinical presentation, family history and specialized laboratory findings. The tendency toward hemolysis of spherocytes and thalassemia red cells may explain the severity of anemia in this patient. The clinical course of these coexistent diseases and the role of splenectomy in relieving the hemolytic component caused by hereditary spherocytosis are described. A detailed review of the literature on HS and beta-thalassemia is also included.

Thermochemotherapy in inoperable head and neck cancer.

A combined hyperthermia and chemotherapy approach was used to treat five patients with locally advanced or recurrent squamous cell carcinoma of the head and neck whose tumors had failed to respond to chemotherapy. In two patients, tumor had recurred after initial combined modality therapy (surgery/radiation) and had failed to respond to one course of cisplatin/5-fluorouracil (cisplatin/5-FU) chemotherapy. The three remaining patients were enrolled onto a phase II evaluation of induction chemotherapy with cisplatin/fluorouracil for advanced head and neck carcinomas and had failed to achieve a partial remission after one treatment cycle. Palpable cervical tumors were heated to 40 degrees to 42 degrees C for 30 to 40 minutes, during which time cisplatin (100 mg/m2) was infused intravenously. A 5-day infusion of 5-fluorouracil (1000 mg/m2/d) followed. Despite less than a partial response to previous cisplatin/fluorouracil chemotherapy alone, two patients had complete clinical resolution of the heated tumor volume with two cycles of the combined thermochemotherapy approach. One patient achieved a partial remission with this approach. The remaining two patients died shortly after the initial thermochemotherapy treatment, as a result of progressive tumor growth. The two complete responders were subsequently treated with radiation (1 patient) and radical neck dissection (1 patient) and remained without evidence of disease 2 and 26 months after the completion of therapy, respectively. The toxicity of this combined modality approach was acceptable and appeared to be no greater than had been experienced during earlier treatment with chemotherapy alone. Further studies using a combination of these treatment modalities for locally advanced head and neck carcinomas are warranted.