Effect of D-penicillamine on human granulopoiesis in vitro.

The effect of D-penicillamine on human bone marrow granulocyte-monocyte precursor cells (CFU-C) is studied in vitro. Bone marrow samples were obtained from 47 donors (40 patients and 7 healthy volunteers) and cultured in semisolid agar in the presence of various concentrations of the drug. We found an inhibitory, possibly dose-dependent, effect of D-penicillamine on colony formation. The pathophysiological mechanism and the clinical relevance of this effect remain poorly understood. These findings, however, emphasize the need for careful monitoring of the granulocyte counts during D-penicillamine therapy.

[Lithium and acute myeloid leukemia]. / Lithium et leucémie aiguë myéloïde.

The authors report a case of acute myeloid leukemia in a thirty-four-year-old man who had been under lithium carbonate for the last six months for manic-depressive psychosis. One year after treatment with cytosine-arabinoside, 6-thioguanine and daunorubicin, the patient is still in complete remission. In the medical literature we found seven additional reports of acute or chronic myeloid leukemia after lithium therapy. Lithium was found to enhance granulopoiesis. Our findings suggest that lithium may initiate or promote leukemia.

[Effect of cimetidine on human granulopoietic stem cells. In vitro study in 31 patients]. / Action de la cimétidine sur les cellules souches de la granulopoïèse humaine. Etude in vitro sur 31 patients.

We studied the action of cimetidine at various concentrations on human hematopoeitic colony and cluster forming cells "in vitro" (CFUc). Bone marrow samples obtained from 31 patients with various hematological and neoplastic diseases were cultured in semisolid agar. When cimetidine was added to cultures there was a reduction of colony and macrocluster formation. At the concentration used in our study (20 micrograms/ml, 30 micrograms/ml, 40 micrograms/ml) these effects were not dose-related. We did not find any significant reduction of microcluster formation. These results are relevant with the hypothesis that histamine H2 receptors antagonists may have an inhibiting action on bone marrow CFUc proliferation. They point out the need for hematological surveillance during long-term cimetidine therapy.

Multiple myeloma after phenytoin therapy.

We report a case of multiple myeloma in a 48-year-old woman treated with phenytoin for 55 months. This association may be fortuitous. The depressive effect of phenytoin on the immune responses, however, could account for the occurrence of the dysglobulinaemia. This case points out the need for periodic examination of serum proteins in patients chronically treated with hydantoin derivatives.

Acute leukaemia after prolonged chlorambucil treatment for non-malignant disease: report of a new case and literature survey.

A case of acute myeloblastic leukaemia is reported in a patient treated with chlorambucil during 72 months for multiple sclerosis. In a review of the medical literature, 43 additional reports of acute leukaemia after chlorambucil therapy for non-malignant diseases were found. Most cases are of a non-lymphoid type and preceded by various blood and bone marrow abnormalities. The prognosis is poor with a short survival. The risk of developing acute leukaemia after long-term immunosuppressive treatment with chlorambucil is emphasized.

[Pericarditis as the presenting manifestation of acute monoblastic leukemia-Report of a case and review of the literature (author's transl)]. / Péricardite inaugurale d'une leucémie aiguë monoblastique. Description d'un cas et revue de la littérature.

A case of acute monoblastic leukemia in a 68-year-old man is reported in which one of the presenting manifestations was a pericardial effusion. A blood-stained fluid was removed from the pericardium. The pericardial fluid showed blast cells on microscopical examination. The patient was treated with 6-Mercaptopurine and Methotrexate and achieved a short partial remission. He died of general infection, 4 months after the start of his illness. We found in the medical literature 30 additional cases with a mean age of 24 +/- 16 years and a striking male predominance (68. p. 100). We found 15 acute lymphoid leukemias, 9 acute myeloid leukemias, 4 acute indifferentiated leukemias, and 2 acute nontyped leukemias. The leukemic pericardial involvement is often associated with splenomegaly, adenopathy and pleural effusion. The management procedures include pericardiocentesis, general of local chemotherapy, irradiation of the cardiac area. The prognosis is generally poor, with a mean survival of 5 months.