DNA aneuploidy in children with relapsed acute lymphoblastic leukemia as measured by flow cytometry.

An aneuploid DNA stem line has been detected by flow cytometric measurements in 17 (29%) out of 59 children entered in the BFM 83 pilot study for ALL relapse. Of 17 DNA aneuploidies, 15 were hyperdiploid. Euploidy was observed in 28 of 34 patients with an early relapse, whereas 11 of 25 children suffering a late recurrence of disease showed aneuploid DNA stem lines. In contradistinction to ALL relapse, a significantly higher frequency (38%) of pretreatment DNA aneuploidy was measured in 376 newly diagnosed patients of the BFM trials. Our findings may reflect the impact of therapy on leukemic cell clones and their relapse pattern.

[Bone marrow transplantation in severe aplastic anemia]. / Knochenmarktransplantation bei schwerer aplastischer Anämie.

Bone marrow transplantations were performed on 15 patients (aged 5-39 years) with severe aplastic anaemia. Twelve patients are alive 76-1930 days (median 668 d) after transplantation, with complete haematopoetic recovery. Total-body radiation with 3.6 Gy in four patients, cyclosporin A administration to ten patients and buffy-coat transfusion to nine patients entirely prevented early rejection. Two patients died of pneumonia (aspergillus; varicella-zoster virus), one patient died of bleeding from a splenic-artery aneurysm. In patients under the age of 40 years with severe aplastic anaemia bone marrow transplantation as early as possible after diagnosis is the treatment of choice if HLA-identical siblings are available as donors. In patients over 40 years treatment should at first be tried with antithymocyte globulin.