Chronic lymphocytic leukaemia with raised serum IgM levels.

Eight patients diagnosed as having chronic lymphocytic leukaemia (CLL) from clinical and haematological data were also observed to possess immunological characteristics similar to tropical splenomegaly syndrome (TSS). We suggest that the raised IgM level in these cases may be the effect of chronic exposure to malaria in patients who later developed CLL. Consequently, raised serum IgM, which is a feature of TSS, may also be found in some cases of CLL in Nigeria.

Sensori-neural hearing impairment in chronic granulocytic leukaemia.

Sudden sensori-neural hearing impairment as a complication of chronic granulocytic leukaemia (CGL) occurred in five of the ten patients seen in Jos University Teaching Hospital over a period of two years. This complication occurred more frequently in younger patients especially females with excessive hepatosplenomegaly, higher leucocyte count and lower platelet count. Leucostasis in internal auditory artery may be acting as a thrombus to cause infarction in the cochlea resulting in the sudden hearing loss.

Immunological identification of peripheral-blood lymphocytes from patients with lymphoproliferative disorders in Nigeria. I. Acute lymphocytic leukaemia (ALL).

The peripheral-blood lymphocytes of eight consecutively diagnosed cases of acute lymphocytic leukaemia (ALL) in Nigerians seen over a period of 2 years were classified as T, B and Null cells, using mainly sheep-rosetting (for T cells) and EAC-rosetting (for B cells) techniques. The patients' lymphocytes response to stimulation with phytohaemagglutinin (PHA) and basic haematological parameters were also determined. There were three male cases (37.5%), aged 10, 14 and 21 years who had T-cell ALL and one boy (12.5%) aged 10 years with B-cell ALL. The remaining four patients (50%) were two girls aged 6 and 6 1/2 years and two males aged 10 and 21 years who had lymphocytic leukaemia of the Null-cell class. These results from a tropical environment agree with previous findings among Caucasians with respect to the age and sex incidence and predominance of ALL with Null cells.

Immunological identification of peripheral-blood lymphocytes from patients with lymphoproliferative disorders in Nigeria. II. Chronic lymphocytic leukaemia (CLL).

The surface markers for blood T and B lymphocytes in sixteen consecutively diagnosed patients with CLL were sought for. There were twelve females and four males, and their ages ranged from 30 to 70 years. Although the absolute numbers of T and B lymphocytes were increased, the percentage scores as well as mitogenic responses of these leukaemic cells were depressed, and all the patients except one who has T-cell CLL were considered to have Null-cell CLL. This finding suggests that CLL may take an unusual form in a tropical environment, and this may account for the long remissions which often occur.

Tropical splenomegaly syndrome: long-term proguanil therapy correlated with spleen size, serum IgM, and lymphocyte transformation.

Forty-three patients with an initial diagnosis of tropical splenomegaly syndrome were placed on long-term proguanil therapy. All patients who failed to respond to proguanil and who were adequately followed up developed identifiable disease, usually malignant lymphoma or chronic lymphatic leukaemia. In patients who responded to proguanil IgM values were always very high and phytohaemagglutinin (P.H.A.)-lymphocyte-transformation scores were always normal before treatment was started. In patients who failed to respond IgM values were within the normal range or below, while P.H.A.-lymphocyte-transformation scores were abnormally low. During proguanil treatment IgM values fell gradually, closely paralleling the decrease in spleen size.