Clinical outcome of therapy-related acute myeloid leukemia patients. Real-life experience in a University Hospital and a Cancer Center in France.

BACKGROUND: t-AML occurs after a primary malignancy treatment and retains a poor prognosis. AIMS: To determine the impact of primary malignancies, therapeutic strategies, and prognostic factors on clinical outcomes of t-AML. RESULTS: A total of 112 adult patients were included in this study. Fifty-Five patients received intensive chemotherapy (IC), 33 non-IC, and 24 best supportive care. At t-AML diagnosis, 42% and 44% of patients presented an unfavorable karyotype and unfavorable 2010 ELN risk profile, respectively. Among treated patients (n = 88), 43 (49%) achieved complete remission: four out of 33 (12%) and 39 out of 55 (71%) in non-IC and IC groups, respectively. With a median follow-up of 5.5 months, the median overall survival (OS) and disease-free survival (DFS) for the whole population were 9 months and 6.3 months, respectively, and for the 88 treated patients 13.5 months and 8.2 months, respectively. Univariate analysis on OS and DFS showed a significant impact of high white blood cells (WBC) and blast counts at diagnosis, unfavorable karyotype and ELN classification. Multivariate analysis showed a negative impact of WBC count at diagnosis and a positive impact of chemotherapy on OS and DFS in the whole population. It also showed a negative impact of previous auto-HCT and high WBC count on OS and DFS and of IC on OS in treated patients which disappeared when we considered only confounding variables (age, previous cancers, marrow blasts, and 2010 ELN classification). In a pair-matched analysis comparing IC treated t-AML with de novo AML, there was no difference of OS and DFS between the two populations. CONCLUSION: We showed, in this study that t-AML patients with unfavorable features represented almost half of the population. Best outcomes obtained in patients receiving IC must be balanced by known confounding variables and should be improved by using new innovative agents and therapeutic strategies.

[Placental transmogrification of the lung. Atypical presentation of the bullous emphysema]. / Transmogrificación placentaria de pulmón. Presentación atípica del enfisema bulloso.

Placental transmogrification of the lung is an extremely rare lesion, associated with giant bullous emphysema and considered by some authors to be a histological variant of unilateral giant bullous emphysema. Its etiology is still unknown and represents a challenge for both clinical and pathological diagnosis. We present the case of a young patient, who consults with dyspnea of one year of evolution, and whose postoperative diagnosis includes this rare entity.

La transmogrificación placentaria del pulmón es una lesión extremadamente infrecuente, asociada al enfisema bulloso gigante y considerada por algunos autores una variante histológica del enfisema bulloso gigante unilateral. Su etiología aún es desconocida y representa un desafío tanto para el diagnóstico clínico como anatomopatológico. Presentamos el caso de un paciente joven, que consulta con disnea de un año de evolución, y cuyo diagnóstico postoperatorio incluye esta rara entidad.

Transmogrificación placentaria de pulmón. Presentación atípica del enfisema bulloso / Placental transmogrification of the lung. Atypical presentation of the bullous emphysema

Resumen La transmogrificación placentaria del pulmón es una lesión extremadamente infrecuente, asociada al enfisema bulloso gigante y considerada por algunos autores una variante histológica del enfisema bulloso gigante unilateral. Su etiología aún es desconocida y representa un desafío tanto para el diagnóstico clínico como anatomopatológico. Presentamos el caso de un paciente joven, que consulta con disnea de un año de evolución, y cuyo diagnóstico postoperatorio incluye esta rara entidad.

Abstract Placental transmogrification of the lung is an extremely rare lesion, associated with giant bullous emphysema and considered by some authors to be a histological variant of unilateral giant bullous emphysema. Its etiology is still unknown and represents a challenge for both clinical and pathological diagnosis. We present the case of a young patient, who consults with dyspnea of one year of evolution, and whose postoperative diagnosis includes this rare entity.

EDTA-dependent lymphoagglutination.

Lymphoagglutination is an extremely rare EDTA-dependent phenomenon and is far less frequent than neutrophil agglutination. We describe 6 new cases and briefly review the literature on lymphoagglutination.

Weekly administration of paclitaxel induces long-term aneugenicity in nude mice.

We investigated the potential in vivo aneugenic effects associated with paclitaxel treatment. For this purpose, we treated female nude mice with paclitaxel using doses equivalent to those used in weekly schedules at the clinical level (three cycles of 30 mg/kg/week for three consecutive weeks followed by one resting week). We then evaluated the frequencies of micronucleated erythrocytes (MNE) in peripheral blood using the acridine orange micronucleus assay. The frequency of MNE was evaluated after 24 h and 168 h of administration of the last dose of each paclitaxel cycle (STA mice group) as well as after one year of the first dose of treatment (LTA mice group). We also analyzed the cytology of peripheral blood and bone marrows obtained from these mice at each time period. In the STA mice group, three cycles of paclitaxel induced a 2.4-fold increase in MNE frequencies compared to the control group (p < 0.01). This effect was observed after 24 h of the last dose of each chemotherapy cycle and persisted at least for 168 h. In the LTA mice group, paclitaxel-treated mice presented a 1.8-fold increase in the MNE frequency (p = 0.01) indicating that paclitaxel-induced MNE increase lasted for at least one year. Although the appearance of micronuclei in erythrocytes and granulocytes in peripheral blood and bone marrow cytological smears, there was no evidence of myeloproliferative disease. The present data therefore indicate an aneugenic potential of paclitaxel for humans, which should be considered in the risk-benefit analysis of its increasing clinical use.