[The importance of leptin in oncology--hypothesis or facts?]. / Význam leptinu v onkologii--hypotéza nebo fakta?

Leptin was described as a protein produced mostly by adipocytes which participates in regulation of caloric intake. This protein has further many physiological regulatory functions especially in hematopoesis and reproduction. The role of leptin in diseases is also considered. Maybe leptin is a part of the pathogenic mechanism or its metabolism can be influenced secondary to disease. Malignant tumours are the important area where leptin can acts. This imagination is supported by recent in vitro studies and some clinical observations. It is consider that some parameters of leptin metabolism can serve as usable marker for diagnosis and monitoring of some malignant tumours--especially breast cancer or some types of leukemia. The authors give a review of actual information of leptin metabolism changes in oncological diseases.

Bone marrow and peripheral blood leptin levels in lymphoproliferative diseases--relation to the bone marrow fat and infiltration.

Leptin is a nonglycosylated protein produced mostly by adipocytes. The role ofleptin in body weight regulation through its anorectic effect in hypothalamus is very well known. Less known are other leptin effects such as the stimulation of hematopoesis and some parts of immunity system. The role of leptin in the pathogenesis of some malignant tumors is discussed. Only a little is known about bone marrow adipocyte leptin production. We examined leptin concentrations in the sera from peripheral blood and bone marrow, the percentage of bone marrow fat, the degree of bone marrow infiltration, the body mass index (BMI) in 42 patients with lymphoproliferative diseases. We found that bone marrow has significantly lower leptin levels (6,6+/-10,9 ng/ml) than peripheral blood (9,1+/-11,5 ng/ml) (p < 0.0001). Bone marrow and peripheral blood leptin levels have also a significant thin correlation (r = +0.91, p < 0.0001). Bone marrow (r = +0.55, p < 0.0005) and peripheral blood (r = +0.52, p < 0.0005) leptin concentrations are significantly correlated to BMI. Blood serum leptin (r = +0.46, p < 0.003) and bone marrow leptin (r = +0.40, p < 0.01) are related to the bone marrow fat percentage. In addition we found a negative correlation of blood serum leptin (r = -0.59, p < 0.0001) and bone marrow leptin (r = -0.42, p < 0.005) to bone marrow malignant infiltration. When we divided the patients into groups with bone marrow infiltration more than 10% and without or less than 10% infiltration, the first group had significantly lower peripheral blood (p < 0.001) and bone marrow (p < 0.02) leptin. We also confirmed a relation of bone marrow fat and infiltration (r = +0.49, p < 0.001). Our results suggest a relationship among leptin levels in blood or bone marrow and bone marrow infiltration in lymphoproliferative diseases. This fact needs further investigation and an evaluation of its application in clinical practice.

[Leptin levels in peripheral blood and bone marrow in orthopedic patients]. / Hladiny leptinu v sérech z periferní krve a kostní drene u ortopedických pacientu.

Leptin is a protein with hormonal activity and is produced mainly by adipocytes. Its primary function in the human organism is regulation of the calorie intake via the anorectic action in the hypothalamus. Leptin participates also in the regulation of haematopoiesis and immunity processes. There are many data on leptin production by peripheral adipose tissue and it is also known that leptin is produced by adipocytes of bone marrow. It was assumed for a long time that adipocytes of bone marrow are not only a passive source of energy but have, similarly as stromal cells, a regulatory function. However, it is not clear in what way the adipose tissue of bone marrow participates in the regulation of haematopoiesis and what role is played in this relationship by leptin production. The authors attempted to assemble in their small study data on leptin production in bone marrow and at the same time parameters of lipids of bone marrow which can be assessed by cytological examination. The authors examined 16 patients (9 men and 7 women) subjected to orthopaedic surgery. They assessed leptin concentrations in sera obtained from peripheral blood and bone marrow, and at the same time they assessed by morphological examination in smears of bone marrow some parameters associated with lipids. The authors found that serum leptin levels from bone marrow are significantly lower than in peripheral blood (p < 0.0005). These values correlate closely (r = +0.77, p < 0.0005). The authors found also a positive correlation between serum leptin (r = +0.56, p < 0.02) and bone marrow leptin (r = +0.72, p < 0.002) and the body mass index (BMI). A positive correlation was found also between serum (r = +0.65, p < 0.006) and bone marrow leptin (r = +0.80, p < 0.0002) and age. The authors did not detect any significant correlations between parameters of the lipids of bone marrow and leptin levels in serum and bone marrow. The assembled results can in combination with data from the literature indicate that the actual amount of leptin in bone marrow is influenced rather by its consumption by haematopoietic tissue than by its production.

Osteoblasts and osteoclasts in bone marrow smears of cancer patients.

Osteoblasts and osteoclasts are the unique cells occurring in bone marrow smears in situations with high bone metabolic turnover (children, trauma, rachitis, Paget disease or tumors). The collection of 2706 sternal or iliac crest aspirates from patients with hematologic malignancies and solid tumors are presented. We demonstrated significantly higher positivity for osteoblasts-osteoclasts presentation in bone marrow smears for hematological malignancies (p < 0.05), solid tumors (p < 0.01), and especially breast cancer (p < 0.001). We found a significant association between osteoblast-osteoclast positivity and dissemination of breast cancer (p < 0.05). None of the breast cancer patients without signs of dissemination (X-ray, sonography or scintigraphy) had positivity for osteoblasts or osteoclasts. We suppose that the osteoblast-osteoclast positivity in bone marrow smears can serve as a cheap marker for breast cancer dissemination.

[Erythema exsudativum multiforme with macroglobulinemia]. / Erythema exsudativum multiforme s makroglobulinémií.

A case of a 47-year-old man with skin lesions of erythema multiforme and macroglobulinemia is reported. Histological changes corresponded with mixed dermoepidermal type of erythema multiforme and direct immunofluorescence showed fibrillar band with anti-IgM and anti-fibrin on basement membrane. Further examination revealed serum monoclonal IgM kappa with traces in urine. Association or coincidence of these findings is discussed.

[Agrobacterium tumefaciens (Radiobacter) as an infectious agent in an oncological patient]. / Agrobacterium tumefaciens (radiobacter) jako infekcní agens u onkologického pacienta.

The authors submit the description of a 62-year-old patient with multiple myeloma where the causal agent of pyretic reactions was Agrobacterium tumefaciens (radiobacter). It was a patient with an implanted venous port which was colonized by the above bacterium. This finding most probably has not been described so far in the Czech literature. In the English literature the authors found 36 cases. The authors draw attention to the possible higher incidence of future infections caused by organisms hitherto considered non-pathogenic for man, in particular in immunocompromised patients.

[Are the procedures in hematology always rational? Considerations]. / Pocínáme si v hematologii vzdy racionálne? Uvahy.

The authors draw attention to the incorrect description of the mean corpuscular haemoglobin concentration, to shortcomings of computer evaluated white cell counts, the necessity to evaluate nuclear shadow in the blood count and rare findings in peripheral blood smears.

[Fatty acid and cholesterol crystals in bone marrow smears of oncology patients]. / Krystalky mastných kyselin a cholesterolu v rozteru kostní drene u onkologických nemocných.

In 50 haematological-oncological and oncological patients the authors found in bone marrow smears fatty acid and liquid cholesterol crystals. The number of crystals of fatty acids does not correlate directly with the triacylglycerol serum levels. Similar findings were recorded also in haematological patients.

[Gaucher's disease in a 22-year-old female patient]. / Gaucherova choroba u 22leté pacientky.

Gaucher's disease is a sphingolipidosis with a genetically conditioned deficiency of cerebroside-beta-glucosidase which can be encountered in everyday practice and not only in paediatrics. The authors submit the case-history of a 22-year-old Ukrainian patient with a fully developed type 1 Gaucher disease, and a brief review of the diagnostic and therapeutic possibilities. Due to the more extensive migration of the population on the territory of the Czech Republic a more frequent occurrence of the disease can be envisaged.