[Cytological classification of adult acute leukemia (author's transl)]. / Classification cytologique des leucémies aiguës de l'adulte

134 cases of acute leukemia in adults were classified according a "double blind" cytological diagnosis, a cytochemical study, and lysozyme assay. Each type has distinct characters, allowing a good nosological definition. The histochemical methods, as well as lysozyme assay are usually unnecessary, particularly in well differenciated myeloblastic, promyelocytic or myelo-monocytic acute leukemia. They are, on the contrary, frequently useful in poorly differenciated myeloblastic or monoblastic leukemia. But, they cannot help to solve every problem in cytological diagnosis: there are still 10% of undifferenciated acute leukemia, the lymphoblastic acute leukemia are not clearly defined and 4% of cases of acute leukemia have atypical characters leading to difficulties in cytological classification. The need for new methods and markers is emphasized.

Cell volume measurements in acute leukaemia: method and value for diagnosis and prognosis.

Cell volume was measured using a Coulter counter in 42 cases of adult acute leukaemia, before any therapy. In every patient, the distribution was log-normal. A breakdown of the results with regard to the cell-type gives the following informations: The mean modal volume (M.M.V.) differs significantly from one type of leukaemia to another: the cell size in the myeloblastic type is larger than in the lymphoblastic, and smaller than in the monoblastic and myelomonocytic types. The dispersion of cell volumes, for a single patient, is low in acute lymphoblastic leukaemia, wider in myeloblastic cases and is even larger in myelo-monocytic patients. In 9 of the 10 acute myelo-monocytic leukaemias studied, the existence of two populations was shown by a double peak. Once relapse occurs, the cell volumes seem greater than during the first phase of the disease, at least in acute lymphoblastic leukaemia. No correlation has been found between the mean modal volumes and the labeling index, after incorporation of 3H-TdR.

[In vitro incorporation of tritiated thymidine in acute leukemia and response to chemotheraphy (author's transl)]. / Incorporation "in vitro" de la thymidine tritiée dans la leucémie aiguë et réponse a la chimiothérapie

The incorporation of tritiated thymidine (3H-TdR) has been assessed in 52 cases of adult acute leukemia, during the first phase of the disease, before and after 48 hours of chemotherapy. Two methods were utilized simultaneously: the measurement of the incorporation of 3H-TdR by liquid scintillation counting and the labeling index by autoradiography. These two data allowed to appreciate the mean incorporation per labeled blast cell. A significant correlation has been found between liquid scintillation counting and labeling index on the one hand, between mean incorporation per labeled blast cell and mean grain count on the other hand. The prognostic value of these different data was significant, at least if one consider the chance to get a complemente remission with the various drugs which were utilized. The responders are characterized, on the average, by a high rate of incorporation of 3H-TdR before therapy, with a higher labeling index than the non-responders. The measurement of the variations of incorporation of 3H-TdR, 48 hours after starting chemotherapy and before any morphological change, allows an early evaluation of the therapeutic effect: in the responders there is generally a decrease of the 3H-TdR incorporation and of the labeling index. On the apposite in the non-responders there is an increase of the mean incorporation per labeled blast cell, even if the labeling index decreases. The measurement of the incorporation of 3H-TdR by liquid scintillation counting which gives an earlier response than autoradiography, may be considered as a useful prognostic tool in acute leukemia, mainly in the non-lymphoblastic types and during the first phase of the disease.

Prediction of the response to chemotherapy in acute leukemia.

The prognostic value of the in vitro incorporation of labeled thymidine was evaluated in 53 cases of acute leukemia, by means of autoradiography and liquid scintillation (LS) count. A higher rate of incorporation before therapy with higher labeling index and LS- specific activity was observed in patients who later responded to chemotherapy with a complete remission. The in vitro depression of labeled thymidine incorporation after incubation with the two drugs selected for the induction therapy was more marked in those who responded to therapy than in the nonresponders. The in vitro incorporation of 3H-thymidine was also evaluated after 48 hours of chemotherapy ("vivo-vitro" test). A decrease of the incorporation was observed frequently in the responders. On the other hand, in the group of nonresponders, there was generally an increase of the incorporation measured by the liquid scintillation count, often contrasting with a decrease of the labeling index, and corresponding to a higher rate of intracellular incorporation. The prognostic value of these findings appears to be significant, as it allows the response to chemotherapy to be predicted, as well as allowing the selection of the various cytotoxic drugs.

[Measurement of platelet volume: methodologic approach and application in diabetes]. / La mesure des volumes plaquettaires: abord méthodologique et application dans le diabète.

A comparative study of platelet count and platelet volume distribution was performed on whole blood (Coulter counter S+) or platelet rich plasma (Thrombo Coulter and Coulter ZBI + Channelyser C 1 000). With the exception of severe thrombocytopenia the results of platelet counts obtained with the coulter S + were very reproducible (CV less than 4%) and a good correlation was observed between results obtained on whole blood and on platelet rich plasma (PRP). The mean platelet volume (MPV) was significantly higher in whole blood than in PRP, but the difference was very slight, suggesting that platelet volume distribution in PRP and in whole blood are similar. In whole blood collected in EDTA MPV increased significantly during the 2 hours after blood collection and then reached a plateau. This finding underlines the need for a standard technique. Preliminary results obtained with the Coulter S + in 86 diabetic patients and in 73 unselected control subjects demonstrated a significant increase of MPV and of the index of platelet distribution (IDP) given by the apparatus, without modification of platelet count in diabetics. These results could suggest a compensated increased platelet consumption in the circulating blood.

[In vitro study of sensitivity of leukemic cells to cytotoxic drugs (anticytogram)]. / Etude de la sensibilité "in vitro" des cellules leucémiques aux cytotoxiques (anticytogramme)

The in vitro sensitivity of leukemic cells to cytotoxic drugs was assessed in 61 cases of acute leukemia in adults, 49 of them were of the no lymphoblastic type and in the first phase of the disease. The depression of the incorporation of 14-C-thymidine and 3-H-uridine after a two hours incubation with the various cytotoxic drugs was compared with the clinical result obtained with two of them There is a significant correlation between the in vitro depression of the incorporation of 14-C-thymidine and the clinical effect of the drugs. This method, which may be utilized also in solid tumors, allows to predict with some accuracy the effect of chemotherapy, and to select between the various cytotoxic drugs. However the failure of a chemotherapy is generally related to an in vitro insensitivity of the malignant cells to almost all drugs.

[Pernicious anaemia associated with Hashimoto's thyroiditis, Sjögren's syndrome and chondrocalcinosis (author's transl)]. / Anémie de Biermer associée à une hypothyroïdie, un syndrome de Gougerot-Sjögren et à une chondrocalcinose articulaire.

An association of pernicious anaemia. Hashimoto's thyroiditis, Sjögren's syndrome and chondrocalcinosis in a 68 years old women is described. Such an observation, does not seem to have been reported previously; the frequency of the different associations and the specificity of the antibodies observed in each cases are discussed.