ABSTRACT
In order to isolate bone marrow plasma cells from patients presenting with multiple myeloma or monoclonal gammopathy of undetermined significance, we developed a method for purifying these cells by negative selection using monoclonal antibodies and immunomagnetic beads. The results presented here were obtained from 75 procedures. Purity was extremely variable (2-100%) and was dependent on the percentage of plasma cells in the original bone marrow sample with a 10% cut-off, beyond which purity was over 96% in all cases. The mean yield was about 20%. The cells collected were viable and suitable for immunophenotyping, semi-quantitative studies of oncoproteins, and PCR.
Subject(s)
Bone Marrow Cells , Cell Separation/methods , Immunomagnetic Separation/methods , Plasma Cells/cytology , Antibodies, Monoclonal , Humans , Monoclonal Gammopathy of Undetermined Significance/pathology , Multiple Myeloma/pathology , Plasma Cells/immunologyABSTRACT
Since July 1st, 1958, we have operated 1095 patients with some hematological disease. We review the chief currently accepted surgical indications for splenectomy (Hodgkin's disease no longer being one of them, or seldom so), and we communicate our results pertaining to the immediate postsurgical period. Mortality and morbidity have been 1.36% and 3.28%, respectively. In over 95% of cases, there have been no complications. The low incidence (1.36%) of infection-related complications was partly due to the important number of splenic drains placed. High quality results can only be achieved when tight collaboration exists between hematologists, radiologists and surgeons.
Subject(s)
Hematologic Diseases/surgery , Splenectomy , Drainage/methods , Hemorrhage/etiology , Humans , Intestinal Obstruction/etiology , Postoperative Period , Retrospective Studies , Splenectomy/adverse effects , Splenectomy/methods , Splenectomy/mortality , Suppuration/etiology , Thromboembolism/etiologyABSTRACT
In the light of their personal experience of 1,036 splenectomies, the authors review the hematological diseases which still require surgery, viz. certain hemolytic anemias, idiopathic thrombocytopenic purpura, Hodgkin's disease under certain conditions, and sometimes the splenic lesions in certain malignant blood diseases; they analyse their results. Thanks to close collaboration between hematologists and intensive care specialists, the mortality has been reduced to 1.35 p. cent and the morbidity to 3.46 p. cent which leaves 95.19 p. cent without any immediate postoperative complications. The late results depend on the initial disease process.
Subject(s)
Hematologic Diseases/therapy , Splenectomy , Anemia, Hemolytic/therapy , Blood Platelet Disorders/therapy , Hodgkin Disease/therapy , Humans , Lymphoma/therapy , Postoperative Complications , Splenic Diseases/surgery , Thrombocytopenia/therapyABSTRACT
123 laparotomies with splenectomy have been performed in 3 groups of patients. 1. 40 patients with infra-diaphragmatic relapses afer mantle field radiotherapy for supra-diaphragmatic disease. 2. 45 previously untreated patients. 3. 37 stages III B patients treated by intensive chemotherapy before splenectomy. Anatomical findings suggest that hematogenous dissemination may be responsible for spleen involvement and that spleen involvement may be suppressed by chemotherapy. In view of these data, chemotherapy in association with radiotherapy seems to be justified even in patients with apparently localised forms since the spleen may be involved in such patients at clinical presentation of the disease. From the preliminary results of studies which aim to appreciate the effectiveness of chemotherapy on splenic lesions, the need for routine laparotomy and splenectomy should be reevaluated.
