RESUMO
Cytogenetic studies were carried out in 18 patients with secondary blood diseases; 15 patients had a history of prior malignancy, two had been professionally exposed to carcinogenic agents, and one patient had been treated with immunodepressors. The interval between initial therapy and secondary disease ranged from 13 to 123 months, with a mean of 57.8 months; the mean survival time from the diagnosis of secondary disease was 6 months. Cytogenetic abnormalities were present in 83% of cases, with a trend to hypodiploidy in 90%. The most often involved chromosomes were #5, #7, and 3p. A correlation between the cytogenetic abnormalities and etiologic factors has been analyzed; data from the present series and from the literature suggest a correlation between chromosome #7 and chemical agents, and chromosomes #11, #12, and #17 and physical agents.
Assuntos
Aberrações Cromossômicas , Leucemia/genética , Síndromes Mielodisplásicas/genética , Doença Aguda , Adolescente , Adulto , Idoso , Antineoplásicos/efeitos adversos , Aberrações Cromossômicas/efeitos dos fármacos , Aberrações Cromossômicas/efeitos da radiação , Bandeamento Cromossômico , Cromossomos Humanos 16-18 , Cromossomos Humanos 6-12 e X , Feminino , Marcadores Genéticos , Humanos , Cariotipagem , Leucemia/etiologia , Leucemia Induzida por Radiação/genética , Masculino , Pessoa de Meia-Idade , Síndromes Mielodisplásicas/etiologia , Neoplasias/terapiaRESUMO
One hundred and nine patients with Ph1-positive chronic myelocytic leukemia were cytogenetically studied with banding methods. Seventy-eight patients were studied in the chronic phase and 39 patients in the blastic phase. The standard translocation was present in 107 cases. Two patients showed complex translocations involving chromosomes No. 6, 9, 22, 11 and No. 9, 22, 11, respectively. Ph1-negative cells were detected in 8 cases (7%). Chromosome aberrations in addition to the Ph1 chromosome were observed in 6 cases (8%) during the chronic phase. The karyotypic findings during the blastic phase were similar to those reported in the past [trisomy 8, iso(17q), and a second Ph1]. The significance of Ph1-negative cells, the geographic heterogeneity of the chromosomal aberrations, the effect of chemotherapy on the appearance of new clones, and the importance of the materials and methods used for the comparison of cytogenetic patterns at different laboratories are discussed.
Assuntos
Aberrações Cromossômicas , Leucemia Mieloide/genética , Translocação Genética , Bandeamento Cromossômico , Humanos , CariotipagemRESUMO
Serial cytogenetic studies were performed in 33 patients with myelodysplastic syndrome in order to establish the frequency of karyotypic evolution and to correlate the chromosome and clinical findings during the course of the disease. Fifteen of the 33 patients (45%) showed abnormalities in the first cytogenetic study and this percentage increased to 57% during the course of the disease. A stable karyotype (normal or abnormal) was found in 19 patients (58%), whereas the rest (42%) showed an unstable karyotype. Trisomy 8, monosomy 7, and del5q were the most frequent abnormalities, not only at presentation, but also during karyotypic evolution. Seven patients (23%) with a known evolution proceeded to leukemia; four of them had stable (22%) and three unstable (25%) karyotypes; however, 33% of patients with unstable karyotypes and only 5% with stable karyotypes died from complications of the disease. Our results suggest that karyotypic evolution is relatively frequent in these patients; this evolution could be related to a poor clinical prognosis, either evolving to leukemia or death.
Assuntos
Medula Óssea/ultraestrutura , Aberrações Cromossômicas , Leucemia/genética , Pré-Leucemia/genética , Doença Aguda , Adulto , Idoso , Medula Óssea/patologia , Bandeamento Cromossômico , Feminino , Humanos , Cariotipagem , Leucemia/patologia , Masculino , Pessoa de Meia-Idade , Pré-Leucemia/patologia , Prognóstico , Fatores de TempoRESUMO
Serial cytogenetic studies have been performed in four patients with myelodysplastic syndromes. In all four a 5q- alteration was present, but with a different pattern of presentation. One patient presented 5q- as the only alteration since diagnosis; two patients acquired this alteration during the course of the disease; and the fourth showed a 5q- plus other alterations since the first cytogenetic study. Likewise, three of the four patients showed a clone with trisomy 8 and without 5q-. According to these observations and others from the literature with similar cytogenetic behavior, we have analyzed the following points: 5q- as a primary event and as the only alteration, 5q- as a secondary event, 5q- plus other alterations, and presence of cytogenetically different clones. Analysis of these points suggests that the 5q- alteration can represent an early mutation conferring a slow capacity of expansion to the affected clones, with the possibility of cytogenetic evolution during the progression of the disease (about 30% of the patients). Likewise, the association of trisomy 8 clones with 5q- clones can be a nonrandom event.
Assuntos
Deleção Cromossômica , Cromossomos Humanos Par 5 , Leucemia/genética , Síndromes Mielodisplásicas/genética , Pré-Leucemia/genética , Idoso , Medula Óssea/ultraestrutura , Cromossomos Humanos Par 8 , Células Clonais , Feminino , Humanos , Cariotipagem , Leucemia/patologia , Masculino , Pessoa de Meia-Idade , Síndromes Mielodisplásicas/patologia , Pré-Leucemia/patologia , TrissomiaAssuntos
Agranulocitose/tratamento farmacológico , Anemia Hemolítica Autoimune/tratamento farmacológico , Anemia Hemolítica/tratamento farmacológico , Imunossupressores/uso terapêutico , Púrpura Trombocitopênica/tratamento farmacológico , Trombocitopenia/tratamento farmacológico , Adolescente , Corticosteroides/uso terapêutico , Hormônio Adrenocorticotrópico/uso terapêutico , Adulto , Azatioprina/uso terapêutico , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Mercaptopurina/uso terapêutico , Pessoa de Meia-Idade , Prednisona/uso terapêutico , EsplenectomiaAssuntos
Gastroenteropatias/complicações , Doenças Hematológicas/etiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anemia/etiologia , Anemia Perniciosa/etiologia , Criança , Doença Crônica , Eritropoese , Feminino , Gastrite Atrófica/complicações , Gastroenteropatias/diagnóstico , Hemorragia Gastrointestinal/complicações , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/etiologia , Doenças Hematológicas/diagnóstico , Humanos , Ferro/metabolismo , Síndromes de Malabsorção/complicações , Síndromes de Malabsorção/etiologia , MasculinoAssuntos
Linfoma não Hodgkin/patologia , Neoplasias do Mediastino/patologia , Adolescente , Adulto , Criança , Terapia Combinada , Diagnóstico Diferencial , Feminino , Humanos , Imuno-Histoquímica , Recém-Nascido , Linfoma de Células B/diagnóstico , Linfoma de Células B/patologia , Linfoma de Células B/terapia , Linfoma Difuso de Grandes Células B/diagnóstico , Linfoma Difuso de Grandes Células B/patologia , Linfoma Difuso de Grandes Células B/terapia , Linfoma não Hodgkin/diagnóstico , Linfoma não Hodgkin/terapia , Masculino , Neoplasias do Mediastino/diagnóstico , Neoplasias do Mediastino/terapia , Mediastino/patologia , Pessoa de Meia-Idade , Leucemia-Linfoma Linfoblástico de Células Precursoras/diagnóstico , Leucemia-Linfoma Linfoblástico de Células Precursoras/patologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia , Neoplasias do Timo/diagnóstico , Neoplasias do Timo/patologiaAssuntos
Mieloma Múltiplo/terapia , Algoritmos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Transplante Ósseo , Terapia Combinada , Humanos , Interferon-alfa/administração & dosagem , Melfalan/administração & dosagem , Mieloma Múltiplo/diagnóstico , Dosagem Radioterapêutica , Indução de RemissãoRESUMO
An up to date approach to different aspects of thrombocytopoiesis and platelet kinetics, in physiological conditions, han been done. The main parts of this review are: A historical revision of relation between megakaryocytes and platelets. An analysis of cellular basis of thrombocytopoiesis (morphological maturation gradient of megakaryocytes). Compartments of the stem cell population (multipotential stem cells and committed megakaryocytic stem cells). Functional compartments of polyploid megakaryocytes (multiplicative and madurative). Platelet formation from cytoplasmic projections of megakaryocytes in marrow sinusoids. Heterogeneity and life span of circulating platelets. Finally, the humoral regulation of platelets production is considered, mainly the two factors which appear to regulate thrombocytopoiesis, that is to say: colony stimulating factor and thrombopoietin.
Assuntos
Plaquetas/fisiologia , Hematopoese , Divisão Celular , Sobrevivência Celular , Fatores Estimuladores de Colônias/fisiologia , Células-Tronco Hematopoéticas/citologia , Humanos , Megacariócitos/citologia , Trombopoetina/fisiologiaRESUMO
Auto-immune haemolytic anaemia (AIHA) has been found in a case of alpha-interferon treatment. Serum antibody and eluate were positive in the absence of the drug. Although the patient recovered after the treatment was stopped, DAGT remained positive for at least 8 months. The mechanism proposed to explain why this drug induced AIHA is similar to that proposed for alpha-methyl-dopa. Drugs could alter the red cell membrane and impair the immune system. Such changes have been observed with alpha-interferon and were related with increased autoimmunity.
Assuntos
Anemia Hemolítica Autoimune/etiologia , Hepatite C/terapia , Interferon-alfa/efeitos adversos , Adulto , Hepatite C/complicações , Humanos , MasculinoRESUMO
Myelodysplastic syndromes represent an entire group of clonal panmyelopathies with very distinct evolutionary pathways. Their common denominator, however, is a self-maintained functional failure of the myeloid hemopoiesis which tends to evolve into severe non-lymphoid leukemia (SNLL) in 20-30% of the cases. First, the prognostic value of each the following is reviewed: the morphological classification F.A.B., the stratification system for "Bournemouth group", the abnormal placement of immature myeloid precursors (ALIP) in bone marrow, and cytogenetic changes. Second, the therapeutic potential for each of the following is assessed: vitamin and support treatments; suprarenal steroids; conventional androgens and danazol; agents of cellular differentiation (cytosine arabinoside in low doses, retinoid acids, vitamin D3, etc.). Finally, the role of aggressive chemotherapies (in succession or unrelated to marrow transplant) in the eradication of myelodysplastic clone or post-myelodysplasia SNLL is examined.
Assuntos
Síndromes Mielodisplásicas/fisiopatologia , Síndromes Mielodisplásicas/terapia , Humanos , PrognósticoRESUMO
PURPOSES: To analyze the reproducibility to detect the t (15; 17) with molecular and cytogenetic techniques. PATIENTS AND METHODS: Fifteen cases of acute promyelocytic leukaemia were studied by means of cytogenetic techniques (GTG banding) and molecular ones (K/S probe and HindIII, EcoRI and BamHI restriction enzymes). RESULTS: The t (15; 17) was detected with cytogenetic techniques in 60% cases and with molecular ones in 33% cases. Using both (cytogenetic and molecular) techniques the translocation was detected in 73% cases. CONCLUSIONS: The use of both techniques may be very useful in order to get a better diagnostic and a closer control of the patient's clinical evolution.
Assuntos
Cromossomos Humanos Par 15/ultraestrutura , Cromossomos Humanos Par 17/ultraestrutura , Leucemia Promielocítica Aguda/genética , Translocação Genética , Bandeamento Cromossômico , DNA de Neoplasias/genética , Humanos , Leucemia Promielocítica Aguda/patologia , Polimorfismo de Fragmento de Restrição , Reprodutibilidade dos TestesRESUMO
Thirteen cases of Ph-positive CML have been studied from a cytogenetic and molecular point of view. All cases had Ph chromosome identified as t(9;22). Three of these cases were in blast crisis, and additional alterations to the Ph chromosome were found. The molecular study was made using the 3'bcr probe to analyze the ability to detect the translocation at the molecular level in bone marrow, peripheral blood, other tissues and in cases with mosaicism. Likewise we have evaluated the possibility to obtain molecular results from Carnoy-fixed samples which have been previously used in cytogenetic studies. In all cases we have detected rearrangement in the bcr region; this shows the interest and usefulness of this new methodology in the study of CML in different situations.
Assuntos
Leucemia Mielogênica Crônica BCR-ABL Positiva/genética , Mosaicismo/genética , Translocação Genética , Doença Crônica , Humanos , CariotipagemRESUMO
Kinetic studies of leukemic blast cells (LBC) and erythroblasts were carried out in 20 cases of acute myeloblastic leukemia (AML), and the results were compared with those observed in dividing granulocytic precursors (DGP) and erythroblasts in a control group of 16 normal subjects. The parameters studied were: mitotic index (MI), labelling index (LI-3HTDR), MI/LI ratio and mitotic time (MT). The results showed that (1) LBC of AML do not proliferate more quickly than normal DGP, on the contrary, they replicate more slowly; (2) LBC obey some 'ecological laws' of normal hemopoiesis as a response to the control of the proliferative activity and release through the 'marrow-blood barrier'; (3) the difference between hyperleukocytemic and subleukemic AML is not related to the multiplicative activity of marrow LBC, but rather to other unknown biological factors; and (4) the kinetic behavior of erythroblastic population in AML is consistent, at least in some cases, with its 'leukemic origin'.