Case of acute monocytic leukemia with 47,XY,+X,t(2;10)(q21.1;q26.1) and basophilia.

The clinical cytogenetic findings of a patient with acute monocytic leukemia with peripheral and bone marrow basophilia are presented. The cytogenetic analysis of bone marrow cells established a pathologic clone with the following unusual karyotype: 47,XY,+X,t(2;10)(q21.1;q26.1). This chromosome abnormality has not been reported previously in leukemic diseases.

[Oligoclonal immunoglobulins in the blood serum and monoclonal light chains in the urine in malignant diseases of myelopoiesis]. / Oligoklonalni imunoglobulini v kruvniia serum i monoklonalni leki verigi v urinata pri niakoi zlokachestveni zaboliavaniia na mielopoezata.

The serum of 21 patients with acute leukemia, 9 patients with chronic myeloid leukemia and 30 clinically healthy controls were examined by isoelectric focusing. The urines of 12 patients were examined by immune isofocusing. Oligoclonal bands were found in the serum of 9 patients. In the urine of 4 patients secretion of monoclonal light chains were found. In comparison with the routinely applied methods electrophoresis and immunoelectrophoresis the isoelectric focusing and the immune isofocusing gave additional information about the immunoglobulins and their light chains in 11 of 30 patients (36.7%).

[15 patients with myelodysplastic syndrome]. / Izsledvaniia vurkhu 15 bolni s mielodisplastichen sindrom.

15 patients (10 men and 5 women) with myelodysplastic syndrome, treated in a Hematologic Clinic during the last three years, are studied. The patients are classified in the following groups: with a refractory anemia (4 patients), with an acquired idiopathic sideroblast anemia (3 patients), with a refractory anemia with an excess of blast cells (8 patients). The diagnosis is proved by morphologic examinations, in some of the patients by isotopic examinations and in 5 patients a cytogenetic analysis is made. 7 patients died and in 5 of them the post mortem examination confirms the clinical diagnosis of myelodysplastic syndrome passed in acute leukosis. 4 patients are still alive and are under active observation. For the remaining 4 patients there are no data. The shortest survival is 6 months and the longest one is 9 years. The prognostic importance of the number of blast cells in the bone marrow is pointed out. The patients with refractory anemia with an excess of blast cells are treated with mercaptopurine or small doses of cytosine arabinoside in addition to the conventional blood-stimulating therapy applied in the other forms of myelodysplastic syndrome.

[Long-term myelodysplastic syndrome transformed into blastic leukemia]. / Dulgogodishen mielodisplastichen sindrom, transformiran v blastna levkoza.

A very rare case of myelodysplastic syndrome of long duration transformed into acute leukemia is reported. The syndrome presented with refractory anemia with ring sideroblasts and after eight years of favourable course abruptly turned into acute myelomonoblastic leukemia with a rapid fatal outcome caused by gram-negative sepsis. The disappearance of the ring-sideroblasts from the bone marrow is pointed out as a bad prognostic sign. Treatment of the myelodysplastic syndrome with small doses of cytosine arabinoside is discussed as well as the nonobligatory passing through the stage of a gradual increase of the blast cells before the transformation into acute leukemia.

[Scintigraphic imaging of the bone marrow in hematologic diseases]. / Stsintigrafsko izobraziavane na kostniia mozuk pri niakoi khematologichni zaboliavaniia.

The scintigraphy of the bone marrow can supply information for its distribution in the body and for its functional state as well. The purpose of the study is to assess the efficacy of the scintigraphic imaging of the bone marrow by means of radiopharmaceutical drugs--99mTc-sulfur colloid for imaging the monocytic macrophagal system and 111In-chloride for imaging of erythroid cells--and to determine its characteristics in some hematologic diseases. 72 patients with hematologic diseases and 10 healthy controls were examined. The results lead to the conclusion that bone marrow scintigraphy is a useful method which helps the physician in the diagnosis of hematologic diseases, the determination of the stage of the disease, the assessment of the efficacy of the treatment applied and in all cases of discrepancy between the bone marrow histology and the clinical status of the patient.

[Fibrin degradation products in the urine in diabetic nephropathy]. / Fibrindegradatsionni produkti v urinata pri diabetna nefropatiia.

An immunologic methods was used in the assessment of FDP (fragments D and E). Urine of 15 diabetics with diabetic nephropathy was investigated. FDP findings are compared with the clinical picture and needle renal biopsy in some of the patients. The method is recommended as a sensitive diagnostic tests for the clinical practice.

[Blast stage in chronic myeloleukemia--diagnostic and therapeutic problems]. / Blasten stadii pri khronichnata mielolevkoza--diagnostichni i terapevtichni problemi.

The data are reported from the study on 34 patients with chronic myeloleukosis (ChML), blast stage (BS). The early progress of BS is stressed upon--in 41% of the patients during the first year after making the diagnosis. A juxtaposition is made between some clinical and laboratory indices and the BS progress as well as with life span. Some criteria are presented that could aid the differentiation of BS from a recurrence of ChML. The unsatisfactory results from BS treatment are also stressed upon in spite of the achievements during the last several years. One of the patients was with twice overcome BS, with a duration of the second remission of 8 months.

[Chronic lymphocytic leukemia. II. Differentiation of various forms of chronic lymphocytic leukemia by cytological and immunological indicators]. / Khronichna limfolevkoza. II. Opredeliane na razlichnite formi na zaboliavaneto po tsitologichni i immunologichni pokazateli.

The authors present their studies on the cytologic and some immunologic features of leukemic cells which determine the specificity of lymphocyte population in the various forms of lymphatic leukemia. 133 patients who were treated in their clinic for the period 1980-1984 were studied. Four clinical forms were differentiated which had been published elsewhere. The morphologic and cytochemical differences of lymphatic leukemia cells in the different variants of the disease are pointed out. Applying the tests for rosette formation, blast transformation and immunofluorescence they have proved immunologic differences in the lymphocyte population of the different forms of the disease.

[Chronic lympholeukemia. I. Clinical variants]. / Khronichna limfolevkoza. I. Klinichni varianti.

The study includes 133 patients with chronic lymphatic leukemia treated by the authors for a five year period (1980-1984). Data from the patients' history, status, blood picture, treatment and therapeutic efficacy are taken into consideration. The importance of splenomegaly is emphasized. Four clinical variants are differentiated: I. calm lymphatic leukemia; 2. secondary splenomegalic lymphatic leukemia; 3. primary splenomegalic lymphatic leukemia; 4. pure splenomegalic lymphatic leukemia. The study is supported by cytologic and immunologic investigations. This allows precision of the prognosis and of the therapeutic conduct.

[So-called immunoglobulin-producing lymphoma with a case presentation and the production of monoclonal immunoglobulin M]. / Vurkhu t. nar. imunoglobulini produtsirashti limfomi s predstaviane na sluchai s proizvodstvo na monoklonalen imunoglobulin M.

The authors discuss the B-cellular lymphomas, producing various kinds of monoclonal paraproteins as well as parts of them--light or heavy chains. A case of a patient with lymphoplasmocytic malignant lymphoma, producing monoclonal IgM in pentamer form mainly, as well as in Valdenström disease but without the symptoms characteristic for it--hyperviscosity and hemorrhagic diathesis, is described. The disease has been histologically, cytologically and electron microscopically diagnosed. Attention is paid to the long-term relatively benign course and subsequent malignant course with manifested laboratory changes as well as change in the objective state, requiring the monotherapy to be substituted for active complex treatment, though the effect was unsatisfactory, with a fatal outcome of the inflammatory complications and progressive anemia. The place of the case in Kiel classification of malignant lymphomas is discussed.

[Long-term observation of a case of Hand-Schüller-Christian disease]. / Produlzhitelno nabliudenie na sluchai s bolestta na Hand--Schüller--Christian.

A case is presented of a 28-year-old man with Hand-Schüller-Christian's disease whose initial manifestations were skull bones lesions and a diffuse interstitial fibrosis. Three years later the patient developed diabetes insipidus without changes in the hypothalamic-hypophysial region on computed tomography. Some features of the clinical picture are discussed.

[Lymphocyte blast transformation according to the clinical variant of rheumatoid arthritis]. / Blasttransformatsiia na limfotsitite spored klinichniia variant na revmatoidniia artrit.

Blast-transformation reaction of lymphocytes to non-specific stimulation with phytohemaglutinines was studies in 83 patients with rheumatoid arthritis with different activity of the general inflammatory reaction, stage and form of the disease. Lymphocytes react with diminished activity to that stimulation both in the early and late stages of the disease, being an index for the intransience of the conditions for antigen stimulation. The diminished lymphocyte reaction correlates with the clinical-laboratory indices for activity of rheumatoid arthritis. It raises in the course of the medicament tosus effect and reflects the effectiveness of treatment. The cellular immunity takes part in the pathogenesis of rheumatoid arthritis. Blast-transformation test could be used as an aide in the determination of rheumatoid arthritis activity as well as of the cellular immunity state.

[Lymphocyte changes in chronic posthemorrhagic iron-deficiency anemia]. / Promeni v limfotsitite pri khronicha sledkruvoizlivna zheliazo-defitsitna anemiia.

Ninety patients with chronic posthemorrhagic iron deficiency anemia were examined, looking for morphological and functional deviations in peripheral blood lymphocytes. Reduced blast transformation of lymphocytes was found under the effect of phytohemagglutinin and as improvement - by the treatment with iron-containing preparations. No reduction was established of T-lymphocytes, immunoglobulins as well as a change in the ultrastructure of lymphocyte mitochondria. The role of iron deficiency is discussed in connection with the phenomena observed as well as the enhanced susceptibility to acute respiratory infections.