[Lymphoma lymphoplasmocytoides: a case report]. / Chloniak limfoplazmocytoidalny--analiza kliniczna.

Clinical symptoms and haematological disorders in patients suffering from lymphoplasmatic/lymphoplasmocytoidal lymphoma were presented, 82 patients were examined (median age of 63), all of the in clinical stage IV (ANN Arbor scale). In all of the patients bone marrow was invaded. The most common symptom was enlargement of peripheral lymph nodes (86%) less often abdominal ones (21%). Splenomegalia was found in 55% and hepatomegalia in 49% of patients 35% of patients had anaemia and 38% thrombocytopenia. Close to 1/3 of patients dermatoses were found, in most cases allergic ones. In 7% another cancer was found.

[Microangiopathic hemolytic anemia in patients with diseases of the hematopoietic and lymphatic systems]. / Niedokrwistosc hemolityczna mikroangiopatyczna u chorych na choroby ukladu krwiotwórczego i limfatycznego.

Microangiopathic haemolytic anaemia was diagnosed in the course of haematopoietic and lymphatic disorders such as chronic granulocytic leukemia, chronic myelofibrosis, chronic lymphatic leukemia, Osler's disease, chronic monocytic leukemia, and lymphoplasmocytic lymphoma, in 11 patients (6 women and 5 men) aged between 33 and 81 years (mean age 58.8 years) treated at the Haematological Out-Patient Clinic of the Postgraduate Medical Education Centre within 1977-1987. The following laboratory tests were carried out: 1) morphology of the peripheral blood and bone marrow, especially some haematological parameters concerning erythrocytes and blood platelets; 2) biochemical tests reflecting erythrocytes disintegration; 3) haemostasis. All examined patients suffered from haemolytic anaemia of various degree with characteristic changes in erythrocyte shape (helmets, tear-drops etc.). Haemolytic origin of anaemia was confirmed by the increased LDH activity. In the majority of patients no compensative stimulation of haematopoiesis (reticulocytosis, red blood cells hyperproliferation in bone marrow) was seen. Clinical symptoms of haemostatic disorders such as haemorrhagic diathesis and vein thrombosis were diagnosed in 50% of the patients. Blood platelet counts ranged from markedly decreased to significantly increased. Bone marrow smears did not show increased number of megacariocytes. Bleeding time was prolonged in the majority of examined patients while prothrombin index--decreased). Abnormal fibrinogen levels (decreased or increased) were found in the majority of patients with fibrin degradation products. Microangiopathic haemolytic anaemia in these patients differ from the typical Moschowitz's disease clinically probably due to the lack of compensative stimulation of erythropoiesis and lower thrombocytopenia.

[Lymphoplasmacytoid lymphoma and the immune system in patients with this type of lymphoma]. / Chloniak limfoplazmocytoidalny a uklad odpornosciowy u chorych na ten typ chloniaka.

Among 82 patients with L-LP in clinical stage IV, 14% were found to have monoclonal gammapathy and 22% polyclonal gammapathy. The other classes of immunoglobulins were not affected. In 78%, cell immunity was impaired. Decrease in T cell count (CD2+ and CD3+) in blood was found. Particularly T helper cells (CD4+), to a lesser degree T suppressor cells (CD8+) were affected. The life time of patients varied from 3 to 120 months. 60% of deaths were caused by infection.

[Bone mineral disorders in patients with multiple myeloma]. / Zaburzenia mineralizacji kosci u chorych na szpiczaka mnogiego.

The aim of the study was to evaluate bone mineralization in the patients with multiple myeloma. The examinations were performed in 49 patients (25 men and 24 women). Seven patients were before chemotherapy and 42 patients were treated with chemotherapy. All of them received prednisone. The bone mineral density was measured by dual-energy X-ray absorptiometry with Lunar spine (L2-L4) in AP projection, femoral neck and total body were examined. There was a decrease of bone mineral density in 35 patients in at least one place (T-score more than 2 SD below normal of young healthy persons). There was no correlation between densitometric results and the duration of multiple myeloma, or chemotherapy. The decrease of bone mineral density (expressed es T-score) of lumbar spine (for the patients without spinal degenerative changes) was higher than that of femoral neck (p < 0.05). The decrease of bone mineral density (expressed as T-score) of lumbar spine and femoral neck was more pronounced than that of total body (p < 0.001). Bone densitometry, especially of lumbar spine and femoral neck and less of total body is indicated in the patients with multiple myeloma. The result of this examination may be considered as an independent parameter of disease intensity.

[Effect of calcitonin treatment on bone mineralization in patients with multiple myeloma]. / Wplyw leczenia kalcytonina na mineralizacje kosci u chorych na szpiczaka mnogiego.

The aim of the study was to evaluate the efficacy of half-year treatment of bone mineral disturbances with calcitonin in the patients with multiple myeloma. Thirty five patients (11 men and 24 women) were examined. They were treated among other with prednisone. Nineteen patients (15 patients with normal bone mineral density of lumbar spine and femoral neck and 4 with low bone mineral density who could not be treated with calcitonin) were treated only with chemotherapy. Other 16 patients with low bone mineral density have received also calcitonin (100 units subcutaneous daily) with vitamin D3 and calcium carbonate. Bone mineral density was evaluated with dual energy X-ray absorptiometry in lumbar spine and femoral neck. After treatment with calcitonin there was more pronounced influence on bone mineral density in lumbar spine and femoral neck than after treatment with chemotherapy only but the difference was not statistically significant. Because the bone mineral disturbances in the patients with multiple myeloma is the big problem there is a need for further and longer evaluation of the treatment of these disturbances.