Comparison of Chromosome Constitution in Chronic Myelocytic Leukemia and Other Myeloproliferative Disorders

The frequency of the Ph¹ chromosome in freshly aspirated marrow cells of14 patients with typical chronic myelocytic leukemia processed by a "directtechnic" without resort to culture or colchicine was significantly higher (>75 per cent) than that observed in the cultured blood cells (< 35 per cent)of the same subjects. The karyotypic abnormally of the abbreviated G-groupchromosome would appear not to be related to therapy, since the frequencywith which it occurred was not materially affected by treatment (including radiation). The Ph¹ chromosome was not observed in any of the metaphases ofblood or marrow of 12 subjects who had developed a leukemia-like picturecomplicating either myelofibrosis, polycythemia vera or myeloid metaplasia. Anew chromosome abnormality—a shortened D-group chromosome—was observed with about the same frequency in the blood and marrow metaphases ofa female patient with treated chronic myelocytic leukemia. This new karyotypicabnormality was associated with the highest frequency of the Ph¹ chromosomein cultured blood cells in the group studied. The Ph¹ chromosome was observed in the metaphases of a patient with the blastic phase of chronic myelocytic leukemia. The variations of the morphology of the Ph¹ chromosome arediscussed and illustrated, especially in relation to the Y-chromosome. In fourpatients with an atypical picture of CML, the Ph¹ chromosome was not observed either in the marrow or cultured blood.

Submitted on April 25, 1962 Accepted on June 7, 1962     

Survival in Chronic Lymphocytic Leukemia

Survival of 839 chronic lymphocytic leukemia patients has been reviewed in relationto a number of patient and disease characteristics. Over-all, the relative 5-yr survival rate was 44%. Studying survival byage and sex led to the following observations: Dividing age into intervals < 50,50-59, 60-69, 70-79, and 80 yr and over,relative survival declined with increasingage; relative 5-yr survival for females washigher than that for males-50% versus 41%.This pattern of superior survival of femalesover males was noted in all but one of theage intervals. Survival was negatively associated with the presence of recordedclinical signs and symptoms, hematologicalabnormalities, and pathological bone marrow findings. Differences in survival werealso found by treatment category and interval from diagnosis to initiation of treatment. Adjustment for differences in distribution of each of these variables did notmaterially diminish the survival differencesnoted by age and sex. An unexpected pattern of survival in relation to white bloodcount level was noted. Survival increasedwith increasing white blood count at diagnosis, peaking in the interval at 25,000-49,000, and decreasing after that. Whensurvival by white blood count was adjustedfor some variables which were found to beassociated with survival, the gradient wasstill noted, though somewhat reduced.

Submitted on June 12, 1972 Revised on February 12, 1973 Accepted on February 16, 1973     

慢性髓性白血病的危险因素探讨

对38例不同病期的慢性髓性白血病患者骨髓进行DNA链损伤(%D值)、DNA-非整倍体及流式细胞仪细胞膜抗原CD15与HLA-DR测定。结果显示三种参数能较可靠地预示病情进展。DNA-非整倍体的存在及DNA链损伤加重,均为CML急变的高危指标。CD15与HLA-DR比值测定简易可靠。其比值倒置先于细胞形态学的恶化,应定期追踪复查。     

慢性粒细胞白血病的骨髓组织病理学研究

应用国产塑料包埋剂对23例慢粒慢性期患者进行了骨髓塑包切片的组织病理学研究,证明慢粒属于异质性疾病,分两类组织学亚型:即以粒系细胞极度增殖为主的粒细胞(GRAN)型和以粒系细胞—巨核细胞混合性增殖,且伴巨核细胞多形性与异位的粒细胞/巨核细胞(GRAN/MEG)型。本文对两型的其它组织学特点一并进行了讨论。     

A Study of Prednisone Therapy in Chronic Lymphocytic Leukemia

A study of prednisone therapy in 18 patients with chronic lymphocyticleukemia is reported.

1. Antileukemic effects consisting of subjective improvement, decrease inorgan infiltration, improvement in hemoglobulin and absolute neutrophilcount occurred.

2. These effects were transient.

3. An increase, often marked, in the number of circulating lymphocytesoccurred in 16 of the 18 patients.

4. The administration of prednisone was attended by an increase in theseverity of infections. Some increase in the frequency of infections was alsoobserved, but this was not statistically significant (p > 0.05).

It is concluded that corticosteroids should not be used electively in patientswith chronic lymphocytic leukemia except in the presence of hemolyticanemia, significant thrombocytopenia or in the presence of advanced diseaseassociated with bone marrow failure.

Submitted on August 10, 1960 Accepted on November 5, 1960     

影响慢性粒细胞白血病长期生存的因素临床分析

本文把存活5年以上的23例慢粒患者与同期生存时间少于5年的40例慢粒患者的临床特点进行了对照分析;发现生存期较长病例的脾肿大较轻,其首次缓解持续时间较长,而白细胞较高的患者,预后并不一定差。     

Leukapheresis Therapy of Chronic Lymphocytic Leukemia

The effects of repeated leukapheresiswith the IBM Blood Cell Separator wereassessed in 13 patients with chroniclymphocytic leukemia (CLL). Five patients had from 14 to 25 leukapheresesat intervals ranging from 7 to 33 days.The median total number of lymphocytes removed was 18.0 x 10¹¹ (range11.9 x 10¹¹-26.6 x 10¹¹). Two of thesepatients had a decrease in lymphocytecount and in lymphadenopathy. One ofthe above and eight additional patientshad intensive leukapheresis therapyconsisting of five procedures per weekfor 1-4 wk. The median total number oflymphocytes removed from these patients was 11.34 x 10¹¹ (range 3.30 x10¹¹-47.4 x 10¹¹). Eight of these patients had a decrease in lymphocytecount, five in spleen size, eight inlymph node size, seven in bone marrow infiltration, and one in liver size.Lymphocyte counts before beginningleukapheresis therapy ranged from20,500 to 684,000 (median 70,900). Themedian lymphocyte count on completion of treatment was 19,200 (range6,590-40,000). After leukapheresis therapy, the median doubling time of thelymphocyte count was 71 days (range29-118 days). In addition to demonstrating a significant proliferative component in CLL, the objective regressionof disease in ten of the 13 patients suggests that leukapheresis is a potentiallyuseful treatment for CLL.

Submitted on June 21, 1971 Revised on August 9, 1971 Accepted on August 10, 1971     

Exaggerated Delayed Hypersensitivity to Mosquito Bites in Chronic Lymphocytic Leukemia

This report has reviewed the clinical histories of 8 patients with chronic lymphocytic leukemia who manifested a marked delayed hypersensitivity type of local skin reaction to insect bites, and mosquito antigen and were capable of reacting normally to other delayed hypersensitivity antigens. We have suggested that this abnormality may represent another example of altered immunologic responsiveness in this disease, consistent with the notion that the lymphocyte is of prime importance for the development of delayed cutaneous hypersensitivity.

Submitted on October 6, 1964 Accepted on December 8, 1964     

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慢性淋巴细胞白血病(CLL)是西方国家最常见的白血病类型,占65岁以上白血病患者的40%。在WHO分类中,CLL特指B细胞恶性疾病,而以前的T-CLL被命名为T细胞幼淋白血病[1]。CLL患者是一个异质性群体,在发病形式、疾病进展、治疗反应和生存期方面具有明显的个体差异。传统的临床分期并