Kaposi's sarcoma associated with hairy cell leukaemia

The case is described of a patient with hairy cell leukaemia who later developed Kaposi''s sarcoma. This association has not been reported before and the coexistence of hairy cell leukaemia with another tumour is very rare. The implications of this unusual association are briefly discussed.     

Portal hypertension in a patient with chronic myeloid leukaemia.

A patient with chronic myeloid leukaemia treated with busulphan for 4-5 years, developed signs of busulphan toxicity and portal hypertension with ascites, oesophageal varices and jaundice. At post-mortem there was minimal leukaemic infiltration but there were alterations in the liver architecture sufficient to explain the portal hypertension. The pathogenesis of the liver changes and their possible relationship to splenomegaly and busulphan toxicity are considered.     

Complex neuromuscular disorder in a patient with chronic myeloid leukaemia.

We report a 44 year old man who developed external ophthalmoplegia and predominantly respiratory, truncal and bulbar weakness with brisk reflexes, histological evidence of an inflammatory myopathy and a high titre of acetylcholine receptor antibodies, one month after starting hydroxyurea and allopurinol for chronic myeloid leukaemia. The temporal relationship suggests a possible association between this patient''s unusual neuromuscular disorder and either the chronic myeloid leukaemia or its treatment.     

利妥昔单抗治疗高龄初治毛细胞白血病患者1例

目的观察利妥昔单抗治疗高龄初治毛细胞白血病的有效性和安全性。方法以利妥昔单抗单药治疗1例93岁初治毛细胞白血病患者,剂量600mg 1/周,共4周,观察其治疗前后白细胞及血小板变化。结果利妥昔单抗治疗后,患者白细胞总数、淋巴细胞比例以及血小板计数趋向正常。结论应用利妥昔单抗治疗高龄初治毛细胞白血病安全有效。     

Aspergillosis in a patient with acute lymphoblastic leukaemia

A case is described of a 3-year-old boy with acute lymphoblastic leukaemia (ALL) who presented initially with aspergillosis of the nasopharynx. Fungal infection with Aspergillus species is not uncommon in immunosuppressed children, but this case is noteworth in that the disease presented at the onset of therapy rather than during the phase of treatment, with maximum immunosuppression following chemotherapy. This type of infection is usually associated with the treatment of acute non-lymphoblastic leukaemias (AML) rather than ALL, and prolonged periods of neutropenia which results from aggressive treatment. This patient responded rapidly to treatment with amphotericin B, coincident with resolution of his neutropenia as the underlying disease was treated, eventually eradicating the fungus.     

Survival of twenty-two months in a patient with primary plasma cell leukaemia treated with melphalan and prednisolone

In the majority of cases plasma cell leukaemia is a rapidly fatal disease with a mean survival time of five months. There have been reports of increased survival using various regimens of chemotherapy although most cases eventually relapse. We describe a patient with primary plasma cell leukaemia who responded to a combination of oral melphalan and prednisolone with control of the disease in the bone marrow but relapsed with extramedullary disease in the central nervous system and testes, and died 22 months after diagnosis. Melphalan poorly penetrates the central nervous system and its testicular penetration is unknown.     

Spurious hypoxaemia in a patient with leukaemia and extreme leucocytosis

Rapid consumption of oxygen by leucocytes can result in erroneous diagnosis of severe hypoxaemia in patients with extreme leucocytosis. We report a case of chronic myeloid leukaemia, extreme leucocytosis and arterial hypoxaemia which was out of proportion to the clinical and radiological evidence of lung disease. The pseudohypoxaemia was confirmed by pulse oximeter and became less significant after successful reduction of leucocyte counts following leucophoresis and chemotherapy. Serial arterial blood gas analysis also demonstrated a slower initial rate of decay of PaO2 as the leucocyte count decreased with treatment.     

Three additional malignancies occurring within one year in a patient with chronic lymphatic leukaemia.

A patient with crhonic lymphatic leukaemia (CLL) is presented who was first seen with a basal cell carcinoma and subsequently developed two further malignant conditions within a year, without receiving any treatment for his leukaemia. It is suggested that this leukaemia was a predisposing factor in the development of his carcinomas.     

Mediastinal lymphadenopathy in a patient with previously treated T-cell acute lymphoblastic leukaemia

Mediastinal lymphadenopathy in a patient with previously treated T-cell acute lymphoblastic leukaemia is a diagnostic problem. The differential diagnosis in an adult is sarcoidosis, metastases, lymphoma or, rarely, tuberculosis. Mediastinal lymph node involvement is uncommon in tuberculosis. In view of its relative rarity but good prognosis, it is important to distinguish tuberculous mediastinal lymphadenitis in adults from other causes of mediastinal masses.