急性白血病肺部感染病机分析

对54例急性白血病并肺部感染患者临床观察分析发现,急性白血病合并肺部感染的病机与一般肺部感染有本质的不同。本病的发生以气血亏虚严重、精血化生衰竭为主要原因。故应以益气、养阴、补血为治疗大法。对化疗期间病人要注意调理脾胃,顾护胃气,以后天养先天。造血功能抑制的患者,切忌一味攻伐,折伤正气。     

Immunophenotyping of childhood acute lymphoblastic leukemia in Saudi Arabia: Second look

Geographical variations in the incidence of disease are of considerable theoretical and practical importance. It has been claimed that the distribution of acute lymphoblastic leukemia (ALL) phenotypes in Saudi Arabia is different from that recorded in the Western literature. One hundred and twelve (112) patients under 15 years of age, diagnosed as ALL between January 1992 and May 1994 had immunophenotypes performed on their blast cells. Common ALL (cALL) together with pre-B-ALL, formed 86.5% of the total; B-cell 3%, T-cell 6% and null cell 4.5%. These figures are not significantly different from the Western literature. A previous claim from this institution in 1990, that both null and B-cell ALL were significantly increased compared with elsewhere, is not supported by the present figures. Age and sex distribution, and FAB classification, L1 77%, L2 20% and L3 3%, were also of the same order as described elsewhere and, in particular, there was no increase in the frequency of L3 subtype.     

Inhibition of clonogenic growth of fresh leukemia cells by unstimulated and IL-2 stimulated NK cells of normal donors

We have demonstrated that unstimulated highly-enriched NK cells have the capability to inhibit the growth of fresh clonogenic leukemic cells from AML, CML and preleukemic patients. The NK-cell population mediating antileukemic reactivity exhibited LGL morphology and NKH1 and CD16 phenotype. The inhibition of leukemic growth could be mediated by cell-to-cell contact or by soluble factor produced by NK cells. Antileukemia activity was only detectable when enriched population of LGL was utilized; NW-filtered lymphocyte population did not exhibit leukemia-inhibitory effect. However, such activity could be generated after culture of the latter effector cells with IL-2. The leukemia directed IL-2 activated effector cells were characterized as NK cells. The data reported here provide new insight into host factors which may control leukemia growth and indicate the possible future application of NK cells for therapy of leukemia.     

Dexamethasone in the treatment of meningeal leukemia

To determine if dexamethasone has a role in the treatment of meningeal leukemia, 8 consecutive patients with acute lymphoblastic and signs or symptoms of CNS were included in the study. After the confirmation of leukemic blast cells on cerebrospinal fluid, they received intrathecal and IV dexamethasone; 3 days later the patients received “triple” intrathecal chemotherapy with dexamethasone, methotrexate and cytarabine, and the spinal fluid was studied again. All patients had good clinical response and 7 out of the 8 patients showed reduction on the CSF cell count after the use of dexamethasone alone. The results suggest that dexamethasone is a lympholytic agent that could play a more active role in the prevention and therapy of meningeal leukemia and should be preferred over hydrocortisone in the so called “triple” intrathecal chemotherapy for the prevention and treatment of CNS leukemia. © 1995 Wiley-Liss, Inc.     

国产安吖啶治疗急性白血病Ⅱ期临床试用

应用国产安吖啶对11例急性白血病进行诱导缓解化疗,初治6例,复治5例。4例达完全缓解(CR),CR率为36.4％。其中初治者为33.3％(2/6),复治者为40％(2/5)。总有效率45.5％。该药的剂量限制性毒性反应为骨髓抑制,部分病例有肝功能损害。     

4种不同类型白血病细胞中磷脂的分析

通过对正常白细胞及４种不同类型白血病细胞中磷脂的分析表明，４种不同类型白血病细胞中磷脂含量均高于正常白细胞。其中，以磷脂酰肌醇和磷脂酰胆碱的增高尤为明显，很可能在白血病细胞中、这两种磷脂的增高参与了与蛋白激酶Ｃ相关的细胞癌变的某种反应。     

急性淋巴细胞性白血病的细胞遗传学研究

对40例中国人急性淋巴细胞白血病(急淋)进行了细胞遗传学的研究,发现正常核型为40%,染色体数量异常占42.5%,染色体结构异常为17.5%,特异染色体异常包括有t(9;22)(q34;q11),t(4;11)(q21;q23)和t(8;14)(q24;q32)及环状染色体等.分析了2例急淋患者初发和复发时核型的变化,显示复发时有附加异常。研究认为细胞形态学,免疫表型和细胞遗传学的联合分析(MIC)有助于急淋的诊断和分型。此外,细胞遗传学检查对于急淋白血病的预后具有重要意义。     

Abdominal zygomycotic thromboangiitis in a patient with AML and t(1;13;14)

 The case report of a 61 year-old man with AML M2 FAB, t(1; 13; 14) and zygomycotic mesenterial thromboangiitis is presented. Two induction cycles of chemotherapy were administered due to primary drug resistance. They were complicated by pneumonia, colonic pseudo-obstruction and perforation with peritonitis. The patient died on the 40th day of therapy, 4 days after undergoing palliative surgery. Zygomycotic thromboangiitis, which very probably contributed to the intestinal perforation, was confirmed morphologically at necropsy. The novel complex chromosomal translocation t(1; 13; 14) (q31; q32; q24) and the problems connected with the diagnosis of invasive fungal infections are discussed. Received: 26 January 1996 / Accepted: 12 June 1996