Macrophagocytosis and hairy cell leukaemia.
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Biomedical subjects
Publications and source records attributed to E E Damasio.
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A to O bone marrow transplantation was performed in a 25-year-old male affected with severe aplastic anaemia, the donor being an HLA compatible brother. Three plasma exchanges had to be performed with an Aminco separator to remove the original and recurring anti-A isohaemagglutinins. The dynamics of O to A blood group conversion were followed by means of differential agglutination. An early wave of marked dyserythropoiesis was observed in the engrafted marrow. Mild to moderate GvHD was treated successfully with MTX, bolus high dosage 6-methylprednisolone and, at relapse, with intravenous ALG.
Peptichemio, a new oncolytic drug with alkylating and antimetabolic properties was employed in combination with vincristine and 6-methylprednisolone (PVP) for the treatment of diffuse non-Hodgkin's lymphomas (NHL), stages III and IV. 52 of 66 patients who entered the PVP protocol were considered evaluable: the overall remission rate in diffuse lymphocytic poorly differentiated lymphomas (DLPD) was 56.6 and 55% in diffuse histiocytic lymphomas (DHL). Median duration of complete remission was 16 months in DLPD and 13 months in DHL. Dramatic results were obtained in "oncologic emergencies," such as mediastinal involvement and spinal cord compression. Bone marrow depression from PVP was moderate and never caused discontinuation of therapy. According to these results the PVP protocol would appear susceptible of offering a major contribution to the chemotherapy of diffuse NHL.
When leukaemic lymphoblasts from acute lymphatic leukaemia were reacted with animal anti-human lymphocyte globulin (AHLG), and subsequently with the appropriate, fluorescein-isothiocyanate-conjugated antibodies, a brilliant membrane fluorescence was observed, which persisted up to 5 log titres, breaking from rings into spots at higher dilutions. The best results were obtained with fresh suspensions and incident illumination. Cross-reactions with mature and immature myeloid cells with the unabsorbed antisera could be abolished by repeated preabsorbtion of AHLG with packed leukocyte preparations from chronic and acute myeloid leukaemias. Thus, it appears that this approach is susceptible of improving the identification of leukaemic lymphoblasts, and may be extended, by means of appropriate antisera, to the acute leukaemias in general.
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This is a review of current treatment for hairy cell leukemia (HCL). Data for this analysis were obtained from the Italian HCL Registry, as well as from other published series. We have given space to the impact of interferon and pentostatin on the management of this disease. Other issues are also discussed, such as the relevance of achieving a complete remission with respect to overall and relapse-free survival. We include a final section on recommendations which may prove useful in designing an appropriate therapeutic strategy.
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