[Thyroid function in children treated for malignant diseases].
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Biomedical subjects
Publications and source records attributed to E Stojimirović.
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Case reports dealing with preleukemic syndromes are rare. During the last years preleukemia has been ill defined. Nowadays, most authors agree that a marrow stem disorder with clinically recognisable haematological abnormalities, which proceed the development of overt leukemia, is to be regarded as preleukemia syndrome. Clinical and haematological features are different in preleukemic syndromes terminating with acute lymphoblastic (ALL) and acute non-lymphoblastic leukemia (ANLL). We describe two cases of preleukemia--the first evolving into ALL and the second into ANLL. Our first patient had developed pancytopenia and hypocellular bone marrow five months before overt ALL. In the moment the diagnosis was made clinical examination revealed enlarged lymph glands, liver and spleen. Laboratory tests showed pancytopenia and bone marrow infiltrated with blasts L1 morphology (F. A. B. classification). Preleukemic phase terminating with ANLL featured pancytopenia and hypercellular bone marrow infiltrated with histiocytes, some showing signs of erythrocyte-, leukocyte- and platelet-ingestion. Diagnosis of acute monoblastic leukemia M5 (F. A. B.) was made three months after the illness onset, according to bone marrow infiltration with monoblasts. Clinical and haematological features helpful in the recognition of preleukemic syndromes are discussed.
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The paper presents a patient J.S., aged 2 1/2 years, with thrombocytopenia, presence of giant thrombocytes and basophile inclusions in the granulocytes. The same lesions were found in the child's father, followed by increased tendency to bleeding also confirmed in other four family members. Familiar character of the disease and morphologic anomaly of thrombocytes and leucocytes were the basis in passing the diagnosis of May-Hegglin anomaly. The specific features of the case are the child's age and the appearance of hemorrhagic syndrome in infancy.
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Determination of chromosomal aberration in the lymphocyte cell culture of the peripheral blood in 50 children with malignant and nonmalignant diseases was the test applied in the investigation of the adverse effects of the cytostatic therapy on the human genome. The study included the cytostatic drugs cyclophosphamide, methotrexat and cytosine arabinoside which are used in the treatment for the autoimmune diseases, in organ and bone marrow transplantations and in malignant diseases. It was confirmed that these cytostatics could be the cause of considerable structural aberrations in chromosomes, particularly so when high dosages and long application are involved. Therefore it is understandable that these drugs as mutagens can be the cause of the secondary cancer in patients treated with cytostatic therapy and also of the congenital malformations in children by mothers treated with these medications.