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G Flandrin

Publications and source records attributed to G Flandrin.

At least 73 records · Page 4Linked to original sources
PubMed1995

A scoring system for the classification of CD5-B CLL versus CD5+ B CLL and B PLL.

B CLL is a monoclonal proliferation of lymphocytes which express the CD5 antigen (CD5+ CLL). Rare exceptions (less than 10%) are CD5-, as are the majority of B PLL. We have studied the clinical, cytological and immunophenotypic characteristics of a series of 12 CD5-CLL and have established a score which allows the distinction between CD5+ CLL, CD5- CLL and PLL. Among the CD5- CLL, there were significantly more cases with advanced stage (Rai and Binet) and splenomegaly. The cytological study found more mixed CLL according to FAB classification (more prolymphocytes). There were significantly more CD23-, FMC7+, SIg strong positive cases. A score from 0 to 6 was established based on clinical, cytological and immunophenotypic criteria. Typical CD5+ CLL was scored 0, score 6 corresponded to typical PLL. There were significantly more higher scores amongst CD5- CLL. It therefore appears that CD5- CLLs share certain features with B PLL. The use of this scoring system will allow determination of prognosis within these different categories, thus identifying groups which require specific therapy.

Adult↗
PubMed1995

t(15;17) hypergranular acute promyelocytic leukemia (M3) developing into a t(3;6) M3 without t(15;17) at relapse.

This report describes a case of acute promyelocytic leukemia (APL) M3. At diagnosis, the specific t(15;17) translocation was observed. After chemotherapy including retinoic acid, a complete remission was achieved and the karyotype became normal. At relapse of the M3 leukemia, the t(15;17) clone was no longer observed but a t(3;6) translocation was then detected. Several hypotheses for this unusual cytogenetic course of APL are discussed.

Adult↗
PubMed1995

Recommended procedures for the classification of acute leukaemias.

The classification of acute leukaemias is now widely based on a combined morphological, cytochemical and immunophenotyping approach. Difficulties are frequently encountered however in reaching an acceptable degree of diagnostic concordance between different laboratories because of variations in the techniques used (in terms of methodologies, reagents and equipment) and diagnostic interpretation. The International Council for Standardization in Haematology (ICSH) convened an expert panel to consider currently available diagnostic techniques with the aim of defining a minimum cytochemical and immunological diagnostic panel that could be used as core components for the classification of acute leukaemia. The proposed ICSH scheme, which attempts to balance the basic requirement for providing precise and informative diagnostic information without limiting its use to only those laboratories with sophisticated facilities, is based on three sequential levels of investigation; primary cytochemistry, intracellular phenotyping and membrane immunophenotyping. The minimum ICSH recommended cytochemistries comprise myeloperoxidase (MPO), chloroacetate esterase (ChlorE) and alpha-naphthyl acetate esterase (ANAE), and standardised methods for these cytochemistries are detailed in this communication. For cases of acute leukaemia that remain unclassified by primary cytochemistry, subsequent immunological analyses for cytoplasmic CD3, CD22, MPO and nuclear TdT are recommended. The ICSH panel considers that the use of these minimum primary cytochemical and intracellular phenotyping procedures will lead to the consistent classification of most acute leukaemias, and that the third level of investigation (membrane immunophenotyping) should be used for the purposes of confirmation, diagnostic clarification of atypical leukaemias, and the subtyping of acute lymphoblastic leukaemias (ALL). The ICSH panel also recognised that there are a number of additional technologies which can provide definitive diagnostic information, such as cytogenetics and DNA genotyping, but these were excluded from the minimum panel because of their restricted availability. While many specialised laboratories, particularly in the areas of diagnostic research, will continue to use individual investigatory protocols, it is considered that the inclusion of the ICSH scheme as core components would lead to greater consistency when comparing independent studies of acute leukaemia.

Acute Disease↗
PubMed1995

Haematological cytology image bank and teletransmission for microscopic diagnosis.

Video recording of microscopic preparations, digitalization and storage, transmission by a specialized telephone network are revolutionizing microscopic diagnosis procedures. Adjustment of standardization of medical diagnosis, based on internationally recognized classifications and their computerized coding are fundamental to this process (ADICAP coding system). We are evaluating telediagnosis procedure to test their relevance in practical hematology. Taking into account clinical and biological informations is necessary to deal with difficult cases, in using in addition to microscopic observations, a compromise of analytic data which must be rapidly available in a data bank by cross references research. In comparison with other pathological applications, the sampling problem is specially crucial in hematologic cases, for which it is necessary to observe at high resolution a fairly high number of microscopic fields, from the peripheral blood and bone marrow smears, in addition to samples of histopathologic sections from bone marrow and/or lymph-node. A previous teleconsultation of an extensive data bank appears as being one of the best way to reduce the procedure of telediagnosis to the only difficult cases, for which clear responses cannot be found in the data bank. A link between the access to the data bank and the telediagnosis procedures appears to be a fundamental approach. Our first experience shown us that a mean of 10 to 15 observed fields are necessary to conclude in ordinary cases (i.e. peripheral blood of lymphoproliferative disorders), while up to 30 fields or more are sometimes necessary for complex cases (acute leukemias, myelodysplastic and myeloproliferative syndromes), including cytologic and histopathologic data from the peripheral blood, bone marrow, lymph nodes.

Computer Communication Networks↗
PubMed1995

[Contribution of computers and telepathology in cancerologic pathology].

The histologic or cytologic diagnosis of a tumoral lesion may be sometimes very difficult to do even for a senior pathologist. Nevertheless, it is necessary to recognize a malignant process with reliability and security. The usual way to solve some difficult problems is firstly to search documentations in books or atlas and then to discuss the slides in common. Sometimes it is necessary to dispatch the original documents to a national or international expert. Now computers are used in any private or public department of Pathology. Some new informatics developments allow to send good digitized pictures to an expert and to discuss with him. It is also possible to elaborate a data base of digitized images which can be edited on CD-Rom. We describe the development and the use of these technics in France and elsewhere. It seems that they could have an increasing role for quality assurance in tumoral pathology.

Cancer Care Facilities↗
PubMed1995

[Evaluation of the Coulter method for reticulocyte count].

Although the automation of reticulocyte counts was developed in the beginning of the 80's, the reticulocyte modules integrated in the hematology analysers have been only recently made available. The purpose of our study is the evaluation of the reticulocyte module included in the Coulter STKS, performed in the Necker-Enfants-Malades hospital laboratory. Regarding the technical conditions of use, this simple and user-friendly method can be easily adapted to routine use. Results, as compared to those obtained with two reference methods, microscopy and cytofluorometry, are accurate if the operator's attention is drawn by some causes of interferences, generally flagged by the instrument.

Evaluation Studies as Topic↗
PubMed1994

Persistent polyclonal lymphocytosis with binucleated B lymphocytes: a genetic predisposition.

Persistent lymphocytosis is usually associated with a malignant lymphoproliferative disease (MLPD). We report six female patients presenting a chronic, moderate lymphocytosis of 2-16 years duration with atypical binucleated lymphocytes on peripheral blood smears. Further investigation showed a polyclonal increase in serum IgM and HLA-DR7 phenotype in all patients. The B cells were polyclonal because Southern hybridization of DNA and polymerase chain reaction failed to demonstrate a clonal rearrangement of immunoglobulin heavy chain genes. Peripheral blood examination showed binucleated lymphocytes in a family member of two of the cases; taken together with the association with HLA-DR7 these data suggest a genetic predisposition. The identification of this benign syndrome is important in order to prevent its misdiagnosis as a MLPD.

Adult↗
PubMed1994

A spontaneous remission of lymphoid blast crisis in chronic myelogenous leukaemia following blood transfusion and infection.

We report a case of spontaneous remission of lymphoid blast crisis in chronic myelogenous leukaemia (CML) which returned to chronic phase, without the use of cytostatic chemotherapy, following an episode of viral infection and blood transfusion. Although complete remissions of acute leukaemia have been described, this evolution is extremely rare and has never been reported in CML blast crisis. The role of hypothetical factors leading to such a rare event are briefly discussed.

Aged↗
PubMed1994

The chronic myeloid leukaemias: guidelines for distinguishing chronic granulocytic, atypical chronic myeloid, and chronic myelomonocytic leukaemia. Proposals by the French-American-British Cooperative Leukaemia Group.

We have reviewed our experience with four of the entities that are included under the generic term chronic myeloid leukaemia (CML), namely the classic Ph+ CGL, both BCR+ and BCR-, aCML and CMML. We have developed a statistical model that confirms that CGL, aCML and CMML can be distinguished from each other with reasonable success employing five quantitative parameters (WBC, percentage immature granulocytes, percentage monocytes, percentage basophils, percentage erythroid precursors in bone marrow) and one qualitative parameter (granulocytic dysplasia). It is hoped that these detailed recommendations will enable investigators to improve their diagnostic accuracy. This should permit more uniform comparisons of molecular biologic and clinical studies.

Bone Marrow↗
PubMed1994

Hairy cell leukemia. An update on a cohort of 93 patients treated in a single institution. Effects of interferon in patients relapsing after splenectomy and in patients with or without maintenance treatment.

We retrospectively analysed the results of interferon alpha-2 (IFN) treatment in 93 patients with hairy-cell leukaemia, of which 31 had previously undergone splenectomy. Induction treatment (3 x 10(6) U three times weekly for 12 months) was completed in 84 cases (90%). Peripheral hematological response was observed in 76 patients. Two patients had persistent splenomegaly, and response was observed in both cases after splenectomy. Five additional patients were responsive after 18-24 months of induction treatment and 1 was unresponsive. Of 28 patients on maintenance treatment (1 x 10(6) U 3 x per week), no patient relapsed after a median follow-up of 30 months. The toxicity level was acceptable and IFN resistance was not observed. On the other hand, of 56 patients without maintenance treatment, 37 relapsed at a median of 19 months. Thirty of 32 evaluable patients remained responsive to a second course of IFN. Of 19 patients without relapse, 11 had undergone splenectomy compared to 0/37 patients who relapsed (p < 0.001). In conclusion, the study shows the following, (1) IFN, provides excellent palliation without major toxic side effects; (2) long term maintenance was well tolerated and prevented peripheral haematological relapse; (3) lack of maintenance treatment was associated with peripheral haematological relapse requiring a second treatment; and (4) certain previously splenectomized patients may not require maintenance treatment. These long term results must be compared with the effectiveness and toxicity of new drugs, such as pentostatin and 2-chloro-deoxy-adenosine.

Cohort Studies↗
PubMed1994

Recurrent cytogenetic abnormalities observed in complete remission of acute myeloid leukemia do not necessarily mark preleukemic cells.

We have undertaken the cytogenetic monitoring of 39 adult patients treated for de novo acute myeloid leukemia (AML) by intensive chemotherapy. We describe this monitoring in seven patients in continuous complete clinical and morphologic remission (CR) of AML. Although in CR, these patients exhibit the emergence of cytogenetically abnormal clones. Abnormalities observed include monosomy 7, del(20)(q11), partial trisomy 1q, and 6p12-22 rearrangements. They correspond to well-known chromosomal rearrangements commonly found in myelodysplasia (MDS), and myeloproliferative syndromes (MPS), as well as AML. Present as the sole detected chromosomal change, they preceded by months the onset of overt leukemia or MDS. In some cases, the abnormal clone showed a proliferative advantage (some patients exhibited up to 100% of abnormal bone marrow metaphases in subsequent analyses). AML relapse, when it occurred, was associated with a different chromosomal modification. Altogether the question arises, whether the abnormalities pointed out in our study (monosomy 7, del(20)(q11), partial trisomy for the long arm of chromosome 1 (q21qter), 6p12-22 rearrangements), and seen after chemotherapy, mark preleukemic cells or not, and whether they participate indirectly, or not at all in the leukemic process.

Adult↗
PubMed1993

Recommended procedures for the classification of acute leukaemias. International Council for Standardization in Haematology (ICSH).

The classification of acute leukaemias is now widely based on a combined morphological, cytochemical and immunophenotyping approach. Difficulties are frequently encountered however in reaching an acceptable degree of diagnostic concordance between different laboratories because of variations in the techniques used (in terms of methodologies, reagents and equipment) and diagnostic interpretation. The International Council for Standardization in Haematology (ICSH) convened an expert panel to consider currently available diagnostic techniques with the aim of defining a minimum cytochemical and immunological diagnostic panel that could be used as core components for the classification of acute leukemia. The proposed ICSH scheme, which attempts to balance the basic requirement for providing precise and informative diagnostic information without limiting its use to only those laboratories with sophisticated facilities, is based on three sequential levels of investigation; primary cytochemistry, intracellular phenotyping and membrane immunophenotyping. The minimum ICSH recommended cytochemistries comprise myeloperoxidase (MPO), chloroacetate esterase (ChlorE) and alpha-naphthyl acetate esterase (ANAE), and standardised methods for these cytochemistries are detailed in this communication. For cases of acute leukaemia that remain unclassified by primary cytochemistry, subsequent immunological analyses for cytoplasmic CD3, CD22, MPO and nuclear TdT are recommended. The ICSH panel considers that the use of these minimum primary cytochemical and intracellular phenotyping procedures will lead to the consistent classification of most acute leukaemias, and that the third level of investigation (membrane immunophenotyping) should be used for the purposes of confirmation, diagnostic clarification of atypical leukaemias, and the subtyping of acute lymphoblastic leukaemias (ALL). The ICSH panel also recognised that there are a number of additional technologies which can provide definitive diagnostic information, such as cytogenetics and DNA genotyping, but these were excluded from the minimum panel because of their restricted availability. While many specialised laboratories, particularly in the areas of diagnostic research, will continue to use individual investigatory protocols, it is considered that the inclusion of the ICSH scheme as core components would lead to greater consistency when comparing independent studies of acute leukemia.

Acute Disease↗
PubMed1993

Translocation t(1;19) in acute lymphoblastic leukemia patients with cytological presentation simulating L3-ALL (Burkitt-like).

The t(1;19) in B-lineage ALL is classically associated with a FAB L1/L2 phenotype and the expression of cIg. Recent reports have demonstrated immuno-phenotypic and molecular heterogeneity among cases demonstrating apparently identical karyotypic abnormalities. We report 5 cases of t(1;19) with cytological features resembling an L3 (Burkitt-like) phenotype, suggesting that accurate assessment of these cases requires detailed correlation of cytological, immunological and molecular characteristics.

Adult↗
PubMed1993

[The progresses in the determination of blood monocytosis and its perspectives of clinical application in pathology].

Automated cell counters have allowed the reproducible analysis of the 5 leucocyte populations (neutrophils, eosinophils, basophils, lymphocytes and monocytes). Determination of the monocyte count by classical microscopic analysis can be inaccurate. We have compared the automated monocyte count from the coulter STKS (program 1F) with counts obtained by microscopic analysis of 1000 leucocytes and by flow cytometric analysis of cells stained simultaneously with a pan-leucocyte and a monocyte-specific antibody. The values provided by the coulter STKS are sufficiently precise to recommend the routine clinical use of this automated counter.

Female↗
PubMed1992

Use of the new Coulter MAXM for leucocyte differentials.

The Coulter MAXM is an automated instrument designed to give a complete haematological profile including cell counts and WBC differential (DIFF). The WBC DIFF is determined by tridimensional flow cytometry on the basis of cell volume, light scattering and conductivity (VCS technology). Evaluation of the MAXM DIFF was performed by comparison with microscopic examination of blood smear. A total of 467 samples were studied by the MAXM and reference techniques, according to a standard protocol employed in our laboratory to define the criteria for smear examination. Good correlation was obtained between the two methods in non-flagged samples and those flagged only with an isolated "Imm Gran" message. In a group of 407 non-haematological and 60 haematological patients, there were 12 (2.6%) false positive and 5 (1.1%) false negative reports, all in non-haematological cases and the five false negative results corresponding to no more than minor abnormalities. The Coulter MAXM was thus shown to be an excellent haematology analyser. This instrument was capable of detecting significant abnormalities of blood smears with a sensitivity of 97.9%, a specificity of 94.7% and a global efficiency of 96.3% in the samples examined in the present study.

Automation↗