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Biomedical subjects

H Theml

Publications and source records attributed to H Theml.

At least 37 records · Page 2Linked to original sources

Lymphoplasmacytic/lymphoplasmacytoid lymphoma: a clinical entity distinct from chronic lymphocytic leukaemia?

Clinical data of 116 patients with chronic lymphocytic leukaemia (CLL) and of 114 patients with lymphoplasmacytic/lymphoplasmacytoid lymphoma (synonym: LP immunocytoma, IC) as diagnosed according to the Kiel classification were compared. This interim evaluation of a prospective multicenter study of the Kiel Lymphoma Study Group characterizes IC the less favorable lymphoma entity as evidenced by a more rapid lymph node enlargement, by a higher incidence of constitutional symptoms and of marked anaemia, and by a higher percentage of patients requiring early treatment. In addition, in IC autoimmune haemolytic anaemia was detected in 11.2% of investigated patients as compared to none of the patients with CLL, and monoclonal gammopathy was disclosed in 34.2% of investigated patients as compared to only three patients with CLL who could be, however, unrecognized cases of IC. Actuarial survival data after a follow-up period of 40 months are in favor of an overall better prognosis of patients with CLL than of patients with IC.

Adult↗

[Hematomorphological differential diagnosis of small cell lymphoma. What is the atypical chronic lymphadenosis?].

More importance is being attached to haematologic cell morphology, particularly in the field of small-cell non-Hodgkin lymphomas. This shifting of diagnostical validity from the structural substrate to the cellular one can clearly be illustrated by the transition of classification according to Rappoport to that according to Lennert (Kiel-classification). Here minute cytomorphological criteria acquire a new validity by their significance in the microscopic cut preparation and in the electron-microscope as well as by their correlation to cell-immunological parameters. Thus, it is possible to make a differential diagnostics of the extending small-cell lymphomas from the blood picture. It enables an ensured morphological differentiation to be made for typical B-lymphadenosis, prolymphocytic leukaemia, T-cell lymphadenosis, lymphoplasmocytoid immunocytoma, centrocytoma, and hairy cell leukaemia. The relevance of this differentiation can be further identified by a consequent immunologic cell characterization.

Cytodiagnosis↗

Estimation of kinetic parameters of neutrophilic, eosinophilic, and basophilic granulocytes in human blood.

Two hematologically normal patients with glioblastoma and six patients with chronic lymphocytic leukemia received continuous 3H-thymidine infusions for 3--10 days. In autoradiographs of blood cell smears taken for 25 days or more after the beginning of 3H-thymidine administration the labeling index and the labeling intensity of granulocytes were determined. A sufficiently high labeling intensity, i.e. a sufficiently long autoradiographic exposure time was found to be critical for obtaining valid and reproducible results. On the basis of certain assumptions discussed in detail, complete labeling of cells with 3H-thymidine followed by autoradiographic evaluation and mathematical analysis of the labeling patterns seems to be a suitable method for estimation of kinetic parameters of postmitotic granulocytes in vivo. The mean intramedullary maturation and storage time was observed to be 115 +/- 7 h or neutrophils, 103 +/- 4 h for eosinophils and 103 +/- 11 h for basophils. The mean relative inflow rate into the blood (or relative turnover rate in the blood) was found to be 4.2 +/- 0.4/h for neutrophils, 4.0 +/- 0.4%/h for eosinophils and 1.2 +/- 0.3%/h for basophils. The mean blood transit time (or blood sojourn time) was estimated to be 25 +/- 2 h or neutrophils, 26 +/- 3 h for eosinophils and 89 +/- 21 h for basophils. Accordingly the half lifes (T 1/2) of granulocytes in the blood were 17.3 +/- 1.4 h for neutrophils, 18.0 +/- 2.1 for eosinophils and 62 +/- 15 h for basophils. Under the quasi steady state conditions of this study the kinetics of granulocytes in the present CLL patients appeared to be normal, despite a marked lymphocytic infiltration of the bone marrow. The apparent discrepancy between these findings and the data obtained with autotransfusion of DFP-labeled granulocytes is discussed.

Aged↗

[Malignant histiocytosis (author's transl)].

According to observations in six patients and published reports, malignant histiocytosis is characterized by premature multifocal proliferation of atypical histiocytes, especially in lymph-nodes, spleen, liver, bone marrow, and lung. The diagnosis can be confirmed by electron-microscopy, and enzyme as well as immunocytochemical tests. Fever, anaemia, leukopenia (with absolute reduction in T-lymphocytes), and jaundice are frequent. Immunoglobulins are normal or polyclonally increased. Malignant histiocytosis is more like monocyte leukaemia and histiocytosis X than neoplasms of the lymphatic system.

Adult↗

A comparative study of the buoyant density distribution of normal and malignant lymphocytes.

Density distribution patterns of normal and malignant lymphocytes were compared following centrifugation to equilibrium on linear density gradients. For normal lymphocytes differences in the distribution patterns were observed between: (1) B and T cells, (2) central and peripheral cells, and (3) resting and activated cells. The findings suggested that cell density is determined by cell lineage the degree of differentiation and the stage of functional activation. Marked differences in the density distribution profiles were also observed among certain types of morphologically distinguishable lymphoproliferations. To some extent density analyses enabled the discrimination between CLL, follicular lymphomas and lymphoblastic lymphomas as well as between O-ALL and T-ALL. Density profiles of malignant lymphocytes failed to disclose any features specific for malignancies. But they revealed some similarities with distinct subsets of normal lymphocytes, i.e. between: (1) CLL and bone marrow lymphoid cells, (2) follicular lymphomas and follicular centre cells, and (3) lymphoblastic lymphomas and activated lymphocytes. These findings are further evidence supporting the hypothesis that the malignant transformation of phenotypically different lymphoproliferations takes place at different levels of lymphocyte differentiation.

B-Lymphocytes↗

[Cytokinetics of lymph nodes in lymph nodes in lymphatic system diseases (author's transl)].

Untreated malignant lymphatic system diseases are characterized by a preponderance of cell new formation (proliferation) against the destruction of lymphatic cells. If the lymph nodes are enlarged during these diseases, then cell new formation occurs largely or mostly in these lymph nodes. The proliferating cells of the lymph node are bigger than small lyphocytes and have, in general, a mean diameter of the nucleus of 10 mu and more. In normal lymph nodes they belong morphologically to the big lymphocytes, immunoblasts and plasmoblasts. In pathological lymph nodes they have to be looked for among the bigger cells of the disease-specific cell population. Whereas in healthy lymph nodes and in chronic lymphatic leukemia only about 1% of lymph node cells was found to proliferate, they amount on the average to 5% in lymphomas of lymphogranulomatosis and mostly to 30--50% in the lympho-reticulosarcoma (lymphoblast and immunoblast sarcoma, corresponding to large-cell, poorly differentiated lymphomas). The proliferating cells often appear as foci in the lymphomas. The generation times of the proliferating cells both in normal and pathological lymph nodes are about 24 hrs. or slightly longer. In lymphatic proliferation, apart from plasma cells big and smallymphocytes are produced in the normal lymph node; in CLL, big and small lymphocytes, in lymphogranulomatosis, big and small lymphocytes and Hodgkin-cells, and in poorly differentiated lymphomas, the corresponding lymphoma cells are produced. The clinicist is at the beginning of drawing conclusions from prevalent kinetic disturbances.

Cell Division↗

[Clinical observations to characterize splenomegalic immunocytomas (author's transl)].

In ten patients with predominant splenomegaly the clinical development and progress of disease following the course of some years are described. The hematological values showed a moderate relative lymphocytosis with a slight but inconstant increase in white blood cell counts. A more or less small number of a morphologically distinctive population of plasmacytoid lymphocytes was an important diagnostic criterion and a decrease of at least one class of immunoglobulins could be shown. Only one patient presented a paraproteinemia (IgM). In the serum of six patients atypical unspecific antibodies were found. The histologic and cytologic feature of the spleens which were removed therapeutically was characterized by a mixed infiltration of lymphocytes and plasmocytoid or plasmacellular elements. By this pattern it was possible to classify these cases as lymphoplasmocytoid (resp. lymphoplasmocytic) immunocytomas according to the new Kiel-lymphoma-classification. From the clinical point of view they represented a subunit with markedly prevalent splenic proliferation. Liver and/or bone-marrow however showed in all cases primarily circumscribed infiltrations of pathognomonic cells or did develop them during the course of disease, even after splenectomy. According to the presented observations this disease is to be placed between chronic lymphocytic leukemia and M. Waldenström not only by pathological but also by clinical criteria.

Adult↗

[Kinetics and differentiation of monocytes in man (author's transl)].

This paper gives a short review of the monocytopoiesis in the bone marrow, the kinetics of monocytes in the blood, the differentiation of monocytes in the tissue and presents new data on monocyte transit time through the peripheral blood. Monocyte kinetics were studied in three hematologically normal persons, four patients with Hodgkin's disease and four patients with chroniclymphocytic leukemia using 3H-TdR-pulse-injection or 3H-TdR continuous infusion. The average value of the mean blood monocyte transit time was 25.1 hours. The mean blood transit times of haematologically normal persons and patients with lymphatic disorders did not differ significantly.

Adult↗

Evidence for monoclonal proliferation in prolymphocytic leukemia of T-cell orgin. A cytogenetic and Quantitative immunoautoradiographic analysis.

B- and T-cell markers were studied in a patient with prolymphocytic leukemia, a rare variant of chronic lymphocytic leukemia. Thymus-derived features were identified on the membrane of the neoplastic lymphocytes using the following cellsurface markers: Heterologous T-cell antigen, sheep erythrocyte receptor, surface immunoglobulin, complement receptor, Fc receptor and mouse erythrocyte receptor. Cytogenetic studies of leukemic cells from unstimulated and mitogen-stimulated cultures revealed a consistent karyotype characterized by marker chromosomes and a decreased chromosome number, whereas chromosomal analysis of hair root cells yielded a normal karyotype. A uniform expression of T-cell antigens measured on single leukemic cells by quantitative microphotometric immunoautoradiography correlated with the cytogenetic findings which are compatible with a descent from one progenitor cell.

Aged↗

Factors in the pathomechanism of chronic lymphocytic leukemia.

It has been shown that CLL is characterized by a piling up of highly differentiated lymphocytic cells. These cells have the structural and metabolic characteristics of a neoplastic cell line of B lymphocytes (except in cases of "T-cell CLL"). However, they lack the immunoglobulin-secreting ability of normal B cells, and are immunologically incompetent and inert. Next to this population, there is a normal but reduced population of B cells and a periodically slightly increased T-cell population. The accumulation of pathological cells is based on a 10-fold increase in proliferation of cells that have a 5-fold increase in their life span. In addition, there is a disturbance of exchange of cells between the intra- and extravascular pools. These characteristics clarify the development of the clinical picture: through packing of the bone marrow with pathological cells on the one hand, and the spleen on the other, anemia, thrombocytopenia, and finally granulocytopenia develop. The gradual displacement of normal B cells often leads to extreme hypogammaglobulinemia as the main component of a multifactorial syndrome of immune deficiency.

Animals↗