[Simultaneous detection of bronchopulmonary cancer and acute myeloid leukemia].
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Biomedical subjects
Publications and source records attributed to J Debray.
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The authors present a case of Philadelphia (Ph1) positive acute myeloblastic leukemia (AML) following a refractory anemia with excess of blasts (RAEB) that had been Ph1-negative for 17 months. During the transformation of RAEB into AML, the Ph1 was discovered in 100% of the examined cells. With therapy a partial remission was obtained, during which some 46,XY cells reappeared mixed with Ph1 cells along with a new clone: 47,XY,+11 originating from a Ph1-negative cell. During the terminal blast crisis, the karyotype returned to 46,XY,Ph1. The AML lasted 21 months. The authors discuss: (1) the significance of Ph1-positive AML with a review of the literature; (2) the de novo acquisition of a Ph1 during the course of a blood disorder; and (3) the meaning of a second abnormal clone originating from 46,XY cells.
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A translocation t(1;7) interpreted as t(1;7)(p11;p11) was first reported by Scheres et al. in eight patients with various hematologic disorders. The karyotype of the abnormal cells was trisomic for 1q and monosomic for 7q. Those investigators reported having found four other cases in the literature. We report herein studies of two patients with the same t(1;7).
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Three cases of retinal vasculitis in SLE-type diseases are reported. The first was central retinal vein occlusion occurring during clinical remission of SLE in a 55 year old black female. Prednisone maintenance therapy was unchanged and visual loss rapidly regressed with heparin therapy. The second case was a 33 year old black female in whom SLE was discovered following relapsing bilateral optic neuritis. A progressive visual improvement was obtained with high dose of prednisone (1 mg/kg/day). The third cas was a 17 year old white girl with retinal vasculitis. She had an unclassified connective tissue disease inaugurated by optic neuritis at the age of 10. High dose prednisone (1 mg/kg/day) was effective on the visual loss. Retinal vasculitis lesions in SLE and their therapy are reviewed.
2 cases of multiple myeloma, both with IgG kappa, are reported in a man and his daughter. 33 other cases of myeloma involving two or more first degree relatives have been reported in the literature. Reported cases showed no major specific characteristics of the myelomas involved. Monoclonal protein family members were rarely identical. Our observation of identical monoclonal protein in two family members has only been found in 4 other reports. Occurrence of several cases of myeloma in one family is unlikely to be due to chance alone and the possibility of familial myeloma must be considered. Reports of benign monoclonal gammapathy in other members of the family of a patient with myeloma is also in favor of genetic factors. HLA-typing has shown an increase in frequency of the 4c complex and HLA-A9 in myeloma, and the latter was present in our patients. A genetic predisposition is further supported by experimental observations in mice. Finally, the short delay between onsets of myeloma in family members, less than 5 years in 20 families out of 27, and 4 years in our case, suggests a possible role of environmental factors.
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Degree and extent of lytic bone lesions were quantified at diagnosis in 69 patients with myelomatosis (MM). longest survival was found in patients with minimal lytic lesions and shortest survival was found in those either without bone lesions or with severe and extensive lesions. Among the 12 patients without bone lesions only 6 were Durie & Salmon stage I and only 1 later developed a single lesion. Based on these data, bone involvement in MM does not seem to be a reliable predictive factor of survival in all cases. This suggests the existence of 2 distinct types of MM: 1 with tumour and 1 without. Lytic lesions could have a prognostic value only in the 1st type.
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A case of extraskeletal mesenchymal chondrosarcoma in a 62-year-old woman is reported. This unusual sarcoma was localized in the right thigh (quadriceps) and treated with a combination of surgery, chemotherapy and radiotherapy. Sixty-three cases were found in the literature, with neurologic localization in 29 cases and muscular localization in 34 cases. Among clinical features, a significant difference in age at the time of diagnosis was found between the two localizations, which strongly suggests the possibility of two different types of extraskeletal mesenchymal chondrosarcoma.
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The first case of haemolytic anaemia with thrombocytopenia and acute renal failure induced by ingestion of aspirin in a 22-year old woman is reported. An IgM anti-aspirin antibody which agglutinated erythrocytes of the patient and of ABO compatible donors in the presence of aspirin was isolated in the serum. In addition, the allergic nature of the patient's hypersensitivity to aspirin was confirmed by positive lymphocyte transformation and basophil degranulation tests in the presence of the drug.
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