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Biomedical subjects

M Krulik

Publications and source records attributed to M Krulik.

At least 73 records · Page 4Linked to original sources
PubMed1987

Erythrocyte mean corpuscular volume during cytotoxic therapy is a predictive parameter of secondary leukemia in Hodgkin's disease.

Mean corpuscular volume (MCV) evolution during cytotoxic therapy was studied in 32 patients with Hodgkin's disease (HD) who developed therapy-related acute nonlymphocytic leukemia (t-ANLL) and in 64 HD controls matched for age, therapy duration, and MOPP (mechlorethamine, vincristine, procarbazine, and prednisone) administration. Maximum MCV during therapy reached 108.3 +/- 8.2 fl in t-ANLL patients and 103.4 +/- 9.1 fl in the controls (P = 0.001). Maximum MCV increase was 26.7 +/- 8.3 fl in t-ANLL patients and 16.6 +/- 8.3 fl in the controls (P = 10(-9). The greatest 3-month increase observed during therapy was 14.8 +/- 6 fl in the t-ANLL patients and 10.1 +/- 4.8 fl in the controls (P = 0.0001). During initial MOPP therapy, the greatest 3-month increase reached 14.1 +/- 5.3 fl in t-ANLL patients and 9.8 +/- 4.5 fl in the controls (P = 0.01). The relative risk of developing t-ANLL was 9 for a MCV maximum increase over 24 fl during therapy, which was observed in 71% of the patients with t-ANLL and in only 22% of the controls. For the greatest 3-month MCV increase over 15 fl observed in 57% of the t-ANLL patients and in 17% of the controls, the relative risk reached 15. This suggests that there is at least one factor, independent from therapy, which predisposes to t-ANLL. MCV evolution during therapy appears useful in determining which HD patients have a high risk of developing t-ANLL.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

Cytogenetic studies in twelve patients with primary myelofibrosis and myeloid metaplasia.

Chromosome studies on bone marrow and/or peripheral blood cells without phytohemagglutinin were performed on 12 patients with primary myelofibrosis with myeloid meta-plasia (PMMM) between 1980 and 1984. Abnormal clones were found in six patients (50%). In five cases the abnormal clone involved the long arm of chromosome #7, two of which also had partial trisomy of chromosome #1 and trisomy of 9. Additional abnormalities involving chromosomes #3, #5, #11, #13, #15, and #21 were each found once. Review of the literature showed few studies on the cytogenetics of PMMM. No specific chromosomal pattern can be established; however, abnormalities described are nonrandom.

Aged↗
PubMed1986

Preleukemic changes in cases of nonlymphocytic leukemia secondary to cytotoxic therapy. Analysis of 105 cases.

Peripheral blood changes preceding therapy-related leukemia were studied in 105 patients who had received cytotoxic therapy, 53 for Hodgkin's disease and 52 for other cancers. Preleukemic anomalies were observed in 74.3% of the cases, appearing after a mean interval of 68.7 months after diagnosis of the initial cancer. This interval was only 57.5 months in patients aged 50 years or older and only 42.3 months in patients with Hodgkin's disease having received cytotoxic therapy for 6 months or less. The first changes most frequently observed were pancytopenia (24.8%) and isolated erythrocyte abnormalities such as anemia or macrocytosis (18.1%). Involvement of two cell lines, isolated thrombocytopenia or leukopenia, circulating immature cells, monocytosis, leukocytosis, or thrombocytosis were also observed. Therapy-related myelodysplastic syndrome was recognized in 19 patients and myelofibrosis in 3. Median duration of the preleukemic phase was 6 months; 9 months in cases of isolated erythrocyte involvement and 5 months in the other cases. Myelomonocytic or monoblastic leukemia appeared less frequently when the first sign involved erythrocytes only. Hematological surveillance thus appears necessary in all patients having received cytotoxic therapy. Bone marrow study with cytogenetic examination should be performed in cases of persistent peripheral blood abnormalities.

Adolescent↗
PubMed1986

[Anemia in the elderly subject secondary to jejunal vascular malformation. Apropos of 2 cases].

Two cases of normocytic regenerative anemia in two patients aged 84 and 86 respectively were related to gastrointestinal bleeding. Abdominal angiography was negative in both cases. Only laparotomy provided a diagnosis of jejunal vascular malformation with the aid of peroperative endoscopy. Angiodysplasia was diagnosed in one case and capillary hemangioma in the other. In these very old people with very somber prognosis, anemia was corrected by surgery without recurrence after 8 and 10 months respectively. Gastrointestinal malformations are found in about 20 p. 100 of unexplained digestive hemorrhages. In most cases they are localized in the right large bowel, especially in old patients. Jejunal localizations are 7 to 8 times less frequent and have been described in younger patients. Up to now, selective abdominal angiography has been the main diagnostic procedure. We must insist on the value of peroperative endoscopy when angiography is negative.

Aged↗
PubMed1986

Spontaneous regression of cytogenetic and haematologic anomalies in Ph1-positive chronic myelogenous leukaemia.

We report a case of a 27-year-old man with Ph1-positive chronic myelogenous leukaemia (CML). At the time of diagnosis 100% Ph1-positive cells were found with a trisomy 8 in 50% of them. In absence of therapy, his haematological status remained stable for 3 years. Subsequently a progressive regression of haematologic and cytogenetic data was observed. Eight years after diagnosis the karyotype showed only 37% Ph1-positive cells and the trisomy 8 had disappeared.

Adult↗
PubMed1986

Acute leukemia after treatment for ovarian cancer. Report of four cases and review of the literature.

Four cases of acute nonlymphocytic leukemia (ANLL) following ovarian cancer are reported. All patients received alkylating agents and had a preleukemic phase. Seventy-nine additional cases of ANLL following therapy found in the literature are also reviewed. All but 2 patients received alkylating or alkylating-related agents alone or in combination. Mean duration of chemotherapy was 31.4 +/- 19.4 months. Eighty-eight percent of the patients presented with preleukemia with a mean duration of 10 +/- 10 months. Mean interval between cancer and ANLL was 57.3 +/- 26 months. Cytogenetic abnormalities were found in 71% among patients who had a karyotype. Long-term alkylating agent therapy seems to have a significant role in the development of ANLL and should be avoided in ovarian cancer.

Aged↗
PubMed1986

[Chemotherapy in 143 advanced epithelial cancers of the ovary. Experience at the Hôtel-Dieu of Quebec and Hôpital Saint-Antoine (Paris)].

Results of initial chemotherapy in 143 patients with advanced epithelial ovarian cancer are presented. Twenty-five patients were treated with alkylating agents, their median survival was 13 months and 15% were alive at 4 years. Nineteen received Cyclophosphamide-Methotrexate-5 Fluorouracil with or without Hexamethylmelamine, median survival was 22 months and 4 years survival was 20%. Forty-eight were treated with Adriamycin and Cisplatinum, their objective response rate proven by second-look laparotomy was 54.4% (26.1% complete response), median survival was 23 months and 35% were alive at 4 years. Thirty-one received Hexamethylmelamine, 5 Fluorouracil, Adriamycin and Cisplatinum with a median survival of 18 months and 4 years survival of 15%. Twenty had various other chemotherapy regimens, their median survival was only 8 months. Recent advances in the therapy of ovarian carcinoma are also discussed.

Altretamine↗
PubMed1985

Acquisition of a Philadelphia chromosome concomitant with transformation of a refractory anemia into an acute leukemia.

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.

Anemia, Aplastic↗