Biomedical subjects
Publications and source records attributed to W Pribilla.
Peripheral blood lymphocytes of hospital personnel handling cytostatic drugs showed no elevation of structural chromosomal aberrations or sister-chromatid exchanges (SCE) over the baseline. The urine of the probands did not induce SCE in peripheral lymphocytes in vitro.
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In ten patients with IRSA, chromosome analysis and bone marrow cytology were performed once or several times during 24 months. Bone marrow chromosomes from eight patients showed a normal karyotype. Two patients were found to have stable clonal chromosome aberrations (45, X,-Y[male] and 46, XX,+mar). In a median duration of 6.8 years of IRSA no patient has yet developed acute leukemia. In another ten deceased patients with IRSA no evidence of leukemia, but a carcinoma of colon and prostate were observed in a latency of 7.7 years. Three patients with symptomatic SA developed in 1-15 months an acute leukemia. Two of them showed severe instable clonal chromosome abnormalities. Distinct bone marrow abnormalities (increase of blasts, normal cellularity, reversed M:E ratio, PAS-pos. erythroblasts), thrombocytopenia, and major clonal chromosome aberrations may help to differentiate IRSA from preleukemic states with symptomatic SA.
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16 adult patients with granulocytopenia and septicemia resistant to antibiotics received 42 granulocyte transfusions. The granulocytes were obtained from healthy donors with a blood cell separator by continuous flow centrifugation. Adding hydroxyethyl-starch an average of 1.8 X 10(10) leukocytes with 69% granulocytes were harvested in 3.5 hours. A small leukocyte increment after the transfusion was seen in half of the recipients. No correlation could be found between fever lysis and survival of the infection, which occurred in half of the cases too. A granulocyte transfusion is indicated in patients, who have granulocytopenia, sepsis and no evidence of bone marrow recovery.
A new alpha chain abnormal hemoglobin variant was found in a Turkish patient with a mild Heinz body hemolytic anemia and splenomegaly. The substitution alpha 86 Leu leads to Arg, which is next to the heme binding proximal histidine, is responsible for a marked instability of the molecule. The oxygen affinity of the erythrocytes was found to be slightly decreased.
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A controlled randomized multicenter trial was carried out to examine the therapeutic value of the androgen mesterolone in aplastic anemia and anemia of renal failure. the drug was given in a dose of 2 mg/kg orally for 6 months. Control patients received no androgens but were otherwise similarily treated. 31 patients with aplastic anemia could be evaluated. No significant difference was found between androgen treated control cases in respect to bone marrow cellularity, improvement of peripheral blood cell counts or survival. In a group of 14 patients not being hemodialyzed with anemia from renal failure, 3 of the androgen treated and none of the control patients showed progressive and significant improvement of erythropoiesis; however, this was not a statistically significant difference when the both groups of patients were compared. The results do not suggest that the androgen mesterolone is of therapeutic value in the majority of adult patients with aplastic anemia. Possible reasons of the discrepancy to positive results reported in the literature are discussed.
The course of spontaneous vitamin B6 deficiency anemia in a 57-year-old woman is reported. The anemia was characterized by hypochromasia of the erythrocytes, hyperferricemia, absence of hemolysis, and hyperplastic, ineffective, sideroblastic erythropoiesis of the bone marrow. It was corrected by oral vitamin B6 therapy. On interruption of the vitamin B6 therapy the anemia relapsed. On resumption of vitamin B6 medication it responded again with normalization of the hemoglobin and erythrocytes values. The hematological remission could be maintained under longterm vitamin B6 medication. The nosological significant of this rare anemia and its differentiation from other forms of anemia are discussed.
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