Table of Contents
1
UI - 11916513
AU - Park S; Picard F; Azgui Z; Viguie F; Merlat A; Guesnu M; Leblond V;
TI -
Dreyfus F
Erythroleukemia: a comparison between the previous FAB approach and the
WHO classification.
SO - Leuk Res 2002 May;26(5):423-9
AD - Service d'hematologie, Hopital Cochin, 27 rue du Faubourg St-Jacques,
75014 Paris, France. parksophie@yahoo.com
Erythroleukemia is, within FAB classification, a proliferation of
erythroblasts superior to 50% and of myeloblasts superior to 30%. The
new WHO classification abolishes the frontier between RAEB-t with 20%
and leukemia with 30% of blasts. AML6 variant is a new entity
characterized by the proliferation of immature erythroblasts and the
absence of non-erythroid blast cells. We analyzed 16 erythroleukemia, 5
RAEB-t and 2 AML6 variants to clarify their relationship.We suggest on
survival, karyotype and cytologic characteristics that secondary
erythroleukemia are the same entity as RAEB-t, confirming the WHO
classification and that amongst de novo erythroleukemia, there is 'AML6
variant' with pure erythroid lineage proliferation.
2
UI - 11952886
AU - Johansson P; Andreasson B; Safai-Kutti S; Rhedin C; Vilen L; Vaart J;
TI -
Kutti J
On the diagnosis of polycythaemia vera as assessed in the health and
medical care in the Vastra Gotaland region, Sweden.
SO - J Intern Med 2002 Apr;251(4):348-54
AD - Haematology Section, Department of medicine, Sahlgrenska University
hospital, Goteborg, Sweden. peter.l.johansson@vgregion.se
OBJECTIVES: The aim was to assess how the diagnosis of polycythaemia
vera (PV) was established and to study to which extent the classic
Polycythemia Vera Study Group (PVSG) criteria and the revised criteria
for the diagnosis of PV as proposed by Pearson and Messinezy in 1996 (PM
criteria) were fulfilled when the diagnosis of PV was made. DESIGN AND
SETTING: A questionnaire was sent to physicians in charge of
haematological patients at the departments of medicine in 12 hospitals
in the Health and Medical Care in the Vastra Gotaland Region (VGR),
Sweden, with a population of 1.5 million inhabitants; they were asked to
provide reports as regards all patients with an unequivocal diagnosis of
Full reports were obtained from six hospitals, which serve about 1.1
million inhabitants. The results from a total of 129 PV patients, 62
from two university hospitals (UHs) and 67 from four county hospitals
(CHs), were the subject of the present analysis. Results. It was shown
that measurement of the red cell mass (RCM) had been carried out in 61
of 62 (98%) patients in UHs compared with 24 of 67 (36%) patients at CHs
(P < 0.01). By using ultrasound imaging and/or scintigraphy the spleen
size had been determined in 55 of 62 (89%) patients at UHs and in 24 of
67 (36%) patients at CHs (P < 0.01). At the UHs, arterial oxygen
saturation had been measured in 32 of 62 (52%) patients; the
corresponding figure for the CH patients was 22 of 67 (33%). Plasma or
serum erythropoietin (EPO) concentrations had been measured in 44 of 62
(71%) of PV patients at UHs and in 31 of 67 (46%) of patients at CHs; in
all these cases the EPO concentrations were subnormal or not measurable.
CONCLUSIONS: At the UHs only 37% of the PV patients fulfilled the PVSG
criteria for the diagnosis of PV whereas the corresponding figure for
CHs was 4% (P < 0.01). The adherence to PM criteria was, however, 71% at
UHs compared with 16% at CHs (P < 0.01).
3
UI - 11877308
AU - Devine SM; Hoffman R; Verma A; Shah R; Bradlow BA; Stock W; Maynard V;
TI -
Jessop E; Peace D; Huml M; Thomason D; Chen YH; van Besien K
Allogeneic blood cell transplantation following reduced-intensity
conditioning is effective therapy for older patients with myelofibrosis
with myeloid metaplasia.
SO - Blood 2002 Mar 15;99(6):2255-8
AD - Blood and Marrow Transplantation Program, Section of
Hematology/Oncology, University of Illinois College of Medicine, 840
South Wood Street, M/C 787, Chicago, IL 60612, USA. sdevine@uic.edu
Standard myeloablative conditioning prior to allogeneic hematopoietic
stem cell (HSC) transplantation has been associated with significant
toxicity in patients older than 45 years of age with myelofibrosis with
myeloid metaplasia (MMM). We sought to evaluate the efficacy of a
reduced-intensity conditioning regimen for allogeneic HSC
transplantation in this setting. A regimen consisting of fludarabine (30
mg/m(2) intravenously daily for 5 days) and melphalan (70 mg/m(2)
intravenously daily for 2 days) followed by transplantation of
filgrastim-mobilized peripheral blood cells from HLA-identical siblings
was administered to 4 older patients (median age, 56 years; range, 48-58
years) with advanced MMM. All patients achieved prompt neutrophil and
platelet engraftment and have experienced a significant regression of
splenomegaly and bone marrow fibrosis. All now have normal bone marrow
cellularity. With a median follow-up of 13 months (range, 11-19 months),
all 4 patients are alive with stable full-donor hematopoietic chimerism.
These results support the feasibility and effectiveness of
reduced-intensity conditioning prior to allogeneic HSC transplantation
for older patients with advanced MMM.
4
UI - 11990518
AU - Merup M; Aberg W; Lofvenberg E; Svensson E; Engman K; Paul C; Gardulf A
TI -
Symptoms, symptom distress and health-related quality of life in
patients with polycythaemia vera or essential thrombocythaemia during
treatment with interferon-alpha.
SO - Acta Oncol 2002;41(1):50-5
AD - Department of Medicine, Karolinska Institutet at Huddinge University
Hospital, Sweden. mats.merup@medhs.ki.se
Sixteen patients with polycythaemia vera or essential thrombocythaemia
were treated with interferon-alpha in order to normalize elevated
platelets. Patients were followed for 6 months and the frequency and
intensity of symptoms and side effects were recorded before and during
the study period by the patients and by the doctor. Health-related
quality of life was also assessed. The most frequently reported
pretreatment symptoms were fatigue, headache and muscle pain. The
intensity of fatigue initially increased during treatment and there was
no relief of any of the three most frequent symptoms during the
treatment period. Common interferon-related symptoms such as fever and
chills were most frequently reported after one week. After one month of
treatment, symptoms related to the gastrointestinal tract reached a
peak. Two patients discontinued treatment during the study period.
Another patient suffered severe depression after the study period when
still on interferon. There was no difference between the frequency of
symptoms recorded by the doctor and that reported by the patients.
5
UI - 11918532
AU - Messinezy M; Westwood NB; El-Hemaidi I; Marsden JT; Sherwood RS; Pearson
TI -
TC
Serum erythropoietin values in erythrocytoses and in primary
thrombocythaemia.
SO - Br J Haematol 2002 Apr;117(1):47-53
AD - Department of Haematological Medicine and Department of Clinical
Pathology, Guy's, King's and St Thomas' School of Medicine, London, UK.
Serum erythropoietin (Epo) values were estimated in samples from 125
patients with erythrocytosis to examine the specificity and sensitivity
of reduced and raised values in the diagnosis of polycythaemia vera (PV)
and secondary erythrocytosis (SE) respectively. Additionally, Epo values
were estimated in samples from 49 patients with primary thrombocythaemia
(PT) to determine whether Epo values were altered. We found high
specificity (92%) and moderate sensitivity (64%) of low serum Epo values
(below the reference range) in the diagnosis of PV, and also poor
sensitivity (47%) of raised Epo values in the diagnosis of SE. Raised
Epo values were not observed in PV patients with Hb > 14.0 g/dl and were
only observed in one PV patient with a relatively low Hb recovering from
a gastro-intestinal haemorrhage. Raised Epo values occurred in some
patients with apparent erythrocytosis (AE) and idiopathic erythrocytosis
(IE), mainly at normal (rather than raised) Hb values (< 16 g/dl). Low
Epo values occurred in a few AE, IE and SE patients at higher Hb values
(> 16 g/dl). Low Epo values were less specific for PV when the Hb was
raised, while raised Epo values were less specific for SE when the Hb
was not raised. Approximately one third of patients with PT had a low
(below the reference range) Epo value, this being associated with a high
normal Hb (> 14 g/dl, P < 0.001) and showing a trend towards association
with absence of treatment. The high normal Hb values were in turn
associated with an increased incidence of thrombotic events (P < 0.05).
These findings could influence the future investigation and management
of PT patients.
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