Chromosomes in acute leukemia

Summary The karyotype of leukemic cells of 78 acute leukemia patients (37 ANLL, 34ALL, and 7 of unknown type) was studied by means of G-banding. Chromsomal abnormalities were found in 50 patients (72%). Chromosomes 8, 21, 5, 7, 11, and 19 were preferentially involeved in the abnormalities, both in ANLL and in ALL. A high incidence of the characteristic rearrangement t(8,21) was noted in AML: (in 6 of 22 AML patients). An identical reciprocal translocation—t(4;11)—was seen in 4 out of 34 ALL patients.     

Chromosomes in acute nonlymphocytic leukemia

Summary The karyotype of leukemic cells was studied in 88 acute nonlymphocytic leukemia (ANLL) patients. Chromosome abnormalities were discovered in 78.4% of all patients and in 72.5% of the 69 patients studied before treatment. Characteristic abnormalities: translocations 8;21, 15;17, 9;22 or 6;9, rearrangements of 11q, gain of chromosomes 8 or 21, and loss or deletion of chromosomes 5 or 7 were detected in 56 of 69 patients with abnormal karyotypes. Translocation 8;21 was revealed in 27 patients; 20 of them had M2 FAB-form, four had M1, and three had M4. In patients with t(8;21) the incidence of complete remission was higher and the duration of first remission and survival longer than in patients with other abnormalities or with a normal karyotype.     

Bacterial urinary infections in acute leukemia

Hundred thirty patients with the acute leukemia were examined. Bacterial urinary infections were detected in 34% of the examined patients, statistically more frequently in women. Decreased response to the inflammatory process is noted in leukemic patients with the urinary infections. Non-stable clinical symptoms, multiple changes in the normal laboratory findings in both the urine and blood serum may suggest urinary infection which should be confirmed by the urinary cultures. The most frequent causes of the urinary infections are various species of gram-negative bacteria of Enterobacteriaceae similarly to non-leukemic patients with urinary infections. Reinfections and superinfections were seen in some patients but the latter were more frequent in the acute lymphoblastic leukemia.     

Annular promyelocytes in acute myeloid leukemia

Granulocytes with ring-shaped nuclei (annular granulocytes; ring granulocytes) are normal bone marrow constituents in rodents. Studies in man have shown a small number of these cells in cases of myeloproliferative diseases. Myelocytes and metamyelocytes have also been described. Similar to rodents and some other animal species, the annular promyelocyte also exists in humans. The significance of these very rare cells in human haemopoiesis becomes an interesting question.     

Interleukin-17 in acute myeloid leukemia

There are several reports that angiogenesis plays important roles in hematological malignancies including acute myeloid leukemia (AML). Human interleukin-17 (IL-17) is a proinflammatory cytokine produced by activated CD4 T cells. IL-17 plays a potential role in T cell mediated angiogenesis. The role of IL-17 in pathologic angiogenesis has not been evaluated yet. The aim of the study was to determine plasma level of IL-17 in patients with AML. IL-17 levels were measured by ELISA in plasma samples taken from 68 adult patients with AML before chemotherapy was administered. In addition 20 out of 68 patients were reanalysed after achieving complete remission (CR). Ten samples from healthy volunteers were evaluated as the control. In this study we have demonstrated that serum level of IL-17 is not elevated in AML patients. These results suggest that angiogenesis in AML is not mediated by CD4 T cells. To our knowledge this is the first report about IL-17 serum level in acute leukemias. We are currently evaluating IL-17 levels in others haematological malignancies.     

Childhood acute lymphoblastic leukemia

As cure rates in childhood acute lymphoblastic leukemia reach 80%, emphasis is increasingly placed on the accurate identification of drug-resistant cases, the elucidation of the mechanisms involved in drug resistance and the development of new therapeutic strategies targeted toward the pivotal molecular lesions. Pharmacodynamic and pharmacogenomic studies have provided rational criteria for individualizing therapy to enhance efficacy and reduce acute toxicity and late sequelae. Currently, assessment of the early response to treatment by measurement of minimal residual disease (MRD) is the most powerful independent prognostic indicator. MRD is affected by both the drug sensitivity of leukemic cells and the pharmacodynamic and pharmacogenetic properties of the host cells. Rapid advances in biotechnology and bioinformatics should ultimately facilitate the development of molecular diagnostic assays that can be used to optimize antileukemic therapy and elucidate the mechanisms of leukemogenesis. In the interim, prospective clinical trials have provided valuable clues that are further increasing the cure rate of childhood acute lymphoblastic leukemia.     

Adjuvant immunotherapy in acute nonlymphocytic leukemia

Summary Of 112 patients (maximum age 70 years) with acute nonlymphocytic leukemia, 62 (55%) went into remission on an induction therapy of cytosine arabinoside and daunorubicin. 20 patients were randomized for maintenance treatment consisting of chemotherapy only and 22 patients for combined chemo-immunotherapy. The chemotherapy consisted in 5-day courses of daunorubicin and cytosine arabinoside and of thioguanine and cytosine arabinoside, alternating every month. The chemo-immunotherapy group also received weekly intracutaneous injections of 10⁹ allogeneic nonirradiated leukemic myeloblasts and 10⁶ BCG organisms (Glaxo) by Heaf gun.The median duration of the first remission was 164 days for the chemotherapy group and 464 days for the chemo-immunotherapy group. The corresponding median times of survival were 344 days for the first group and 734 days for the second group. The difference concerning median duration of survival is statistically significant. Thus immunotherapy seems to prolong survival.     

The cytogenetics of acute leukemia

Methodological prerequisites for the culture of leukaemic blasts and the fluorescence banding of spread metaphases are represented in detail. By using an improved method the percentage of aneuploid karyotype findings increased in AML from 49% to 68% and ALL from 65% to 81% of all evaluable patients. Specific aberrations known up to the present day are discussed. They could be diagnosed in 46% of aneuploid AML-clones and in 59% of ALL-clones. The fluorescence banding according to the three-colour technique is demonstrated by three examples of "non-specific" aberrations: a) Tandem translocation of 1q and 7 q (64a, male, FAB:M5B), b) Karyotype instability with variability of chromosome numbers arising from trisomy, tetrasomy and polyploidisation of single normal as well as marker chromosomes (57a, female, FAB:M6), c) Identification of a marker chromosome as a derivative chromosome 16 (33a, female, FAB:L2, c-ALL).