Biological aspects of chronic lymphoid leukemia

The present study is concerned with clinical prognostic classifications of chronic lymphocytic leukemia derived from numerous statistics and multivariate survival analysis. We analyse the prognostic significance of some biological patterns: bone marrow histological studies, lymph node biopsies, size, structure and doubling time of blood lymphocytes, tumoral markers and karyotype analysis. The problem of the monoclonal clone origin is discussed: differentiation abnormality or proliferation of a physiological clone.     

Inheritable forms of medullary thyroid carcinoma

Medullary thyroid carcinoma (MTC) arises from parafollicular or C cells of the thyroid that produce calcitonin. It accounts for 5-10% of all thyroid cancers. Hereditary MTC represents 20-30% of all MTCs. It can be transmitted with an autosomal dominant pattern, either as a single entity, familial MTC, or it can arise as part of a multiple endocrine neoplasia (MEN) syndrome type 2A or 2B. The identification of hereditary MTC has been facilitated in recent years by the direct analysis of the ret proto-oncogene.     

Mathematical simulation of the regulation of the size of the lymphoid population in relation to chronic lymphoid leukemia

A model was constructed of accumulation kinetics of labeled lymphocytes based on the experiments of long-term injection of 3H-thymidine label in vivo into the blood of healthy and suffering from chronic lympholeucosis animals. There was found an essential difference between the coefficients of reproduction and death of cells of the proliferating pool for the normal, initial and advanced stages of the disease. This served as a basis for the creation of the closed non-linear model of autoregulation of lymphoid population size describing different stages of leucosis development.     

Lymphatic manifestation forms in the terminal phase of chronic myelocytic leukemia

A blastic transformation in chronic myeloic leukaemia (CML) is reported, which, on the one hand, is characterized by the "lymphoid" feature of blasts and, on the other hand, by the appearance of great lymph node swellings. The clear distinction from (secondary) malignant lymphomas may be difficult. The inclusion of such forms of blastic transformation in CML is based on cytogenetic findings. Their non-granulocytic or "lymphoid" nature emerges from their cytological behavior. The fact that these lymphoid transformations respond to vincristin and prednison emphasize that their recognition as special entities is justified. They also demonstrate that the neoplastic process in CML may not only involve myelopoietic but pluripotent stem cells as well.     

Quantitative monitoring of lymphoid malignancies. Application and findings in chronic lymphocytic leukemia

The present study investigated the surface immunoglobulin (Ig) phenotypic pattern in 64 cases of chronic lymphocytic leukemia (CLL). The fluorescence activated cell sorter techniques were modified to provide sensitive and highly reproducible detection and quantification of the otherwise faint surface immunoglobulins on the cells in CLL. In over 98% of the cases of CLL, light chain of the surface Ig could be identified and measured. Serial measurements were shown to be highly reproducible. The phenotypic pattern and density identified on the surface of the circulating lymphocytes precisely reflected the findings in any given patient when other lymphoid tissue (bone marrow, lymph node or spleen) was sampled. Intraclonal heterogeneity detected by surface Ig was seen in some cases of CLL in spite of a relatively uniform morphology by other classical techniques. Three patterns of cell-to-cell variation were seen: 1) that of a non-Gaussian distribution of surface light Ig staining intensity 2) that of the presence of increased surface light Ig chain on a portion of the cells with a subpopulation of CLL cells showing an additional class of heavy chain, and 3) that of anisotropy where the surface Ig quantitatively did not correlate with cell size. Immunoglobulin phenotypic characterization of the cases of CLL was correlated with their clinical stage of disease activity. The distribution of surface light chain phenotype did not relate to any pattern of clinical stage of activity of the disease. By contrast, cases where the cells had a predominance of surface IgM were associated with a more advanced stage of CLL and a poorer clinical prognosis. When surface IgG was predominant, a lesser degree of clinical activity of disease was identified. The phenotypic pattern of the surface Ig on the lymphocytes in CLL mirrors the pattern of differentiation in the murine model of B-cell differentiation, and clinical aggressiveness appears to correlate with the character and degree of B-cell differentiation.