The authors carried out the funduscopic examination in 53 cases of leukemia (acute myeloblastic leukemia 17, acute lymphoblastic leukemia 2.0, acute monocytic leukemia 9, chronic myelogenous leukemia 5, acute progranulocytic leukemia 2) and 51 cases of various anemias (aplastic anemia 37, iron deficiency anemia, secondary anemia due to bleeding 4, miscellaneous 4) which were confirmed by hematological studies at Kyung-Pook National University Hospital from October 1969 to October 1975. The following results were obtained. 1) Of 53 cases of leukemia, 62% revealed retinopathy with retinal homorrhage. In 65% of 17 cases of acute myeloblastic leukemia, 55% of 2.0 cases of acute lymphoblastic leukemia, 77 % of 9 cases of acute monocytic leukemia, and 4.0% of 5 cases of chronic myelogenous leukemia, retinopathies were noted. 2) Of 51 cases of anemia, 45% revealed retinopathy with retinal hemorrhage. In 49% of 37 cases of aplastic anemia, and 33% of 6 cases of iron deficiency anemia, retinopathies were noted, but none of secondary anemia due to blood loss had retinal hemorrhage. 3) Acute leukemia had more retinal hemorrhage frequency than chronic leukemia. 4) The extent of the retinal hemorrhages seemed to parallel the severity of the anemia in aplastic anemia. 5) Generally the thrombocytopenia was noted in the aplastic anemia but the extent of the retinal hemorrhages not seemed to parallel the severity of the thrombocytopenia. 6) The extent of the retinal hemorrhages seemed to parallel the severity of the anemia in iron deficiency anemia. 7) Specific retinal pictures could not be noted in the various blood dyscrasias. 8) With the retinal pictures, no differentiation on type of the leukemia and the anemia could be noted.
Anemia* ; Anemia, Aplastic ; Anemia, Iron-Deficiency ; Granulocyte Precursor Cells ; Hemorrhage ; Leukemia* ; Leukemia, Monocytic, Acute ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Leukemia, Myeloid, Acute ; Leukemia, Promyelocytic, Acute ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Retinal Hemorrhage ; Retinaldehyde ; Thrombocytopenia

To compare the clinical outcome of autologous peripheral blood stem cell transplantation (APBSCT) and autologous bone marrow transplantation (ABMT) in treatment of patients with acute leukemia in first remission, 41 patients received APBSCT, 17 patients received unpurged ABMT and 30 patients received purged ABMT. The results showed that hematopoietic recovery was significantly earlier after APBSCT than that after purged or unpurged ABMT. The 3-year disease-free survival (DFS), relapse rate (RR) and transplant-related mortality (TRM) for all patients of 3 groups were 51.7%, 41.7% and 6.8%, respectively. DFS and RR were significantly influenced by disease types (ALL or AML) and intervals between diagnosis and CR(1) or CR(1) and transplant. The main causes of transplant-related death were infection and hemorrhage. After APBSCT, DFS, RR and TRM were 48.4%, 43.9% and 4.9%, respectively, and did not differ significantly from those found in unpurged ABMT (47.1%, 45.6% and 11.8%) or purged ABMT (66.5%, 29.6% and 6.7%). It is concluded that the clinical outcome of APBSCT is similar to unpurged or purged ABMT but APBSCT allows faster recovery of hematopoiesis and needs less transfusion support.
Acute Disease ; Adolescent ; Adult ; Bacterial Infections ; etiology ; mortality ; Bone Marrow Purging ; Bone Marrow Transplantation ; adverse effects ; Child ; Disease-Free Survival ; Female ; Follow-Up Studies ; Hemorrhage ; etiology ; mortality ; Humans ; Leukemia ; pathology ; therapy ; Leukemia, Erythroblastic, Acute ; pathology ; therapy ; Leukemia, Monocytic, Acute ; pathology ; therapy ; Leukemia, Myeloid, Acute ; pathology ; therapy ; Leukemia, Myelomonocytic, Acute ; pathology ; therapy ; Leukemia, Promyelocytic, Acute ; pathology ; therapy ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Peripheral Blood Stem Cell Transplantation ; adverse effects ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; pathology ; therapy ; Remission Induction ; Survival Rate ; Transplantation, Autologous

To evaluate the sensitivity and specificity analysis of the lineage related antibodies in acute leukemia immunophenotyping by flow cytometry (FCM), immunophenotyping in 184 patients with acute leukemia was performed by FCM analysis. The results showed that in the lineage-related antibodies of acute myelocytic leukemia (AML), the sensitivity of CD13 and CD33 was higher (95.5% and 91.2%, respectively), the specificity of them was deficient (72.5% and 62.2%, respectively); the sensitivity of MPO was low (69.1%), but the specificity was high (100%); the sensitivity and specificity of CD117 were high (88.2% and 100%, respectively); the sensitivity of CD14 and CD15 was low (18.4% and 27.2%, respectively); the specificity of CD14 with monocytes was high. As the lineage-related antibodies of B-lineage ALL were concerned, CD19 showed high sensitivity and low specificity (100% vs 83.4%); the sensitivity and specificity of CD79a (96.4% vs 100%) and CD22 (100% vs 100%) were high; the sensitivity and specificity of CD10 (53.6% vs 82.5%) and CD20 (70.4% vs 87.5%) were low. In T-lineage ALL, the specificity of CD3 was high (97.5%), but the sensitivity was below the mark (80.0%); the sensitivity of CD7 was high (100%), but the specificity was low (77.9%); while the sensitivity and specificity of CD5, CD2 and CD1a were all deficient. In conclusion, the sensitivity and specificity analysis of the lineage-related antibodies in acute leukemia immunophenotyping are coincident with St Jude immunophenotyping project. It seems only that CD117 is superior to MPO in defining AML, but the sensitivity and specificity analysis of CD22 and CD79 are similar in defining B-lineage ALL, therefore, anyone of them may be selected as your need.
Acute Disease ; Adolescent ; Adult ; Aged ; Antibodies, Monoclonal ; immunology ; Antibodies, Neoplasm ; immunology ; CD79 Antigens ; analysis ; immunology ; Child ; Child, Preschool ; Female ; Flow Cytometry ; methods ; Humans ; Immunophenotyping ; methods ; Leukemia ; classification ; immunology ; Leukemia, Erythroblastic, Acute ; immunology ; Leukemia, Monocytic, Acute ; immunology ; Leukemia, Myeloid ; immunology ; Leukemia, Myeloid, Acute ; immunology ; Leukemia, Promyelocytic, Acute ; immunology ; Male ; Middle Aged ; Proto-Oncogene Proteins c-kit ; analysis ; immunology ; Reproducibility of Results ; Sialic Acid Binding Ig-like Lectin 2 ; analysis ; immunology

RATIONALE AND OBJECTIVES

The burden of acute myeloid leukemia (AML) is felt worldwide with increasing number of diagnosed cases. A recommended treatment option for a longer remission is hematopoietic stem cell transplantation after chemotherapy with cytarabine and an anthracycline antibiotic, either Idarubicin or Daunorubicin. In the Philippines, Doxorubicin, a cheaper and more accessible option for chemotherapy among those who have financial incapabilities. It is no longer part of the National Comprehensive Cancer Network (NCCN) recommendation for use however; it remains to be part of the Philippine National Clinical Practice Guideline in the treatment of AML. This leads us to wonder what the difference in outcome of patients who have received doxorubicin compared to those who received Idarubicin as induction chemotherapy.

This is a retrospective cohort study. Data was collected through chart review of AML patients admitted for induction chemotherapy. Descriptive statistics was used to analyze the sociodemographic and clinical profile of patients. Survival analysis was done using the Kaplan-Meier computation. The t-test for two proportions was used to compare outcomes between the two groups.

This study included 65 participants, 55 received idarubicin and 10 received doxorubicin. The average age of diagnosis in the Idarubicin group is 41.38 years, and 34.9 years in the Doxorubicin group. Majority of participants are females (58.18% vs 80%) and married (67.27% vs 60%). They are predominantly nonsmokers (89.09% vs 80%), with no maintenance medications (61.82% vs 70%), and comorbidities (70.91% vs 90%). There was no significant difference in the median overall survival of both groups (507 days vs 428 days, logrank test = 0.74).

Outcomes of this study leads us to conclude that Doxorubicin is not inferior to Idarubicin in terms of survival.

We report a case of acute myelogenous leukemia (AML) developed in a human immunodeficiency virus-infected patient, which is a very rare event. The subtype of AML was initially determined as AML M6a (French-American-British classification), but it was transformed into AML M5b in the course of treatment. Blasts showed very intense staining with periodic acid-Schiff and multiple complex chromosomal abnormalities in the karyotype.
Chromosome Aberrations ; HIV ; Humans ; Karyotype ; Leukemia, Erythroblastic, Acute* ; Leukemia, Myeloid, Acute

No abstract available.
Humans ; Infant* ; Leukemia, Megakaryoblastic, Acute* ; Sarcoma, Myeloid*

Leukemia cutis, the specific infiltration of leukemia, can be seen in any leukemia, but, are especially common in the acute myelogenous leukemia M4 and M5 variants. It may clinically mimic many inflammatory dermatoses. We herein report a case of a 59-year-old man with acute monocytic leukemia who concurrently presented with various cutaneous manifestations that clinically resembled benign skin lesions such as rosacea, contact dermatitis, and milium. Histologic study of all the lesions revealed leukemia cutis of the monocytic type. We presented this case to illustrate how leukemia cutis can masquerade as clinically benign-appearing, cutaneous eruptions.
Dermatitis, Contact ; Humans ; Leukemia* ; Leukemia, Monocytic, Acute ; Leukemia, Myeloid, Acute ; Middle Aged ; Rosacea ; Skin ; Skin Diseases

During the neutropenic phase, leukemia patients receiving chemotherapy are prone to bacterial and, fungal infections; occasionally mycobacterial, viral and protozoal organisms may also cause infections. Mycobacterium tuberculosis infection was reported very rarely in these patients. This report describes four patients with M. tuberculosis infection identified from 185 adult patients who were diagnosed myelogenous leukemia between January 2003, and December 2004. There was no patient with M. tuberculosis infection from 44 lymphoid leukemia and 11 acute biphenotypic leukemia patients. Sites of infection were all lymph nodes. Three among four patients were presented with lymphadenopathy at initial diagnosis of leukemia, and the other one presented with lymphadenopathy after induction chemotherapy. There was no patient presented with lymphadenopathy during the neutropenic phase. Tuberculous lymphadenitis was presented in a patient with three acute myelogenous leukemia (FAB class 2 M4, 1 M2) and a chronic myelogenous leukemia, accelerated phase. An acute myelogenous leukemia patient had a leukemic cell and tubercle bacilli in the same lymph node. Tuberculosis should also be included as a differential diagnosis in myelogenous leukemia patient with lymphadenopathy, especially in the countries in which the disease is endemic.
Adult ; Diagnosis ; Diagnosis, Differential ; Drug Therapy ; Humans ; Induction Chemotherapy ; Leukemia ; Leukemia, Biphenotypic, Acute ; Leukemia, Lymphoid ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Leukemia, Myeloid* ; Leukemia, Myeloid, Acute ; Lymph Nodes ; Lymphatic Diseases ; Mycobacterium tuberculosis ; Tuberculosis ; Tuberculosis, Lymph Node*

During the neutropenic phase, leukemia patients receiving chemotherapy are prone to bacterial and, fungal infections; occasionally mycobacterial, viral and protozoal organisms may also cause infections. Mycobacterium tuberculosis infection was reported very rarely in these patients. This report describes four patients with M. tuberculosis infection identified from 185 adult patients who were diagnosed myelogenous leukemia between January 2003, and December 2004. There was no patient with M. tuberculosis infection from 44 lymphoid leukemia and 11 acute biphenotypic leukemia patients. Sites of infection were all lymph nodes. Three among four patients were presented with lymphadenopathy at initial diagnosis of leukemia, and the other one presented with lymphadenopathy after induction chemotherapy. There was no patient presented with lymphadenopathy during the neutropenic phase. Tuberculous lymphadenitis was presented in a patient with three acute myelogenous leukemia (FAB class 2 M4, 1 M2) and a chronic myelogenous leukemia, accelerated phase. An acute myelogenous leukemia patient had a leukemic cell and tubercle bacilli in the same lymph node. Tuberculosis should also be included as a differential diagnosis in myelogenous leukemia patient with lymphadenopathy, especially in the countries in which the disease is endemic.
Adult ; Diagnosis ; Diagnosis, Differential ; Drug Therapy ; Humans ; Induction Chemotherapy ; Leukemia ; Leukemia, Biphenotypic, Acute ; Leukemia, Lymphoid ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Leukemia, Myeloid* ; Leukemia, Myeloid, Acute ; Lymph Nodes ; Lymphatic Diseases ; Mycobacterium tuberculosis ; Tuberculosis ; Tuberculosis, Lymph Node*

BACKGROUND: Acute erythroleukemia (AEL), FAB-M6 is a rare heterogenous disorder diagnosed by myeloblasts more than 30% of nonerythroid cells (NEC). Pure erythroleukemia (Di Guglielmo disease) with an excess of proerythroblasts can be classified as MDS or M0. An aberration of the p53 gene in acute myelogenous leukemia is rare, but related to complex karyotypes with poor prognosis. METHODS: To evaluate heterogenous features, 32 cases of AEL or suspicious AEL were categorized as consisting of more than 50% erythroblasts and M6a with more than 30% myeloblasts of NEC, M6b with more than 30% proerythroblasts of all erythroblasts, and M6c with more than 30% both myeloblasts and proerythroblasts. The relation of the p53 protein overexpression and chromosomal abnormalities to AEL and these subtypes was investigated. RESULTS: There were 18 M6a, 6 M6b, and 8 M6c. The percentage of erythroblasts was M6a 58.7%, 77.7% M6b, and 67.2% M6c. The percentage of myeloblasts in NEC was M6a 53.6%, M6b 4.3%, and M6c 39.2%. The percentage of proerythroblasts in all erythroblasts was M6a 5.6%, M6b 56.2%, and M6c 34.1%. Survivals of M6b and M6c were significantly shorter than M6a (12.0 vs. 2.0 vs. 2.0 months, P=0.003). Five of 11 cases showed complex karyotypes (1 M6a, 2 M6b, 2 M6c), of -5, 5q-, -7, 7q-, -17 and/or 17p-, with shorter survival and poor response. The p53 protein overexpression was M6a 27.3%, M6b 100%, and M6c 83.3%. The p53 protein overexpression was positive in all 5 cases of multiple complex karyotype with frequent treatment failure or shorter survival, but was negative in 5 normal karyotypes. CONCLUSTIONS: The occurrence of complex karyotypes and aberration of the p53 gene frequently observed in M6b and M6c subtypes of acute erythroleukemia would be considered in establishing a new and innovative treatment to target neoplastic proerythroblasts that are resistant to standard therapy for acute myelogenous leukemia.
Chromosome Aberrations ; Erythroblasts ; Genes, p53 ; Granulocyte Precursor Cells ; Karyotype ; Leukemia, Erythroblastic, Acute* ; Leukemia, Myeloid, Acute ; Prognosis ; Treatment Failure