Cytogenetic studies, using improved short-term culture techniques, were performed on 64 patients with acute leukemia to determine the incidence and kinds of clonal karyotypic changes detectable with this newer methodology. An adequate number of analyzable mitoses was obtained from 59 patients. Clonal chromosomal alterations were found in 88% (52 of 59) of patients, as compared to approximately 50% in previous studies of acute leukemia in which conventional techniques were used. From our series, abnormal karyotypes were detected in 37 of 44 (84%) cases with primary acute nonlymphocytic leukemia, all 5 with secondary acute nonlymphocytic leukemia, and all 10 with acute lymphoblastic leukemia. Among the entire group of patients, several recurrent abnormalities were observed, e.g., -7 in eight cases, +8 in seven cases, t(15;17) in four cases, and t(8;21) or a variant of this translocation in four cases. In five patients, the only abnormality was a rather subtle structural rearrangement (e.g., tiny deletion). Five other patients had clonal changes which were found in less than 10% of the mitoses examined in each case. Our results indicate that most patients with acute leukemia, both acute nonlymphocytic leukemia and acute lymphoblastic leukemia, have clonal chromosome abnormalities associated with their disease.

Acute lymphocytic leukemia

Abnormality

Chromosome abnormality

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Citations (90)

Metastatic breast cancer: preliminary results with oral hormonal therapy.

PubMed (1985)

Joseph C. Allegra Joseph Bertino Philip Bonomi P. Byrne John T. Carpenter

Hormonal Therapy

Megestrol

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Citations (17)

All-trans retinoic acid in myelogenous leukaemia

The Lancet (1991)

RobertE. Gallagher P. H. Wiernik

10.1016/0140-6736(91)92442-5

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Citations (1)

Chemotherapy-induced scleroderma: a pleiomorphic syndrome

Clinical and Experimental Dermatology (2005)

Doru T Alexandrescu Niyati Bhagwati P. H. Wiernik

A scleroderma-like disease has recently been described in association with taxanes. We present the first case of diffuse scleroderma occurring in a woman treated with doxorubicin and cyclophosphamide for breast cancer. The clinical pattern of skin involvement and histological alterations were identical to those found in the classical form of scleroderma. Skin involvement progressed to affect 80% of total body area, and subsequently remained unchanged despite progression of the underlying cancer, making a paraneoplastic aetiology of the scleroderma unlikely. Specific chemotherapeutic agents might be directly responsible for the clinical manifestations and the parameters of progression. Analysis of all similar case reports defines the particular features and clinical course of this phenomenon.

Scleroderma (fungus)

10.1111/j.1365-2230.2004.01668.x

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Citations (33)

Surgery in acute leukemia: A review of 167 operations in thrombocytopenic patients

American Journal of Hematology (1987)

James F. Bishop CA Schiffer Joseph Aisner JP Matthews P. H. Wiernik

Abstract Of 435 consecutive patients with acute leukemia, 95 patients had 167 operations with a platelet count of < 100 × 10 9 /L and 130 operations with platelet counts of < 50 × 10 9 /L. Only 7% of operations had intraoperative blood loss of >500 ml, and 7% required >4 units of red cells transfused in the perioperative period. No patient died of bleeding attributable to surgery within 1 month of the operation. Granulocyte count was <0.5 × 10 9 /L in 66% of operations with 57% febrile preoperatively. However, no patient developed infection within the surgical field in the postoperative month. Logistic regression analyses were used to assess preoperative factors, which identified those operations at risk for excessive bleeding or postoperative surgical complications. Major (group 1) operations, preoperative fever, and preoperative coagulation abnormalities were associated with operations with an intraoperative blood loss >500 ml and/or perioperative red blood cell RBC transfusions >4 units ( P < .001). Surgery in cytopenic patients with acute leukemia is safe provided optimal supportive care is available.

10.1002/ajh.2830260205

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Citations (77)