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  • 11
    Electronic Resource
    Electronic Resource
    Springer
    Annals of hematology 67 (1993), S. 127-128 
    ISSN: 1432-0584
    Keywords: Myelodysplastic syndrome ; Reticulocytes ; Erythrocyte abnormalities
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A patient with a myelodysplastic syndrome (MDS) and reticulocytosis of 〉50% in the absence of a correspondingly increased erythrocyte turnover is reported. Evaluation of the kinetics of erythrocyte turnover revealed a decreased erythrocyte life span of 44 days. From these data a prolongation of the reticulocyte maturation time to 〉20 days can be concluded. The patient's erythrocytes lacked the increase of mean corpuscular volume and a significant increase of erythrocyte enzymes that would be expected in marked reticulocytosis. This finding suggests that the reticulocytes represented not newly formed red blood cells, but “pseudoreticulocytes”, i.e., mature erythrocytes that retained their substantia reticulofilamentosa.
    Type of Medium: Electronic Resource
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  • 12
    ISSN: 1432-0584
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 13
    Electronic Resource
    Electronic Resource
    Springer
    Annals of hematology 56 (1988), S. 45-46 
    ISSN: 1432-0584
    Keywords: Haemolytic anaemia ; Wilson's disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Common manifestations of Wilson's disease are disorders of the liver and brain. A rare complication of this inherited disease is acute intravascular haemolytic anaemia. We report the case of a 33-year old female patient who was admitted to the hospital with acute haemolysis as the initial symptom of Wilson's disease. The haemolysis preceded the definitive diagnosis by 20 months. It is concluded that in any case of unclear haemolytic anaemia, especially in adolescents or in young adults, Wilson's disease should be considered.
    Type of Medium: Electronic Resource
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  • 14
    ISSN: 1432-0584
    Keywords: Key words De novo AML ; Adults ; HD-Ara-C/DNR consolidation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  A total of 149 consecutive de novo AML patients aged 50 years or less (median age = 37 years) were enrolled in this prospective multicenter trial initiated in May 1985. All patients received the same induction and early consolidation therapy with daunorubicin (DNR), cytosine arabinoside (Ara-C), and etoposide (DAV). High-dose Ara-C/DNR therapy included Ara-C at 3 g/m2, in 12 doses (HD-Ara-C/DNR I) and eight doses (HD-Ara-C/DNR II), followed by DNR 30 mg/m2 for 3 days. A complete remission (CR) was achieved in 104 (70%) patients; 61 complete responders received at least one cycle with HD-Ara-C/DNR. If those patients who were transplanted in first CR (n = 26), were not considered, the median relapse-free-survival (MRFS) of the remaining 78 patients was 15 months, with a probability of relapse-free survival (RFS) at 116 months of 30% (95% CI, 20–40%) after a median follow-up of 95 months. The MRFS of the HD-Ara-C/DNR consolidated patients was 25 months, with a probability of RFS at 116 months of 37% (95% CI, 24–50%). If all patients who were transplanted (n = 44) were not considered, the median survival time (MST) was 18 months with a probability of being alive at 118 months of 24% (95% CI, 16–33%). MST of the HD-Ara-C/DNR consolidated patients was 58 months with a survival probability of 46% (95% CI, 31–60%) at 118 months. Prognostic factor analysis did not reveal any significant influence of age, sex, FAB subtype, white blood cell count, hemoglobin level, thrombocyte count, LDH, or response to the first induction course on RFS of the HD-Ara-C/DNR consolidated patients. In summary, HD-Ara-C/DNR consolidation can improve the long-term outcome of a subgroup of de novo AML patients. Further improvement of the outcome seems to depend on the identification of patients with an inferior outcome under that strategy who might benefit from alternative treatment strategies.
    Type of Medium: Electronic Resource
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  • 15
    ISSN: 1432-0584
    Keywords: De novo AML ; Adults ; HD-Ara-C/DNR consolidation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A total of 149 consecutive de novo AML patients aged 50 years or less (median age = 37 years) were enrolled in this prospective multicenter trial initiated in May 1985. All patients received the same induction and early consolidation therapy with daunorubicin (DNR), cytosine arabinoside (Ara-C), and etoposide (DAV). High-dose Ara-C/DNR therapy included Ara-C at 3 g/m2, in 12 doses (HD-Ara-C/DNR I) and eight doses (HD-Ara-C/DNR II), followed by DNR 30 mg/m2 for 3 days. A complete remission (CR) was achieved in 104 (70%) patients; 61 complete responders received at least one cycle with HD-Ara-C/DNR. If those patients who were transplanted in first CR (n=26), were not considered, the median relapsefree-survival (MRFS) of the remaining 78 patients was 15 months, with a probability of relapse-free survival (RFS) at 116 months of 30% (95% CI, 20–40%) after a median follow-up of 95 months. The MRFS of the HD-Ara-C/DNR consolidated patients was 25 months, with a probability of RFS at 116 months of 37% (95% CI, 24–50%). If all patients who were transplanted (n=44) were not considered, the median survival time (MST) was 18 months with a probability of being alive at 118 months of 24% (95% CI, 16–33%). MST of the HD-Ara-C/DNR consolidated patients was 58 months with a survival probability of 46% (95% CI, 31–60%) at 118 months. Prognostic factor analysis did not reveal any significant influence of age, sex, FAB subtype, white blood cell count, hemoglobin level, thrombocyte count, LDH, or response to the first induction course on RFS of the HD-Ara-C/DNR consolidated patients. In summary, HD-Ara-C/DNR consolidation can improve the long-term outcome of a subgroup of de novo AML patients. Further improvement of the outcome seems to depend on the identification of patients with an inferior outcome under that strategy who might benefit from alternative treatment strategies.
    Type of Medium: Electronic Resource
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  • 16
    Electronic Resource
    Electronic Resource
    Springer
    Infection 11 (1983), S. 170-172 
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung An zwei Kasuistiken von Mucormykose bei Patienten mit akuten Leukämien werden die typischen Symptome und Verläufe dieser Infektion bei infektabwehrgeschwächten Patienten dargestellt. Bei diesen Patienten tritt vorwiegend die pulmonale oder disseminierte Form der Mucormykose auf, die meist rasch tödlich verläuft. Die Diagnose ist schwierig, da ein mikrobiologischer Nachweis aus Sputum oder Blut nur selten gelingt. Der Verdacht auf das Vorliegen einer Mucormykose oder einer anderen Pilzinfektion sollte insbesondere dann aufkommen, wenn bei einem Patienten mit einer Abwehrschwäche eine Infektion auf eine adäquate antibiotische Therapie nicht anspricht.
    Notes: Summary We are presenting two typical case histories of mucormycosis in patients with acute leukaemia which illustrate some of the important features of this infection in compromised hosts. In such patients, mucormycosis is mostly pulmonary or widely disseminated and often has a rapidly fatal course. A microbiological diagnosis from blood or sputum is difficult to establish. Mucormycosis or other fungal infections should be suspected in compromised patients with infections which do not respond to adequate antibiotic therapy.
    Type of Medium: Electronic Resource
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  • 17
    ISSN: 1432-1440
    Keywords: Germ cell tumors ; Gonadal toxicity ; Chemotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The impact of aggressive chemotherapy on reproductive and endocrine gonadal function was prospectively studied in 44 patients with germ cell tumors. Diagnostic procedures to determine gonadal toxicity consisted of hormone determinations, semen analyses, interviews with a standardized questionnaire, and gonadal histology. After chemotherapy all patients showed elevated serum levels of follicle-stimulating hormone (FSH) and azoospermia due to germ cell and stem cell loss. Recovery of spermatogenesis, as indicated by normalization of serum FSH levels and sperm density, occurred in 77% of the patients 25–60 months after cessation of chemotherapy. In all patients serum testosterone and luteinizing hormone (LH) values remained within normal limits after therapy indicating resistance of Leydig cells to cytotoxic drugs. Three patients fathered four healthy children after completion of chemotherapy. These data suggest significant reproductive dysfunction in all men treated for germ cell tumors. However, most patients showed late and complete recovery of spermatogenesis. In contrast, endocrine gonadal function was unaffected after chemotherapy in all patients. FSH and LH are feasible markers to assess drug-induced gonadal toxicity.
    Type of Medium: Electronic Resource
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  • 18
    ISSN: 1432-1440
    Keywords: Bone marrow transplantation ; Aplastic anaemia ; Acute leukaemia ; Chronic granulocytic leukaemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary From 1972–1983 53 patients underwent bone marrow transplantation. The median age was 18 years (3–41). 27 patients suffered from severe aplastic anaemia, 22 patients had acute leukaemia and 4 patients had chronic granulocytic leukaemia in chronic phase. Out of 22 patients with acute leukaemia, 2 had florid leukaemia, 2 had an early relapse and 18 patients were in first or second remission of their disease. 2/53 patients received a syngeneic transplant, 51/53 patients an allogeneic transplant. 47/51 patients had a HLA-A, B, C-identical, MLC-negative sibling donor, 1/51 had a HLA-A, B-C-identical, MLC-positive sibling donor, 2/51 a HLA-phaenotypical identical parental donor and 1/51 a HLA-identical, MLC-negative unrelated donor. The comparison of the results obtained in patients with severe aplastic anaemia transplanted from 1972–1979 with those transplanted from 1980–1983 shows that the bone marrow transplantation has to be performed in an early stage of the disease before the patients become multiple transfused, sensitized and severely infected and that the conditioning regimen for polytransfused patients has to be more intensive than in untransfused patients. From the patient group transplanted 1972–1979, only 1/14 patients is a long-term survivor in contrast to 8/13 patients transplanted from 1980–1983. 11/22 patients with acute leukaemia are alive between more than 5 years and 14 days after bone marrow transplantation. Only 1/4 patients, who were transplanted not in remission, is alive. For patients with acute leukaemia the bone marrow transplantation should be performed in an early stage of their disease when the tumor burden is small and when the patients are in good clinical condition. 2/4 patients with CGL are alive between 12 months and 3 months after bone marrow transplantation. In our patient group graft versus host disease was the most important problem with a high mortality due to GvHD associated infections.
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  • 19
    Electronic Resource
    Electronic Resource
    Springer
    Infection 19 (1991), S. 201-204 
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung In einer Universitätsklinik wurde während eines Zeitraumes von sechs Jahren bei 23 PatientenCorynebacterium jeikeium aus Blutkulturen isoliert.C. jeikeium-Bakteriämien traten weder zeitlich noch örtlich gehäuft auf. Die retrospektive Analyse der Patientendaten zeigte, daß in den meisten Fällen eine maligne hämatologische Grunderkrankung mit Neutropenie vorlag, ein zentral-venöser Katheter implantiert und eine antibiotische Therapie vorausgegangen war. Die Patientenpopulation mit nur einer positiven Blutkultur unterschied sich in wichtigen Aspekten von derjenigen mit mehreren positiven Blutkulturen. So waren Patienten mit nur einer positiven Blutkultur seltener an akuter Leukämie erkrankt, hatten signifikant höhere neutrophile Granulozytenkonzentrationen im peripheren Blut und waren zuvor über einen kürzeren Zeitraum antibiotisch behandelt worden. Weiterhin fanden sich in dieser Patientengruppe in allen Fällen andere mögliche Ursachen der Fieberepisoden. Auch die Mortalität war deutlich geringer. Trotz des zunehmend häufigeren Nachweises vonCorynebacterium jeikeium in Blutkulturen bleiben schwere Infektionen durch diesen Erreger weiterhin meist auf die Patientenpopulation mit hämatologischer Grunderkrankung und Neutropenie beschränkt.
    Notes: Summary During a six-year period 23 patients with isolation ofCorynebacterium jeikeium (formerly known asCorynebacterium group JK) from one or more blood cultures at a university hospital were identified. Cases occurred sporadically without time- or ward-related clustering. Review of the cases showed that most infections were nosocomial, that most of the patients had underlying malignant disease, had a chronic intravascular catheter implanted, had been pretreated with antibiotics, and were neutropenic at the time the blood cultures were drawn. Patients with only one versus those with more than one positive blood culture differed in some important aspects. Patients with only one positive blood culture were less likely to have acute leukemia, had significantly higher neutrophil counts and a shorter duration of preceding antibiotic treatment, and all had other probable causes of infection and fever. The mortality also appeared to be lower in these patients. Despite the possibility of increasing frequency of blood cultures positive forC. jeikeium, severe infections due to this organism continue to be largely confined to neutropenic patients with hematologic malignancy.
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  • 20
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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