Nouvelle revue francaise d'hematologie最新文献

Multiple myelomas occasionally exhibit bone marrow lesions simulating a concomitant chronic idiopathic myelofibrosis. In the present study, trephine biopsy histologies of such "myelofibrotic" myelomas are described and compared to those from a case of true chronic idiopathic myelofibrosis which developed in the course of chronic lymphocytic leukaemia. "Myelofibrotic" myeloma are characterized by osteosclerosis, marrow fibrosis and focal megakaryocytic hyperplasia in the presence of plasma cell infiltration of the bone marrow. These myelomas are to be distinguished from the more commonly occurring multiple myeloma with simple marrow fibrosis and/or osteosclerosis. Furthermore, "myelofibrotic" myelomas are not identical to myelomas coexisting with true chronic idiopathic myelofibrosis, a condition which would appear to be extremely rare and should only be diagnosed if focal megakaryocytic hyperplasia with atypia can be unequivocally demonstrated. Avoidance of misinterpretation of "myelofibrotic" myeloma requires a knowledge of these different myeloma variants.

Restoration of a haemocompatible surface after endothelial damage induced by treatments such as embolectomy, angioplasty, endarterectomy or irradiation or following vascular graft implantation is an important factor for the ultimate success of these interventions. The development of substances which enhance endothelial cell growth and accelerate their proliferation is therefore of great interest in such situations. In the present work naftazone was shown to accelerate human saphenous vein endothelial cell proliferation in vitro at concentrations which did not alter the hemostatic balance, resulting in a cell density at confluence 20% higher than in controls. This compound was able to partially substitute for serum requirements and further displayed additive effects in the presence of fibroblast growth factors. Thus naftazone, an original synthetic molecule distinct from growth factor peptides, is a promising candidate drug for the amelioration of vascular repair.

In the present report, we describe two cases of rare extramedullary relapse (skin, muscle) after allogeneic bone marrow transplantation (BMT). As both patients were male and had received sex mismatched (non T-depleted) BMT, marrow samples were analysed with a Y-chromosome specific probe allowing the sensitive detection of host DNA. The proportion of host DNA remained low in all post BMT samples from these patients, even at the time of extramedullary relapse.

The present report concerns a retrospective study of 16 patients with localized intermediate- or high-grade non-Hodgkin's lymphoma of the testis treated in one institution from 1973 to 1990. Ann Arbor stage of disease was IE in 11 and IIE in 5 cases. All except one patient underwent initial inguinal orchidectomy, 11 were disease free after surgery and 12 received inverted Y radiation therapy. All patients achieved a complete remission (CR). Relapse occurred in 8 of 9 patients who did not receive initial chemotherapy, but in only 3 of 7 patients initially treated with chemotherapy including anthracyclins. In 3 cases relapse was confined to the CNS, while diffuse relapse in 8 others included 4 cases of CNS involvement. Eight patients are now alive in CR (5 in first CR, 1 in second CR and 2 in third CR) with a median follow-up of 68.5 months (range 54-101). Chemotherapy thus emerges as the initial treatment of preference for localized testicular lymphoma. Therapy should be preceded by a thorough assessment of the stage of disease and due to the high frequency of CNS relapse, CNS prophylaxis should be considered for all patients.

Transplantation of autologous peripheral blood progenitor cells (PBPC) is now a well established method to reconstitute haematopoiesis after high-dose chemoradiotherapy. Allogeneic PBPCs have rarely been used as the sole measure to induce haematopoietic recovery after myeloablative therapy because of uncertainties regarding the durability of engraftment and the risk of acute and chronic graft-vs-host disease (GVHD). In addition, this technique requires the exposure of normal donors to granulocyte colony stimulating factor (G-CSF) in order to mobilise a sufficient number of PBPCs which can then be collected by leukapheresis. We report here our initial experience with allogeneic transplantation of PBPCs in order to demonstrate the feasibility and safety of harvesting sufficient numbers of PBPCs in healty donors. In addition, the early results presented in this communication show that allogeneic PBPCs can successfully be used to restore haematopoiesis in HLA-identical siblings of the donor without causing devastating graft-vs-host disease.

Clinical findings leading to the diagnosis of acute leukaemia result from the consequences of both pancytopenia and tumoral manifestations. Although leukaemic infiltration of hematopoietic organs is common, the involvement of non-hematopoietic abdominal organs remains rare. The authors report a series of six cases, where intra-abdominal localization of acute lymphoblastic or myeloblastic leukaemia was detected at diagnosis or relapse. Chemotherapy may lead to remission or cure if the early abdominal complications are managed with care.