Post-remission treatment of acute myelogenous leukemia

Acute myelogenous leukemia (AML) is characterized by both an increase in the number of white cells and arrest of their normal maturation and function, which causes anemia, granulocytopenia, and thrombocytopenia. The goal of treatment is to eliminate all neoplastic hematopoietic cells in the marrow, peripheral blood, and elsewhere. This goal can be accomplished in some but not all adult patients with AML through the use of two distinct, consecutive phases of treatment. The combination chemotherapy administered during the first phase in a patient with newly diagnosed AML is intended to induce a complete remission, a condition in which leukemic cells can no longer be identified by cytologic, immunologic, or cytogenetic methods and the patient's peripheral-blood counts have become normal. The second phase of treatment (post-remission treatment) is designed to eradicate any residual leukemic cells anywhere. Thus, post-remission treatment should prevent relapse and improve survival. The development of better post-remission therapies in recent years has received much attention

Phagocytic plasma cells in a patient with multiple myeloma

Phagocytosis of blood cells by malignant plasma cells in multiple myeloma is an extremely rare condition. Here we present a 39-year-old woman with multiple myeloma. Bone marrow smear showed an extensive phagocytosis of erythrocytes and platelets by myeloma cells

Anaemia of chronic disease in rheumatoid arthritis - Raised serum interleukin-6 (IL-6) levels and effects of IL-6 and anti-IL-6 on in vitro erythropoiesis

Serum and bone marrow from 21 patients with rheumatoid arthritis (RA) were studied in order to establish the pathogenetic role of interleukin-6 (IL-6) in anemia of chronic disease (ACD). Erythroid colony growth, using burst forming units of erythroblasts (BFUe) as a parameter, was impaired in ACD and not in nonanemic RA controls. Serum IL-6 was elevated in ACD and it correlated well with parameters of disease activity such as erythrocyte sedimentation rate and C-reactive protein. IL-6 addition to bone marrow cultures had inconsistent effects while anti-IL-6 addition resulted in impaired erythroid colony growth, suggesting stimulatory effects of IL-6 produced in the medium, which may be masked by simultaneous production of cytokines with suppressive effects. It was concluded that elevated serum IL-6 in ACD reflects disease activity. It probably plays no pathogenetic role in ACD. Its stimulatory effects on erythroid growth might counteract suppressive effects of other interleukins

CD20 and CD40 mediated mitogenic responses in B-lineage acute lymphoblastic leukaemia

Activation of CD20, a cross-membrane ion channel, induces cell cycle progression from G0 to G1 in B lymphocytes. Subsequent activation of CD40, a membrane receptor of the nerve growth factor receptor superfamily, transits the B cells to the S phase. CD40 may also act synergistically in combination with IL-4 (B lymphocytes) or IL-3/IL-7 (B-cell precursors). We investigated the proliferative responses of B-lineage acute lymphoblastic leukaemia (ALL) cells to CD20/CD40 activation. In 18/56 ALL cases, CD20 activation resulted in significant increases in DNA synthesis. Similar, although more moderate, effects were seen of activation of CD40 in 10/44 cases. Responses to CD20 or CD40 activation were independent of co-stimulation with IL-3, IL-4 or IL-7, and various cocktails of the different growth stimuli did not act synergistically