Normal chemotactic activity of granulocytes obtained by filtration leucapheresis

The chemotactic activity of granulocytes obtained by the Terumo Filtration Leucapheresis System (F.L.) was examined by the method of Boyden's chamber. The number of cells migrating through the Millipore filter was expressed as the chemotactic activity. The mean values were 117 for the F.L. and 122 in a control, in which cells were collected from the same donor blood using dextran sedimentation. The results suggested that the in vitro chemotactic function of granulocytes obtained by F.L. was within normal limits.</p

STUDIES ON THE LONG-TERM SURVIVORS IN CHRONIC MYELOGENOUS LEUKEMIA AND THE CHEMOTHERAPY OF ITS BLASTIC PHASE Part 1 Studies on the long-term survivors in chronic myelogenous leukemia in Japan

In order to search for the factors prolonging life span of chronic myelogenous leukemia(CML), the survey of long-term survivors in Japan was attempted for the first time. CML patients surviving over 7 years from the initial diagnosis were surveyed by sending inquiring cards to 1,197 hospitals with more than 200 beds and the following results were obtained: 1) Seventy cases of long term-survivors in CML over 7 years, were collected by the end of March 1977, when 29 cases of them had been alive. The longest one survived 21.3 years after the initial diagnosis. 2) The annual incidence has tended to be increased since around 1963. 3) As for host factors, i) No difference in sex; ii) Age ranged from 14 to 70 years old with the highest incidence of 30-34, iii) Included were 11 cases of atomic-bomb survivors; about one half might be diagnosed at the early stage through regular health check. 4) As for tumor factors, leuko-, erythro- and thrombocyte counts and myeloblasts plus promyelocytes percentages in peripheral blood and bone marrow at initial diagnosis did not significantly differ between long-term survivors and randomlychosen control group died of CML within 7 years. Only splenomegaly at the diagnosis was significantly less in long-term survivors than that in controls. All 23 cases with chromosome analyzed were Ph(1) positive. 5) As for drugs, out of 27 cases, of whom all drugs given in the chronic phase were precisely recorded, 9 were treated with busulfan alone throughout course and 5 with busulfan and 6-MP alternately. 6-MP was given at least once in the chronic phase to 10 cases and adrenocorticosteroid to 3 cases. Eleven of 32 cases survived over 10 years without treatment over 5 years, suggesting an unusually-high sensitivity of leukemic cells in these cases to antileukemic agents. 7) Of 70 cases, 41 had already died by the time of the present survey. Thirty of 41 (79.2%) had died of blastic crisis. Median survival after blast crisis of these 30 cases was only 3.7 months. 8) In conclusion, specific factors frequently observed in long-term survivors in CML are: i) low grade of splenomegaly at the diagnosis, ii) high sensitivity of leukemic cells to antichemotherapeutics including busulfan, and iii) either an alternate use of busulfan and 6-MP or steroid on the CML patients in chronic phase. Evaluation of the effect of 6-MP or steroid on CML patients in chronic phase for prolonging life span should be comfirmed in future

STUDIES ON THE LONG-TERM SURVIVORS IN CHRONIC MYELOGENOUS LEUKFMIA AND THE CHEMOTHERAPY OF ITS BLASTIC PHASE Part 2 Studies on the Chemotherapy of Blastic Phase of CML

To improve the effect of chemotherapy of chronic myelogenous leukemic(CML) in blastic phase, the following clinical analysis were conducted. 1) The present study consisted of 53 adult patients with CML, who were registered to the 2nd Department of Medicine, Okayama University Hospital and diagnosed as blastic phase between from January 1970 to March 1980. There were 29 males and 24 females, and age ranged from 15 to 77 years (median: 41). 2) These 53 patients were divided into 4 groups. i) Group I-A (5 cases) was diagnosed as blastic crisis(BC) with hiatus leukemicus(HL) and initially treated with multicombination chemotherapy such as NCD, DMP or NCDP regimens (N: Neocarzinostatin, C: Cytosine arabinoside, D: Daunorubicin, M; 6-Mercaptopurine, P: Prednisolone). ii) Group I-B (16 cases) was diagnosed as BC with HL and initially treated with VP or VPM regimens (V: Vincristine, P: Prednisolone, M: 6-Mercaptopurine). iii) Group II-A (11 cases) was early diagnosed as BC without HL according to our established criteria, and initially treated with multicombination chemotherapy such as NCMP, DCMP, NDMP, NCDP or NCDVP. and, iv) Group II-B (21 cases) was early diagnosed as BC without HL and initially treated with VP, MP, or VPM. 3) Complete remission(CR) rate of each group was 20.0% in Group I-A, 56.2% in Group I-B, 27.3% in Group II-A and 47.6% in Group II-B. 4) Median survival and its surviving ranges after BC of each group were 3.6 months (1.8-4.5), 6.7 (1.0-24.2), 6.0 (2.6-22.8) and 13.0 (4.1-43.5). Median survival of CR-responders was 3.6, 10.0, 8.7 and 17.0 months, respectively. 5) The rate of one-year survivors of each group was 0%, 31.3% 9.1% and 52.4%. 6) In conclusion, the most ideal approach to prolongation of the survival period of CML patients after entering BC is i) to diagnose BC as early and accurate as possible, and ii) to treat these patients initially with rather mild regimens such as VP or VPM, instead of aggressive regimens with multicombination drugs