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Clinics (Sao Paulo, Brazil) Mar 2015To compare the characteristics of tubercular vs. leukemic involvement of abdominopelvic lymph nodes using multidetector computed tomography (CT). (Comparative Study)
Comparative Study
PURPOSE
To compare the characteristics of tubercular vs. leukemic involvement of abdominopelvic lymph nodes using multidetector computed tomography (CT).
MATERIALS AND METHODS
We retrospectively reviewed multidetector computed tomography features including lymph node size, shape, enhancement patterns, and anatomical distribution, in 106 consecutive patients with newly diagnosed, untreated tuberculosis (55 patients; 52%) or leukemia (51 patients; 48%). In patients with leukemia, 32 (62.7%) had chronic lymphocytic leukemia, and 19 (37.3%) had acute leukemias; of these, 10 (19.6%) had acute myeloid leukemia, and 9 (17.6%) had acute lymphocytic leukemia.
RESULTS
The lower para-aortic (30.9% for tuberculosis, 63.2% for acute leukemias and 87.5% for chronic lymphocytic leukemia) and inguinal (9.1% for tuberculosis, 57.9% for acute leukemias and 53.1% for chronic lymphocytic leukemia) lymph nodes were involved more frequently in the three types of leukemia than in tuberculosis (both with p <0.017). Tuberculosis showed peripheral enhancement, frequently with a multilocular appearance, in 43 (78.2%) patients, whereas patients with leukemia (78.9% for acute myeloid leukemia and acute lymphocytic leukemia, 87.5% for chronic lymphocytic leukemia) demonstrated predominantly homogeneous enhancement (both with p <0.017). For the diagnosis of tuberculosis, the analysis showed that a peripheral enhancement pattern had a sensitivity of 78.2%, a specificity of 100%, and an accuracy of 88.7%. For the diagnosis of leukemia, the analysis showed that a homogeneous enhancement pattern was associated with a sensitivity of 84.3%, a specificity of 94.5%, and an accuracy of 89.6%.
CONCLUSION
Our findings indicate that the anatomical distribution and enhancement patterns of lymphadenopathy seen on multidetector computed tomography are useful for differentiating between untreated tuberculosis and leukemia of the abdominopelvic lymph nodes.
Topics: Abdomen; Adolescent; Adult; Aged; Contrast Media; Diagnosis, Differential; Female; Humans; Leukemia; Male; Middle Aged; Multidetector Computed Tomography; Pelvis; Reproducibility of Results; Retrospective Studies; Sensitivity and Specificity; Tuberculosis, Lymph Node; Young Adult
PubMed: 26017645
DOI: 10.6061/clinics/2015(03)02 -
British Journal of Haematology Jan 2020Acute myeloid leukaemia (AML) is a blood cancer characterized by acquired genetic mutations. There is great interest in accurately establishing measurable residual... (Review)
Review
Acute myeloid leukaemia (AML) is a blood cancer characterized by acquired genetic mutations. There is great interest in accurately establishing measurable residual disease (MRD) burden in AML patients in remission after treatment but at risk of relapse. However, inter- and intrapatient genetic diversity means that, unlike in the chronic myeloid and acute promyelocytic leukaemias, no single genetic abnormality is pathognomonic for all cases of AML MRD. Next-generation sequencing offers the opportunity to test broadly and deeply for potential genetic evidence of residual AML, and while not currently accepted for such use clinically, is likely to be increasingly used for AML MRD testing in the future.
Topics: Hematologic Neoplasms; High-Throughput Nucleotide Sequencing; Humans; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Leukemia, Promyelocytic, Acute; Neoplasm, Residual
PubMed: 31804716
DOI: 10.1111/bjh.16362 -
British Journal of Haematology May 2007Chemokine (C-X-C motif) receptor 4 (CXCR4) is essential for homing and maintenance of haematopoietic stem cells in distinct stromal cell niches within the marrow.... (Review)
Review
Chemokine (C-X-C motif) receptor 4 (CXCR4) is essential for homing and maintenance of haematopoietic stem cells in distinct stromal cell niches within the marrow. Chemotactic responsiveness of haematopoietic stem cells is restricted to the ligand for CXCR4, stromal cell-derived factor-1 (SDF-1/CXCL12), which is constitutively secreted by marrow stromal cells. Myeloid and lymphoid leukaemia cells also express CXCR4 that induces leukaemia cell chemotaxis and migration beneath marrow stromal cells. CXCR4 expression levels have a major prognostic impact in acute myeloid leukaemia. There is growing in vitro and in vivo evidence that CXCR4 expression by leukaemia cells allows for homing and their retention within the marrow. As such, leukaemia cells appear to utilise CXCR4 to access niches that are normally restricted to progenitor cells, and thereby reside in a microenvironment that favours their growth and survival. CXCR4- and integrin-mediated contact between leukaemia cells and stromal cells protects leukaemia cells from spontaneous and chemotherapy-induced cell death and therefore may represent a mechanism to explain minimal residual disease and subsequent relapses commonly seen in the treatment of these diseases. This review summarises our current knowledge regarding the importance of CXCR4 in acute and chronic leukaemia, discusses the importance of CXCR4 detection by flow cytometry in the diagnostic workup of leukaemia patients, and introduces the potential role of CXCR4-targeting compounds for the treatment of leukaemia patients.
Topics: Acute Disease; Bone Marrow; Cell Communication; Chemotaxis, Leukocyte; Chronic Disease; Flow Cytometry; Humans; Leukemia; Receptors, CXCR4; Receptors, Lymphocyte Homing
PubMed: 17456052
DOI: 10.1111/j.1365-2141.2007.06590.x -
Cancer Control : Journal of the Moffitt... 2004Malignant stem cells have been identified in acute myelogenous leukemia, chronic myeloid leukemia, and some types of acute lymphoblastic leukemia. Like normal stem... (Review)
Review
BACKGROUND
Malignant stem cells have been identified in acute myelogenous leukemia, chronic myeloid leukemia, and some types of acute lymphoblastic leukemia. Like normal stem cells, these leukemic stem cells (LSCs) are able to self-renew, differentiate, and proliferate extensively. Evidence suggests that LSCs are critical for the initiation and perpetuation of leukemic disease.
METHODS
We reviewed the literature describing the characteristic features of LSCs in various leukemias and the novel molecular approaches being used to specifically ablate the LSC population.
RESULTS
Studies have demonstrated the potential importance of ablating LSCs when treating leukemia. The unique characteristics of LSCs that differentiate them from their normal counterparts can be exploited to specifically target the malignant population.
CONCLUSIONS
Current therapeutic strategies may not effectively ablate the LSC, leaving the potential for disease progression or relapse. A better understanding of LSC cell and molecular biology will allow the design of more effective therapies.
Topics: Antibodies, Monoclonal; Antineoplastic Agents; Drug Evaluation; Enzyme Inhibitors; Humans; Leukemia; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Leukemia, Myeloid, Acute; Neoplastic Stem Cells; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Treatment Outcome
PubMed: 15024346
DOI: 10.1177/107327480401100216 -
Canadian Medical Association Journal Jun 1967Certain aspects of the chronic leukemias that may influence future therapeutic trials are reviewed. In chronic lymphocytic leukemia (CLL), there is minimal mitotic... (Review)
Review
Certain aspects of the chronic leukemias that may influence future therapeutic trials are reviewed. In chronic lymphocytic leukemia (CLL), there is minimal mitotic activity in lymphoid tissues; indolent, long-lived lymphocytes, unresponsive to antigenic or phytohemagglutinin (PHA) stimulation accumulate. In many patients, erythroid precursors fail to proliferate despite the stimulus of a severe anemia, but a proliferative response can be initiated by prednisone. We need to know how the normal proliferative responses of these cells are modified, because the correction of these abnormalities would relieve most of the disease manifestations. CLL may not be a neoplastic disorder. In chronic myelogenous leukemia (CML), the leukocyte doubling time shortens as the disease duration lengthens; a significant correlation between this time and survival is demonstrated. Before therapy designed to eliminate the Ph(1)-positive (Philadelphia chromosome) stem cell is tried, we need to know whether a normal hematopoietic stem cell exists in Ph(1)-positive CML.
Topics: Adolescent; Adult; Aged; Child; Humans; Leukemia, Lymphoid; Leukemia, Myeloid; Middle Aged
PubMed: 5338329
DOI: No ID Found -
Best Practice & Research. Clinical... Mar 2010Patients with B-chronic lymphocytic leukaemia /small lymphocytic lymphoma (CLL) have a 5-10% risk of developing autoimmune complications, which primarily cause... (Review)
Review
Patients with B-chronic lymphocytic leukaemia /small lymphocytic lymphoma (CLL) have a 5-10% risk of developing autoimmune complications, which primarily cause cytopaenia. These autoimmune cytopaenias can occur at any stage of CLL and do not have independent prognostic significance. The most common autoimmune complication is autoimmune haemolytic anaemia with a lower frequency of immune thrombocytopaenia and pure red blood cell aplasia and only rarely, autoimmune granulocytopaenia (AIG). Autoimmune cytopaenia should always be considered in the differential diagnosis of cytopaenia in patients with CLL. Patients with CLL can also have more than one form of autoimmune cytopaenia, which can occur together with bone-marrow failure. Treatment is usually effective but rarely curative for autoimmune cytopaenia complicating CLL. Optimal therapy will depend on a timely and accurate diagnosis of autoimmune cytopaenia and should be individualised according to the severity of the cytopaenia and the presence or absence of concomitant progressive CLL requiring therapy.
Topics: Autoimmune Diseases; Humans; Leukemia, Lymphocytic, Chronic, B-Cell
PubMed: 20620970
DOI: 10.1016/j.beha.2010.01.004 -
Blood Aug 1982A small proportion of patients with acute or chronic leukemia has an extraordinarily high blood leukocyte count. These high counts can result in a very high fractional... (Review)
Review
A small proportion of patients with acute or chronic leukemia has an extraordinarily high blood leukocyte count. These high counts can result in a very high fractional volume of leukocytes (leukocrit), which is also a function of the mean leukocyte volume in different types of leukemia. Despite a high fractional volume of leukocytes, bulk viscosity of blood is usually not increased because a decrement in the fractional volume of erythrocytes accompanies the increase in leukocytes. Nevertheless, the excessive numbers of leukocytes present two major problems: first, they can seriously affect flow in the circulation of the lung, brain, and less often, other organs by obstructing microchannels or by forming aggregates and white thrombi in small veins. Moreover, leukemic blasts may compete for oxygen in the microcirculation and they may be invasive, damaging vessel walls. Second, their rapid destruction in response to cytotoxic drugs causes metabolic disturbances, especially uric acid accumulation, which can lead to obstructive uropathy.
Topics: Adolescent; Allopurinol; Antineoplastic Agents; Blood Flow Velocity; Blood Viscosity; Cerebrovascular Circulation; Child; Child, Preschool; Exchange Transfusion, Whole Blood; Hematocrit; Humans; Hyperkalemia; Leukapheresis; Leukemia; Leukocyte Count; Leukocytosis; Microcirculation; Oxygen Consumption; Pulmonary Circulation; Uric Acid
PubMed: 7046844
DOI: No ID Found -
BMJ Case Reports Apr 2021A 38-year-old man presented with mild blurring of vision in both eyes for the past 1 week. On examination, the retinal vessels were dilated and tortuous, along with...
A 38-year-old man presented with mild blurring of vision in both eyes for the past 1 week. On examination, the retinal vessels were dilated and tortuous, along with multiple dot blot haemorrhages all over the fundus with yellowish white focal retinal infiltrates at the macula temporal to the fovea. The salmon pink discolouration of the blood column made us look at the peripheral blood smear, which was suggestive of chronic myeloid leukaemia, leading to a diagnosis of leukaemic retinopathy in both the eyes.
Topics: Adult; Fovea Centralis; Humans; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Male; Retina; Retinal Diseases; Retinal Vessels
PubMed: 33883106
DOI: 10.1136/bcr-2020-237662 -
Blood Sep 2000Angiogenesis has been associated with the growth, dissemination, and metastasis of solid tumors. The aims of this study were to evaluate the vascularity and the levels...
Angiogenesis has been associated with the growth, dissemination, and metastasis of solid tumors. The aims of this study were to evaluate the vascularity and the levels of angiogenic factors in patients with acute and chronic leukemias and myelodysplastic syndromes (MDS). The numbers of blood vessels were measured in 145 bone marrow biopsies and the levels of vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), tumor necrosis growth factor-alpha (TNF-alpha), tumor growth factor-alpha (TGF-alpha), and hepatocyte growth factor (HGF) were determined in 417 plasma samples. Except for chronic lymphocytic leukemia (CLL), vascularity was significantly higher in all leukemias and MDS compared with control bone marrows. The highest number of blood vessels and largest vascular area were found in chronic myeloid leukemia (CML). VEGF, bFGF, and HGF plasma levels were significantly increased in acute myeloid leukemia (AML), CML, CLL, chronic myelomonocytic leukemia (CMML), and MDS. HGF, TNF-alpha, and bFGF but not VEGF were significantly increased in acute lymphoblastic leukemia (ALL). TNF-alpha levels were significantly increased in all diseases except for AML and MDS. No significant increase was found in TGF-alpha in any leukemia or MDS. The highest plasma levels of VEGF were in CML, and the highest plasma levels of bFGF were in CLL. The levels of HGF were highest in CMML. These data suggest that vascularity and angiogenic factors are increased in leukemias and MDS and may play a role in the leukemogenic process.
Topics: Acute Disease; Chronic Disease; Endothelial Growth Factors; Fibroblast Growth Factor 2; Hepatocyte Growth Factor; Humans; Leukemia; Lymphokines; Myelodysplastic Syndromes; Neovascularization, Pathologic; Vascular Endothelial Growth Factor A; Vascular Endothelial Growth Factors
PubMed: 10979972
DOI: No ID Found -
Medecine Sciences : M/S Feb 2003Oncogenes involved in the development of hematological malignancies were first discovered through the study of experimental leukemias induced in animals by retroviruses.... (Review)
Review
Oncogenes involved in the development of hematological malignancies were first discovered through the study of experimental leukemias induced in animals by retroviruses. The discovery that some of these genes were located at the breakpoints of chromosome rearrangements in human malignancies, such as the MYC gene in Burkitt's lymphoma and the ABL gene in chronic myeloid leukemia (CML) has suggested that chromosome abnormalities were causally implicated in the pathogenesis of human diseases. Numerous nonrandom somatically acquired chromosomal translocations or inversions have been identified in human leukemias. The molecular cloning of the genes located at the breakpoints of these rearrangements allowed to identify more than 100 new oncogenes, the products of which affect normal programs of cell proliferation, differentiation and survival. Chromosome translocations can lead to the deregulated expression of a normal gene product, but in most cases of leukemia, chromosome rearrangements result in the expression of a chimeric fusion protein. Oncogene products associated with acute leukemias are often transcription factors while tyrosine kinases and antiapoptotic proteins are more commonly activated or overexpressed in chronic leukemias and in lymphomas. Recent data indicated that gene rearrangements were not the sole gene alterations occurring in human leukemia since point mutations could also affect the function of transcription factors playing a key role in hematopoiesis such as C/EBP alpha, GATA1 and AML1. But the most exciting finding was the discovery of activating point mutations in tyrosine kinase receptors such as FLT3 and c-KIT in acute leukemia. Treatment of leukemia could therefore benefit from new therapeutic approaches targeting the function of specific oncogene products as already demonstrated for CML and acute promyelocytic leukemia.
Topics: Cytogenetics; History, 20th Century; Humans; Leukemia; Oncogenes
PubMed: 12836614
DOI: 10.1051/medsci/2003192201