acid-phosphatase and Leukocytosis

Hairy cell leukemia (HCL) is characterized by leukemic cells with abundant "hairy" cytoplasm, strong cytoplasmic positivity for tartrate-resistant acid phosphatase (TRAP), characteristic immunophenotype and sensitivity to treatment with purine nucleoside analogs. HCL-variant (HCL-v) encompasses chronic B-cell leukemias resembling classical HCL but exhibiting variant cytomorphology, variant immunophenotype and resistance to conventional HCL therapy. We present the case of a 67-year-old Taiwanese male with HCL-v who had leukocytosis and splenomegaly. His hairy leukemic cells were weakly positive for TRAP and expressed CDllc and CD103 but not CD25. He received oral chemotherapy with chlorambucil and in complete hematological remission in 9 months but relapsed 2 months later. Literature review revealed 9 cases of HCL and 3 cases of HCL-v including current case from Taiwan. All patients were adults with splenomegaly. The HCL patients had a significantly higher frequency of leukopenia (p = 0.024) and monocytopenia (p = 0.008) and a lower frequency of leukocytosis (p = 0.018) than HCL-v patients. All 8 HCL patients responded favorably to 2-chlorodeoxyadenosine with or without splenectomy. The 3 HCL-v patients had leukocytosis and received chemotherapy with variable outcome. HCL and HCL-v are rare in Taiwan and their pathological and immunophenotypical features were not fully characterized. A multimodality approach incorporating hematological findings, cytomorphology, histopathology, cytochemistry, complete immunophenotyping and clinical features is needed to identify and characterize such cases in Taiwan.

Topics: Acid Phosphatase; Aged; Antigens, CD; Antineoplastic Agents, Alkylating; Biomarkers, Tumor; Bone Marrow; Chlorambucil; Humans; Isoenzymes; Leukemia, Hairy Cell; Leukocytosis; Male; Recurrence; Remission Induction; Splenomegaly; Tartrate-Resistant Acid Phosphatase

Atorvastatin (ATV) has bone anabolic properties, and alendronate (ALD) is an important antiresorptive drug. This study aimed to evaluate the effects of the combination of ALD and ATV on ligature-induced alveolar bone loss in rats.. Periodontitis was induced by ligature in 78 Wistar rats. Groups of six rats prophylactically received 0.9% saline (SAL), ALD (0.01 or 0.25 mg/kg subcutaneously) or ATV (0.3 or 27 mg/kg by gavage). Then, groups of six rats received the combination of ALD+ATV (0.25 mg/kg + 27 mg/kg, 0.01 mg/kg + 0.3 mg/kg, 0.25 mg/kg + 0.3 mg/kg or 0.01 mg/kg + 27 mg/kg) prophylactically. An extra group of six rats received therapeutic SAL or a lower-dose combination of ALD+ATV (0.01 mg/kg + 0.3 mg/kg, respectively) therapeutically. Three extra groups of six rats each received SAL or a lower-dose combination of ALD+ATV (0.01 mg/kg + 0.3 mg/kg, respectively) prophylactically or therapeutically for histometric and immunohistochemical analyses. The rats were killed on day 11 after ligature placement, and the maxillae were removed and processed for macroscopic, histomorphometric and TRAP immunohistochemical analyses. Gingival samples were collected to evaluate myeloperoxidase (MPO) activity. Blood samples were collected to measure serum bone-specific alkaline phosphatase (BALP) and transaminase levels and for hematological studies. Rats were weighed daily.. All combined therapies prevented alveolar bone loss when compared with SAL or low doses of monotherapy (ALD or ATV) (p < 0.05). The lower-dose combination of ALD+ATV (0.01 mg/kg + 0.3 mg/kg, respectively), administered either prophylactically (39.0%) or therapeutically (53.5%), prevented alveolar bone loss. Decreases in bone and cementum resorption, in leukocyte infiltration and in immunostaining for TRAP and MPO activity corroborated the morphometric findings. The lower-dose combination of ALD+ATV (0.01 mg/kg + 0.3 mg/kg, respectively) prevented BALP reduction (p < 0.05) and did not alter the level of serum transaminases. Moreover, the lower-dose combination of ALD+ATV (0.01 mg/kg + 0.3 mg/kg, respectively) also reduced neutrophilia and lymphomonocytosis and did not cause weight loss when compared with administration of SAL.. The lower-dose combination of ALD+ATV (0.01 mg/kg + 0.3 mg/kg, respectively) demonstrated a protective effect on alveolar bone loss.

Topics: Acid Phosphatase; Alanine Transaminase; Alendronate; Alkaline Phosphatase; Alveolar Bone Loss; Animals; Aspartate Aminotransferases; Atorvastatin; Body Weight; Bone Density Conservation Agents; Dental Cementum; Gingiva; Heptanoic Acids; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Infusions, Parenteral; Injections, Subcutaneous; Isoenzymes; Leukocyte Disorders; Leukocytes; Leukocytosis; Male; Monocytes; Neutrophils; Peroxidase; Pyrroles; Rats, Wistar; Root Resorption; Tartrate-Resistant Acid Phosphatase

Hairy cell leukemia (HCL) is an uncommon type of chronic B cell leukemia mainly affecting middle-aged adults. HCL presenting with pancytopenia is rare in Japan and a distinct subtype of HCL termed HCL-Japanese variant is predominantly seen. We describe a HCL patient with unusual presentation. The patient was a 26-year-old male, such early onset of HCL being quite rare. The patient showed leukocytosis with many circulating hairy cells and cellular bone marrow. These findings were preferentially seen in HCL-Japanese variant, but, cytomorphologic, cytochemical and immunophenotypical studies on the pathologic cells were consistent with those of typical HCL seen in Western countries. Interferon-alpha therapy was very effective in this case. Differentiation of the subtype of HCL appears to be important for the choice of the treatment. The cytological findings were useful for the differential diagnosis of HCL presenting with leukocytosis.

Topics: Acid Phosphatase; Adult; Age of Onset; Biomarkers, Tumor; Diagnosis, Differential; Humans; Interferon-alpha; Isoenzymes; Leukemia, Hairy Cell; Leukocytosis; Male; Receptors, Interleukin-2; Splenomegaly; Tartrate-Resistant Acid Phosphatase

Topics: Acid Phosphatase; Animals; Female; Leukocyte Count; Leukocytosis; Lysosomes; Male; Neutrophils; Propranolol; Rabbits; Receptors, Adrenergic, beta; Restraint, Physical; Stress, Physiological; Time Factors

Chronic lymphocytic leukemia (CLL) and hairy cell leukemia (HCL) are two common chronic lymphoproliferative disorders, each having characteristic clinical, morphologic, and immunologic features. Phenotypically, CD5 reactivity in CLL and CD11c (Leu-M5) reactivity in HCL have characterized these two leukemias among B-cell disorders. In this study, we report 14 cases of a novel chronic lymphoproliferative disorder characterized by lymphocytosis and CD11c expression, but morphologically similar to CLL. The patients' ages ranged from 46 to 81 years (median 62). Eleven had palpable splenomegaly, five with markedly enlarged spleens; only one patient had generalized lymphadenopathy. The white blood cell count ranged from 5.2 to 131.0 x 10(9)/L (median 20.8). The morphologic diagnosis in all cases was CLL, with the cells usually having abundant cytoplasm. No morphologic features, of hairy cells were evident; tartrate-resistant acid phosphatase cytochemistry was negative in all cases. Bone marrow biopsies were available in 8 of 14. Four showed focal nodular infiltrates and two had diffuse infiltrates similar to CLL; two showed only minimal interstitial involvement. All cases expressed multiple B-cell markers, and 12 of 14 had monoclonal surface immunoglobulin. The leukemic cells of all cases strongly expressed CD11c, while CD5 was expressed in 7 of 14; only 1 of the 14 cases expressed the lymph node homing receptor, Leu-8. This unique group of leukemias appears to represent the malignant transformation of lymphocytes arising from a stage of lymphocyte differentiation between that found in typical cases of CLL and that of HCL. CD11c is known to have an important function in cellular adhesion and may be important in determining the pattern of lymphocyte tissue distribution found in this group of patients.

Topics: Acid Phosphatase; Aged; Aged, 80 and over; Antigens, CD; Antigens, Differentiation; Antineoplastic Agents; B-Lymphocytes; Bone Marrow; CD11 Antigens; CD5 Antigens; Female; Histocytochemistry; Humans; Immunophenotyping; Leukemia, Hairy Cell; Leukemia, Lymphocytic, Chronic, B-Cell; Leukocytosis; Male; Middle Aged; Splenomegaly; Thrombocytopenia

Topics: Acid Phosphatase; Adult; Female; Humans; Leukocyte Count; Leukocytosis; Lymphocytes; Neutrophils; Pre-Eclampsia; Pregnancy

Topics: Acid Phosphatase; Adenosine Triphosphatases; Animals; Ascitic Fluid; Autoradiography; Bone Marrow; Bone Marrow Cells; Glucuronidase; Granulocytes; Hematopoiesis; Injections, Intravenous; Leukocidins; Leukocytes; Leukocytosis; Models, Biological; Nucleotidases; Rabbits; Staphylococcus; Thymidine; Toxins, Biological; Tritium; Uridine

Topics: Acetylesterase; Acid Phosphatase; Animals; Ascitic Fluid; Autoradiography; Bone Marrow; Bone Marrow Cells; Esterases; Histocytochemistry; Leukocytosis; Monocytes; Naphthols; Rabbits; Tritium

Topics: Acid Phosphatase; Hematologic Diseases; Leukemia; Leukocyte Disorders; Leukocytes; Leukocytosis; Phosphoric Monoester Hydrolases