muramidase and Disseminated-Intravascular-Coagulation

The discovery of cytosine arabinoside, and then the anthrocycline antibiotics, 6-thioguanine, vincristine, cyclophosphamide, and other drugs, has added to the armamentarium of known effective agents. The use of combination chemotherapy, the recognition of the need during induction for virtual marrow aplasia to obtain a remission, and recognition of the predilection of the disease for the central nervous system requiring prophylaxis constitute major advances. The impediment to long-term survival is the lack of effective maintenance therapy.

Topics: Acute Disease; Adolescent; Agranulocytosis; Antineoplastic Agents; Cells, Cultured; Child; Child, Preschool; Chromosome Aberrations; Chromosome Disorders; Disseminated Intravascular Coagulation; Drug Therapy, Combination; Female; Graft vs Host Reaction; Hodgkin Disease; Humans; Infections; Leukemia; Leukocytosis; Male; Muramidase; Preleukemia; Thrombocytopenia; Uric Acid

Serum concentrations of hepatocyte growth factor (HGF) were measured in 60 patients suffering from acute myelocytic leukaemia (AML). At the time of diagnosis elevated HGF concentrations (> 1.25 ng/ml) were found in 28% of the patients. HGF levels correlated with the presence of disseminated intravascular coagulation (DIC), levels of lysozyme, creatinine, peripheral blood blast counts and lactic dehydrogenase. In the group of patients with high HGF (>1.25 ng/ml) we found a tendency towards an increased early mortality; 41% of them died within 15 d from diagnosis, as opposed to 5% of the patients with normal HGF (log rank test p=0.07). DIC-related bleeding or thrombosis contributed to this early mortality. In responders, HGF levels normalized after treatment. HGF levels are low in neutropenia and neutropenic infections.

Topics: Biomarkers, Tumor; Blood Cell Count; Creatinine; Disseminated Intravascular Coagulation; Hepatocyte Growth Factor; Humans; L-Lactate Dehydrogenase; Leukemia, Myeloid, Acute; Muramidase; Survival Analysis

Between 1978 and 1980, 45 cases of acute monoblastic leukaemia have been diagnosed, treated and followed in our institute. Morphological diagnosis was performed according to the French-American-British classification. Tumoral syndrome (particularly extra-medullary) and hyperleucocytosis were the most striking findings at the time of diagnosis. Cytogenetic analysis performed in 31 cases before treatment has showed that abnormality of the long arm of chromosome 11 seemed to be more frequently associated with the poorly differentiated cytological subtype M5 (a). Intensive chemotherapy with zorubicin and cytosine arabinoside led to complete remission in 75% of the cases. Central nervous system prophylaxis appeared definitively useful in preventing meningeal relapse. Despite a prolongation of the median duration of complete remission which now reaches 12 months, the prognostic is still poor.

Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Chromosome Aberrations; Disseminated Intravascular Coagulation; Female; Gingival Hypertrophy; Hepatomegaly; Humans; Infant; Leukemia, Monocytic, Acute; Lymphadenitis; Male; Meningeal Neoplasms; Middle Aged; Muramidase; Prognosis; Skin Diseases; Splenomegaly

Seventy-four cases of pure acute monoblastic leukemia (AMol) have been retrospectively studied. All patients were treated at Hospital Saint-Louis between 1970 and 1978. Diagnosis was based on morphological and cytochemical features according to the FAB classification. This type of leukemia occurred at any age and in both sexes, with a high frequency of extramedullary involvements. Hyperleukocytosis was very frequent and was significantly correlated with increased blood and urine levels of lysozyme, with renal failure and hypokalemia, and with coagulation abnormalities. AMol still has a poor prognosis, despite a best remission rate (75%) obtained with rubidazone, since the duration of complete remission was short. Central nervous irradiation prolonged remission and prevented meningeal relapses, while 6 meningeal relapses occurred in the patients not irradiated. The high frequency of the extramedullary relapses, including gum and skin, emphasized the question of persistant blast cell sanctuaries after achievement of bone marrow remissions. A more intensive induction with several drugs active against monoblasts could be more efficient and prolong the duration of complete remissions.

Topics: Adolescent; Adult; Aged; Aging; Blood Urea Nitrogen; Child; Child, Preschool; Creatinine; Disseminated Intravascular Coagulation; Female; Hemostasis; Humans; Infant; Leukemia, Monocytic, Acute; Male; Middle Aged; Muramidase; Remission, Spontaneous; Retrospective Studies

The clinical and laboratory features of nine patients with chronic myelomonocytic leukemia are described. Hepatic or splenic enlargement accompanied by an absolute monocytosis in an older patient with an elevated serum or urine lysozyme and serum vitamin B12 levels were characteristic of the majority of patients in this series. No single clinical or laboratory finding was diagnostic for the disease. Most importantly, seven of nine patients had abnormal coagulation values; in two cases the abnormalities were consistent with disseminated intravascular coagulation and correlated with a hemorrhagic diathesis. It is concluded that patients with chronic myelomonocytic leukemia who have thrombocytopenia or a bleeding tendency should be evaluated for evidence of disseminated intravascular coagulation.

Topics: Aged; Bone Marrow; Disseminated Intravascular Coagulation; Female; Hepatomegaly; Humans; Leukemia, Myeloid; Male; Middle Aged; Monocytes; Muramidase; Splenomegaly; Vitamin B 12

Acute monocytic leukemia is an uncommon form of acute leukemia. Distinctive clinical features include gingival hypertrophy, lymphoadenopathy, coagulation disorders, and lysozymuria. Blast cell morphology and cytochemistry are diagnostic. Receptors for the Fc fragment of IgG have been demonstrated on the basis of a few cases. The drug VP 16-213 has been shown to be very effective in treatment of untreated and previously treated patients.

Topics: Blood Coagulation Disorders; Cell Nucleus; Disseminated Intravascular Coagulation; Esterases; Etoposide; Gingival Hypertrophy; Histocytochemistry; Humans; Leukemia, Monocytic, Acute; Lymph Nodes; Monocytes; Muramidase; Prednisolone; Vinblastine; Vincristine

There was no significant difference in the levels of factor XII between sick newborns and normal age-matched controls, although the levels of both groups were lower than normal older children. Detailed coagulation studies on 44 sick infants revealed 11 to have disseminated intravascular coagulation (DIC). In those with DIC, the mean Hageman factor was 20% and in those without DIC, 25% (P greater than 0.05). Rabbits given a constant infusion of lysozyme (which inhibits factor XII) showed laboratory evidence of endotoxin-induced DIC. The data suggest that neither reduced factor XII levels nor Hageman factor inhibition provided protection from DIC. The data further suggest that other coagulation pathways might be involved in order to elicit the DIC.

Topics: Animals; Blood Coagulation; Blood Coagulation Tests; Disseminated Intravascular Coagulation; Endotoxins; Factor XII; Female; Gestational Age; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Models, Biological; Muramidase; Rabbits; Respiratory Distress Syndrome, Newborn

Twenty cases of acute monoblastic leukemia are studied according to definite criterias: cytology, cytochemical staining, lysozyme production. The study points out the tumoral characters: hematodermy, gingivitis, central nervous system leukemia and the lack of important bone marrow incompetence. 47 per cent of complete remissions are obtained with daunorubicin, aracytin combination therapy. Other useful chemical agents, and prospects for maintenance therapy are discussed.

Topics: Adolescent; Adult; Aged; Antineoplastic Agents; Cytarabine; Daunorubicin; Disseminated Intravascular Coagulation; Female; Gingiva; Humans; Hypokalemia; Leukemia, Monocytic, Acute; Male; Middle Aged; Muramidase; Potassium; Splenomegaly

Topics: Adenocarcinoma, Mucinous; Animals; Arginine; Blood Coagulation; Blood Coagulation Tests; Brain Chemistry; Bronchi; Chemical Precipitation; Disseminated Intravascular Coagulation; Esterases; Factor V Deficiency; Factor VII; Factor VII Deficiency; Factor X; Fibrinogen; Hemophilia B; Humans; Hypoprothrombinemias; Kaolin; Mucins; Mucus; Muramidase; Phospholipids; Prothrombin; Rabbits; Thromboplastin; Time Factors; Venoms

Topics: Animals; Blood Cell Count; Blood Coagulation Tests; Blood Platelets; Coumarins; Disseminated Intravascular Coagulation; Endotoxins; Factor VII; Female; Fibrin; Fibrinogen; Kidney Glomerulus; Male; Muramidase; Rabbits; Shwartzman Phenomenon; Thorium Dioxide