muramidase and Leukemia--Monocytic--Acute

We report a case of acute monocytic leukemia with normal serum lysozyme but with immunoperoxidase positivity for lysozyme in the leukemic blasts. The diagnosis of acute monocytic leukemia was made on the basis of cellular morphology, immunocytochemistry and cytochemistry. Discrepancy between serum lysozyme and intracytoplasmic lysozyme has not previously been reported in the literature. Levels of serum lysozyme may be misleading in cases of acute monocytic leukemia (FAB classification M5).

Topics: Adult; Cell Transformation, Neoplastic; Humans; Leukemia, Monocytic, Acute; Male; Monocytes; Muramidase; Staining and Labeling

Topics: Acid Phosphatase; Adult; Aged; Alkaline Phosphatase; Bone Marrow Cells; Cerebral Hemorrhage; Daunorubicin; Female; Gastrointestinal Hemorrhage; Glucuronidase; Humans; Leukemia; Leukemia, Monocytic, Acute; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Leukocytes; Male; Middle Aged; Monocytes; Muramidase; Naphthol AS D Esterase; Periodic Acid-Schiff Reaction; Peroxidases; Pregnancy; Prognosis; Remission, Spontaneous

Topics: Acute Disease; Aged; Female; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Monocytic, Acute; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Leukocytes; Male; Middle Aged; Muramidase; Remission, Spontaneous

Topics: Aged; Aged, 80 and over; Antibodies, Monoclonal; Bence Jones Protein; Electrophoresis; Humans; Immunoglobulin Light Chains; Leukemia, Monocytic, Acute; Male; Muramidase; Paraproteinemias; Proteinuria

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Biopsy; Bone Marrow; Diagnosis, Differential; Fatal Outcome; Humans; Leukemia, Monocytic, Acute; Male; Muramidase; Nephrotic Syndrome; Proteinuria; Remission Induction

Nuclear factor-IL-6 (NF-IL6) belongs to the CCAAT/enhancer binding protein family of transcription factors. NF-IL6 binds to the regulatory regions of many genes induced in activated macrophages in vitro. However, which particular genes are regulated by NF-IL6 in vivo is poorly defined. In order to identify the downstream genes of NF-IL6 in a monocytic lineage, we combined an inducible expression system with subtraction cloning in a study of murine M1 monocytic leukemia cells. We demonstrated that inducible expression of NF-IL6 is able to increase endogenous gene expression of macrophage inflammatory protein (MIP)-1 alpha, osteopontin and CD14 in M1 cells. We also showed that NF-IL6 activated murine MIP-1 alpha proximal promoter luciferase construct which contains two NF-IL6 binding sites and a point mutation of either site markedly reduces the luciferase activity. These findings indicate that MIP-1 alpha is a direct target of NF-IL6.

Topics: Animals; Base Sequence; Binding Sites; CCAAT-Enhancer-Binding Proteins; Chemokine CCL4; DNA-Binding Proteins; Gene Expression Regulation, Leukemic; Humans; Leukemia, Monocytic, Acute; Lipopolysaccharide Receptors; Macrophage Inflammatory Proteins; Mice; Molecular Sequence Data; Muramidase; Nuclear Proteins; Osteopontin; Promoter Regions, Genetic; RNA, Messenger; Sialoglycoproteins; Transcriptional Activation; Tumor Cells, Cultured

Using only morphological criteria as proposed by the French-American-British (FAB) Study Group, the subclassification of acute monocytic leukemia (FAB M5) into the categories M5a and M5b can be difficult. We therefore investigated 13 cases of well-established M5 leukemias. The results show that immunohistochemical techniques allow a better subdivision of the acute monocytic leukemias. The less-mature types are characterized by a focal lysozyme and a negative CD68 reaction, whereas the more differentiated types express a diffusely positive lysozyme and also a positive CD68 phenotype: a staining pattern also found in the rare true histiocytic lymphomas. We regard these results as a useful addition to the FAB classification.

Topics: Adult; Aged; Antigens, CD; Antigens, Differentiation, Myelomonocytic; Bone Marrow; Carboxylic Ester Hydrolases; Female; Humans; Immunophenotyping; Leukemia, Monocytic, Acute; Male; Middle Aged; Muramidase

The revised French-American-British (FAB) classification system for acute myeloid leukemia (AML) recommends the determination of serum lysozyme (SL) or urine lysozyme (UL) levels as an aid in distinguishing acute myeloblastic leukemia with maturation (FAB M2) from acute myelomonocytic leukemia (M4). We reviewed retrospectively 208 cases of adult leukemia in which SL and/or UL were obtained. Elevated lysozyme levels were not found in any of the M0, M3, or M7 cases, but were increased (false positive) in three (14%) M1 cases, 18 (19%) M2 cases and one (20%) M6 case. Although a UL value in excess of 3x normal was found in most cases of AML M4 and M5, only five (11%) M4 cases and three (20%) M5 cases had SL elevations of this magnitude. Lysozyme levels need to be interpreted in conjunction with other parameters for FAB classification.

Topics: Aged; Female; Humans; Leukemia, Erythroblastic, Acute; Leukemia, Megakaryoblastic, Acute; Leukemia, Monocytic, Acute; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Leukemia, Promyelocytic, Acute; Male; Middle Aged; Muramidase

Using an ultrastructural immunogold method, we performed a quantitative study on cellular lysozyme (LZ) content in young normal bone marrow cells and in 14 cases of acute myeloid leukaemia (AML) of the M2, M3, M4 and M5 types. In five cases of M2 we found significantly lower LZ content than in normal promyelocytes and than in nine cases of M3, M4 and M5. In M3, M4 and M5 cells a very high LZ content was observed whereas the serum LZ activity was high in M4 and M5 and normal in M3. The intragranular LZ content was especially high in M5 and in most granules of M4 cells. The immunogold reaction (IGR) for LZ was also performed in cells previously reacted for myeloperoxidase (MPO). In M2 the granules showed definite positive MPO reactivity and low LZ density (granulocytic pattern), whereas in M5 we found high granular LZ content and weak or almost negative MPO activity (monocytic pattern). In M4 we found 'granulocytic' and 'monocytic' type of granules in the same cell. The IGR for LZ performed in post-embedded M5 cells which were previously subjected to phagocytosis of latex particles, showed granules that had moved toward the phagosome, releasing LZ without degranulation. The above findings and those showing normal serum LZ in M3 despite their high cellular LZ content, definitely indicate that only leukaemic M4 and M5 cells secrete LZ into their environment, explaining the high serum LZ observed in those leukaemias.

Topics: Acute Disease; Bone Marrow; Gold Colloid; Humans; Leukemia, Monocytic, Acute; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Leukemia, Myelomonocytic, Acute; Leukemia, Promyelocytic, Acute; Microscopy, Electron; Muramidase; Peroxidase; Phagocytosis

Topics: Humans; Leukemia, Monocytic, Acute; Male; Middle Aged; Muramidase; Nephrotic Syndrome; Proteinuria

Inhibitors of myosin light chain kinase, 1-(5-chloronaphthalene-1-sulfonyl)-1H-hexahydro-1,4-diazepine hydrochloride (ML-9) and 1-(5-iodonaphthalene-1-sulfonyl)-1H-hexahydro-1,4-diazepine hydrochloride (ML-7), induced Nitroblue tetrazolium reducing activity, lysozyme activity and morphological maturation of human monoblastic U937, THP-1 and promyelocytic HL-60 cells, but not of erythroblastic K562 cells. However, three analogs of ML-9, which are an inhibitor and an activator of protein kinase C, and a calmodulin antagonist, respectively, did not induce differentiation of the cells.

Topics: Azepines; Cell Differentiation; Humans; Leukemia; Leukemia, Erythroblastic, Acute; Leukemia, Monocytic, Acute; Leukemia, Promyelocytic, Acute; Muramidase; Myosin-Light-Chain Kinase; Naphthalenes; Nitroblue Tetrazolium; Oxidation-Reduction; Tumor Cells, Cultured

Topics: Blast Crisis; Humans; Hypokalemia; Leukemia, Monocytic, Acute; Leukemia, Myelomonocytic, Chronic; Male; Middle Aged; Muramidase

Topics: Chromatography, High Pressure Liquid; Humans; Leukemia, Monocytic, Acute; Leukemia, Myeloid, Acute; Muramidase; Nephelometry and Turbidimetry

Topics: Carboxylic Ester Hydrolases; Humans; Infant; Leukemia, Monocytic, Acute; Lymphocytes; Male; Muramidase; Staining and Labeling

The human monoblast leukemia line U937 is growth inhibited and induced to express various characteristics of mature monocytes by lymphokines (LK) and other cytokines. Previous experiments have shown that interferon-gamma (IFN-gamma) is responsible for some but not all of the differentiation-inducing effects on U937. To determine the variety and specificity of activity, the following factors were studied: phytohemagglutinin-induced LK that contained IFN-gamma (100 units/ml); purified IFN-gamma; human colony-stimulating factor 1 (CSF-1); and conditioned medium(a) (CM) from the human bladder carcinoma cell line 5637 and the hepatoma cell line SK-HEP. LK preparations contained no colony-stimulating activity, whereas CM from 5637 and SK-HEP both contained granulocyte-macrophage CSF (3000 to 4000 units/ml) but no IFN activity. IFN-gamma is the major immunoglobulin G Fc receptor-inducing species within lymphokine, since anti-interferon-gamma antibody inhibited most of this activity. Other sources of Fc receptor-inducing activity were CM from SK-HEP and 5637 cell lines. Human CSF-1 when tested up to 800 units/ml was inactive for Fc receptor induction. LK induced the chemotactic peptide receptor, but this induction was due to factors other than IFN-gamma as anti-IFN-gamma antibody did not inhibit the induction, and purified IFN-gamma at a dose equivalent to that found in LK (100 units/ml) had no activity in the assay. SK-HEP and 5637 CM had strong chemotactic peptide receptor-inducing activity, but human CSF-1 was inactive up to 800 units/ml. Peroxide production after stimulation with phorbol myristic acid could be induced by LK, LK with anti-IFN-gamma antibody, 5637, and SK-HEP treatment. IFN-gamma (100 units/ml) and CSF-1 (800 units/ml) were ineffective. Peroxide production was induced by IFN-gamma at concentrations above 1000 units/ml. The inducibility of several enzymatic activities was determined as additional measures of maturation. N-Acetylglucuronidase was induced, for example, by LK, IFN-gamma, 5637 CM, and phorbol myristic acid. Alkaline phosphatase was induced by LK, IFN-gamma, dexamethasone, and phorbol myristic acid. 1,25-Dihydroxycholecalciferol was also examined and could induce most of the maturational markers examined. The results demonstrate that non-IFN cytokines from several sources have profound differentiation-inducing effects on monoblast leukemia cells in a pattern different from that of IFN-gamma.(ABSTRACT TRUNCATED AT 400 WORDS)

Topics: Antibodies; Antigens, Neoplasm; Biological Products; Cell Differentiation; Cell Line; Chemotactic Factors; Cytokines; Humans; Hydrolases; Interferon-gamma; Leukemia, Monocytic, Acute; Lymphokines; Muramidase; Phagocytosis; Receptors, Fc; Receptors, Formyl Peptide; Receptors, Immunologic; Rosette Formation

This study reports the cytochemical, electrophoretic and immunological characteristics of blasts cells from 39 cases of acute myelomonocytic leukaemia (M4). The results indicate considerable cytochemical heterogeneity, particularly with respect to esterase (alpha naphthyl acetate and chloroacetate) activities and suggest that an increased serum lysozyme concentration is a more consistent feature. Investigations with a range of monoclonal antibodies also revealed some differences in expression of monocyte-associated determinants although it is considered that immunological assessments are more consistent than cytochemistry in the detection of monocytic blast cell components. Analysis of ANAE isoenzymes by isoelectric focusing was found to be of particular value in cases where interpretation of ANAE cytochemistry was difficult.

Topics: Antibodies, Monoclonal; Carboxylic Ester Hydrolases; Humans; Isoelectric Focusing; Isoenzymes; Leukemia, Monocytic, Acute; Leukemia, Myeloid, Acute; Muramidase; Naphthol AS D Esterase; Peroxidases

A 28-year-old woman developed leukopenia and slight cervical lymphadenopathy. Bone marrow aspiration and special stains established the diagnosis of acute monocytic leukemia. Following chemotherapy a complete hematologic remission was elicited. Seven months later, she consulted an ophthalmologist because of bilateral conjunctival lesions. Ophthalmologic examination showed subconjunctival, perilimbal grayish-pink infiltrates. A conjunctival biopsy disclosed sheets of mononuclear cells consistent with acute monocytic leukemia. Four months later, she developed cutaneous lesions in the face and chest wall. Subsequent biopsies of conjunctiva and skin and immunohistochemical demonstration of muramidase in the tumor cells supported the diagnosis of monocytic leukemia. Electron microscopic studies were particularly valuable and disclosed that more than 80% of the leukemic cells contained two types of cytoplasmic complexes of rough endoplasmic reticulum that displayed both tubular and helical configurations. These complexes differed morphologically from the ribosome-lamellar complexes observed in hairy cell leukemia and other hematologic disorders.

Topics: Adult; Conjunctiva; Female; Humans; Immunochemistry; Leukemia, Monocytic, Acute; Microscopy; Microscopy, Electron; Muramidase; Recurrence

Immunological and cytochemical findings are presented from 12 cases of morphologically unequivocal acute monocytic leukaemia (AMoL). The results indicate considerable heterogeneity and three main non-morphological subgroups were identified. The blast cells from half the patients were positive for the presence of both cytoplasmic alpha naphthyl acetate esterase (ANAE) and monocyte-associated membrane determinants whereas the cells from three cases lacked detectable monocytic antigens despite the presence of strong cytochemical ANAE activity. A further three cases expressed monocytic antigens but were cytochemically unreactive for ANAE. These cytochemical results, which were extended by electrophoretic studies of ANAE isoenzymes, suggest that the absence of significant cytoplasmic ANAE activity does not preclude the diagnosis of AMoL and that serum lysozyme estimations may be of value in the recognition of immunocytochemically-atypical cases.

Topics: Adult; Aged; Antigens, Neoplasm; Antigens, Surface; Cell Membrane; Female; Fluorescent Antibody Technique; Histocytochemistry; Humans; Isoenzymes; Leukemia, Monocytic, Acute; Male; Middle Aged; Monocytes; Muramidase; Naphthol AS D Esterase; Phenotype

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

Topics: Female; Humans; Infant; Isocitrate Dehydrogenase; Leukemia, Monocytic, Acute; Lymphatic Diseases; Male; Muramidase; Peptidyl-Dipeptidase A

Topics: Abdomen; Esterases; Hepatomegaly; Humans; Kidney Diseases; Leukemia, Monocytic, Acute; Monocytes; Muramidase; Pain; Splenomegaly

Topics: Adult; Antibiotics, Antineoplastic; Child; Child, Preschool; Daunorubicin; Female; Humans; Infant; Leukemia, Monocytic, Acute; Leukocyte Count; Male; Muramidase; Potassium; Recurrence; Retrospective Studies

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

Topics: Enzyme Activation; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Monocytic, Acute; Leukemia, Myeloid, Acute; Leukocytes; Muramidase; Phagocytosis

Fifteen of 73 newly diagnosed patients with acute myeloid leukemia (AML), admitted to Mount Sinai Hospital between July 1977 and October 1979, presented with leukocyte counts greater than 100,000/microliter. Eleven of these 15 patients with hyperleukocytosis had myelomonocytic (AMML-M4) or monocytic (AMOL-M5) leukemia compared to 15 of 58 patients with lower white cell counts (p < 0.001). Identification of type of leukemia, using the FAB classification, was based on morphology and special stains, including myeloperoxidase, Sudan black B, periodic acid-Schiff and nonspecific esterase with and without inhibition by fluoride. The proportion of patients with splenomegaly is higher in those with hyperleukocytosis (73 percent) than in those with lower white blood cell counts (p < 0.001) regardless of cell type. Leukemic infiltration of the skin, gums and central nervous system was seen exclusively in patients with AMML and AMOL. The serum lysozyme levels were significantly higher for all patients with AMML and AMOL regardless of the white blood cell count. The mean serum lysozyme for M-4, M-5 patients was 59.7 microgram/ml compared to 18.9 microgram/ml in patients with other cell types (p < 0.0001). Patients with a white blood cell count less than or equal to 100,000/microliter had a complete remission rate of 69 percent compared to 47 percent for patients with higher white blood cell counts.

Topics: Humans; Leukemia, Monocytic, Acute; Leukemia, Myeloid; Leukocyte Count; Leukocytosis; Muramidase; Splenomegaly

Topics: Bone Marrow; Female; Humans; Leukemia, Monocytic, Acute; Microscopy, Electron; Middle Aged; Muramidase; Ribosomes

A human leukemic cell line (THP-1) cultured from the blood of a boy with acute monocytic leukemia is described. This cell line had Fc and C3b receptors, but no surface or cytoplasmic immunoglobulins. HLA haplotypes of THP-1 were HLA-A2, -A9, -B5, -DRW1 and -DRW2. The monocytic nature of the cell line was characterized by: (1) the presence of alpha-naphthyl butyrate esterase activities which could be inhibited by NaF; (2) lysozyme production; (3) the phagocytosis of latex particles and sensitized sheep erythrocytes; and (4) the ability to restore T-lymphocyte response to Con A. The cells did not possess Epstein-Barr virus-associated nuclear antigen. These results indicate that THP-1 is a leukemia cell line with distinct monocytic markers. During culture, THP-1 maintained these monocytic characteristics for over 14 months.

Topics: Cell Line; Complement C3b; Esterases; Humans; Infant; Leukemia, Monocytic, Acute; Lymphocyte Activation; Male; Monocytes; Muramidase; Phagocytosis; Receptors, Complement; Receptors, Fc; T-Lymphocytes

The clinical and laboratory features of 37 patients with variants of acute monocytic leukemia are described. Three of these 37 patients who had extensive extramedullary leukemic tissue infiltration are examples of true histiocytic "lymphomas." Three additional patients with undifferentiated leukemias, one patient with refractory anemia with excess of blasts, one patient with chronic myelomonocytic leukemia, one patient with B-lymphocyte diffuse "histiocytic" lymphoma and one patient with "null" cell, terminal deoxynucleotidyl transferase-positive lymphoblastic lymphoma had bone marrow cells with monocytic features. Another patient had dual populations of lymphoid and monocytoid leukemic cells. The true monocytic leukemias, acute monocytic leukemia (AMOL) and acute myelomonocytic leukemia (AMMOL), are closely related to acute myelocytic leukemia (AML) morphologically and by their response to chemotherapy. like AML, the leukemic cells from the AMMOL and AMOL patients form leukemic clusters in semisolid media. Cytochemical staining of leukemic cells for nonspecific esterases, presence of Fc receptor on the cell surface, phagocytic ability, low TdT activity, presence of surface "ruffles" and "ridges" on scanning EM, elevations of serum lysozyme, and clinical manifestations of leukemic tissue infiltration are features which accompanied monocytic differentiation in these cases.

Topics: Adolescent; Adult; Aged; Blood Cells; Bone Marrow; Female; Hodgkin Disease; Humans; Leukemia, Monocytic, Acute; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Lymphoma, Large B-Cell, Diffuse; Male; Microscopy, Electron, Scanning; Middle Aged; Muramidase

Topics: Acute Disease; Adolescent; Adult; Aged; Female; Humans; Leukemia; Leukemia, Monocytic, Acute; Leukemia, Myeloid; Male; Middle Aged; Muramidase

The diagnostic and prognostic value of the assay of lysozyme in serum and urine was appreciated in 184 cases of acute leukemia. The levels were decreased in the lymphoblastic, mainly of the non B-non T type, and undifferenciated varieties, markedly raised in the monoblastic and myelo-monocytic varieties, while in the myeloblastic ones they were found normal, decreased or slightly increased, and, on the average, significantly higher in the well differenciated than in the poorly differenciated types. For a given cytological type, the level of lysozyme is not correlated with the frequency of the induction of complete remission. However, in the acute myeloblastic leukemia, a significantly higher frequency of infection during or after the induction treatment was observed in the cases presenting initially without a raised serum lysozyme level.

Topics: Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Monocytic, Acute; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Muramidase; Prognosis

In a consecutive series of 22 patients with acute leukemia, the total body potassium was studied in 18 patients on 39 occasions during relapse and remission. Total body water was also determined. A control group consisting of 88 age-matched healthy volunteers was also studied. The patients had a significantly lower mean potassium concentration, per kg body weight, per kg lean body mass and per kg water, than the controls (p less than 0.001). Individually, 11 out of the 18 patients had at least one value below the lower 95% confidence limit. Hypokalemia was frequent both in the patients with low (7/11) and normal (3/6) potassium per kg lean body mass. Five of 13 investigated patients showed laboratory indications of secondary hyperaldosteronism, which might be partly responsible for the hypokalemia. Increased serum or urine levels of lysozyme were found in 62% of the patients.

Topics: Adult; Aged; Aldosterone; Antineoplastic Agents; Electrolytes; Female; Humans; Hypokalemia; Leukemia, Lymphoid; Leukemia, Monocytic, Acute; Leukemia, Myeloid, Acute; Male; Middle Aged; Muramidase; Potassium; Renin

Topics: Cytoplasm; Humans; Infant; Leukemia, Monocytic, Acute; Male; Muramidase; Skin; Skin Manifestations

Topics: Antigen-Antibody Reactions; Electrophoresis, Cellulose Acetate; Humans; Leukemia, Monocytic, Acute; Multiple Myeloma; Muramidase

Topics: Acute Disease; Adult; Colitis, Ulcerative; Crohn Disease; Female; Humans; Leukemia, Monocytic, Acute; Male; Middle Aged; Muramidase; Uremia

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

The purified chromatin of leukocyte nuclei from two patients, one with chronic granulocytic and another with acute myelomonocytic leukemia, has been investigated for lysozyme activity. The chromatin contained 4.8% resp. 4% of the total amount of lysozyme found in the leukocytes. The function of lysozyme in the nucleus remains unclear.

Topics: Blood Proteins; Cell Nucleus; Chromatin; Humans; Leukemia, Monocytic, Acute; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Leukocytes; Muramidase

44 patients suffering from myelomonocytic leukemia (MML) have been observed over the last four years. They have been subclassified in acute myelomonocytic and acute monoblastic leukemias (AMML, n = 12; AMoL, n = 10), subacute myelomonocytic leukemias (SMML, n = 13), and chronic myelomonocytic leukemias (CMML, n = 9) on the basis of bone marrow cytology(blast and promonocyte counts, maturation of granulopoesis) and cytochemical findings (peroxydase and unspecific esterase reaction). This subclassification has been proved to be of prognostic relevance by its good correlation with the mean survival times (AMML : 4.5 months, AMoL : 2.4 months, SMML : 8 months, CMML : 18 months). The acute forms have been treated in general with combined cytostatic chemotherapy, whereas SMML and CMML have been treated this way only in case of progression to an acute phase. These progressions to an AMML have been observed more often and earlier in subacute forms than in chronic forms. The diagnosis of SMML and CMML is supported by the finding of sea-blue histiocytes in the bone marrow, increased lysozyme levels in serum and urine and by the absence of the Philadelphia-Chromosome.

Topics: Acute Disease; Adolescent; Adult; Aged; Bone Marrow Examination; Chronic Disease; Female; Histiocytes; Humans; Leukemia, Monocytic, Acute; Leukemia, Myeloid; Male; Middle Aged; Muramidase; Prognosis

A 68-year-old woman presented with haematological changes of chronic lymphocytic leukaemia and acute monocytic leukaemia. This diagnosis was confirmed by identification of cell surface markers for T and B lymphocytes and the identification of abnormal immunoglobulins and lysozyme in serum and urine.

Topics: Aged; Antigens; B-Lymphocytes; Female; Humans; Immunoglobulins; Leukemia, Lymphoid; Leukemia, Monocytic, Acute; Muramidase; Neoplasms, Multiple Primary; T-Lymphocytes

Twelve cases of pure acute monocytic leukemia in adults were studied. They were selected on the basis of the morphology of the blast cells on Romanowsky-stained smears of blood and bone marrow, as well as positivity of the cells for the naphthol ASD acetate esterase reaction specifically inhibited by sodium fluoride. There was no sex predominance. Neoplastic involvement of the skin and/or gingiva was very frequent. The leukemic proliferation in blood and bone marrow consisted of monoblasts, promonocytes and monocytes. The peroxidase reaction was negative or only faintly positive. Serum and urinary lysozyme levels were increased. The blast cells retained their ability to stimulate, in vitro, colony formation by normal bone marrow cells used as targets. All of these characteristics permit specific identification of this type of acute leukemia. The prognosis is grim: only five of 12 patients achieved complete remission, and four of these five had relapses in less than 14 months; the median survival was five months.

Topics: Adult; Age Factors; Aged; Bone Marrow; Colony-Stimulating Factors; Female; Humans; Leukemia, Monocytic, Acute; Male; Middle Aged; Muramidase; Prognosis; Sex Factors

Samples from 49 cases of myeloproliferative diseases were tested by an immunocytochemical technique for leucocyte lysozyme and lactoferrin. The presence of these constituents in myeloid precursors from cases of acute and chronic myeloid leukaemia reflected the degree of cellular maturation, lysozyme appearing (as it does in normal myeloid cells) at the stage of primary granule production (in promyelocytes), while lactoferrin wad detectable only in more mature, secondary granule-containing myeloid cells. Auer rods stained positively for lysozyme, in keeping with their relationship to primary granules. Monocytes from five cases of leukaemia showing predominantly monocytic differentiation were indistinguishable from normal monocytes in their staining reactions for lysozyme despite the presence of raised serum and urinary lysozyme levels. In four cases of acute myeloid leukaemia circulating polymorphs deficient in lactoferrin were detected: in one of these cases a similar percentage of polymorphs was lysozyme negative.

Topics: Humans; Immunoenzyme Techniques; Intracellular Fluid; Lactoferrin; Lactoglobulins; Leukemia, Monocytic, Acute; Leukemia, Myeloid, Acute; Leukocytes; Monocytes; Muramidase; Myeloproliferative Disorders; Neutrophils

Lysozyme [EC 3.2.1.17] was purified from human tears, serum, and urine of acute monocytic leukemia patients, renal disease patients, and residents in cadmium-polluted areas of Tsushima Island using an affinity adsorbent containing lysozyme-lysate of Micrococcus lysodeikticus cell walls as the ligand. By means of this procedure, leukemia lysozyme was purified 100- to 200-fold with an activity recovery of 80%. It was crystallized at pH 10. This purified preparation appeared homogeneous in disc electrophoresis and showed a specific activity 2.5-fold higher than that of crystalline lysozyme from hen egg-white. Tear lysozyme was also purified to a nearly homogeneous state while the enzymes from normal serum and urine of a nephrosis patient and of residents in cadmium-polluted area were still disc electrophoretically heterogeneous and showed low specific activity as compared with purified leukemia lysozyme.

Topics: Amino Acids; Chromatography, Affinity; Crystallization; Humans; Kidney Diseases; Leukemia, Monocytic, Acute; Muramidase; Tears

Topics: Adult; Clinical Enzyme Tests; Hematologic Diseases; Humans; Leukemia, Monocytic, Acute; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Muramidase; Polycythemia Vera; Primary Myelofibrosis; Urine

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: Chemical Phenomena; Chemistry, Physical; Dose-Response Relationship, Drug; Egg Proteins; Female; Humans; Leukemia, Monocytic, Acute; Molecular Weight; Muramidase; Placenta; Pregnancy

The clinical course of a patient with acute monocytic leukemia and prominent infiltration of the skin and testes is described. In vitro studies demonstrated that the circulating monocyte precursors were capable of adherence to nylon fibers, and phagocytosis of bacteria and latex particles. In vivo, migration of leukemic cells to skin windows was observed. Extreme nuclear folding, marked surface activity, and morphologic features suggesting nuclear and cytoplasmic maturation were seen by light and electron microscopy. The presence of morphologically and functionally more differentiated monocytic cells may account for the marked tiuuse invasion in this patient and, possibly, in other patients with monocytic leukemia.

Topics: Bone Marrow Examination; Cell Adhesion; Cell Movement; Cerebrospinal Fluid; Cyclophosphamide; Daunorubicin; Drug Therapy, Combination; Guanazole; Hematopoietic Stem Cells; Humans; Latex; Leukemia, Monocytic, Acute; Male; Megakaryocytes; Microscopy, Electron; Microspheres; Middle Aged; Monocytes; Muramidase; Neutrophils; Nylons; Phagocytosis; Testis

Two cases of the development of acute myeloid leukemia (AML) after treatment with alkylating agents are reported. In Case 1, melphalan and then cyclophosphamide had been given for multiple myeloma. 46 months after onset of cytostatic treatment AML occurred, as confirmed cytochemically and by qualitative determination of urinary lysozyme. In Case 2, cyclophosphamide had been given for rheumatoid arthritis. After a latency of 34 months 'smouldering leukaemia' developed with an atypical monocytic leukaemic cell population. In a third case, multiple myeloma and monocytic leukaemia developed synchronously. The causative role of melphalan and cyclophosphamide in the development of AML seems securely established. Despite the risk of alkylating agents in the treatment of multiple myeloma or Hodgkin's disease causing AML, they should not be replaced, as other drugs have been shown to be less beneficial. On the other hand, alkylating agents should be used with great caution in the treatment of non-malignant diseases.

Topics: Aged; Alkylating Agents; Arthritis, Rheumatoid; Cyclophosphamide; Female; Humans; Immunoglobulin G; Leukemia, Monocytic, Acute; Male; Melphalan; Middle Aged; Muramidase; Plasmacytoma; Time Factors

Topics: Anemia, Sideroblastic; Bone Marrow Examination; Cytarabine; Female; Humans; Immunodiffusion; Immunoelectrophoresis; Immunoglobulins; Iron; Leukemia, Monocytic, Acute; Leukemia, Myeloid, Acute; Male; Melphalan; Mercaptopurine; Middle Aged; Multiple Myeloma; Muramidase; Precancerous Conditions; Prednisone; Staining and Labeling; Vincristine

The cytochemical methods for lysozyme and nitroblue-tetrazolium reduction have been used to study the blast cells of acute myeloid leukaemia. Both proved useful in characterizing the cases with predominant monocytic differentiation. THE DEMONSTRATION OF LYSOZYME ACTIVITY HELPED TO DEFINE TWO MAIN GROUPS: (a) with predominantly lysozyme-negative cells (myeloblastic-promyelocytic), and (b) with considerable numbers of positive cells (monoblastic-monocytic). In addition this test was also of value in the differentiation of other leukaemic disorders. Reduction of nitroblue-tetrazolium was also a feature of monocytic differentiation. The combination of these two methods with those for myeloperoxidase and non-specific esterase activity contributes to the cytological characterization of acute myeloid leukaemia.

Topics: Cell Differentiation; Esterases; Histocytochemistry; Humans; Leukemia; Leukemia, Monocytic, Acute; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Lymphoma, Non-Hodgkin; Muramidase; Oxidation-Reduction; Peroxidases; Tetrazolium Salts

Topics: Adult; Anemia; Anemia, Sideroblastic; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Monocytic, Acute; Leukemia, Myeloid; Leukemoid Reaction; Leukocytosis; Monocytes; Muramidase; Myeloproliferative Disorders; Polycythemia Vera; Primary Myelofibrosis

Topics: Acute Disease; Age Factors; Aged; Agranulocytosis; Anemia; Bone Marrow Examination; Cell Transformation, Neoplastic; Ecchymosis; Erythropoiesis; Female; Hematocrit; Humans; Iron; Leukemia; Leukemia, Monocytic, Acute; Leukemia, Myeloid; Leukocytes; Male; Middle Aged; Muramidase; Myeloproliferative Disorders; Splenomegaly; Syndrome; Thrombocytopenia

Topics: Humans; Leukemia, Monocytic, Acute; Leukemia, Myeloid; Muramidase

Topics: Acute Kidney Injury; Female; Humans; Hypokalemia; Leukemia, Monocytic, Acute; Leukemia, Myeloid, Acute; Middle Aged; Muramidase

Topics: Bacterial Infections; Diabetes Mellitus; Hodgkin Disease; Humans; Leukemia; Leukemia, Monocytic, Acute; Leukemia, Myeloid; Leukocytes; Lymphoma, Large B-Cell, Diffuse; Muramidase

Topics: Adolescent; Adult; Aged; Diagnosis, Differential; Esterases; Histocytochemistry; Humans; Leukemia, Lymphoid; Leukemia, Monocytic, Acute; Leukemia, Myeloid, Acute; Leukocytes; Lymphocytes; Middle Aged; Muramidase; Prognosis

Topics: Acute Disease; Adenosine; Aminohydrolases; Electrophoresis; Humans; Isoenzymes; Leukemia, Lymphoid; Leukemia, Monocytic, Acute; Leukemia, Myeloid, Acute; Leukocytes; Muramidase; Mycosis Fungoides; Phenotype

Topics: Adult; Aged; Blood Urea Nitrogen; Female; Humans; Hypokalemia; Kidney Tubules; Leukemia, Monocytic, Acute; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Leukocyte Count; Male; Middle Aged; Muramidase; Myeloproliferative Disorders; Polycythemia Vera; Primary Myelofibrosis; Radiography; Spleen

Topics: Adult; Anemia, Sideroblastic; Bone Marrow Diseases; Humans; Leukemia; Leukemia, Monocytic, Acute; Leukemia, Myeloid; Lymphoma; Monocytes; Multiple Myeloma; Muramidase; Polycythemia Vera; Primary Myelofibrosis

Topics: Acute Disease; Adenine Nucleotides; Adenosine Diphosphate; Adult; Aged; Blood Platelets; Collagen; Epinephrine; Female; Fibrin; Humans; Kaolin; Leukemia; Leukemia, Monocytic, Acute; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Lymphoma, Non-Hodgkin; Male; Middle Aged; Muramidase; Platelet Adhesiveness; Remission, Spontaneous; Thrombin

Topics: Adult; Aged; Blood Cell Count; Bone Marrow Cells; Bone Marrow Examination; Child; Cytarabine; Densitometry; Female; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Monocytic, Acute; Leukemia, Myeloid, Acute; Male; Middle Aged; Muramidase; Remission, Spontaneous; Thioguanine; Vincristine

Topics: Clinical Enzyme Tests; Humans; Leukemia, Lymphoid; Leukemia, Monocytic, Acute; Leukemia, Myeloid, Acute; Muramidase

Topics: Acid Phosphatase; Adult; Aged; Bone Marrow Examination; Esterases; Female; Histocytochemistry; Humans; Leukemia, Monocytic, Acute; Leukemia, Myeloid, Acute; Leukocyte Count; Leukocytes; Male; Microscopy, Electron; Muramidase; Skin Window Technique

Topics: Female; Humans; Leukemia, Monocytic, Acute; Leukemia, Myeloid; Micrococcus; Muramidase

Topics: Adult; Agranulocytosis; Alpha-Globulins; Beta-Globulins; Blood Cell Count; Blood Protein Electrophoresis; Bone Marrow Examination; Cobalt Isotopes; Cytarabine; Humans; Leukemia, Monocytic, Acute; Leukemia, Myeloid, Acute; Male; Muramidase; Periodicity; Protein Binding; Vitamin B 12

Topics: Acid Phosphatase; Alkaline Phosphatase; Amidohydrolases; Binding Sites; Culture Techniques; Diagnosis, Differential; Esterases; Female; Histocytochemistry; Humans; Immunoglobulin G; Leukemia, Monocytic, Acute; Leukemia, Myeloid, Acute; Male; Microscopy, Electron; Monocytes; Muramidase; Oxidoreductases; Peroxidases; Skin Window Technique

Topics: Bone Marrow Cells; Clinical Enzyme Tests; Diagnosis, Differential; Histocytochemistry; Humans; Leukemia, Lymphoid; Leukemia, Monocytic, Acute; Muramidase

Topics: Adult; Bone Marrow Examination; Densitometry; Female; Hodgkin Disease; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Monocytic, Acute; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Leukocytes; Male; Methods; Muramidase; Spectrophotometry

Topics: Diagnosis, Differential; Humans; Leukemia, Monocytic, Acute; Leukemia, Myeloid, Acute; Monocytes; Muramidase