muramidase and Preleukemia

Topics: Adrenal Cortex Hormones; Aged; Alkaline Phosphatase; Androgens; Antineoplastic Agents; Blood Cell Count; Blood Transfusion; Chromosome Aberrations; Chromosome Disorders; Folic Acid; Humans; Leukocytes; Middle Aged; Muramidase; Myeloproliferative Disorders; Peroxidase; Preleukemia; Prognosis; Pyridoxine; Vitamin B 12

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

Retrospective analysis of patients with acute myelomonoblastic (or nonlymphocytic) leukemia has helped to clarify the early stages of the evolution of this disease, and a clinical picture has emerged that is sufficiently discriminating to permit prospective observations. The clinical and laboratory features of the hematologic disorder preceding overt, blast-cell leukemia (i.e., the "preleukemic syndrome" or "hemopoietic dysplasia") are described, and diagnostic criteria and approaches to management are considered. This hematologic syndrome appears to be a stage in a multiphasic panmyelopathy that involves all products of the marrow stem cell. Available data indicate that most of these patients develop acute leukemia within 24 months of the onset of the hematologic abnormalities, but longer courses are not uncommon. Prospective documentation in a large group of patients is needed before the natural course can be accurately defined; such studies are now being planned.

Topics: Adrenal Cortex Hormones; Aged; Antineoplastic Agents; Blood Transfusion; Bone Marrow; Child; Chromosome Aberrations; Colony-Forming Units Assay; Erythrocyte Transfusion; Erythrocytes; Female; Humans; Iron; Male; Middle Aged; Muramidase; Preleukemia; Pyridoxine; Splenectomy; Syndrome