[Treatment of Wilms' tumor (author's transl)]

Uniform treatment based on the therapeutic approach of the 1st and 2nd US National Wilms' Tumor Study was decided on in March 1976 by paediatricians, surgeons, urologists and radiotherapists in Austria. Wilms' tumour was diagnosed in 34 children between 1 january 1976 an 29 february 1980 (stage I: n = 11, stage II: n = 8, stage III: n = 8, stage IV: n = 7). Parents of two children refused treatments; both children have since died of metastases. Of the remaining 32 children 29 (90.6%) are alive, 10 for more than 4, 15 for more than 3 and 19 for more than 2 years after diagnosis. 21 children are without need of treatment. Three children have died, one due to postoperative complications, one due to haemorrhagic chickenpox, but free of tumour, and one after insufficient treatment. Two of the five children with a recurrence between 2 1/4 to 15 months after diagnosis had been treated inadequately in the initial phase. The tumour free survival rate in 74.2%. Two children with early occurring or recurrent lung metastases have survived for 53 1/2 and 54 months up to now.

A colony assay for blast cell progenitors in non-B non-T (common) acute lymphoblastic leukemia

A clonal method in cell culture is described that permits the quantitation of blast precursors in common (non-T, non-B) ALL; the method also yields information about progenitor properties, based on analysis of cells in colonies. The technique is identical to that used successfully for normal and malignant B-cell progenitors except that it requires culture at below O2 tension (5%-7%); mononuclear cells from blood or marrow are depleted of T cells and cultured with media conditioned by T cells in the presence of phytohemagglutinin and irradiated T cells. Cultures are incubated for 5-7 days in a moist atmosphere at 5% CO2 and 5%-7% O2. Colonies were obtained from marrow or blood of 16 of 18 ALL patients. Cells in colonies had the same characteristics (E-, slg-, cALL+ and clgM+ or clgM-) as the cells in the patient. By replating pooled colonies, self-renewal of progenitors was shown. The findings are considered in light of a model of leukemic blasts that depicts such populations as lineages maintained by progenitors that either renew themselves or give rise to blast cells with little or no proliferative capacity.

[Bone marrow failure with plasmocytosis in a diabetic child (author's transl)]

After three years of insulin treatment for diabetes mellitus a 12 year old girl developed lethal bone marrow failure. Significance of marked marrow plasmocytosis and the relationship to the bone marrow changes in adult diabetics are discussed.

[Congenital Agranulocytosis (author's transl)]

The rare clinical picture of congenital agranulocytosis is described and its differential diagnosis from other forms of chronic neutropenia discussed on the basis of a case report of an infant followed up over a period of 3 years. Characteristic features of the agranulocytosis are inhibited maturation of the neutrophils (only as far as the promyelocyte and immature myelocyte stage), in conjunction with a normal or elevated level of eosinophil granulocytes. Erythropoiesis and megakaryopoiesis are found to be normal; plasmocytes, monocytes and lymphocytes are increased. The consequence of permanent infections is sometimes an excessive hypergammaglobulinaemia. This fact, in combination with the phagocytic activity of the monocytoid cells, enables these children, once out of infancy, to overcome even severe infections much more successfully than would be anticipated from the changes in the white blood picture.

Reverse transcriptase activity: increase in marrow cultures from leukaemic patients in relapse and remission

An enzyme activity with the characteristics of reverse transcriptase was detected in marrow from patients with leukaemia in relapse and in firm haematological remission. The endogenous enzyme activities increased following culture, and in remission patients the enzyme activities reached levels equal to or exceeding those found in relapse.