Clinical, hematologic, and pathologic features of leukemic T-cell lymphoma

Cells obtained from malignant lymph nodes and the peripheral blood of 106 patients with non-Hodgkin's lymphomas were examined for T- and B-cell characteristics. Surprisingly, 79 cases were of the T-cell type on the basis of spontaneous rosette formation with sheep erythrocytes (E-rosettes). Of the remaining cases, 15 were B-cell in nature (monoclonal S-Ig positive), seven were non T-, non B-cell and four cases were undetermined. Forty-nine (62.0%) of the T-cell malignancies were of a leukemic variety, characterized by pleomorphism in the peripheral blood cell size, and histological appearance. Most of the leukemic T-cells showed obvious lymphocytic differentiation, with condensed nuclear chromatin and scant cytoplasm, although in many of the cases, the lymphomatous infiltrate was dominated by large or pleomorphic lymphoid cells. All tumors were of a diffuse variety, and on histologic examination included a mixed type (21 cases), PDLL forms (15 cases), a large lymphoid cell type (eight cases), and WDLL forms (five cases). Although the mixed type with a pleomorphic lymphoid infiltrate was distinctive, there has been considerable variation from case to case. Clinically this unusual t-cell, leukemic variety of non-Hodgkin's lymphomas primarily involved middle-aged and elderly subjects, and was characterized by wide spread organ invasion (preferentially to the liver, spleen and skin), resistance to chemotherapy, and a poor prognosis. A mediastinal mass was not observed in all cases. The patients had a median survival of only ten months.

Multiple myeloma among atomic bomb survivors in Hiroshima and Nagasaki, 1950-76: relationship to radiation dose absorbed by marrow

The relationship between atomic bomb exposure and the incidence of multiple myeloma has been examined in a fixed cohort of atomic bomb survivors and controls in the life-span study sample for Hiroshima and Nagasaki. From October 1950 to December 1976, 29 cases of multiple myeloma were confirmed in this sample. Our analysis shows that the standardized relative risk (RR) adjusted for city, sex, and age at the time of bombings (ATB) increased with marrow-absorbed radiation dose. The increased RR does not appear to differ between cities or sexes and is demonstrable only for those survivors whose age ATB was between 20 and 59 years. The estimated risk in these individuals is approximately 0.48 cases/million person-years/rad for bone marrow total dose. This excess risk did not become apparent in individuals receiving 50 rad or more in marrow total dose until 20 years or more after exposure.

Antibodies to adult T-cell leukemia-virus-associated antigen (ATLA) in sera from patients with ATL and controls in Japan: a nation-wide sero-epidemiologic study

A nation-wide sero-epidemiologic survey of adult T-cell leukemia virus (ATLV), detected es anti-ATLA (ATLV-associated antigen), was made in Japan. Sera from adult donors in 15 different locations were screened for anti-ATLA. High incidences (6 to 37%) of antibody-positive donors were found in seven regions, one in northern Japan, and the others in southwestern regions. These areas are ATLV-endemic areas corresponding to ATL-endemic areas. Examination of sera from healthy donors aged 6 to 80 years in ATL-endemic areas showed an age-dependent increase of seropositive donors with a maximum of about 30% at 40 years of age. Anti-ATLA was found in all but two of 142 patients with ATL. Anti-ATLA-positive patients with ATL were mainly found in ATLV-endemic areas, and only a few in ATL-nonendemic areas. Six patients with cutaneous T-cell lymphoma in ATLV-nonendemic areas gave a negative reaction for anti-ATLA. The geometric mean titer of anti-ATLA of patients with ATL was higher than that of healthy donors.

[Treatment of non-Hodgkin's lymphoma with NK-631 (peplomycin)--with special reference to the effect on T and non-T cell lymphomas]

NK-631 (Peplomycin) has an anti-tumor spectrum, equivalent to or higher than its analogue bleomycin and low toxicities to the lungs. Fourteen patients with advanced non-Hodgkin's lymphoma received NK-631 10 to 30 mg once or twice a week. As the results, there were 57.1% response rate of all patients. The response rate according to the immunologic classification were 100%(6/6 cases) for patients with non-T cell lymphoma and 25%(2/8 cases) for patients with T-cell lymphoma. On the other hand, we observed some toxicities such as transient fever in 64.3%, G-I tract symptoms in 21.4%, skin toxicities in 21.4% and pulmonary fibrosis in one case. This agent is considered to be one of the useful agents to non-Hodgkin's lymphoma especially non-T cell lymphoma.

Familial acute myelogenous leukemia associated with RNA virus and polymorphism of 1qh+

In order to investigate the genetic background of leukemogenesis of two brothers with acute myelogenous leukemia (AML), they and their family members were studied genetically, immunologically, virologically, and cytogenetically. Their parents were first cousins once removed and had the same or a very close type of human leukocyte antigen (HLA) and blood groups. In all five non-leukemic family members the immunoglobulin G (IgG) level was elevated, and in two healthy siblings the IgM level was beyond the normal range. The RNA reverse transcriptase activity in serum of the younger brother (Case 2) with AML was elevated. A cytogenetic study of the family revealed polymorphism of 1qh+. Based on these findings, we discuss the genetic and environmental factors of familial leukemia.

Erythroblastic transformation of Philadelphia chromosome (Ph1)-positive chronic myelogenous leukemia associated with marked chromosomal rearrangements

In a 22-year-old female with Philadelphia chromosome (Ph1)-positive chronic myelogenous leukemia (CML) a tumor consisting of megaloblastic proerythroblasts appeared in the right ilio-femoral region 2 years and 8 months after the diagnosis of the disease and was treated effectively with irradiation. She developed erythroblastic transformation 3 months after the tumor appeared. Cytogenetic study of the bone marrow cells in the acute phase revealed marked chromosomal rearrangements such as ring, dicentric, or tricentric chromosomes.