Myeloid Splenomegaly Research Articles

Application de la radiothérapie dans les hémopathies malignes : expérience du pôle d’onco-hématologie de l’hôpital Dalal Jamm de Dakar

INTRODUCTION: The treatment of hematologic malignancies is based on chemotherapy and/or targeted therapies. The place of radiotherapy was once highly debated because it could be responsible for significant late toxicity, but the progress of recent years has made practices evolve in the direction of the integration of radiotherapy in the multidisciplinary management of these malignant hemopathies. .We report the profile of malignant haematological pathologies, the indications for radiotherapy and its impact in improving the care of patients in the onco-hematology center of the Dalal Jamm Hospital in Dakar. MATERIALS AND METHODS: All patients treated with curative or palliative radiotherapy in the radiotherapy department of Dalal Jamm Hospital in Dakar for a malignant hemopathy duly diagnosed between June 2018 and July 2021 were retrospectively included. RESULTS: From June 2018 to July 2021, 20 patients with malignant hemopathy were treated in the radiotherapy department. These 11 men and 9 women had a mean age of 50.1 years ± 15.6. The main malignant haematological pathologies were lymphomas (6 cases) including 2 cases of non-Hodgkin's type, 4 cases of multiple myeloma, 6 cases of solitary plasmacytoma, 2 cases of multiple myeloid associated with a solitary plasmacytoma, 1 case of chronic lymphoid leukemia and 1 case of myeloid splenomegaly. The indication for radiotherapy was curative in the cases of Hodgkin lymphoma and solitary plasmacytoma and palliative in the remainder. The dose was 36 Gy in 18 fractions for Hodgkin lymphoma, 30 Gy in 10 fractions for cases of solitary plasmacytomas in exclusive irradiation, 20 Gy in 5 fractions for plasmacytomas in consolidation after resection and 8 Gy in one fraction for analgesic treatments. With a mean follow-up of 23 months, we noted three deaths including the case of myeloid splenomegaly, chronic lymphoid leukemia and one case of multiple myeloma associated with a solitary plasmacytoma. The rest of the patients were in remission. CONCLUSION: Radiotherapy, with to its technical progress, has gained in precision and retains a place in the multidisciplinary management of hematologic malignancies. KEYWORDS: Hematologic malignancies; Radiotherapy; Senegal.

AB1377 Clinical interest of bone marrow examination in rheumatology practice: An observationnal study of 257 patients

BackgroundExamination of the haematopoietic marrow is essential in the diagnosis of many disorders, principally malignant haematological diseases which can be encountered in rheumatology practice. Bone marrow aspiration (BMA) and biopsy...

Cirurgias conservadoras do baço para tratamento da doença de Gaucher

Complications of splenomegaly in Gaucher's disease, such as hypersplenism and mechanical compressions, have been treated by partial splenectomy. However, the splenic remnant, vascularized by the hilar vessels, may enlarge leading to recurrent splenomegaly and all its adverse effects. More than eighteen years of experience treating portal hypertension, splenic trauma, myeloid splenomegaly, splenomegalic somatic and sexual hypodevelopment, chronic lymphocytic lymphoma and cystadenoma of pancreatic tail by subtotal splenectomy, maintaining the upper pole supplied only by the splenogastric vessels showed that the splenic remnant does not increase its size. Based on evidence that the hilar vessels may contribute to the increase of the splenic remnant, we performed in five cases with Gaucher's disease subtotal splenectomy, maintaining the upper pole supplied only by the splenogastric vessels. The splenic remnant did not modify in size during a postoperative follow-up of more than twelve years, and the hematological parameters remained normal. Another patient whose splenogastric vessels were insufficient to maintain the upper splenic pole, was submitted to total splenectomy and autologous splenic tissue transplantation on the greater omentum. The autotransplant survived and presented with function. All six patients had uneventful postoperative follow-up in relation to the splenic conservative procedure. In conclusion, in presence of giant splenomegaly with severe hematologic and clinical symptoms the spleen must be resected in a conservative fashion such as subtotal splenectomy or total splenectomy followed by autotransplants of splenic tissue.

Cirurgias conservadoras do baço para tratamento da esplenomegalia por mielofibrose

A mielofibrose idiopatica e uma doenca mieloproliferativa cronica, que pode evoluir com hepatoesplenomegalia, tambem denominada metaplasia, e acometer varios orgaos. Ocasionalmente, o baco alcanca proporcoes gigantescas e precisa ser retirado. Entretanto, esse procedimento e seguido de elevada morbidade e mortalidade. As esplenectomias parciais, que preservam o pediculo esplenico, foram propostas para reduzir complicacoes pos-operatorias. Apos melhora transitoria do quadro clinico, surge a recorrencia da esplenomegalia e da sintomatologia. A presente comunicacao relata duas alternativas para tratamento de esplenomegalia: a esplenectomia subtotal, com preservacao do polo esplenico superior suprido apenas pelos vasos esplenogastricos, e a esplenectomia total, com auto-implantes de tecido esplenico. Realizamos a esplenectomia subtotal em cinco pacientes. O acompanhamento por ate dez anos e a melhora clinica dos doentes sugerem que essa operacao deva ser considerada para o tratamento de bacos gigantes devido a esplenomegalia decorrente de mielofibrose. Um outro paciente foi submetido a esplenectomia total e auto-implante esplenico no omento maior. No seguimento de tres anos deste ultimo paciente, nao foram registradas complicacoes relacionadas ao remanescente esplenico. Entretanto, o paciente necessitou de controle hematologico intensivo por causa da gravidade de sua doenca de base. Concluindo, se for indicada operacao para complementar a terapeutica hematologica da esplenomegalia, deve-se realizar um procedimento conservador do baco. A esplenectomia subtotal ou a esplenectomia total com auto-implantes de tecido esplenico sao duas boas escolhas em tais situacoes.

The very-long-term course of polycythaemia: a complement to the previously published data of the Polycythaemia Vera Study Group.

The very-long-term follow-up of patients initially included in the PVSG protocols provides useful information. The excess risk of cancer after chlorambucil appears to persist for 5 years after stopping this treatment. The risk of leukaemia induced by marrow suppression (32P or chemotherapy) was marked before the 10th year, but low thereafter. Phlebotomy is unacceptable as permanent treatment because of the poor clinical tolerance and the frequency of vascular complications. This treatment is also associated with a risk of early progression towards myelofibrosis with myeloid splenomegaly. In the very long term, 15 years or more after the diagnosis, this complication is the major clinical risk, affecting almost 50% of our patients surviving at this time. The prevention of this type of complication could constitute one of the objectives of future protocols dealing with this disease.

LEUKOERYTHROBLASTIC ANEMIA WITH DIFFUSE OSTEOSCLEROSIS

Case Reports1 September 1943LEUKOERYTHROBLASTIC ANEMIA WITH DIFFUSE OSTEOSCLEROSISJOSEPH MENDELOFF, M.D., JULIUS ROSENTHAL, M.D.JOSEPH MENDELOFF, M.D.Search for more papers by this author, JULIUS ROSENTHAL, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-19-3-518 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThis report is that of a case of a severe progressive anemia with osteosclerosis. The clinical picture as well as the pathological findings we deem to be of sufficient interest for detailed description.CASE REPORTThe patient, a male, white, born in the U. S., a clerk by occupation, was admitted to the Welfare Hospital for Chronic Diseases on November 11, 1939, with chief complaint of anemia of seven years' duration, weakness, dyspnea on exertion, and swelling of legs and scrotum.History before admission to Welfare Hospital: In July, 1934, at the age of 52, he was advised to have...Bibliography MOZER JJ: Les ostéoscleroses diffuses, les anémies osteosclerotiques, Geneva Thesis, 1927, No. 1213. Google Scholar KRUMBHAAR EB: Hodgkin's disease of bone marrow and spleen without involvement of lymph nodes, Am. Jr. Med. Sci., 1931, clxxii, 764. Google Scholar LIVINGSTON SK: Hodgkin's disease of the skeleton without glandular involvement, Jr. Bone and Joint Surg., 1935, xvii, 189. Google Scholar FALCONER AW: Report on a familial type of generalized osteosclerosis, Med. Press and Circular, 1937, cxvv, 12. Google Scholar ROHOLMGUTMANGUTMAN KABEB: Serum phosphatase activity in generalized osteosclerosis due to chronic fluorine intoxication in man, Proc. Soc. Exper. Biol., and Med., 1937, xxxvii, 376. CrossrefGoogle Scholar KARK RM: Two cases of aplastic anemia, Guy's Hosp. Rep., 1937, lxxxvii, 343. Google Scholar RHOADSMILLER CPDK: Histology of the bone marrow in aplastic anemia, Arch. Path., 1938, xxvi, 648. Google Scholar LIEBERMAN HS: Hodgkin's disease of the bones, Jr. Bone and Joint Surg., 1938, xx, 1039. Google Scholar MUSSEY AM: Osteopetrosis, Arch. Dis. Child., 1938, xiii, 161. Google Scholar CLIFTOMFRANKFREEMAN WMAS: Osteopetrosis, Am. Jr. Dis. Child., 1938, lvi, 1020. Google Scholar LAMBJACKSON FHRL: Osteopetrosis, Am. Jr. Clin. Path., 1938, viii, 255. CrossrefGoogle Scholar ANDERSON HE: Pregnancy complicated by osteopetrosis, Jr. Bone and Joint Surg., 1938, xx, 481. Google Scholar DOWNEYNORDLAND HM: Hematologic and histologic study of a case of myeloid megakaryocytic hepato-spleno-megaly, Folia haematol., 1939, lxii, 1. Google Scholar VAUGHNHARRISON JMCV: Leuco-erythroblastic anemia and myelosclerosis, Jr. Path. Bact., 1939, xlviii, 339. CrossrefGoogle Scholar OLIN H: Osteodystrophy, Illinois Med. Jr., 1939, lxxv, 517. Google Scholar KRAMERHALPERT BB: Marble bones, Am. Jr. Dis. Child., 1939, lvii, 795. CrossrefGoogle Scholar CARPENTERFLORY GCM: Chronic nonleukemic myelosis: report of a case with megakaryocytic myeloid splenomegaly, leukoerythroblastic anemia, generalized osteosclerosis, and myelofibrosis, Arch. Int. Med., 1941, lxvii, 489. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: New York, N. Y.*Received for publication September 2, 1941.From the Department of Pathology and Second Medical Division, service of Dr. Walter G. Lough, Welfare Hospital for Chronic Diseases. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byMyelofibrosis with Myeloid Metaplasia in Survivors of the Atomic Bomb in HiroshimaROBERT E. ANDERSON, M.D., TAKASHI HOSHINO, M.D., TSUTOMU YAMAMOTO, M.D.Agnogenic myeloid metaplasia 1 September 1943Volume 19, Issue 3Page: 518-532KeywordsAnemiaDyspneaInflammation ePublished: 1 December 2008 Issue Published: 1 September 1943 PDF downloadLoading ...