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Central nervous system involvement at presentation in acute granulocytic leukemia. A prospective cytocentrifuge study
slenoais
Echocardiography subaorlic
Protein-calorie
Cancer
Undernulrllion undernutrition
Anlhromelrics Cancer
Meningitis
staging
Non-Hodgkin’s
lymphoma
Continued on page A32
Review of the records of 122 patients with non-Hodgkin’s lymphoma revealed that all sites of involvement were detected by gallium scanning in three patients (2.5 per cent) and sites not found by routine physical examination and roentgenogram in 22 patients (17 per cent). Only 18.5 per cent of all diseased sites were found by gallium scanning and sites mistakenly assigned as positive or negative were found 28 per cent of the time. Most of these mistakes were false negatives. Only one patient was upstagedas a result of gallium scanning.The gallium scan cannot replace more invasive staging procedures, such as lymphangiography, and does not provide information reliably enough to base therapeutic decisions on its outcome.
Lymph&ma
We have undertaken a prospective study of the incidence of central nervous system disease at presentation in acute granulocytic leukemia (AGL). Thirty-nine consecutive newly diagnosed patients with AGL underwent lumbar puncture and cytocentrifuge examinations of the cerebrospinal fluid In seven of the 39 patients blast cells were demonstrable. All affected patients had acute myelomonocytic leukemia (AMML). This represented seven of the 13 patients with AMML. Other high risk factors associated with meningeal infiltration were elevated serum lysozyme levels, high peripheral while cell count, lower age, splenomegaty and infiltrationof other organs. In the patients with meningeal leukemia, remission rates were lower and survival time shorter than in the 32 nonfnvolvedpahenis. A lumbar pun&e is indicated-inalinswiy diiosed patients with AMML and treatment should be instituted if blast cells are present.
Gallium scanning
Longo DL, Schilsky RL, Blei L, Cano R, Johnston GS. Young RC: Gallium-67 scanning: limited usefulness in staging patients with non-Hodgkin’s disease lymphoma. Am J Med 1980; 68: 695-700.
levels
leukemia
Serum lysozyme
Acute granulocylic
Meyer RJ, Ferreira PPC, Cuttner J, Greenberg ML, Goldberg J, Holland JF: Central nervous system involvement at presentation in acute granulocytic leukemia. A prospective cytocentrifuge study. Am J Med 1980; 68: 691-694.
Central nervous system involvement
Leukemia
A study of the nutritional status of hospitalized cancer patients revealed a nearly universal prevalence of protein-calorie undernutrition.The creatinine to height ratio was the most sensitive indicator of protein-calorie undernutrition.Neither basal metabolic rate nor caloric intake differed from expected values for normal sedentary subjects of comparable size. Steatorrhea was rare. Survival was de&eased if nutritional parameters fell below certain threshold levels. These investigators conclude that protein-calorie undernutrition is present in most hospitalized cancer patients but that it may be obscured by residual obesity. Survival might be enhanced if nutrition could be maintained above critical levels.
hyperlrophic
Asymmetric septal hypertrophy was identified in 17 of 19 cases of untreated hypothyroidism evaluated by M-mode echocardiography. In five patients this abnormality was associated with systolic anterior motion of the mitral valve and reduced left ventricular outflow tract dimension simulating the echocardiographic pattern of idiopathic hypertrophic subaortic stenosis. In 10 patients who returned to euthyroa state with L-thyroxine therapy, the echocardiographic abnormalities resolved. We conclude that long-standing hypothyroidism leads to a reversible cardiomyopathy, manifested by asymmetric septal hypertrophy with or without other echocardfographic features of a hypertrophic-obstructive cardiomyopathy.
Idiopathic
septal hypertrophy
Nixon DW, Heymsfield SB, Cohen AE, Kutner MH, Ansley J, Lawson DH, Rudman D: Protein-calorie undernutrition in hospitalized cancer patients. Am J Med 1980; 68: 683-690.
Asymmetric
Santos AD, Miller RP, Mathew PK. Wallace WA, Cave Jr WT. Hinojosa 1: Echocardiographic characterization of the reversible cardiomyopathy of hypothyroidism. Am J Med 1980; 88: 675-682.
cardiomyopathy
Hypothyroidism
Reversible
Echocardiography subaorlic
Protein-calorie
Cancer
Undernulrllion undernutrition
Anlhromelrics Cancer
Meningitis
staging
Non-Hodgkin’s
lymphoma
Continued on page A32
Review of the records of 122 patients with non-Hodgkin’s lymphoma revealed that all sites of involvement were detected by gallium scanning in three patients (2.5 per cent) and sites not found by routine physical examination and roentgenogram in 22 patients (17 per cent). Only 18.5 per cent of all diseased sites were found by gallium scanning and sites mistakenly assigned as positive or negative were found 28 per cent of the time. Most of these mistakes were false negatives. Only one patient was upstagedas a result of gallium scanning.The gallium scan cannot replace more invasive staging procedures, such as lymphangiography, and does not provide information reliably enough to base therapeutic decisions on its outcome.
Lymph&ma
We have undertaken a prospective study of the incidence of central nervous system disease at presentation in acute granulocytic leukemia (AGL). Thirty-nine consecutive newly diagnosed patients with AGL underwent lumbar puncture and cytocentrifuge examinations of the cerebrospinal fluid In seven of the 39 patients blast cells were demonstrable. All affected patients had acute myelomonocytic leukemia (AMML). This represented seven of the 13 patients with AMML. Other high risk factors associated with meningeal infiltration were elevated serum lysozyme levels, high peripheral while cell count, lower age, splenomegaty and infiltrationof other organs. In the patients with meningeal leukemia, remission rates were lower and survival time shorter than in the 32 nonfnvolvedpahenis. A lumbar pun&e is indicated-inalinswiy diiosed patients with AMML and treatment should be instituted if blast cells are present.
Gallium scanning
Longo DL, Schilsky RL, Blei L, Cano R, Johnston GS. Young RC: Gallium-67 scanning: limited usefulness in staging patients with non-Hodgkin’s disease lymphoma. Am J Med 1980; 68: 695-700.
levels
leukemia
Serum lysozyme
Acute granulocylic
Meyer RJ, Ferreira PPC, Cuttner J, Greenberg ML, Goldberg J, Holland JF: Central nervous system involvement at presentation in acute granulocytic leukemia. A prospective cytocentrifuge study. Am J Med 1980; 68: 691-694.
Central nervous system involvement
Leukemia
A study of the nutritional status of hospitalized cancer patients revealed a nearly universal prevalence of protein-calorie undernutrition.The creatinine to height ratio was the most sensitive indicator of protein-calorie undernutrition.Neither basal metabolic rate nor caloric intake differed from expected values for normal sedentary subjects of comparable size. Steatorrhea was rare. Survival was de&eased if nutritional parameters fell below certain threshold levels. These investigators conclude that protein-calorie undernutrition is present in most hospitalized cancer patients but that it may be obscured by residual obesity. Survival might be enhanced if nutrition could be maintained above critical levels.
hyperlrophic
Asymmetric septal hypertrophy was identified in 17 of 19 cases of untreated hypothyroidism evaluated by M-mode echocardiography. In five patients this abnormality was associated with systolic anterior motion of the mitral valve and reduced left ventricular outflow tract dimension simulating the echocardiographic pattern of idiopathic hypertrophic subaortic stenosis. In 10 patients who returned to euthyroa state with L-thyroxine therapy, the echocardiographic abnormalities resolved. We conclude that long-standing hypothyroidism leads to a reversible cardiomyopathy, manifested by asymmetric septal hypertrophy with or without other echocardfographic features of a hypertrophic-obstructive cardiomyopathy.
Idiopathic
septal hypertrophy
Nixon DW, Heymsfield SB, Cohen AE, Kutner MH, Ansley J, Lawson DH, Rudman D: Protein-calorie undernutrition in hospitalized cancer patients. Am J Med 1980; 68: 683-690.
Asymmetric
Santos AD, Miller RP, Mathew PK. Wallace WA, Cave Jr WT. Hinojosa 1: Echocardiographic characterization of the reversible cardiomyopathy of hypothyroidism. Am J Med 1980; 88: 675-682.
cardiomyopathy
Hypothyroidism
Reversible