Download Aplastic Anemia: Pathophysiology and Approaches to Therapy by H. Heimpel (auth.), Hermann Heimpel M. D., Edward C. PDF

By H. Heimpel (auth.), Hermann Heimpel M. D., Edward C. Gordon-Smith M. D., Wolfgang Heit M. D., Bernhard Kubanek M. D. (eds.)

Research on aplastic anaemia has till lately been constrained to scientific description, morphology and epidemiology. New how you can tradition haemopoietic cells, and advances in our wisdom of proliferation and differentiation within the haemopoietic telephone approach .opened a brand new zone of medical curiosity for this "prototype" of haemopoietic failure. moreover, bone marrow transplantation grew to become not just a scientific approach to therapy, but in addition a resource of information worthy for the dialogue of pathophysiological versions of aplastic anaemia. this case triggered us to rearrange a global con­ ference on aplastic anaemia, with specific emphasis on its patho­ body structure and the rationals of the present healing methods. This convention used to be held at Schloss Reisensburg from July 20-22, 1978 with the participation of either experimental and scientific scientists energetic during this box or in comparable parts of study. The complaints of the symposion mirror the current wisdom in addition to the numerous new questions which arose from the discussions. The editors are gratefully indebted to the individuals of this assembly, to Gerlinde Trogele and all of the co-workers of the Uni­ versity of Ulm engaged in instruction of this symposium and of this quantity, and final no longer least to all sponsors who supplied the monetary foundation for this medical event.

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Despite small numbers, this study and previously published reports [6, 31, 33, 34] suggest that early bone marrow transplantation is the treatment of choice for severe aplastic anemia following hepatitis. 43 The Role of Viral Infections in Aplastic Anemia Table 3. 0 85% 75% 90% 65% 92 % moderate to marked decrease 8% normal or increased Aplastic 75 Hypoplastic 43 ? 54 17 (1-59) % Patients with lowest recorded: PMN/mm 3 <1000 <500 Platelets/mm 3 <50,000 <20,000 Marrow cellularity: , Criteria for inclusion: Hepatitis to aplasia <9 months, no drug ingestion, no other disease.

One obvious reason for the shift among drugs causing side effects is difference in sale and use of the drugs. Figure 4 shows that the sale of chloramphenicol, after an early increase, has gone down remarkably in Sweden, as has, somewhat later, Kg/ year o , / "'o'" OXYPHENBUTAZONE o 0 -- 0 , 1000 6, 500 ~' , PHENYLBU TAZONE 6 _" 6 _ " 6 o I 1965 i I I 1970 - --0 _ " 6 I 1975 YEAR Fig. 4. Change in sales figures for chloramphenicol, oxyphenbutazone and phenylbutazone in Sweden Epidemiology and Aetiology of Aplastic Anemia 35 the sale of phenylbutazone and oxyphenbutazone.

Bone marrow biopsy of patient C. : Severe hypoplasia at diagnosis in January 1976 Fig. 2. Bone marrow aspirate of patient C. : Hypercellularity with increased granulopoiesis in April 1977 Aplastic Anemia Terminating in Leukemia 49 this time. Cytogenetic studies of bone marrow cells, however, exhibited mitoses with chromosome numbers ranging between 46 and 52. In the metaphases with 52 chromosomes, the supernumerary chromosomes were identified as number 8, 9, 12, 17 and 22 by Giemsa banding technique; additionally, a small, unidentifiable marker chromosome was present.

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