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Clinical hematologists are frequently faced with the intriguing problem of agnogenic myelo dysplastic syndromes; these syndromes are peculiar in their failing or poor response to therapy and in that they frequently terminate in acute leukemia. An international symposium held in Innsbruck in 1978 was dedicated to clinical and pathophysiologic aspects of the preleukemic syndromes. This monograph consists of articles that correspond to the papers presented at the symposium and of the edited discussions. It was the aim of the symposium and of this monograph to outline comprehensively the pathophysiologic background of the preleukemic syndromes and to summarize the present information about their clinical management. The first part of the monograph covers that pathology of these disorders: Disturbed maturation and proliferation of the hemopoietic cells are the causes of cyto penias, of structural and ultrastructural anomalies, and of enzymatic and functional defects. Further articles are concerned with the evaluation of these features and of chromosome anomalies as possible tools for the diagnostic and prognostic classification of myelodysplasias. Pathogenetic data and immunologic considerations form the rationale for therapeutic ap proaches. F. Schmalzl K. -P. Hellriegel v Contents K. -P. Hellriegel and F. Schmalzl Preleukemia: Definition and Classification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . H. Heirnpel Conventional Morphological Examination of Blood and Bone Marrow Cells in the Diagnosis of Preleukemic Syndromes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 C. Peschle Pure Red Cell Aplasia Type III: Progression to Acute Myeloid Leukemia and Absence of the IgG Inhibitor to Erythropoiesis . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Discussion . . . . . . . . . . . . . . . . . . '. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 . . . . I. Fohlmeister, H. E. Schaefer, K. -P. Hellriegel, and R.
Sommario
Preleukemia: Definition and Classification.- Conventional Morphological Examination of Blood and Bone Marrow Cells in the Diagnosis of Preleukemic Syndromes.- Pure Red Cell Aplasia Type III: Progression to Acute Myeloid Leukemia and Absence of the IgG Inhibitor to Erythropoiesis.- Discussion.- Blood and Bone Marrow Follow-Up Studies on Patients with Preleukemic States - Observation of Different Phases of the Evolving Leukemic Process.- Discussion.- Abnormalities of Granulocytes and Megakaryocytes in Preleukemic Syndromes.- The Platelet Ultrastructure in Preleukemia.- Hereditary Deficiency of Myeloperoxidase and Preleukemia?.- Discussion.- Cytochemical Investigations on the Blood and Bone Marrow Cells in Preleukemia - Demonstration of Maturational Anomalies.- Complementary Investigations in Myelodysplastic Syndromes.- Discussion.- Chromosome Findings in Preleukemia.- Discussion.- Cell Proliferation in Refractory Anemia with Hyperplastic Bone Marrow (Preleukemia).- Bone Marrow Cell Kinetics in Patients with Pancytopenia.- Discussion.- In Vitro Disorders of Granulopoiesis in Preleukemia.- Sequential Marrow Culture Studies and Terminal Deoxynucleotidyl Transferase Activities in Myelodysplastic Syndromes.- The Value of In Vitro Culture in Diagnosis and Progress in Preleukemia and Oligoblastic Leukemia.- Discussion.- A Prospective Study of Patients with Preleukemia.- The Factors of Prognosis in Refractory Anaemia with an Excess of Blasts in the Bone Marrow.- Studies on Human Preleukemia VII - Prognostic Factors for the Diagnosis of the Preleukemic Stage in Aregenerative Anemia with Hypercellular Bone Marrow.- Discussion.- Tests for Diagnosis of Preleukemic States Round Table Discussion.- How can We Interpret the Cell-Kinetic Status of Preleukemia?.- Discussion.-Androgen Therapy in the Refractory Anemia with Excess of Myeloblasts in the Bone Marrow.- Cytotoxic Drugs in the Treatment of Preleukemic Syndromes.- Discussion.- Speculations on Problems of Immunology in Preleukemia.- Studies on Human Preleukemia VI - Non-Specific Immunotherapy (BCG) in Five Patients with Aregenerative Anemia and Hypercellular Bone Marrow.- Discussion.- Bone Marrow Transplantation - A Possible Therapeutic Approach for Preleukemia?.- H.-J. Kolb and the Munich Cooperative Group for Bone Marrow Transplantation Bone Marrow Transplantation for Treatment of Preleukemic Syndromes?.- Discussion.- Preleukemia - Problems and Trends.
