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Indolent Clinical Course (indolent + clinical_course)
Selected AbstractsLate-onset Behçet's disease does not correlate with indolent clinical course: report of seven Taiwanese patientsJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 5 2008J Tsai Abstract Background, Behçet's disease (BD) is a recurrent multisystem disease of uncertain aetiology. The young adults are most often affected, usually during the third decade. Late occurrence of the disease is considered uncommon and less frequently investigated. Objective, The aim of this study was to examine the clinical features of BD patients with disease onset at a later age and compare them with the usual age of onset group. Methods, Retrospective review of clinical charts of BD patients was conducted. Patients with age of onset at or after 40 years of age were identified. The clinical profiles and medications required to control the disease activity were documented. Comparisons of clinical features and the medications used were made between patients with disease onset before and after 40 years of age. Results, Seven late-onset BD patients were identified. Among them, five patients required the use of systemic immunosuppressant in addition to colchicine and corticosteroid for adequate disease control. There is no significant difference in clinical profiles between patients with disease onset before and after 40 years of age, but the incidence of uveitis, an indicator of unfavourable prognosis, was surprisingly high. More specifically, it was noted in four of seven patients identified. Conclusion, Our findings indicate that the clinical course of BD is not indolent in the patients with late-onset BD. More importantly, physicians should be aware that BD can occur in older patients, and close attention regarding their disease activities is warranted as their clinical courses may not be as benign as previously believed. [source] Oncocytic papillary renal cell carcinoma with inverted nuclear pattern: Distinct subtype with an indolent clinical coursePATHOLOGY INTERNATIONAL, Issue 3 2009Bong-Hee Park Reported herein are seven cases of a histologically distinct oncocytic papillary renal cell carcinoma (OPRCC) with an inverted nuclear pattern. To define its prognostic significance, the clinicopathological features of OPRCC were compared to those of types 1 and 2 PRCC. The median age of the seven patients was 67 years. Grossly, tumors were well-circumscribed and small (1.2 cm ± 0.4 cm). Microscopically, the OPRCC were composed of well-developed thin papillae, lined with a single layer of cuboidal-to-columnar oncocytic cells. The tumor cells had round-to-oval nuclei and eosinophilic granular cytoplasm, which was strongly positive for anti-mitochondrial immunostaining. The nuclei were characteristically polarized toward the surface of the papillae and contained mostly small nucleoli. The tumors had high expression of ,-methylacyl-coenzyme A racemase, CD15, CD117, cytokeratin (CK) 7, E-cadherin, epithelial membrane antigen, MOC 31, mucin-1, vascular endothelial growth factor and vimentin, low expression of CD10 and Ki-67, and no expression of CK20. Genetically, gain of chromosomes 3p, 11q, and 17q, and loss of chromosome 4q was observed. All seven patients were alive with no recurrence or metastasis at a mean follow-up time of 37.1 ± 23.7 months. In conclusion, OPRCC show unique pathological features with indolent clinical behavior and are more similar clinicopathologically to type 1 than to type 2 PRCC. [source] ,, T-cell large granular lymphocyte (LGL) leukemia with spontaneous remissionAMERICAN JOURNAL OF HEMATOLOGY, Issue 3 2004Tsutomu Shichishima Abstract T-cell large granular lymphocyte (LGL) leukemia is a clonal disorder with an indolent clinical course. In July 1995, a 46-year-old Japanese man was admitted to our hospital because his anemia had progressed. He had a white blood cell count of 3.9 × 109/L with 75% lymphocytes, which were intermediate to large and had almost round nuclei and azurophilic granules, and anemia with a red blood cell count (RBC) of 2.69 × 1012/L, hemoglobin (Hb) of 9.5 g/dL, and hematocrit (Hct) of 28.3%. Electron microscopic examination showed that most of the lymphocytes had a parallel tubular array and dense core granules in their cytoplasm. Flow cytometry and Southern blotting of the T-cell antigen receptor (TCR) genes using the peripheral blood species showed monoclonal proliferation of LGLs with a CD3+, TCR,,+, CD4,, CD8,, CD16+, CD56,, CD57,, HLA-DR+ phenotype, and a TCR , gene rearrangement, respectively, suggesting that the patient was diagnosed as having ,, T-cell LGL leukemia. He had no symptoms, organomegaly, or skin lesions. About 1.5 years after diagnosis, the anemia gradually improved with disappearance and appearance of a rearranged band in the TCR-, gene and TCR-, gene, respectively. About 7 years after diagnosis, the anemia improved completely with a RBC of 5.01 × 1012/L, Hb of 14.8 g/dL, and Hct of 44.3%, and he was in complete remission without TCR-, and -, gene rearrangements. He had received no therapy. This is the first report of spontaneous remission of ,, T-cell LGL leukemia. Am. J. Hematol. 75:168,172, 2004. © 2004 Wiley-Liss, Inc. [source] Selective apoptosis of natural killer-cell tumours by l -asparaginaseBRITISH JOURNAL OF HAEMATOLOGY, Issue 6 2005Miki Ando Summary We examined the effectiveness of various anti-tumour agents to natural killer (NK)-cell tumour cell lines and samples, which are generally resistant to chemotherapy, using flow cytometric terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end-labelling (TUNEL) assay. Although NK-YS and NK-92 were highly resistant to various anti-tumour agents, l -asparaginase induced apoptosis in these two NK-cell lines. NK-cell leukaemia/lymphoma and acute lymphoblastic leukaemia (ALL) samples were selectively sensitive to l -asparaginase and to doxorubicin (DXR) respectively. Samples of chronic NK lymphocytosis, an NK-cell disorder with an indolent clinical course, were resistant to both drugs. Our study clearly separated two major categories of NK-cell disorders and ALL according to the sensitivity to DXR and l -asparaginase. We examined asparagine synthetase levels by real-time quantitative polymerase chain reaction (RQ-PCR) and immunostaining in these samples. At least in nasal-type NK-cell lymphoma, there was a good correlation among asparagine synthetase expression, in vitro sensitivity and clinical response to l -asparaginase. In aggressive NK-cell leukaemia, although asparagine synthetase expression was high at both mRNA and protein levels, l -asparaginase induced considerable apoptosis. Furthermore, samples of each disease entity occupied a distinct area in two-dimensional plotting with asparagine synthetase mRNA level (RQ-PCR) and in vitrol -asparaginase sensitivity (TUNEL assay). We confirmed rather specific anti-tumour activity of l -asparaginase against NK-cell tumours in vitro, which provides an experimental background to the clinical use of l -asparaginase for NK-cell tumours. [source] Neutrophilic-chronic myeloid leukemiaCANCER, Issue 9 2002Low levels of p230 BCR/ABL mRNA, undetectable p230 BCR/ABL protein may predict an indolent course Abstract BACKGROUND Neutrophilic-chronic myeloid leukemia (CML-N) has been described as a CML variant associated both with a distinctive molecular defect of the Philadelphia chromosome and with a more benign clinical course than classic CML. The translocation (9;22) in CML-N results in the transcription of an e19/a2 type BCR/ABL mRNA that codes for a 230-kD BCR/ABL protein (p230). The indolence of the clinical course of patients with CML-N has been disputed. METHODS The objectives of this study were to quantify and correlate with clinical outcome the p230 mRNA and protein in patients with CML-N, to describe six new patients and the follow-up (with molecular analysis) of five previously reported patients with CML-N, and to review characteristics of all patients with CML-N and p230 BCR/ABL reported to date in the literature. RESULTS Quantitative polymerase chain reaction assays on specimens from the great majority of patients with CML-N revealed minimal numbers of molecules of p230 BCR/ABL transcripts per total RNA. This also was associated with a lack of detectable p230 BCR/ABL protein in patient specimens, even in one patient who was followed for 16 years after diagnosis. This may explain the milder leukemic phenotype in most patients with CML-N. A review of all 23 patients who had an e19/a2 type BCR/ABL translocation suggested that the low level of p230 BCR/ABL mRNA and the lack of detectable p230 BCR/ABL protein in patients with no additional cytogenetic abnormalities may predict their indolent clinical course. CONCLUSIONS Patients with p230 positive CML-N have indolent course, probably as a result of low p230 mRNA and protein levels. This supports the need to conduct additional molecular studies, even if cytogenetic studies have revealed t(9;22), because of the prognostic importance of the molecular findings. Cancer 2002;94:2416,25. © 2002 American Cancer Society. DOI 10.1002/cncr.10490 [source] | ||||||||||