Parameters That Contribute to Hearing Loss in Cml Patients

Abstract 4455 Background: Chronic Myeloid leukaemia (CML) is a clonal disease that results from an acquired genetic change in a pluripotential haemopoietic stem cell. Hearing loss is a rare complication of CML. The most probable cause of the hearing loss in CML has been attributed to hyperleukostasis rather than leukaemic infiltration as seen in other leukaemias. This supported by the fact that hearing loss can be reversed in some patients if leukapheresis is done early. Patients and Methods: This retrospective study was conducted at the Korle-Bu Teaching Hospital, Accra, Ghana. Study included adult patients diagnosed with (CML) over a five year period from January 2007 to December 2011 who presented with hearing loss. Seven of them presented with hearing loss. Diagnosis of CML was made by a bone marrow aspirate and confirmed with Fluorescence in situ hybridization (FISH) analysis for Philadelphia chromosome. Medical records of cases were analyzed for their demographic characteristics and clinical features. Haemoglobin levels, total white cell count at presentation and platelet count were also obtained from their full blood counts. Correlation between hearing loss and parameters such as age, sex, total white cell count at presentation, level of haemoglobin, platelet count and results of FISH analysis on presentation were analysed and level of significance obtained using Pearson's correlation. Results: Eight-three patients were diagnosed with CML over the period and 8.4% (7) presented with hearing loss. Six of the patients were males and there was one female. Significant level of significance was found between hearing loss and white cell count (p=0.043), haemoglobin level (p=0.024), sokal score (p=0.001) and results of FISH at diagnosis (p=0.039). Level of significance was 5%. Conclusion: There was significant correlation between hearing loss and parameters such as white cell count at presentation, haemoglobin level, sokal score and results of FISH at diagnosis in this study. These factors played a role towardsthe loss of hearing of these CML patients in the study. Disclosures: Baidoo: GSK: Speakers Bureau.

Extracorporeal photopheresis in Sézary syndrome: hematologic parameters as predictors of response

Data were analyzed from 23 patients with Sézary syndrome (defined by erythroderma, more than 10% circulating atypical mononuclear cells, and peripheral blood T-cell clone) undergoing monthly extracorporeal photopheresis as the sole therapy for up to 1 year. The cohort showed a significant reduction of skin scores during treatment (P = .001). Thirteen patients (57%) achieved a reduction in skin score greater than 25% from baseline at 3, 6, 9, or 12 months (responders). Reduction in skin score correlated with reduction in the Sézary cell count as a percentage of total white cell count (P = .03). Responders and nonresponders were compared. None of the measured parameters was significantly different between the 2 groups. It was assessed whether any of the baseline parameters predicted outcome. A higher baseline lymphocyte count was significantly associated with a decrease in skin score at 6 months (P < .05). A higher baseline Sézary cell count as a percentage of total white cell count predicted a subject was more likely to be a responder after 6 months of treatment (P = .021). No other parameters predicted responder status. These data show that the modest falls in CD4, CD8, and Sézary cell counts were seen in all patients and might have resulted from lymphocyte apoptosis. This mechanism could explain the more favorable response seen in patients with higher percentages of Sézary cells in the peripheral blood. Alternatively, minimum tumor burden might be required for the induction of a cytotoxic response. Analysis of tumor-specific cytotoxic T cells is needed to investigate these possibilities further.

Effects of various steroids on the thymus, spleen, ventral prostate and seminal vesicles in old orchidectomized rats

ABSTRACT The effects of several steroids on the regenerating thymus in ageing male rats have been studied. Rats aged from 12 to 15 months were orchidectomized and 7 days later implanted s.c. with silicone elastomer tubing containing 25 mg testosterone, 5α-dihydrotestosterone (DHT), oestradiol, progesterone or corticosterone. One group of rats received an empty implant. Thirty days later the rats were killed and the thymus, spleen, ventral prostate and seminal vesicles weighed and retained for histology. Whole blood was taken for total and differential white cell counts; plasma was prepared for radioimmunoassay of testosterone, oestradiol, progesterone and corticosterone. After orchidectomy only, a multilobular thymus was present, and histologically the tissue appeared healthy. In testosterone- and oestradiol-treated rats, thymus weight was reduced to about 50% of that in untreated animals. Histologically, much of the thymus taken at autopsy was fat and what remained was poorly organized and contained a much lower density of thymocytes. The total white cell count was significantly reduced in these animals, the effect appearing to be predominantly on lymphocytes. Although treatment with DHT also resulted in a lower mean thymus weight than that of orchidectomized animals, histologically the tissue appeared similar to that of the untreated castrated animals. In rats treated with DHT, the total white cell count was significantly higher than in testosterone-implanted rats. Both progesterone and corticosterone implants resulted in significantly smaller mean thymus weights, although these steroids were not as potent as testosterone or oestradiol. Corticosterone, but not progesterone, appeared to cause a significant reduction in circulating lymphocytes. Dihydrotestosterone possessed only half the potency of testosterone in restoring the weights of the accessory sex organs. Serum concentrations of testosterone in orchidectomized old rats were 0·33 ± 0·02 nmol/l and in testosterone-implanted rats 4·8 ± 0·4 nmol/l. These results raise the possibility that testosterone and oestradiol may have caused atrophy of the thymus, while DHT may have retarded regeneration of the thymus without any atrophic effect. It remains to be seen whether the different responses between testosterone and DHT, in both the thymus and accessory sex organs, are due to differences in intrinsic action or differences in the metabolism of the steroids. J. Endocr. (1987) 113, 51–55

The Pathogenesis of Trypanosoma congolense Infection in Calves

Calves infected with Trypanosoma congolense TREU 112 had, at the onset of anemia, a very low total white cell count and neutropenia but with chronicity there was lymphocytosis. Infected calves had a marked reduction in granulocyte mobilization for the first 14 weeks of infection and there was reduced ability to mount an inflammatory response during the onset of anemia. Bone marrow aspiration biopsies showed marked erythroid hyperplasia in response to the anemia with a relative and likely absolute reduction in myeloid precursors and marrow granulocyte reserves.