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Volume selective magnetic resonance (MR) proton spectroscopy was used to investigate the haemopoietic (iliac bone) and fatty bone marrow (tibia) in patients with leukemia and polycythaemia vera. Selective measurements of the relaxation times T1 and T2 for the "water" and "fat" resonances in the bone marrow spectra were performed. Nine patients with acute leukemia and three patients with chronic leukemia were examined at diagnosis. Three patients with acute leukemia in remission were also examined. Five of the leukemic patients had follow-up examinations performed in relation to chemotherapeutic treatment. Nine patients with polycythaemia vera and 21 normal control subjects were examined with identical methods for comparison. All patients had bone marrow biopsies performed prior to every MR examination. Significant differences could be detected in the spectral patterns from iliac bone marrow in patients with leukemia at diagnosis compared to the healthy normal controls. The "relative water content" was increased in the iliac bone marrow spectra of the leukemic patients compared to the normal subjects, which indicates an increase in the amount of haemopoietic tissue and a corresponding decrease in marrow fat content. The T1 relaxation times of the "water" resonance in the spectra from the iliac bone marrow of the leukemic patients were significantly prolonged at diagnosis, compared to the normal controls and the patients with polycythaemia vera. After chemotherapeutic induction of remission, the spectra from the iliac bone marrow in the patients with leukemia resembled normal spectra. Four leukemic patients had abnormal spectra from the tibial bone marrow and one patient showed early changes in tibial marrow during chemotherapeutic treatment, before any major changes could be detected in the iliac bone marrow.

The binding of 125I-lactoferrin to a variety of peripheral blood cells was examined. In the concentration range from 10(-9) mol/l to 10(-6) mol/l a receptor-like binding of lactoferrin was observed in monocytes as well as in polymorphonuclear leucocytes. At the low concentrations of lactoferrin in plasma (about 10(-9) mol/l) the cellular binding to monocytes was about 10 times higher than the binding to polymorphonuclear leucocytes and lymphocytes. A major result from a kinetic analysis was a lower apparent binding affinity to polymorphonuclear leucocytes (KD about 2 X 10(-7) mol/l) than to lymphocytes and monocytes (KD about 2 X 10(-8) mol/l). Studies in leukaemic cells showed that lymphocytes from patients with chronic lymphocytic leukaemia bound lactoferrin to the same small extent as normal lymphocytes. In contrast, a larger component of binding with high affinity (KD about 2 X 10(-8) mol/l) could be demonstrated to lymphoblasts as well as to myeloblasts.

An epidemiologic study of the total population of patients with leukemia in Denmark during 1943-77 was performed with special emphasis on time trends. The material stemmed from the national Danish Cancer Registry and was believed to be virtually complete. Of the 13,813 patients, 40% had acute leukemia; 40%, chronic lymphocytic leukemia; patients, 40% had acute leukemia; 40%, chronic lymphocytic leukemia; and 20%, chronic myeloid leukemia. Over the 35-year period, the incidence of acute leukemia increased threefold in the age groups 0-9 and 50-70+ years; whereas the increase in the age group 0-9 years climaxed in the 5-year period 1968-72, and the increase in the age group 50-70+ years was sustained. The incidence of chronic lymphocytic and chronic myeloid leukemia remained unchanged. No geographic pattern was discernible.

In vivo tissue characterization by measurement of T1- and T2-relaxation processes is one of the greatest potentials of magnetic resonance imaging (MRI). This may be especially useful in the evaluation of bone marrow disorders as the MRI-signal from bone marrow is not influenced by the overlying osseous tissue. Nine patients with acute leukaemia, one patient with myelodysplastic syndrome, and ten normal volunteers were included in the study. The T1- and T2-relaxation processes were measured in the lumbar spine bone marrow using a wholebody superconductive MR-scanner operating at 1.5 Tesla. In the patients MRI was done at the time of diagnosis and during follow-up of chemotherapy and related to bone marrow biopsies taken within three days of the MRI. At the time of diagnosis T1-relaxation time was increased two to three times in the patients (range 0.7-3.0 sec.) compared to the controls (range 0.38-0.60 sec.). No significant difference was seen in the T2-relaxation process. In relation to chemotherapy T1 decreased towards the normal range in the patients who obtained complete remission, whereas T1 remained prolonged in the patients who did not respond successfully to the treatment. The results indicate that MRI may be a non-invasive clinically useful tool in the evaluation of acute leukaemia especially as a follow-up control of chemotherapy.

Cell-associated and serum β2-microglobulin was estimated in seven patients with chronic lymphocytic leukaemia. The amount of cell-associated β2-microglobulin was significantly reduced (P<0.01), due to a decrease in the fraction of β2-microglobulin that passes unretarded through a concanavalin A affinity column (presumably non-HLA-associated β2-microglobulin). Serum concentrations of β2-microglobulin were increased, but no correlation was found between the decrease in cell-associated β2-microglobulin and the increase in serum β2-microglobulin. All of the β2-microglobulin from leukaemic serum was eluted corresponding to a molecular weight of 11,800 and none of it was retarded on a concanavalin A affinity column. The decrease in cell-associated β2-microglobulin might reflect a change in the qualitative or quantitative expression of β2-microglobulin-associated membrane structures on the leukaemic cells, perhaps conferring resistance to the cells against hypothetical immunological host defence mechanisms, [ABSTRACT FROM AUTHOR]

Therapy with DNA topoisomerase II inhibitors has been shown to result in an increased risk of acute myeloid leukemia (AML), often presenting balanced translocations to chromosome bands 11q23 and 21q22. Also other balanced aberrations, more rarely observed in therapy-related AML (t-AML), such as t(15;17) and inv(16) have been associated with these drugs. Recently we observed a case of chronic myeloid leukemia (CML) with t(9;22) after therapy of a germ cell tumor with etoposide, cisplatin and bleomycin. Based on this case and a review of chemotherapy-related leukemias with t(9;22) from the literature, we suggest a causal relationship between therapy with DNA topoisomerase II inhibitors and development of various types of leukemia carrying the Philadelphia chromosome. [ABSTRACT FROM AUTHOR]