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Among 75 untreated patients with typical (CD19+, CD5/CD19+, CD23/CD19+) B-cell chronic lymphocytic leukemia (B-CLL) cytogenetic aberrations of peripheral blood cells were evaluated, using fluorescence in situ hybridization techniques. Two cytogenetic aberrations were evaluated: trisomy 12 and TP53 deletion. The clonality was determined when > or = 10% of the cells had of trisomy 12 or deletion TP53 gene. Trisomy 12 in 7 patients was detected, while trisomy 12 and TP53 deletion simultaneously in 6 patients were present. If the first group will be linked to the second one then 13 patients among 75 (17%) will have trisomy 12. In group of patients with trisomy 12 and TP53 deletion percentage of cells with trisomy 12 was almost two time more compare to patients with trisomy 12 as a single aberration. It is possible, that TP53 deletion ("the guardian of the genome") facilitates proliferation clones with others genomic aberrations. In two patients with trisomy 12 control cytogenetic study was performed. Increase of percentage cells with trisomy 12 for 8% and 30% respectively was detected. However, proliferation of cells with TP53 deletion was observed too. Clinical course of B-CLL in group of patient with trisomy 12, trisomy 12 and TP53 deletion simultaneously is more aggressive compared to the course of disease of patients with no cytogenetic aberrations (patients of Group I from Part I of paper). Frequency of IGHV gain mutation occurrence was not analyzed in both groups of patients. But trisomy 12 together with unmutated IGHV gene is found by some authors. The absence IGHV gene mutation is independent unfavourable prognostic factor.

In a group of 75 untreated patients with a typical B cell chronic lymphocytic leukaemia (B-CLL) (CD19+, CD5/CD19+, CD23/CD19+), the frequency and clinical significance of TP53 gene deletion and chromosome 12 trisomy were assessed. The studies of peripheral blood lymphocytes were conducted using interphase in situ hybridization technique. Clonality was identified when TP53 deletion or chromosome 12 trisomy was found in at least 10% of cells. From all 75 examined patients 32 individuals without any of the genetic aberrations were analyzed (Group I) and 30 subjects with TP53 deletion (Group II) were chosen. In the other 13 patients, discussed in the next paper, either chromosome 12 trisomy (Group III--seven subjects) or both chromosome 12 trisomy and TP53 deletion (Group IV--six subjects) were found. In the Group I, there has been no further contact with three patients, while in the Group II--with two individuals. In the Group I, one patient of 29 in the study (3%) died after 84 months (seven years) from the diagnosis, whereas in the Group II--nine subjects of 28 in the study (32%) died within 1-36 months from the diagnosis. In three of those patients in the terminal condition, cytogenetic studies were repeated revealing an increase of approximately 5% in the percentage of peripheral blood cells with TP53 deletion. The frequent presence of TP53 deletion detected in 48% of patients is surprising. It is generally thought that the aberration is found in 10-15% of clinical cases. The studies should be confirmed on a larger group of patients.

Uncontrolled cell proliferation is the hallmark of cancer, and tumour cells have typically acquired damage to genes that directly regulate their cell cycles. Genes that link checkpoint controls to cancer and other related genetic disease include the TP53 and ATM genes. The abnormalities of these genes are clearly associated with particular forms of the B-cell chronic lymphocytic leukemia and poor prognosis.

Intravascular lymphoma (IVL) is characterized by proliferation of large malignant lymphoid cells within the lumen of small vessels. Sites usually affected include the central nervous system and skin although involvement of multiple organ symptoms have been described. IVL is very rare and aggressive type of lymphoma. Based on review of the literature we present clinicopathological, immunohistochemical and molecular features of the IVL. The etiological possibilities are discussed.

CD43 is an integral cell membrane mucin appearing on hematopoietic cells in embryonic life probably on cells of vitellus bag, in embryonic and foetal liver and in foetal bone marrow. In adults CD43 occurs both on bone marrow hematopoietic stem cells as well as on peripheral mature white blood leukocytes with the exception of resting B lymphocytes. CD43 is also found on tissue macrophage, dendritic cells, smooth muscle cells, epithelium and endothelium. CD43 expression was detected on cells of leukaemias myeloid and lymphoid, lymphoma cells and metastases of solid neoplasms. Due to the elongated, twig-resembling shapes and numerous negatively charged rests of sialic acid CD43 can act in an anti-adhesive fashion e.g., disturbing ICAM-1 (CD54)--LFA-1 (CD11A/CD18) interaction. Alternatively, in certain conditions CD43 can be pro-adhesive. So, e.g., adhesion hematopoietic progenitor cells to stromal bone marrow cells partly depends on CD34-CD43 cooperation. Similarly, according to the degree of cell maturity and the kind of cell line, CD43 can induce either activation or cell apoptosis. So, bindig CD43 by specific monoclonal antibody induces activation and proliferation of T cells and also the oxidation burst of monocytes and neutrophils. On the other hand, CD43 induces apoptosis, especially in dividing progenitor hematopoietic stem cells.

This article summarizes the clinical, radiological and laboratory features of syndrome, which is known by the acronym "POEMS". POEMS syndrome is a rare multisystemic syndrome with plasma cell dyscrasia. POEMS is characterized by the combination of polyneuropathy, organomegaly, endocrinopathy, M protein and skin changes. Other signs are frequently observed in affected patients, such as peripheral edema, arteriopathy, nephropathy, thrombocytosis and osteosclerotic lesions. The plasma cell dyscrasia in POEMS syndrome differs from the dyscrasia found in multiple myeloma. It has been suggested that pleiotropic cytokines which act in synergy on immune, nervous, endocrine and vascular systems could play a pathogenic role in POEMS syndrome.

CD43 (other names: sialophorin, leukosialin, sialoglycoprotein of white blood cells) is an integral cell membrane mucin. In population of peripheral B cells CD43 occurs only on activated B cells and CD5 positive B cells. These last cells create neoplasm population in patients with B-cell chronic lymphocytic leukemia (B-CLL). Anti-CD43 monoclonal antibodies are used routinely in investigations of tissue fragments in cases of non-Hodgkin's lymphoma, whereas we did not find publication on theme of CD43 expression on peripheral blood B cells in patients with B-cell chronic lymphocytic leukemia. Wherefore advisable appeared estimation CD43 expression on B-CLL cells and comparison it with expression of typical B-CLL markers--such as CD5 and CD6. Immunological phenotype of peripheral blood and bone marrow lymphocytes has been evaluated using flow cytometry (Cytoron Absolute Ortho-Diagnostic Systems) and two-color staining. Twenty six untreated patients with B-CLL were studied. Because on well-known correlations between CD43 expression and metastasis potential of tumor, patients were divided on two groups differing score of total tumor mass (score TTM). Score TTM was evaluated according to criterion of Jaksic and Vitale. Twelve patients whose TTM score was equal or lower than 9 and median lymphocytosis was 24.6 x 10(9) in microliter were included in group I. 14 patients whose TTM score was higher than 9 were included in group II. Median lymphocytosis in these patients was 152.6 x 10(9) in microliter. The median percentage of CD43+/CD19+ cells in peripheral blood was 62.6% in the group I, and 75% in the group II (p < 0.05). Median fluorescence intensity (MFI) of CD43 antigen was 87.7 in the I group comparing to 77.4 in the group II. So one observed tendency to lowering MFI during tumor growing but the difference was not significant (p = 0.25). In peripheral blood during progression of disease more clearly than CD43+ cells increased percentage of CD5+ and CD6+ cells. The median percentage of CD19+/CD5+ cells was 62.7% in the group I, 82.4% in the group II and the difference was significant (p < 0.002). The difference in the median percentages CD6+/CD19+ cell 71.8% in group I and 84.3% in the II one were also significant (p < 0.03). MFI of CD5 and also CD6 antigens did not change in course of disease. Moreover, examination of CD43 and CD5 expression in marrow additionally to blood study were performed in 12 cases (6 from group I, 2 from group II and 4 new not included). The median percentage of CD43+/CD19+ cell was 35.1% in blood and 43.7% In marrow, in contrast to these results was the median percentage of CD19+/CD5+ cell, which was higher in peripheral blood (70.4%) than in bone marrow (60.9%). The results of this study indicate that CD43 is present on peripheral blood B-CLL cells. Moreover, percentage of these cell increases during progression of disease however more weakly than percentage of CD5 and CD6 positive cells. Expression of CD43 is independent from expression CD5 and CD6 and diminishes during tumor mass increasing, what can depended from releases exocellular domains of CD43. CD43+ cell from B-CLL patients have a tendency to accumulation in tissues what is illustrated by higher percentage of CD43+ cell in bone marrow than in peripheral blood.

Antigen CD5 is the glycoprotein which belong to the scavenger receptor cysteine-rich family. Mainly there is on the T cells subpopulation. During fetal life B CD5+ cells are major subpopulation of B cells in the spleen, lymph nodes and there are also in the cord blood. In adult CD5+ cells are minor subpopulation (27%) of B cells from the peripheral blood. CD5 there are on chronic lymphocyte leukaemia B cells (B-CLL) also. Usually expression CD5 on B-CLL cells associated with weak or lack expression of the surface immunoglobulins and CD79 beta, CD20, CD22, CD21 (CR-2), CD35 (CR-1) antigens. It appeared interesting to compare the expression of CD5 antigen (the mean fluorescence intensity--MFI of CD5) on B cells from the cord blood, adults peripheral blood and B-CLL patients. MFI of CD5 on B and T cells were also compared in each groups. MFI of CD 19 was studied too. Lymphocytes from the cord blood (11 assays), adult peripheral blood of healthy volunteers (18 assays) and the peripheral blood of no treated patients with B-CLL (56 assays) were studied. The immunological phenotype of lymphocytes was evaluated with the monoclonal antibodies anti-CD5 and anti-CD19 by the flow cytometry method. We have demonstrated that MFI of CD5 on B cells from patients with B-CLL was strongest and weakest from normal individuals. MFI of CD5 on T cells from patients with B-CLL is stronger in comparison to healthy volunteers. MFI of CD19 is weakest on cells from patients with B-CLL and strongest in normal individuals. On the basis of the our results and other medical papers we suggest on the one hand that biology of B-CLL depend on deficit antigens specific for B cells lines on the other hand depend on overexpression of CD5 antigens on leukaemic B and T cells also.

Heterogeneity of B-cell chronic lymphocytic leukemia (B-CLL) may by partial an explanation of the ability of CLL cells to interact with the environment and it seems to be not related exclusively to cytogenetic abnormalities. For this reason T cell subpopulations were analysed in bone marrow and peripheral blood in two selected groups of B-CLL patients. These groups differed significantly in percentages of CD4+ helper T cells in bone marrow. In the first group (11 patients) percentage of CD4+ cells was higher than 9 p.c., in the second (10 patients) this percentage was equal, or lower than 2 p.c. Moreover these groups differed also in total tumor mass score (TTM-score) according to the criteria of Jaksić and Vitale. TTM-score in the first group was 9.7 in the second--22.9. In the first group CD4- cells predominated over CD8+ cytotoxic suppressor cells, as well as CD4+ CD45RO+ helper-inducer cells predominated over CD4+ CD45RA+ suppressor-inducer cells. In the second group we observed some superiority of CD8+ and CD4+ CD45RA+ cells. We can speculate that the predominance of CD4+ and CD4+ CD45RO+ cells over CD8+ and CD4+ CD45RA+ cells in bone marrow facilitate the proliferation or inhibits the apoptosis of CLL cells when the TTM-score is small. On the contrary when the TTM-score is larger, than the leukemic cells expanded in bone marrow without concomitant helper cells.

CD8 antigen is present on the surface of cytotoxic-suppressor T cells, NK cells and majority of thymocytes. Expression of CD 8 is associated with CD 3 antigen, which is a part of a T cell receptor. However, CD 8 antigen is undetectable on normal B cells. In sporadic cases of B cell-chronic lymphocytic leukaemia (B-CLL) it was found on leukaemic B cells. We report a case of B-CLL of benign course with CD19+, CD5+, CD40+, CD19+, CD20+, CD19+, CD19+HLADR+ leukaemic cells expressing CD8 antigen on CD19+ leukaemic cells. It seems that original neoplasms source was localized out of bone marrow. We suggest that the origin of the target cell for neoplasms transformation could be CD5+ B cell and CD8+ T cell gamma + delta + CD8+.

The average dosage of radiation which was measured in Poland during the year after damage of the nuclear power in Chernobyl (according to UNSCEAR) was 0.27 mSv, which gives 11% natural radiation dosage in the period of one year (2.6 mSv). Disturbances of cells genome caused by radiation are possible because of big dosage of radiation in Lublin region. It was interesting to define morbidity and mortality of multiple myeloma (MM) after the damage in Chernobyl. The average latent period of MM is about 20 years (like thyroid carcinoma). The increase of thyroid carcinoma morbidity after the damage of Chernobyl nuclear power plant in Byelorussia. Ukraine, Russia was observed. The increased morbidity rate of MM among patients of Haematologic Department (especially in the third stage of disease) and the increased mortality rate in Lublin region was confirmed.

G-CSF is one of drugs which play important role as one of link of the long chain used in biotherapy of cancers. However effect of G-CSF was known more than 20 years ago, it doesn't exclude chemotherapy and/or radiotherapy but it is effective complementary of this methods. The purpose of this short review is to describe biological activity, effects and clinical applications of G-CSF.

A comparative research on lymphocyte immunological phenotypes in peripheral blood and bone marrow was carried out on 14 patients with B-cell chronic lymphocytic leukaemia. Three types of B cell markers were estimated: 1-light chains (lambda or kappa) on the surface of cells, 2-CD5 antigen, 3-capability of forming mouse erythrocyte rosettes (MER); the last two markers are mostly characteristic of leukaemic cells. The patients were divided into 3 groups according to the localisation of the main mass of tumorous cells: group I-the patients, whose clinical picture was dominated by the infiltration of lymphoid structures of the abdominal cavity and/or with massive infiltration of peripheral lymph nodes; group II-the patients, whose clinical picture was dominated by the infiltration of bone marrow; group III-the intermediate-patients with large mass of tumor in lymphoid structures and with bone marrow insufficiency symptoms. In most of the patients of group I, the percentage of CD5+ cells in peripheral blood was higher than the one in bone marrow (arithmetic means were 38.5% for blood and 26.7% for marrow). It was the reverse in group II (the means were 44.8% for blood and 64.3% for marrow, P < 0.01). The percentage in group III was similar to that of group I (the means-48% for blood and 29.25% for marrow). No correlation between the percentage of CD5+ and MER+ cells was found in respective groups of the patients although the last marker behaved similarly to CD5. The results obtained suggest that while estimating percentages of CD5+ cells in peripheral blood and bone marrow, one can differentiate between chronic lymphocytic leukaemia (with domination of CD5+ cells in bone marrow) and leukaemic phase of small lymphocyte lymphoma (with domination of CD5+ cells in peripheral blood).

We present an unusual case of the myelodysplastic syndrome (subtype refractory anemia with the excess of blasts in transformation--RAEB-t) associated with significant increase of IgG (4,700 mg/dl), lambda (160 U/dl) in blood serum and circulating clone of B lymphocytes SIgG, lambda, manifesting clonal rearrangement of JH domain. Peripheral blood cells of the patient showed two different chromosomal abnormalities: 47,XY, + del/8/p? and 47,XY, +22, +14, -19. We suppose that two independent neoplastic clones are developed in the described case, i.e. a population displaying markers of myeloblasts and monoblasts, and a clone of B lymphocytes.

Lipopolysaccharide (LPS) and phorbol esters (TPA) stimulate lymphocytes proliferation in two different ways. While LPS primary function is specific receptor binding, TPA directly activate cellular protein kinase C. The stimulation of human leukaemic lymphocytes (from chronic lymphocytic leukaemia patients) with LPS and TPA results in two different types of response: to both stimulators, and to LPS only. Therefore the supposed defect of cellular receptors can not explain all the observed effects. The existence of TPA independent second messengers and changes in signal transduction pathways downstream of PKC can be considered.

Unlabelled: In a group of 16 patients with chronic lymphocytic leukaemia and leukaemic forms of the lymphoma lymphoplasmocytoides immunophenotypes of peripheral blood and lymph node lymphocytes were studied., Conclusions: 1) immunophenotype heterogeneity observed in a minority of patients in lymph-nodes or peripheral blood seems to be connected with the co-existence of leukaemic and normal reactive B-cells, 2) SIgG+ cells seem to represent activated B lymphocytes producing and secreting autoantibodies, 3) circulating peripheral T lymphocytes do not reflect the distribution of T cell subpopulations in lymph-nodes.

Considerations to multistep development of B-lymphocytic chronic leukaemia are presented under the following aspects: experimental in vitro cultures of bone marrows B lymphocyte precursors, polyclonal nature of proliferating B lymphocytes in the early stage of CLL, especially in the autoimmune status, the role of viruses, the effect of nonrandom chromosome abnormalities and associated alterations in gene functions, clonal evolution during terminal stages of CLL.

This article contains the review and the critical discussion of studies of T and B lymphocytes in chronic B-cell lymphocytic leukaemia. It is not explicitly known now, which stage of differentiation of lympho-haemopoietic cells undergoes malignant transformation in CLL-B. Basing on VDJ recombination activity it is supposed that some cases derive from the stem cell, others--from B lineage cells.

In a group of 9 patients with chronic lymphocytic or lymphoplasmocytic leukaemia in clinical stage from 2 to 4 (classification of Rai et al.) 8 various CHOP programmes (cyclophosphamide, hydroxyldaunomycin, oncovin, prednisone) were used. In 6 cases (67%) partial remission was obtained, with normalization of peripheral blood and bone marrow patterns, with statistically significant decrease of the proportion of cells forming rosettes with murine erythrocytes, and with reduction or full normalization of the size of previously enlarged lymph nodes. In one case the control examination of a lymph node failed to demonstrate the previously present clone of cells with chromosomal aberration, although in histological examination the diagnosis of lymphoplasmocytic lymphoma was maintained. In the remaining 3 cases no partial remission was noted, and in one case progression was recognized. We think similarly as the French haematologists studying chronic lymphatic leukaemia, that the CHOP programme is effective in the treatment of chronic lymphatic or lymphoplasmocytic leukaemia.

The purpose of the study was evaluation of the effect of treatment on the immunological phenotype of peripheral blood lymphocytes in patients with chronic lymphocytic leukaemia or in leukaemic forms of non-Hodgkin lymphomas, with low or medium grade malignancy. The study was carried out in 13 patient. In those responding to treatment a tendency was observed for normalization of the immunological phenotype of peripheral blood lymphocytes (increased proportion of cells forming rosettes with sheep erythrocytes, reduced proportion of cells forming rosettes with murine erythrocytes), and a tendency for polyclonal pattern of B-cells with immunoglobulins on their surface (although this feature was not a rule). In non-responders these tendencies were much less pronounced or absent. Similarly, in non-responders the tendency for polyclonal B-cell pattern may be only apparent, and may be connected with proliferation of a new lymphocyte population with another type of light chain.

In a group of 23 patients with chronic lymphocytic leukaemia in 1-4 clinical stages of the disease according to Rai et al (34) classification, mostly untreated (only 5 treated) considerable heterogeneity was found as evidenced by: variability of the morphological patterns of bone marrow, differences of immunological phenotypes of peripheral blood lymphocytes between individual cases, --coexistence of the features of maturity and immaturity in the populations of peripheral blood lymphocytes in the same case.

The authors describe mitotic activity in non-stimulated cultures of mononuclear cells obtained from the peripheral blood of patients with lymphosarcoma. The investigations were carried out on 3 patients in stage 3rd and 4th of this disease and 5 patients in the stage of sarcomatous-cell leukaemia. During a period of 24-48 hours after setting up of culture a rise was observed in the number of blast cells and appearance of up to 10% of mitotic figures. This observation may be useful for differentiation of sarcomatous-cell leukaemia from chronic lymphocytic leukaemia in which cells obtained from the peripheral blood and cultured in vitro without addition of mitogen do not demonstrate mitotic activity.

In 82 patients with non-Hodgkin lymphoma (NHC) the DNA synthesis by mononuclear cells from the peripheral blood was assessed by means of the index of mitoses (IM) or by pulse labelling of cells with 3H-TdR. In chronic lymphatic leukaemia (47 cases), hairy-cell leukemia (1 case), plasma-cell leukaemia (1 case) no synthesis of DNA was found in mononuclear cells. On the other hand, it was raised in most cases of lymphoplasmocytoma, centrocytoma, centroblasto-centrocytoma, centroblastoma and in lymphoblastic leukaemia or lymphoma.