Edward L. Amorosi

Autoimmune Thrombocytopenic Purpura in Homosexual Men

Since November 1980 we have diagnosed 11 cases of severe autoimmune thrombocytopenic purpura in homosexual men; their mean platelet count (+/- SE) was 16 000 +/- 3000/mm3. All patients have been sexually active with multiple partners and exposed to numerous viruses and drugs. During this period, we also have diagnosed 20 cases of classic autoimmune thrombocytopenic purpura in heterosexual persons, with a normal women to men ratio of 3:1. Eight of nine homosexual patients had elevated platelet IgG compared with normal values in eight of 10 homosexual control subjects having normal hemograms (p less than 0.01). All responded moderately or completely to steroids. The three patients who had splenectomy had excellent responses. Four of five patients had a decreased helper/suppressor T cell ratio compared to healthy controls (p less than 0.001). Circulating immune complexes and total gamma globulin levels were elevated and lymphocytes relatively decreased in homosexual patients compared with homosexual controls (p less than 0.05). Thus, some sexually-active homosexual men seem to have an increased incidence of an immune regulation disorder directed against platelets.

Use of the Megathrombocyte as an Index of Megakaryocyte Number

Abstract An excellent correlation was obtained between the percentage of large platelets, or megathrombocytes, and the number of bone-marrow megakaryocytes in 115 patients with both thrombocytopeni...

Heterogeneity of Human Platelets: IV. IDENTIFICATION OF A YOUNG PLATELET POPULATION WITH [75Se]SELENOMETHIONINE

Summary. Heavy‐large platelets have previously been shown to be more active metabolically and functionally compared to light‐small platelets and to be present in increased per cent during conditions of enhanced thrombopoiesis. In the present report, the kinetics of platelet synthesis has been followed by in vivo labelling of megakaryocytes with the amino acid analogue, [75Se]selenomethionine. Kinetic measurements in three volunteer subjects indicated that heavy‐large platelets were young platelets and suggested a progression with age of heavy‐large platelets to light‐small platelets.

Large-cell variants of mantle cell lymphoma: cytologic characteristics and p53 anomalies may predict poor outcome.

Large‐cell variants are uncommon in mantle cell lymphoma (MCL). Here we describe the pathologic and clinical findings in five patients with large‐cell lymphoma related to MCL (L‐MCL), and compare them to a group of classic small‐cell MCL (s‐MCL) cases.

MEIS1 and HOXA7 genes in human acute myeloid leukemia

Co-activation of Meisl with Hoxa7 or Hoxa9 homeobox genes by retroviral gene insertion has recently been reported to be leukemogenic in murine myeloid leukemia. In this study we determined their expression in human leukemia. Most human myeloid leukemia cell lines co-expressed MEIS1 with HOXA7 and HOXA9. Among patients with acute leukemia, 50% of AML patients expressed MEIS1, while the majority of ALL patients were negative. A total of 89.5% of patients expressing MEIS1 co-expressed HOXA7. In unadjusted models, poorer response to chemotherapy was associated with expression of HOXA7 regardless of MEIS1 status and older patients were more likely to express either gene.

Antiplatelet treatment of thrombotic thrombocytopenic purpura.

Excerpt In the 50 years since its first description (1), some aspects of the pathogenesis of thrombotic thrombocytopenic purpura have been clarified, but its etiologic definition and the developmen...

Immunohistological analysis of Rosai-Dorfman histiocytosis: a disease of S-100+CD1-histiocytes

Five cases of Rosai-Dorfman histiocytosis (RDH) (also called Sinus Histiocytosis with Massive Lymphoadenopathy; SHML) have been studied by immunohistochemical methods with heteroantisera and monoclonal antibodies. One case was also studied by Southern blot hybridization analysis with DNA probes specific for T cell receptor beta chain and immunoglobulin heavy chain. Immunophenotyping of large histiocytes, characteristic of RDH, evidenced the presence of S-100 protein and the absence of CD1 and other markers usually found in histiocytes and macrophages. DNA hybridization study showed the absence of clonal T or B lymphoid populations.

Peripheral T Cell Lymphoma in a Patient with Common Variable Immunodeficiency Disease: Case Report and Literature Review

This report documents the occurrence of a peripheral T cell lymphoma arising in the bone marrow and liver of a patient with common variable immunodeficiency disease. The T cell origin of this lymphoma was demonstrated by immunohistochemical phenotyping and gene rearrangement studies and was not associated with EBV infection of the lymphoma cells. The frequency and characteristics of lymphomas complicating CVID are reviewed.

High-grade T-cell lymphoma complicating B-cell chronic lymphocytic leukemia: An unusual manifestation of “Richter's syndrome”

Approximately 3% of patients with B‐cell chronic lymphocytic leukemia (CLL) develop a high‐grade large‐cell lymphoma consistent with Richters Syndrome. In most cases, these lymphomas are of B‐cell origin and are believed to arise by clonal evolution from the CLL cells. We present a case of a patient with a 10‐year history of B‐CLL who developed an aggressive large‐cell lymphoma, confirmed by immunophenotype to be of T‐cell origin. We suggest that in patients with CLL, immunodysregulation can result in the proliferation of T cells, which may mutate and result in the development of a new malignant clone. Am. J. Hematol. 66:203–206, 2001.

The association of progressive, atrophying, chronic, granulomatous dermohypodermitis with Hodgkin's disease

The case of a patient with an unusual skin disorder—progressive, atrophying, chronic, granulomatous dermohypodermitis (PACGD)—who developed Hodgkins disease is reported. A review of the literature revealed only two other cases of PACGD, one of which affected a patient who also was found to have Hodgkins disease. In an additional report, the diagnosis of Hodgkins disease was made in a patient who may have had the same dermatologic disorder. The case is reported because the association of these two rare diseases is believed to be more than a chance event.