George Kende

Blurring of vision. A previously undescribed complication of cyclophosphamide therapy

Five children with cancer treated with high dose cyclophosphamide experienced blurring of vision. In three patients, the blurring lasted less than one hour and disappeared abruptly, but in the other two, it was prolonged, lasting three and 14 days with gradual improvement. In all five complete restoration of normal vision occurred. We have not found other reports of this association in the literature.

Congenital haemolytic anaemia associated with adenylate kinase deficiency

SUMMARY. Chronic haemolytic anaemia associated with adenylate kinase (AK) deficiency is very rare and only seven cases in five families have been described. We present six children of one family who are deficient of this enzyme and in three of them a combined G6PD deficiency was found. AK deficiency was transmitted by an autosomal recessive gene and heterozygous state was not accompanied by disease, whereas homozygously affected individuals present a congenital chronic non‐spherocytic haemolytic anaemia with haemoglobin levels of 8‐9 g/dl. Patients also deficient in G6PD suffer from a more severe haemolytic anaemia with haemoglobin levels around 6 g/dl. The AK‐deficient children are also mentally retarded. Splenectomy performed in five of the six patients resulted in complete remission of the haemolytic process.

Antibodies to epstein-barr virus in patients with Hodgkin's disease and leukemia

Sera from 67 Hodgkins disease patients, 71 leukemia patients, and 186 healthy subjects were tested for antibodies to Epstein‐Barr (EB) viral antigens by immunofluorescence methods. In both disease categories, in particular Hodgkins disease patients, levels of antibodies to the viral capsid antigen (EBV‐VCA) and MGT were higher than in the healthy controls. Significantly higher titers were found in Jewish patients of Asian‐African origin, as compared to Jews of European origin, with Arab patients as intermediates. The effect of ethnic origin was independant of age and histopathologic type. Sex had no effect on titer. Inconsistent differences in titer were found between age groups in the various ethnic‐histopathologic type groups. Some of the leukemia patients had no detectable antibodies to EBV, while all Hodgkins disease patients showed previous contact with EB virus. Antibodies to the early antigen (EBV‐EA) were found in 27% of Hodgkins and 37% of leukemia patients, and in none of the healthy controls tested.

Childhood non‐Hodgkin's lymphoma— a study of 17 cases in Israel

Seventeen children with non‐Hodgkins lymphoma observed recently at the Chaim Sheba Medical Center are described. Two clinical forms of the disease are apparent: poorly‐differentiated lymphocytic lymphosarcoma presenting with mediastinal and peripheral nodal localization and occasional bone marrow infiltration, and Burkitts lymphoma. In the tatter, predominantly affecting the Arab population, abdominal localization was, in most cases, the presenting symptom, with CNS and jaw involvement in some patients. The Burkitts lymphoma patients deteriorated rapidly. No relationship was found between the EB virus antibody titer and the histopathologic or clinical features of the disease. The possible relationship between the high prevalence of childhood non‐Hodgkins lymphoma and abdominal lymphoma with malabsorption on the one hand, and the low prevalence of childhood acute lymphatic leukemia in the Arab population on the other warrants further regional studies.

Acute lymphoblastic leukemia subtypes in israel: The sheba medical center experience☆

During the period from 1978 to 1981, 52 patients with ALL were diagnosed and treated at the Chaim Sheba Medical Center. Using standard cell markers to subtype the blasts, 49 of the patients could be classified: 16 were found to be T-cell ALL, 10 common ALL, five null ALL, four pre-B and 14 were partially characterized as non-B, non-T. Analysis of the series revealed two distinctive features: high prevalence (30%) of T-cell ALL among both Jews and Arabs and a high proportion, two-thirds, of high risk patients due to high initial WBC counts, unfavourable age or T-cell characteristics. The minimal incidence of ALL among the Gaza Strip Arab children during the study period is 4:100,000, which is close to the incidence in the Western world. During previous years the leukemia incidence in the Gaza Strip was very low while the most common lymphatic malignancies were Burkitt tumor and other non-Hodgkin lymphomas.

Poor Prognosis in Childhood Acute Lymphoblastic Leukemia (ALL) Is Associated with HLA-A11

Acute childhood lymphoblastic leukemias (ALL) consists of several biologically distinct malignancies derived from different ancestral cells. A number of clinical and hematologic parameters are currently considered to be indicators of poor prognosis, i.e., male sex, high whiteblood cell counts, age below 2 or over 10 years, the presence of certain karyotypic abnormalities, and cell surface markers (1–3).