Serum levels of the soluble forms of CD23 (sCD23) and CD25 (sCD25) were prospectively analyzed with respect to their prognostic relevance in early stage B-cell chronic lymphocytic leukemia (B-CLL). SCD23 and sCD25 levels were determined in 105 patients with newly diagnosed B-CLL (Binet stage A). In 93 of the patients, these levels were correlated with other already established indicators for risk of disease progression, including the histologic pattern of bone marrow infiltration, lymphocyte doubling time (LDT), and the serum level of thymidine kinase (TK). High serum levels of both sCD23 and of sCD25 were associated with a diffuse bone marrow infiltration, a LDT < or = 12 months, and elevated (>5 U/L) serum TK, respectively. Moreover, examination of the clinical course of 76 untreated patients showed that high levels of sCD23, but not of sCD25, at initial diagnosis were linked with disease progression. Furthermore, in a stepwise Cox regression model, high levels of sCD23 and a short LDT were shown to be strong predictors of progressive disease within the first year of disease presentation. Therefore, it appears to be justified to incorporate sCD23 levels into the risk profile of early stage B-CLL and to take them into account for stratification in risk-adapted treatment strategies.

A 22-year-old man was given 70-75 million I.U. vitamin A by mouth for 38 days as a treatment for psoriasis. But it had to be stopped because of the appearance of typical signs of vitamin A poisoning. Acute renal failure set in nine days later, after hospital admission for cerebral signs. In addition to conventional conservative treatment, seven haemodialyses were undertaken, with complete restitution to normal within 12 days. The skin disease and the cerebral signs predominated, in addition to later anaemia, hypercalcaemia, bone pain, and acute renal failure, the latter confirmed by renal biopsy. There were no histological changes in the liver.

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