This article documents four children with cutaneous lymphomas. Two of them had regional disease and the other two already had disseminated disease when they were diagnosed. Immunophenotyping of the lymphomatous infiltration disclosed a cell antigen profile with pre-pre-B (HLA-DR+, CALLA+, VIB-C5+), pre-B (HLADR+, CALLA+, VIB-C5+, cytoplasmatic immunoglobulin+), and transitional pre-B characteristics (HLA-DR+, CALLA+, VIB-C5+, surface immunoglobulin+). The morphology of the blast cells in all patients showed features of lymphoblastic lymphoma. Two patients had the convoluted cell type in common, but they were immunologically different, one displaying pre-pre-B and the other pre-B immunophenotypes. The remaining two cases were diagnosed as lymphoblastic lymphomas "type others" according to the Kiel Classification, one with pre-B and the other with transitional pre-B characteristics. The morphologic and immunohistochemical parameters as well as the clinical data from the four cases clearly indicate the heterogeneity of cutaneous non-Hodgkin's lymphomas in children.
We have compared the efficacy of high-dose IgG with that of Rhesus antibodies (anti-Rh0 (D)) in 5 patients with autoimmune thrombocytopenic purpura (3 adults and 2 children). Although only transient, high-dose IgG (0.4 g/kg X 5 days) was effective in all patients (peak values 50-200 X 10(9)/1), whereas anti-Rh0 (D) (11-20 micrograms/kg X 5 days) led to comparable results in only 3 patients (165 X 10(9)/1, 72 X 10(9)/1, 33 X 10(9)/1). This response to anti-Rh0 (D) was neither related to the degree of induced haemolysis (increase of LDH and decrease of haptoglobin) nor to the amount of IgG antibodies bound to red blood cells, as quantified by the 125-I-antiglobulin test. A decrease of platelet-associated IgG was recorded in 3 patients: 2 of them showed an improvement of platelet counts and in one of them there was no response. We conclude that the therapeutic response of high-dose IgG and anti-Rh0 (D) is independent of the degree of induced haemolysis and may not be predicted from the effectiveness of either therapy alone.
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