Cyclic oscillation of blood neutrophils in a patient with multiple myeloma

Chikkappa, G; Chanana, A. D.; Chandra, P; Ep, Cronkite; Thompson, KH

doi:10.1182/blood.v55.1.61.bloodjournal55161

Cited by 2 publications

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“…The disorder is usually familial, sometimes with similar but less pronounced variations of the neutrophils in asymptomatic relatives of patients (Morley et al, 1967b). Occasionally, however, it may be associated with either an underlying hematologic neoplasm (Natelson, 1953;Chikkappa et al, 1980) or with other diseases (Reimann, 1948(Reimann, , 1963Morley et al, 1967a,b). Figure 31 shows the cyclic variation in the number of circulating neutrophils and the about opposite variation in the number of circulating monocytes as seen in a patient who as a child was studied extensively by Page and Good (1957) and who was seen at this medical center for the first time 13 years later at the age of 29.…”

Section: Infi-adian Rhythms In Healthy Subjects Notmentioning

confidence: 99%

“…Experimental production of cyclic granulopoiesis in the dog was accomplished by inducing mild marrow failure by damage to the stem-cell compartment by treatment with alkylating agents and has more recently been reported in a patient with multiple myeloma treated over a prolonged time span with cytotoxic agents (Chikkappa et al, 1980). Morley et al (1967a) described four cases of chronic granulocytic leukemia that showed high-amplitude oscillations in the number of circulating leukemic leukocytes in the peripheral blood.…”

Section: Infi-adian Rhythms In Healthy Subjects Notmentioning

confidence: 99%

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Chronobiology in hematology and immunology

et al. 1983

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The hematopoietic and the immune systems in all their components are characterized by a multifrequency time structure with prominent rhythms in cell proliferation and cell function in the circadian, infradian, and rhythms in cell proliferation and cell function in the circadian, infradian, and circannual frequency ranges. The circulating formed elements in the peripheral blood show highly reproducible circadian rhythms. The timing and the extent of these rhythms were established in a clinically healthy human population and are shown as chronograms, cosinor summaries and, for some high-amplitude rhythms, as time-qualified reference ranges (chronodesms). Not only the number but also the reactivity of circulating blood cells varies predictably as a function of time as shown for the circadian rhythm in responsiveness of human and murine lymphocytes in vitro to lectin mitogens (phytohemagglutinin and pokeweed mitogen). Some circadian rhythms of hematologic functions appear to be innate and are presumably genetically determined but are modulated and adjusted in their timing by environmental factors, so-called synchronizers. Phase alterations in the circadian rhythms of hematologic parameters of human subjects and of mice by manipulation of the activity-rest or light-dark schedule and/or of the time of food uptake are presented. Characteristically these functions do not change their timing immediately after a shift in synchronizer phase but adapt over several and in some instances over many transient cycles. The circadian rhythm of cell proliferation in the mammalian bone marrow and lymphoid system as shown in mice in vivo and in vitro may lend itself to timed treatment with cell-cycle-specific and nonspecific agents in an attempt to maximize the desired and to minimize the undesired treatment effects upon the marrow. Differences in response, and susceptibility of cells and tissues at different stages of their circadian and circaseptan (about 7-day) rhythms and presumably of cyclic variations in other frequencies are expected to lead to the development of a chronopharmacology of the hematopoietic and immune system. Infradian rhythms of several frequencies have been described for numerous hematologic and immune functions. Some of these, i.e., in the circaseptan frequency range, seem to be of importance for humoral and for cell mediated immune functions including allograft rejection. Infradian rhythms with periods of 19 to 22 days seem to occur in some hematologic functions and are very prominent in cyclic neutropenia and (with shorter periods) in its animal model, the grey collie syndrome.(ABSTRACT TRUNCATED AT 400 WORDS)

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Section: Infi-adian Rhythms In Healthy Subjects Notmentioning

confidence: 99%

Section: Infi-adian Rhythms In Healthy Subjects Notmentioning

confidence: 99%

Chronobiology in hematology and immunology

et al. 1983

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“…Most cases are congenital and two thirds are considered non-familial or sporadic. Acquired cases can present at any age, rarely in association with other blood or im-mune disorders, or neoplasms [Chikkappa et al, 1980;Loughran and Hammond, 19861. The familial form of this disorder appears to be autosomal dominant (ADCH) [(MIM 162800) Online Mendelian Inheritance in Man (OMIM), 1994)l but large pedigree structures and multigenerational blood counts are usually not reported. Although a number of case series described clinical manifestations, most do not distinguish familial and non-familial cases, or pool data from both.…”

Section: Introductionmentioning

confidence: 99%

Genetics, phenotype, and natural history of autosomal dominant cyclic hematopoiesis

1996

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Cyclic hematopoiesis, (CH, or cyclic neutropenia) is a rare disease manifested by transient severe neutropenia that recurs approximately every 21 days. The hematologic profile of families with the autosomal dominant form (ADCH) has not been well characterized, and it is unknown if the phenotype is distinct from the more common sporadic congenital or acquired forms of CH. We studied nine ADCH families whose children displayed typical CH blood patterns. Pedigrees confirmed dominant inheritance without evidence of heterogeneity or decreased penetrance; three pedigrees suggested new mutations. Families were Caucasian with exception of one with a Cherokee Native American founder: A wide spectrum of symptom severity, ranging from asymptomatic to life-threatening illness, was observed within families. The phenotype changed with age. Children displayed typical neutrophil cycles with symptoms of mucosal ulceration, lymphadenopathy, and infections. Adults often had fewer and milder chronic neutropenia without distinct cycles. While CH is commonly described as "benign", four children in three of the nine families died of Clostridium or E. coli colitis, documenting the need for urgent evaluation of abdominal pain. Misdiagnosis with other neutropenias was common but can be avoided by serial blood counts in index cases. Genetic counseling requires specific histories and complete blood counts in relatives at risk to assess status regardless of symptoms, especially to determine individuals with new mutations. We propose diagnostic criteria for ADCH in affected children and adults. Recombinant human granulocyte colony-stimulating factor treatment resulted in dramatic improvement of neutropenia and morbidity. The differential diagnosis from other forms of familial neutropenia is reviewed.

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Cyclic oscillation of blood neutrophils in a patient with multiple myeloma

Cited by 2 publications

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Chronobiology in hematology and immunology

Chronobiology in hematology and immunology

Genetics, phenotype, and natural history of autosomal dominant cyclic hematopoiesis

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