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Biomedical subjects

B Houwen

Publications and source records attributed to B Houwen.

At least 37 records · Page 2Linked to original sources
PubMed1985

Serum beta 2-microglobulin: a real improvement in the management of multiple myeloma?

Beta 2-microglobulin (B2-m) determinations in serum have recently been introduced as a method of stratifying patients suffering from multiple myeloma. Conflicting results from several studies prompted us to study retrospectively the correlation of B2-m with presenting features and disease stage, as well as the prognostic value of B2-m, in 87 myeloma patients. Significant correlations were found between B2-m and presenting features such as haemoglobin level, serum calcium level and total body myeloma cell mass. The strongest correlation existed between B2-m and serum creatinine (r = 0.68). B2-m did not discriminate between the different disease stages as defined by Durie and Salmon, nor between myeloma Stage IA and monoclonal gammopathy of undetermined significance (MGUS). Considered alone, B2-m was found to have prognostic value in terms of survival. This correlation disappeared after correction for serum creatinine level and tumour load (multivariate analysis). Furthermore, changes in tumour load during therapy were not reflected in changes in B2-m levels, thereby rendering B2-m levels invalid as tumour marker. Our findings indicate no value for B2-m determinations in the staging and follow-up of myeloma patients.

Creatinine↗
PubMed1983

Gastrointestinal involvement with myeloma.

A patient with IgA-k multiple myeloma is presented. There was initially a good response to chemotherapy but the patient later developed small intestinal obstruction. This was due to multiple polypoid plasmacytomas. The mesenteric nodes were also involved, and were found on immunofluorescence microscopy and flow cytometry with double fluorescent labelling to be composed of two separate populations of cells (IgA-k and IgG-k), one population having a diploid content of DNA and the other tetraploid. These two distinct cell populations differed in both proliferative characteristics and size. The findings are discussed and the literature relating to gastrointestinal involvement in plasma cell dyscrasias reviewed.

Bone Marrow↗
PubMed1983

Plasma spermidine concentrations as early indication of response to therapy in human myeloma.

Eighteen patients with melphalan refractory myeloma were treated with vindesine and prednisone. Plasma spermidine concentrations were measured by radioimmunoassay before and after a single vindesine injection. Seven patients showed a significant rise of plasma spermidine after vindesine and five of these showed a clinical response on further evaluation. Of the 11 patients who did not show raised spermidine concentrations, 10 did not respond to the therapy. The correlation between clinical response/rise of spermidine and between non-response/no rise of spermidine was statistically significant (p less than 0.05). Pretreatment spermidine concentrations did not distinguish those who responded to treatment nor did they differ in patients and controls.

Antineoplastic Agents↗
PubMed1982

Combination chemotherapy for acute lymphocytic leukaemia in 25 adults.

Twenty-five consecutive adult patients with acute lymphocytic leukaemia (ALL) all achieved complete remission, twenty-two with vincristine-prednisone, while thirteen patients also received daunorubicin (DNR). Three patients obtained remission only after treatment with cytosine arabinoside (Ara-C), 6 thioguanine (6-TG) and adriamycin (ADM). Despite central nervous system (CNS) prophylaxis by intraventricular infections via an Ommaya reservoir, 2/22 patients had a CNS relapse. The median remission duration of the whole group was 19 months. Four patients could stop therapy after 3 years. The median survival duration of all patients was 38 months. The quality of life of the patients during this chemotherapeutic regimen was good.

Adolescent↗
PubMed1982

Enteral nutrition by nasogastric tube in adult patients treated with intensive chemotherapy for acute leukemia.

In this study, nutritional status 3 wk after starting 20 induction course of chemotherapy with enteral nasogastric tube feeding was compared to the nutritional status after 35 courses with a normal oral hospital diet. Tube feeding consisted of 2000 to 3000 cal daily of a hospital made pasteurized formula or sterile Nutrison RTS. In the group fed by nasogastric tube the mean weight loss was significantly smaller (p less than 0.01) and there were fewer patients with a severe weight loss of more than 5% during the first 3 wk (p less than 0.01) than in the hospital diet group. Serum albumin reduction of more than 10% was present in 4/20 and 23/35 for each group respectively (p less than 0.01). Bacterial contamination occurred in the pasteurized hospital-made formula which led to Pseudomonas septicemia in one patient. During a short-term catabolic state (3 wk) sterile feeding by nasogastric tube can prevent weight loss and hypoalbuminemia in most patients. Bacteriological control of the food and supply system is mandatory in granulocytopenic patients.

Acute Disease↗
PubMed1981

Phytohemagglutin-induced lymphocyte cytotoxicity in hemodialysis patients with hepatitis B virus infection.

Phytohemagglutinin (PHA)-induced or primary cytotoxicity in vitro which is mediated by T lymphocytes, was studied during hepatitis B virus (HBV) infection in 45 hemodialysis patients, and related to liver cell damage and recovery. HBsAg positive patients with raised transaminases had increased primary cytotoxicity similar to nine otherwise healthy subjects with acute hepatitis B. HBsAg positive patients with normal transaminases showed decreased primary cytotoxicity and recovered patients showed normal values. Increased primary cytotoxicity could not be attributed to an increase in T lymphocytes, as all groups of hemodialysis patients had decreased lymphocyte and T-lymphocyte counts without significant differences between them. In the follow-up study none of the 13 HBsAg positive patients with normal transaminases recovered. However, five of the 18 patients with raised transaminases did recover from hepatitis B, accompanied by a decrease in cytotoxicity. These results show that an increased PHA-induced lymphocyte cytotoxicity corresponds with the occurrence of liver cell damage and subsequent recovery in hemodialysis patients with HBV infection. This suggests that cytotoxic T lymphocytes are involved in liver cell damage and recovery in HBV infection.

Adult↗
PubMed1976

Hepatitis B surface antigen in environmental samples from hemodialysis units.

For assessment of environmental contamination with hepatitis B surface antigen (HBS Ag), the presence of blood and of HBS Ag was determined in samples from two completely separated hemodialysis units. Samples from mucosal and skin surfaces and samples of saliva from patients were also investigated. The surfaces of both units were divided into epidemiological categories to determine the distribution of environmental contamination with HBS Ag. HBS Ag was determined by radioimmunoassay. Oral samples from all patients seropositive for HBS Ag were psoitive for HBS Ag. The rectum and the skin were positive in three instances. The presence of blood did not coincide with HBS Ag. In the unit in which HBS Ag-positive patients were treated, 4.3% of the total samples were HBS Ag-positive. Of the samples that were free of blood, 1.5% were HBS Ag-positive, whereas 18.5% of the blood-contaminated samples contained the antigen. HBS Ag-positive samples were taken from surfaces in the immediate environment of HBS Ag-positive patients, as well as from surfaces with which patients had no direct physical contact. The data lead to the conclusion that spilled blood and hemodialysis equipment are not the only sources of contamination. This fact implies that HBS Ag-positive patient undergoing hemodialysis should be completely separated from HBS Ag-negative patients.

Cross Infection↗
PubMed1976

T-lymphocyte number and function and the course of hepatitis B in hemodialysis patients.

To study the relation between general cellular immunity and the course of hepatitis B within a group of chronic hemodialysis patients, T-lymphocyte number and function were investigated in 13 persistently hepatitis B surface antigen (HBSAg)-positive patients, in 32 HBSAg-negative patients, and in 11 patients who had recovered from hepatitis B and compared with that of 21 age-matched controls. Phytohemagglutinin-induced lymphocyte stimulation in vitro and the number of circulating T-cells in the HBSAg-positive group were significantly decreased as compared with those of the recovered group and the controls. Lymphocyte stimulation by pokeweed mitogen and by an antigen cocktail showed the same tendency, but no significant differences between the HBSAg-positive and the recovered groups. Uremic sera from the three patient groups had similar depressive effects on phytohemagglutinin induced lymphocyte stimulation of controls. Serum immunoglobulin G, (IgG), IgA, and IgM were normal in the three patient groups. It is concluded that chronic hemodialysis patients, who have become persistent HBSAg-carriers, have a significantly decreased T-lymphocyte number and function as compared with hemodialysis patients who are able to eliminat hepatitis B virus (HBV). The difference could not be ascribed to the HBV infection itself. This indicates that T-cells play an important role in the elimination of HBV in hemodialysis patients.

Adult↗