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Biomedical subjects

C D Bloomfield

Publications and source records attributed to C D Bloomfield.

At least 235 records · Page 13Linked to original sources

Cycochemical profiles in acute lymphoblastic leukemia.

Lymphoblasts from 61 untreated patients with acute lymphoblastic leukemia (ALL), classified according to the French-American-British (FAB) morphologic classification, were studied for cytochemical characteristics and membrane surface markers. Seventy-three % (eight of 11) of patients with E-rosette positive lymphoblasts (T ALL) had strong focal paranuclear acid phosphatase (AcP) activity in more than 75% of their lymphoblasts; lymphoblasts from only 6% (three of 48) (p = 0.005) of patients with E-rosette negative, surface immunoglobulin negative lymphoblasts (non-T, non-B ALL) exhibited this characteristic AcP activity. The non-T, non-B ALL cases that manifested focal paranuclear AcP activity had clinical features more characteristic of the T ALL cases. The distribution of beta-glucuronidase activity in the lymphoblast cytoplasm was similar to that of AcP for T ALL and non-T, non-B ALL but the stain was generally more difficult to interpret THan the AcP and was a less reliable indicator of immunologic type of ALL. The periodic acid-Schiff (PAS) and nonspecific esterase stains were not useful in distinguishing between T ALL and non-T, non-B ALL but PAS negativity was associated with certain clinical features within the non-T, non-B ALL group. Cytochemical evaluation of the lymphoblasts at diagnosis in patients with ALL may be useful in identifying subsets of ALL that have distinct immunologic and clinical characteristics and important therapeutic and prognostic implications.

Acid Phosphatase↗

The Philadelphia chromosome in acute leukemia.

The cytogenetics, cytology and cytochemistry, clinical findings, therapeutic response and survival of patients presenting with acute leukemia and the Philadelphia chromosome (Ph1) are briefly reviewed based upon a survey of the world literature and 16 cases seen at the University of Minnesota during the last 10 years. Details regarding the 16 cases from the University of Minnesota series are presented and two appendices listing the majority of reports of Ph1 + acute leukemia are included. Comparison of adults with Ph1+ and Ph1- acute leukemia demonstrate important clinical, therapeutic and prognostic differences. In general, patients with Ph1+ acute leukemia respond less well to treatment and survive significantly shorter periods of time. Since the presence of the Philadelphia chromosome in acute leukemia has therapeutic and prognostic significance, marrow chromosome studies should be performed in adults presenting with acute leukemia, especially acute lymphocytic leukemia.

Acute Disease↗

Sister chromatid exchange in lymphocytes from patients with malignant lymphoma.

Sister chromatid exchange (SCE) frequencies were studied in differentially stained lymphocytes from 47 patients with malignant lymphoma. Thirteen patients were untreated when studied. The mean SCE frequency [+/- standard error (SE)] for these patients was 12.7 +/- 0.9 per mitosis. The mean score for 40 controls was 6.1 +/- 0.3. SCE mean scores were significantly higher in the untreated patients than in the controls (P less than 0.001). Seven patients were treated with radiotherapy alone. They demonstrated a mean SCE frequency (8.8 +/- 0.8) significantly lower (P less than 0.01) than that found in untreated patients. Eleven patients received cyclophosphamide within 4 weeks prior to study. They demonstrated a mean SCE frequency (14.3 +/- 1.3) significantly higher (P less than 0.05) than that found in patients who had received regimens that did not contain cyclophosphamide in the prior 4 weeks (11.1 +/- 1.3) or who had been off drugs for at least 8 weeks (10.1 +/- 0.8). Our data suggest that untreated patients with malignant lymphoma have elevated SCE frequencies, which may be further increased by certain chemotherapeutic agents.

Adolescent↗

Acute promyelocytic leukemia. Management of the coagulopathy during daunorubicin-prednisone remission induction.

Seven adults with acute promyelocytic leukemia (APL) and disseminated intravascular coagulation were treated for remission induction with daunorubicin hydrochloride and prednisone. In all patients the coagulopathy was managed with continuous-infusion heparin sodium and vigorous transfusion with platelets, cryoprecipitate, and fresh frozen plasma. Five patients survived induction; they all achieved complete remission (CR). Median duration of CR was 27 + months; two patients presently survive in their initial CR at 28 and 48 months. Recognition of APL as a distinct type of acute leukemia and prompt initiation of treatment aimed at rapid cytoreduction and control of the coagulopathy has resulted in a prolonged disease-free survival for the majority of patients.

Adolescent↗

Combination versus successive single agent chemotherapy in lymphocytic lymphoma.

Fifty-three patients with advanced lymphocytic lymphoma were randomly assigned to treatment with the combination cyclophosphamide, vincristine, and prednisone (CVP) or the same agents used successively in maximal doses (C-V-P). Complete remissions occurred in 68% with CVP and 48% with C-V-P. For patients with nodular lymphoma, the complete remission rate was 81% with CVP and 46% with C-V-P. In patients with diffuse lymphoma a complete remission rate of 50% was obtained with both regimens. The median duration of response was longer for patients who obtained complete remission with CVP (37+ months) than for those entering remission with C-V-P (25+ months). More patients treated with CVP still survive. Current results suggest that CVP is a better induction regime than C-V-P in patients with nodular lymphoma. However, in patients with diffuse lympoocytic lymphoma, neither regimen results in more than 50% complete remissions or significant numbers of prolonged responses. More effective therapy is needed.

Adult↗

High-dose methotrexate for the remission induction of refractory adult acute lymphocytic leukemia.

Six adults with refractory acute lymphocytic leukemia (ALL) were treated with high-dose methotrexate, citrovorum factor, and vincristine. All patients had previously received extensive treatment with standard therapeutic agents, including vincristine, and all but one had received prior methotrexate. Two patients achieved complete remission and one achieved partial remission. Responses were seen at 3--6 gm/m2 of methotrexate. The durations of remission were 7--10 weeks. High-dose methotrexate with citrovorum factor is effective in the treatment of advanced ALL and should be considered for inclusion in initial combination chemotherapeutic regimens for adult ALL.

Adult↗

Sister chromatid exchange in patients with viral disease.

Sister chromatid exchange (SCE) frequencies were studied in differentially stained chromosomes from lymphocytes of 17 patients with viral disease. The mean SCE score for the patients was 8.7 +/- 2.9 standard deviations. SCE scores were significantly elevated in the patients compared with the controls (p less than 0.01); however, variability in SCE means was observed in the patients. SCE elevations were also present in long term cultured Epstein Barr virus positive human B lymphocytes.

B-Lymphocytes↗

Prolonged maintained remissions of adult acute non-lymphocytic leukaemia.

Maintenance chemotherapy consisting of weekly oral 6-thioguanine and intramuscular cytosine arabinoside was administered to 24 adult patients with acute non-lymphocytic leukaemia in complete remission. The median duration of complete remission was 16-5 months, with 9 patients (38%) still in their first remission after 18--56 months. 33% of the patients have been in continuous remission for over 2 yr, 21% for over 3 yr, and 12-5% for over 4 yr. Median survival so far is 22-5 months. This maintenance regimen is well tolerated, is easily administered on an outpatient basis, and produces substantial numbers of long-term remissions.

Administration, Oral↗

Treatment of acute nonlymphocytic leukemia in elderly patients: a prospective study of intensive chemotherapy.

Twenty-seven patients over 60 years of age with acute nonlymphocytic leukemia (ANLL) were prospectively treated with one of three intensive chemotherapeutic regimens. Complete remissions were achieved in eight patients (30%). Remissions were obtained in seven of 14 patients (50%) age 61 to 70 years, but in only one of 13 patients (8%) 71 years and older. The most effective regimen in patients 61 to 70 years consisted of a combination of daunorubicin and cytosine arabinoside. The median duration of remission for all eight responders is 9+ months and their median survival is 14+ months. Intensive therapy is indicated in the elderly patient 61 to 70 years of age with ANLL.

Acute Disease↗

Acute nonlymphocytic leukemia in patients with nodular lymphoma.

Acute nonlymphocytic leukemia (ANLL) developed in four patients 66 to 157 months following the diagnosis of nodular poorly differentiated lymphocytic lymphoma (PDL-N). The ANLL was signalled by increasing anemia and thrombocytopenia. A characteristic cytologic pattern of the leukemia was found. In each patient, a panmyelosis was present with striking morphologic abnormalities in leukocytes, erythrocytes and megakaryocytes. Marrow cytogenetic studies demonstrated abnormalities in all three patients studied. One of three patients treated with intensive chemotherapy obtained a complete remission. When long term survivors with PDL-N develop increasing anemia and thrombocytopenia, morphologic and cytogenetic marrow examinations are indicated to distinguish progressive lymphoma from therapy-induced myelosuppression or ANLL.

Acute Disease↗

Bone marrow involvement in Burkitt's lymphoma.

Thirteen patients with a malignant lymphoma exhibiting the cytologic characteristics of Burkitt's lymphoma manifested marrow involvement at the time of initial diagnosis (11 patients) or later in the course of the disease (two patients). Eleven patients were 16 years of age or younger. Eight had evidence of abdominal disease, five in the ileocecal area. Despite extensive marrow involvement in most of these patients, frankly leukemic blood pictures were uncommon. Platelet counts and absolute neutrophil counts were frequently normal. Membrane surface markers were studied in four patients. The malignant cells from three exhibited mulambda surface immunoglobulin; the cells from the other manifested muk surface immunoglobulin. All of the patients had a rapid clinical course in spite of intensive chemotherapy. The median survival from detection of marrow involvement was 2.5 months.

Adolescent↗