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Biomedical subjects

C D Bloomfield

Publications and source records attributed to C D Bloomfield.

At least 253 records · Page 14Linked to original sources
PubMed1977

The Philadelphia chromosome (Ph1) in adults presenting with acute leukaemia: a comparison of Ph1+ and Ph1-patients.

To evaluate the frequency and clinical significance of the Philadelphia chromosome (Ph1) in adult acute leukaemia, bone marrow chromosomes were studied in 15 adults with acute lymphocytic leukaemia (ALL) and 55 with acute nonlymphocytic leukaemia (ANLL). Morphology, clinical findings, therapeutic response and survival were compared in patients with and without the Ph1. The Ph1 was found in six newly diagnosed adults presenting with ALL. Adults with Ph1+ ALL differed from those with Ph1-ALL in being older, in having more frequent lymphadenopathy and splenomegaly and in demonstrating higher initial leucocyte counts and more peripheral blasts. Complete remissions were obtained in all nine adults with Ph1-All but in only three of six with Ph1+ ALL. Adults with Ph1-ALL survived significantly longer. Four adults with ANALL were Ph1+. They did not respond to treatment and survived significantly shorter periods than adults with Ph1-ANLL. No clinical or morphologic features indicated which patients with acute leukaemia would have the Ph1. Since the presence of the Ph1 in acute leukaemia has therapeutic and prognostic significance, marrow chromosome studies should be performed in adults presenting with acute leukaemia, especially ALL.

Adolescent↗
PubMed1977

Familial Hodgkin's disease and the major histocompatibility complex.

Two sisters who developed nodular sclerosis Hodgkin's disease (H.D., N.S.) within 3 months of their 25th birthdays were HLA and MLC identical. All family members possessed the HLA-B7 antigen. The propositi, a third HLA/MLC identical sister, and the mother, shared the maternal B7 and lacked Dw2. The father and a fourth sibling with the paternal B7 were heterozygous for Dw2. In six unrelated patients with H.D., N.S., the presence of B7 and Dw2 correlated precisely. In 69 consecutive patients with H.D., N.S., the frequencies of 23 HLA antigens did not differ significantly from the frequencies in 245 control subjects.

Adult↗
PubMed1977

Lymphography as a guide during laparotomy in Hodgkin's and non-Hodgkin's lymphomas.

Lymphography of 123 newly diagnosed patients with lymphoma was followed by staging laparotomy without intra-operative abdominal roentgenography. These patients were retrospectively evaluated for residual abnormal nodes with postoperative abdominal roentgenography. Sixteen patients with pathologically normal nodes at laparotomy had residual lymphographically abnormal nodes at postoperative roentgenography. Nine patients received less extensive irradiation than they would have if the remaining abnormal nodes had been biopsied and found to contain tumor. Two had shortened survivals as an apparent consequence.

Adolescent↗
PubMed1977

Prognostic significance of lymphocytic surface markers and histology in adult non-Hodgkin's lymphoma.

Neoplastic tissues from 75 adults with non-Hodgkin's malignant lymphoma, histologically classified according to the Rappaport schema, were studied for B- and T-lymphocyte surface markers. All nodular poorly differentiated lymphocytic lymphomas and diffuse well-differentiated lymphocytic lymphomas were B cell. Of 30 diffuse poorly differentiated lymphocytic lymphomas 16 were B, five were T, and nine were "null"; of ten diffuse histiocytic lymphomas, seven were B and three were null. In patients with diffuse lymphoma, those whose malignant cells demonstrated B markers survived significantly longer than those whose malignant cells demonstrated no markers. The prognostic capabilities of the Rappaport histologic classification and surface marker studies were compared. For patients with diffuse lymphomas, classification as B or null more accurately predicted survival than did identification as lymphocytic or histiocytic. However, survival was best predicted by a classification combining the Rappaport histologic scheme with surface marker studies.

Adult↗
PubMed1976

Prognostic significance of lymphocyte surface markers in adult non-Hodgkin's malignant lymphoma.

Neoplastic tissues from 75 adults with non-Hodgkin's malignant lymphoma were examined for B and T lymphocyte surface markers. All nodular lymphomas were B-cell type. Of 40 diffuse lymphomas, 23 were B, 5 were T, and 12 were "null" type. Patients with nodular lymphoma survived significantly longer than those with diffuse lymphoma (P = 0-00003). For patients with diffuse lymphoma, however, surface markers provide prognostic information not obtainable by histological classification as "poorly differentiated lymphocytic" or "histiocytic". Patients whose malignant cells had B markers survived significantly longer than those whose malignant cells had no markers (P=O-008). Survival of patients with diffuse lymphoma was best predicted by a classification utilising both surface markers and histological appearances. Differences in survival among patients with B-cell and "null" or T-cell lymphomas may relfect differences in sensitivity to specific drugs.

Adult↗
PubMed1976

Combinaed chemotherapy with cyclophosphamide, vinblastine, procarbazine, and prednisone (CVPP) for patients with advanced Hodgkin's disease. An alternative program to MOPP.

Thirty-eight patients with advanced Hodgkin's disease were treated with a combination of cyclophosphamide, vinblastine, procarbazine, and prednisone (CVPP). Complete remissions were obtained in 74% of patients. Response rates were similar for previously untreated and previously extensively irradiated patients. Fifty-six percent of patients older than 50 and 50% of patients with bone marrow involvement responded. All patients with mixed cellularity Hodgkin's disease responded compared with 74% of patients with nodular sclerosis. At the present time the median duration of complete remission is 27+ months. However, of the responders, 75% (21 of 28) remain in continous complete remission for 14+ to 49+ months. Only five patients have relapsed but two have died from apparent sepsis without evidence of recurrent disease. The complete remission rate for CVPP is comparable of that for MOPP, CVPP is an easily administered, well-tolerated alternative to MOPP chemotherapy for patients with advanced Hodgkin's disease.

Adolescent↗
PubMed1976

Blast crisis as an initial or terminal manifestation of chronic myeloid leukemia. A study of 28 patients.

The clinical and morphologic features of nine patients who initially presented with blastic leukemia and the Philadelphia chromosome were studied. Corresponding features were evaluated at the time of diagnosis of blast crisis in 19 patients who had a previous history of chronic myeloid leukemia (CML). Although many of the presenting symptoms and signs were similar, infections, lymphadenopathy, tissue infiltration and central nervous system involvement were more common in patients who presented with blastic leukemia. Marked leukocytosis, basophilia and marrow hypercellularity were present in both groups. Although patients in both groups had morphologic patterns that resembled acute leukemia, cytology suggestive of acute lymphocytic leukemia was more frequent in patients who initially presented with blastic leukemia. Megakaryocyte, platelet and erythroid abnormalities were more frequent in patients with a prior history of CML. Although there were clinical and morphologic features in the patients who presented with blastic leukemia which suggested the diagnosis of CML in blast crisis, chromosome studies were necessary to identify some of these patients. In both groups of patients multiple therapeutic regimens were used. Complete remissions were obtained in two patients; both presented with blastic leukemia, had "lymphoblastic" morphology and were treated with chemotherapeutic agents generally used for the treatment of acute lymphocytic leukemia. It appears that morphology of the blast crisis may be important in choosing the treatment regimen.

Adult↗
PubMed1976

Significance of haematological parameters in the non-Hodgkin's malignant lymphomas.

Blood findings at diagnosis, in 140 adults with lymphoma, were correlated with bone marrow involvement and survival. An abnormal haemoglobin, leucocyte count or platelet count was found in 57% of patients. Lymphocytopenia occurred in 46%. All patients with thrombocytopenia or neutropenia, 69% with leucopenia and 63% with anaemia had marrow involvement with lymphoma. Marrow involvement in histiocytic and stem cell lymphoma was always associated with anaemia. Marrow involvement in poorly differentiated lymphocytic lymphoma (PDL) was associated with anaemia, thrombocytopenia, leucopenia, lymphocytopenia or lymphoma cells in the blood in 93% of patients. Bone marrow involvement was found in only 13% of patients with normal haematological parameters. In the absence of marrow involvement blood abnormalities at diagnosis did not generally correlate with survival. However, among patients with diffuse PDL who had marrow involvement, anaemia, thrombocytopenia and leucopenia adversely affected survival. Lymphocytopenia did not correlate with survival.

Adult↗
PubMed1976

Extended field radiotherapy in non-Hodgkin's lymphoma.

Sixteen patients with laparotomy-proved Stages I-III non-Hodgkin's lumphoma were treated with high dose extended field irradiation. All patients obtained complete remission and 75% remain continually free of disease for 22+ to 63+ months. When the extent of disease is carefully delineated by a thorough staging procedure which includes laparotomy, irradiation alone may cure a high percentage of patients.

Adolescent↗
PubMed1976

B and T lymphocytes in Hodgkin's disease. Analysis at diagnosis and following therapy.

B and T lymphocytes were studied in the blood and lymph nodes of fifty patients with Hodgkin's disease. At diagnosis, most patients (77%) had normal percentages of circulating B and T lymphocytes. Most patients (60%) also showed normal percentages of B and T lymphocytes in involved lymph nodes. Splenectomy had no effect on circulating B and T lymphocytes in four of five patients studied 2 weeks postoperatively. Seventeen patients were studied before and after treatment to determine the effect of therapy. Very high percentages of B lymphocytes were found in patients studied following radiotherapy. It appears that the known defects in cell-mediated immunity in Hodgkin's disease are not expressed as significant abnormalities in B-or T-lymphocyte ratios in blood or lymphoid tissues at diagnosis. The proliferation of B lymphocytes following radiotherapy could represent a compensatory mechanism to cell-mediated deficiency or a loss of normal suppressor activity of T lymphocytes.

Adolescent↗
PubMed1975

Nodular lymphoma: bone marrow and blood manifestations.

Morphological and clinical features of 39 patients with nodular lymphoma were studied with particular reference to bone marrow and blood involvement. Twenty-one patients (54%) were found to have bone marrow involvement at the time of initial diagnosis. Thirteen (33%) also had peripheral blood involvement. A specific cell type, the small nodular lymphoma cell, was found in the bone marrow smears of 19 and the 21 patients with bone marrow involvement and in the peripheral blood smears of all patients with blood involvement. When large cells predominated in the lymph node or bone marrow sections, the bone marrow smears and the imprints of the lymph node and trephine biopsy demonstrated these large cells to have morphological qualities of lymphocytes rather than histiocytes.

Biopsy↗
PubMed1975

B and T cell lymphomas. Analysis of blood and lymph nodes in 87 patients.

B and T cell populations were studied in blood and neoplastic tissues from 64 untreated and 23 treated patients with non-Hodgkin's lymphoma. This study was undertaken primarily to evaluate the relation of B and T cell markers in various lymphomas to the currently accepted morphologic classifications and to determine the utility of various tissues in defining the cell of origin of a lymphoma. When histologically involved blood, bone marrow, lymph nodes or body fluids were studied, a B or T cell origin of the lymphoma was identified in 26 of 28 (68 per cent) patients. A B cell origin was found in 17 adults classified as having nodular (N) or diffuse (D) poorly differentiated lymphocytic lymphoma (PDLL). One lymphoma of T cell origin was observed in an adult with poorly differentiated lymphocytic lymphoma-diffuse (PDLL-D). In contrast, all cases of PDLL-D in children were T cell in origin. The origin of American Burkitt's (stem cell) lymphoma in two children was the B cell. When histologically involved blood was studied, a B or T cell origin was demonstrated in 10 of 21 (48 percent) adults. Evidence of a monoclonal proliferation of B lymphocytes in the blood was found two adults with more than 7 per cent lymphoma cells in Wright-Giemsa stained blood smears. When neoplastic lymph nodes were studied, the diagnosis of a B cell lymphoma was made in 8 of 12 (67 per cent) adults. Study of surface markers on malignant cells in cerebrospinal or serosal fluids frequently revealed a B or T cell origin of the lymphoma. B and T lymphocyte numbers in the blood did not correlate with immunoglobulin or skin test abnormalities. Abnormalities in circulating B or T cell percentages at diagnosis were a poor prognostic sign in patients with PDLL-D.

Adolescent↗
PubMed1975

Morphology of chronic lymphocytic leukemia and its relationship to survival.

The morphology of lymphocytes in blood and bone marrow from patients with chronic lymphocytic leukemia was studied; blood lymphocyte morphology was related to survival. Three primary morphologic groups emerged. Group 1 was characterized by small to medium-sized lymphocytes with narrow rims of cytoplasm and coarsely clumped nuclear chromatin. In group II the predominant lymphocytes were large with abundant cytoplasm. Group III was characterized by a heterogeneous population of lymphocytes with characteristics of both groups I and II. Clinical features of the patients were studied, and B and T typing of the lymphocytes was done. The median survival in group I was 26+ months; in group II 46+ months; and in group III 50+ months. Our data are at variance with previous reports and suggest that survival in patients with large lymphocytes is longer than in those with small lymphocytes.

Aged↗
PubMed1975

Bilateral trephine bone marrow biopsies in lymphoma and other neoplastic diseases.

We have evaluated the usefulness of bilateral rather than unilateral posterior iliac spine trephine biopsies in searching for lymphoma and other neoplastic diseases in the bone marrow. Two hundred and eighty-two patients with these diseases were studied. Tumor was found on only one side in 22% of patients with non-Hodgkin's malignant lymphoma, in 43% of patients with Hodgkin's disease, and in 36% of patients with other neoplastic processes. Thus, the second biopsy yields an additional 11% to 22% of positive biopsies. We conclude that bilateral trephine bone marrow biopsies should be routinely performed when searching for tumor in the bone marrow.

Biopsy, Needle↗