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Biomedical subjects

C Rozman

Publications and source records attributed to C Rozman.

At least 361 records · Page 20Linked to original sources
PubMed1985

Prognostic discrimination among younger patients with chronic granulocytic leukemia: relevance to bone marrow transplantation.

To obtain information relevant to the question of bone marrow transplantation, we examined the prognostic significance of disease features recorded at the time of diagnosis among 625 patients, aged 5 to 45, with Philadelphia chromosome-positive, nonblastic chronic granulocytic leukemia. The actuarial death rate for this population was 5% during the first year after diagnosis, 12% during the second year, and averaged 22.5% per year during the next eight years. Multivariable regression analysis of features recorded in nearly all cases indicated that sex, spleen size, hematocrit, platelet count, and percentage of circulating blasts were significant prognostic indicators. Analyses of additional data available in 113 to 421 cases suggested that serum lactic dehydrogenase activity, percentage of blasts in marrow, nucleated RBCs in blood, and percentage of basophils plus eosinophils might also provide useful prognostic information. A Cox model, generated with five variables representing features recorded regularly (the first five listed), permitted segregation of these patients into three groups with significantly different survival patterns. The high-risk group exhibited an actuarial mortality of 30% during the first two years after diagnosis and an annual risk of 30% thereafter. In contrast, the most favorable group had a two-year actuarial mortality of 9% and an average risk thereafter of 17% per year, with a median survival of 5 1/2 years. We conclude that it should be possible to classify potential candidates for bone marrow transplantation according to risk with conventional therapy. Such information may be useful in making decisions regarding early v deferred marrow transplantation.

Adolescent↗
PubMed1985

Multiple myeloma with monoclonal IgG and IgD of lambda type exhibiting, under treatment, a shift from mainly IgG to mainly IgD.

A patient with multiple myeloma (MM), who initially presented with a predominant IgG lambda and a minor IgD lambda paraprotein pattern, is described. After chemotherapy, levels of the IgD lambda protein increased and the IgG lambda levels decreased. The following results were obtained when serum IgD was predominant. In the bone marrow, there were three plasma cell populations: a major one containing only delta chains, a minor one containing only gamma chains, and another minor one containing both delta and gamma chains. All these plasma cell populations contained lambda chains. Stimulation of circulating mononuclear cells with pokeweed mitogen (PWM) achieved differentiation of circulating B lymphocytes into plasma cells: 30% with only cytoplasmic delta lambda chains and 10% with only cytoplasmic gamma lambda chains. These IgG-containing plasma cells showed cytoplasmic reactivity with rabbit antiserum raised against monoclonal IgD which was shown to contain specificities recognizing both delta chains and idiotypic determinants present in both serum IgD lambda and IgG lambda. Circulating B lymphocytes were 'monoclonal': almost all expressed surface delta lambda chains, and a small proportion of them expressed both delta gamma and lambda chains. High levels of IgD were detected in the supernatants of all cultures, but high concentrations of IgG were only detected in those from PWM-stimulated cultures with very low levels of IgM and IgA. These findings suggest that plasma cells producing either IgD or IgG were derived from a common B-cell clone. Double paraproteinaemia exhibiting a shift in immunoglobulin production from IgG to IgD has not been previously described.

Antibodies, Monoclonal↗
PubMed1984

Myeloproliferative disease in two young siblings.

Two siblings developed a myeloproliferative disease. One of them was a 9-year-old girl with a short history of bleeding, whose initial clinical and hematologic features were concordant with idiopathic myelofibrosis. Shortly afterwards this disorder evolved to a leukemic phase which subsequently resulted in the death of the patient. Four years later, at the age of 16, her brother was diagnosed as having acute myelofibrosis, and some months afterwards he died from fulminant pneumonia coincidently with pancytopenia and presence of scarce blast cells in peripheral blood. From the pathogenetic point of view, neither exposure to bone marrow toxins nor bone marrow chromosome abnormalities could be detected. HLA-typing disclosed the same haplotype (A2, A9, B5, B21, C5) in both patients.

Acute Disease↗
PubMed1984

Bone marrow histopathologic patterns and immunologic findings in B-chronic lymphocytic leukemia.

In 82 patients with B-chronic lymphocytic leukemia, the correlations between the histopathologic bone marrow patterns (interstitial, nodular, mixed, and diffuse), serum immunoglobulin (Ig), and blood B-lymphocyte levels and T-lymphocyte levels have been analyzed. The most commonly lowered Ig class was IgM (43% of cases) followed by IgA (35%), and IgG (10%). There was a trend to a more frequent decrease of Ig levels when "advanced" bone marrow patterns (mixed + diffuse) were compared with the earlier ones (interstitial + nodular). The frequency of such a decrease was statistically significant for IgA class (P less than 0.01). The absolute number of blood T-lymphocytes was increased in the diffuse pattern (P less than 0.01).

Aged↗