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Biomedical subjects

D Catovsky

Publications and source records attributed to D Catovsky.

At least 577 records · Page 32Linked to original sources

Chronic granulocytic leukaemia: multiple-drug chemotherapy for acute transformation.

The response to 60 trials of therapy in 50 patients with chronic granulocytic leukaemia (C.G.L.) in acute transformation is reported. None of the 13 patients who received single-agent chemotherapy had a satisfactory response. The use of two drugs in combination produced only one satisfactory response in 30 patients. Various types of multiple-drug treatments in eight patients achieved one good response which lasted four months. In contrast when nine patients with rapidly progressive acute transformation of C.G.L. received a regimen-TRAMPCO(L)-incorporating seven or eight drugs (thioguanine, daunorubicin, cytarabine, methotrexate, prednisolone, cyclophosphamide, and vincristine, with or without L-asparaginase colaspase) five improved significantly. Four patients had a good clinical and haematological response with survival for over three, eight, over 12, and 14 and a half months; and one patient had a partial response. Toxicity was not extreme and maintenance therapy with the same regimen was given on an outpatient basis. TRAMPCO(L) seems superior to previously reported regimens and should be considered for rapidly progressive transformation of C.G.L. especially when simpler treatments have failed.

Adolescent↗

T-lymphoblastic leukaemia: a distinct variant of acute leukaemia.

Two cases of acute lymphoblastic leukaemia (A.L.L.) of T-cell type are reported. Clinically they were characterized by very high peripheral blood blast cell counts at presentation, the early development of meningeal leukaemia, and relative resistance to treatment with combination chemotherapy. Leukaemic cells from both patients lacked all the B-cell markers investigated, but 60-65% of their cells formed rosettes with sheep red cells. Cytochemical and surface structure studies helped to define additional features of these cells and confirmed their T-cell nature.It seems that this variant of A.L.L. may not be uncommon and that it can be distinguished on clinical and immunological grounds from the usual type of A.L.L. which runs a less aggressive course and lacks B- or T-cell markers.

Adolescent↗

Cytochemical profile of B and T leukaemic lymphocytes with special reference to acute lymphoblastic leukaemia.

The PAS and acid phosphatase reactions showed a different pattern of positivity in the cells of lymphoproliferative disorders according to their B or T cell nature. In B-cell leukaemias (chronic lymphocytic and prolymphocytic) a low proportion of lymphocytes gave a positive result with the acid phosphatase reaction, while the majority were PAS positive in granular form. In contrast, in the T-prolymphocytic and T-lymphoblastic leukaemias the acid phosphatase reaction was positive in the majority of cells, while the PAS reaction was only positive in a minority. The significance of these findings, particularly for the recognition of a distinct T-cell variant of acute lymphoblastic leukaemia, is discussed.

Acid Phosphatase↗

Immunological studies in a case of T-cell leukaemia.

The blood lymphocytes from a case of prolymphocytic leukaemia were subjected to a battery of different tests in order to establish as certainly as possible their T or B cell type of origin. The results of the tests for surface markers indicated the T-cell origin of the leukaemic cells in this patient, and this provided a good opportunity to determine the participation of T cells in the various tests proposed for measuring human lymphocyte function.

Aminosalicylic Acids↗

Lysozyme activity and nitroblue-tetrazolium reduction in leukaemic cells.

The cytochemical methods for lysozyme and nitroblue-tetrazolium reduction have been used to study the blast cells of acute myeloid leukaemia. Both proved useful in characterizing the cases with predominant monocytic differentiation. THE DEMONSTRATION OF LYSOZYME ACTIVITY HELPED TO DEFINE TWO MAIN GROUPS: (a) with predominantly lysozyme-negative cells (myeloblastic-promyelocytic), and (b) with considerable numbers of positive cells (monoblastic-monocytic). In addition this test was also of value in the differentiation of other leukaemic disorders. Reduction of nitroblue-tetrazolium was also a feature of monocytic differentiation. The combination of these two methods with those for myeloperoxidase and non-specific esterase activity contributes to the cytological characterization of acute myeloid leukaemia.

Cell Differentiation↗

Familial acute myeloid leukaemia with acquired Pelger-Huet anomaly and aneuploidy of C group.

All five members of one generation in an Icelandic family were affected by acute myeloid leukaemia or preleukaemia. Two sibs died of acute myeloid leukaemia and another of myelofibrosis associated with leukaemic changes. The other two sibs are alive; one of them (the propositus) has haematological features consistent with preleukaemia; both of them have evidence of an abnormal cytogenetic clone in the bone marrow with 47 chromosomes, an extra chromosome in the C group. The finding of the acquired Pelger-Huët anomaly in the neutrophils of the five affected sibs suggests that a specific genetic cell defect has been transmitted with autosomal dominant characteristics. The presence of immunological deficiencies and an undue susceptibility to oncogenic viruses, as suggested by warts affecting three family members, may have played a part in the pathogenesis of the leukaemic process.

Adolescent↗