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Biomedical subjects

E N Thompson

Publications and source records attributed to E N Thompson.

36 records · Page 2Linked to original sources
PubMed1976

The patterns of fetal haemoglobin production in leukaemia.

Elevated levels of haemoglobin F (Hb F) have been foudn in a wide range of haematological malignancies, but very high levels were found only in juvenile chronic myeloid leukaemia (JCML), and erythroleukaemia occurring in infancy. In both these disorders a reversion to a fetal form of erythropoiesis may occur, as judged by both the structure of the Hb F and by the disappearance of Hb A2 and the carbnoic-anhydrase isozymes during the course of the illness. The clinical picture of JCML is not always associated with a reversion to fetal erythropoiesis; there appears to be a heterogeneity of conditions with this clinical label. Thus the reversion to a completely fetal pattern of erythropoiesis seems to occur in a variety of leukaemias which start in early life. This change is associated with a uniformly bad prognosis. Of a group of 17 patients with acute myeloid leukaemia 15 developed an increase in the level of Hb F about 60 days after the commencement of treatment; significantly greater increases were observed in those achieving a clinical remission. The level of Hb F usually declined during remission but high levels persisted in a few cases. Increased levels of Hb F were found also in patients with other haematological malignancies who had undergone periods of marrow aplasia during treatment. In all cases the Hb F was heterogeneously distributed throughout the red cells. Analysis of gamma15 or gammaCB3 peptides of Hb F from a variety of leukaemias gave glycine compositions ranging from 0.20 to 0.85 residues with many values in the fetal range; all cases with a reversion to fetal erythropoiesis had values in the fetal range. Attempts to confirm the 'fetal' origin of the cells containing Hb F by means of other markers was possible only in the cases of JCML and in one child with erythroleukaemia. These studies indicate that in some forms of leukaemia there may be a genuine reversion to fetal erythropoiesis while in others the emergence of cells containing Hb F appears to be part of a rapid regeneration process occurring after a period of marrow aplasia. The diagnostic and prognostic value of these observations is discussed.

Adult↗
PubMed1975

A comparative study of acute myeloblastic leukaemia in children and adults.

The presenting features and clinical course of 89 adults and 15 children with acute myeloblastic leukaemia (AML) presenting to a Regional Leukaemia Centre has been analysed. Remission rate was related to age, being 40% for the total adult group and 60% for all children. Young adults and children had a particularly high remission rate, whilst elderly patients faired badly. Survival diminished with increasing age and patients who entered complete remission survived for a significantly longer time (P less than 0.001) than those who did not. Adult AML differs from childhood AML, the adults having a lower remission rate, a significantly shorter survival (P less than 0.005) and almost complete absence of second remissions. Adults showed no correlation between complete remission and initial WBC or initial blast cell count, but in children there was a significant correlation (P less than 0.05) between initial total WBC and complete remission. A significant correlation between initial platelet count and complete remission could not be demonstrated in either group. Although the numbers of children are small, preadolescent children may represent a favourable sub-group, particularly those between 7 and 8 years of age.

Adolescent↗
PubMed1974

Bactericidal capacity of peripheral blood leucocytes in relation to bacterial infections in acute lymphoblastic leukaemia in childhood.

Phagocytosis and bacterial capacity of peripheral blood leucocytes were studied in 49 children with acute lymphoblastic leukaemia. No impairment of phagocytic ability was found, but 36% of children in relapse and 25% in remission had varying degrees of diminished intracellular killing capacity of ingested Staphylococcus aureus. Serial values in the same individual were constant irrespective of drugs used or stage of the disease. There was a highly significant positive correlation between bactericidal capacity ratio and the number of episodes of infection per patient; there was no significant correlation with death from infection.

Adolescent↗
PubMedDate not supplied

Utility of intraoperative fine needle aspiration biopsy in the surgical management of patients with pulmonary masses.

Sporadic reports have postulated that intraoperative fine needle aspiration biopsy (FNAB) is a useful adjunct in the surgical management of patients with pulmonary masses. We reviewed 38 consecutive intraoperative pulmonary FNABs performed at our institution in order to assess the efficacy of this technique, as measured by (1) its sensitivity, specificity, predictive values and concordance rates, and (2) the appropriateness of the resultant surgical therapy. Six cases were benign (16%) and 32 malignant (84%); none were small cell carcinomas. Aspirates from the six benign lesions were designated either benign or nondiagnostic; there were no false-positive diagnoses (specificity = 100%). Aspirates from 30 of the 32 malignant neoplasms were diagnosed as malignant, one was considered suspicious for carcinoma, and one was interpreted as benign (sensitivity = 97%). The positive and negative predictive values were 100% and 86%, respectively. The concordance rate for benignancy/malignancy between the intraoperative FNAB interpretation and final diagnosis was 97%. The intraoperative FNAB diagnosis contributed to less-than-optimal surgical therapy in only one case. Thus, we conclude that intraoperative pulmonary FNAB has utility in the proper surgical management of pulmonary masses.

Adenocarcinoma↗