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Biomedical subjects

F Lampert

Publications and source records attributed to F Lampert.

At least 127 records · Page 7Linked to original sources

[Cytomegaly infection in infancy in a family with demonstrated HIV antibodies].

Cytomegalovirus (CMV) was isolated from the urine of babies from two consecutive pregnancies of a mother. The first baby had died of pneumonia at the age of six months, two years before the second confinement (twins of different sexes). The male twin was examined at the age of eight months on account of generalized lymphomas, pulmonary infiltrates and thrombopenia. He excreted CMV in the urine, and HIV antibodies were found in the serum. All members of the family (also the baby who died in 1983, from whom serum samples had been stored at -20 degrees C) finally proved to be carriers of antibodies against HIV. The parents and the female twin did not show any clinical symptoms indicating a HIV infection; however, CMV was also isolated from a urine sample from the mother.

Acquired Immunodeficiency Syndrome↗

Effective remission induction in children with recurrent acute myeloid leukemia by mAMSA, Ara-C, and VP 16.

Five children treated for acute myeloid leukemia according to the BFM protocol AML 83 experienced first bone marrow relapse after 7, 10, 14, 18, and 30 months and were retreated for second remission induction. The chemotherapy consisted of mAMSA (100 mg/m2 per day i.v., days 1-3), ARA-C (100 mg/m2, twice daily, days 1-6), and VP 16 (150 mg/m2 per day, days 4-6). Four of the children achieved a complete second remission after one course of chemotherapy, and the fifth child died of pneumonia during bone marrow aplasia. All surviving children received an identical second course within 4-5 weeks, followed by maintenance chemotherapy. Remission duration was 0, 3, 4, 5, and 5 months. Toxicity was confined to heavy bone marrow depression with thrombocytopenia (nadir 2-7000, days 7-13) and leukocytopenia (nadir 0-400, days 8-14). Bleeding episodes could be prevented by substitution with platelets. Four patients experienced infections (pneumonia, septicemia). We conclude that combination chemotherapy using mAMSA, ARA-C, and VP 16 is effective in inducing a second remission in patients with early bone marrow relapse. The main side effect was considerable bone marrow toxicity.

Amsacrine↗

Alteration of blast phenotype after low-dose cytarabine in children with acute myeloid leukemia.

Two children with acute myeloid leukemia (FAB M1 and M2) experienced bone marrow relapse during maintenance chemotherapy 7 and 10 months after diagnosis. Low-dose ARA-C monotherapy (2 X 10 mg/m2 per day s.c. for 14 days) was then initiated, as suggested by others reporting induction of differentiation and achievement of remission without toxic side effects. In contrast to these reports, remission induction was not observed in the two children after low-dose ARA-C but was achieved by subsequent high-dose chemotherapy. However, blast cell characteristics revealed some alterations. Blast count and chromosome pattern remained unchanged. Cytochemistry revealed the appearance of esterase- (0----11%), 0----21%) and PAS- (0----74%, 0----45%) positive cells in the patients and a remarkable increase (patient 1: 0----71%) and decrease (patient 2: 90----12%) in acid phosphatase positivity. Expression of myeloid marker VIM D5 decreased distinctly (70----4%, 77----11%). However, the biologic relevance of these alterations remains in question. The failure to respond clinically to low-dose ARA-C in both children is discouraging.

Antigens, Ly↗

Acute leukemia with chromosome translocation (4;11): 7 new patients and analysis of 71 cases.

Clinical and laboratory features of seven patients with acute leukemia associated with the (4;11) chromosome translocation are presented. Leukemic blasts of these patients showed lymphoid morphology in 6 (although 1 was treated for monoblastic leukemia 3 years earlier) and monocytoid morphology in 1, were positive for TdT and HD 37 (CD 19) in 6 patients, whereas weak expression of CALLA was seen in only 1 patient and T-lineage-associated antigens in none. Leukemic blasts from four patients showed the simultaneous expression of B-lymphoid and myeloid antigens, suggesting leukemogenesis in a very early multipotent progenitor cell. In 2 patients an isochromosome of the long arm of No. 7 chromosome was found in the leukemic karyotypes in addition to t (4; 11) (q 21; q 23); in one instance present at diagnosis, in the other one occurring at relapse. In one other patient leukemia karyotype also demonstrated trisomy 8. Leukemic cells of three patients were investigated by molecular genetics and demonstrated immunoglobulin gene rearrangements for the Ig heavy chain sequences but not for the light chain constant regions and T cell receptor sequences. All patients were treated by intensive chemotherapy. Four of the 7 patients are in continuous complete remission. The longest event-free survival time (over 2 1/2 years) was seen in one patient who had also DOWN-syndrome. Including these 7 patients a clinical analysis of 71 patients with t (4; 11) acute leukemia was made, emphasizing the following characteristics at diagnosis: female sex (62%), age under 2 years (49%), leukocyte count over 100 X 10(9)/1 (61%), splenomegaly (80%), CNS-disease (11%). Survival of over 2 years was reported in less than 15% of the patients. It remains to be seen if risk-adapted treatment can alter the course of this early B-precursor acute leukemia with hitherto very bad prognosis.

Acute Disease↗

No adverse prognostic influence of hepatitis B virus infection in acute childhood lymphoblastic leukemia.

In the years 1980-1985 72 children with acute lymphoblastic leukemia were diagnosed and treated by intensive combination chemotherapy (BFM protocols 79, 81, 83). Of these children 33 acquired a Hepatitis B-virus-carrier state with 1983 as the peak year of incidence. Both groups of patients, the infected and the uninfected ones, were comparable as to prognostic factors. All except 8 patients are off chemotherapy after a total duration of treatment of 1 1/2 or 2 years. Probability for event-free survival (life table analysis, maximum observation time 82 months, minimum 12 months) is equal (0.77 vs. 0.75) in both groups. With 3 exceptions, all HBV-infected patients still carry the HBs-antigen in the serum; 22 of the 30 living patients in the infected group developed anti-HBc.

Acute Disease↗

Fatal aplastic anaemia in a child with features of Dubowitz syndrome.

We describe a boy with features of Dubowitz syndrome who developed anaemia, thrombocytopenia and granulocytopenia at 3 years of age. The family refused blood component transfusion and he died 6 months later from severe anaemia and pulmonary bleeding. This is the second case of bone marrow aplasia in 38 reported cases of Dubowitz syndrome. It is proposed that patients with Dubowitz syndrome need long-term follow up, including complete blood counts.

Anemia, Aplastic↗

Evolution of tumor cytogenetic aberrations and N-myc oncogene amplification in a case of disseminated neuroblastoma.

Chromosome analyses including in situ hybridization with the protooncogene N-myc were carried out at diagnosis and several times at relapse in the bone marrow cells of a girl with disseminated neuroblastoma (stage IV) at ages 9, 23, 24, and 26 months, respectively. The tumor karyotype was pseudodiploid exhibiting partial monosomy for the short arm of chromosome #1, an aberration of the short arm of chromosome #2, and double minutes at diagnosis. Further structural aberrations of chromosomes #4, #6, and #17, and homogeneously staining regions could be demonstrated at relapse. In particular, the following structural aberrations were encountered: t(1;?)(p22;?),t(2;?)(p24;?), t(4;6)(q31;q25), and a der(17q). All tumor metaphases without homogeneously staining regions contained double minutes. N-myc, normally positioned within bands 2p23-24, was found to be amplified in a homogeneously staining region on the short arm of chromosome #15 by in situ hybridization. It is speculated that the translocation t(2;?)(p24;?) might be related to N-myc oncogene activation and subsequent amplification.

Bone Marrow↗

A chronic, infantile, neurological, cutaneous and articular (CINCA) syndrome. A specific entity analysed in 30 patients.

We have studied the clinical presentation and course of a chronic inflammatory disease occurring in childhood and observed in 30 patients. The first symptoms were generally present at birth, except in a few patients where they were first noticed in early infancy. All the patients had the association of three main symptoms: neurological, cutaneous and articular. The skin rash was the first symptom observed in all the patients and looked like a chronic non pruritic urticaria varying during the day. The articular manifestations involved knees, ankles and feet, elbows, wrists and hands unaffecting the other joints. They could be mild giving arthritis during flare-ups or severe with major radiological modifications affecting the epiphysis, metaphysis and growth cartilage. The neurological manifestations were characterized by a chronic meningitis and symptoms indicating meningeal irritation: headaches, seizures, spasticity of legs. Most patients had a cerebral atrophy and a low IQ. Sensory organ involvement occurred progressively during the follow-up: ocular inflammation with optic atrophy, deafness and hoarseness. Common morphological features characterized these patients with short stature, head enlargement, saddle back nose and short and thick extremities with clubbing of fingers. The course was that of a chronic inflammatory disease with numerous flare-ups associating fever, splenomegaly and adenomegaly. Except for a high level of eosinophils in blood, CSF and tissues, the biology was non specific and only exhibited features of inflammation. Except for two families, the disease was sporadic. A high frequency of prematurity with features resembling a foetal infection was observed but no proof of a possible causal virus has so far been found so that etiology remains unknown.

Adolescent↗

[Specific chromosome aberrations in leukemias and tumors in childhood].

Non-random, specific chromosome aberrations can be found by direct preparation in the karyotype of the malignant cell populations of the various leukemias and solid tumors in childhood. These chromosomal deletions in neuroblastoma, Wilms-Tumor, reticlassification and prognosis. There are mainly chromosomal deletions in neuroblastoma, Wilms-Tumor, retinoblastoma whereas translocations predominate in leukemias and lymphomas.

Chromosome Aberrations↗

[Intestinal cryptosporidiosis in suspected acquired immune deficiency].

In a 13-year-old boy--with haemophilia A, positive tests for HTLV-III antibodies, and lymphocytopenia--there occurred watery voluminous stools which persisted over many months. Cryptosporidia were demonstrated microscopically in the stool. Cryptosporidiosis should be considered in patients with acquired immune deficiency who have diarrhoea.

Acquired Immunodeficiency Syndrome↗

Translocation (19;?) in two stage II neuroblastomas.

Chromosomes of two abdominal neuroblastomas (stage II) from a 10-month-old male infant and a 6-year-old girl were analyzed. A modal chromosome number of 70 and 46, respectively, was found. Neither double minute chromosomes (DM) or homogeneously staining regions (HSR), nor visible structural abnormalities of chromosome #1 could be detected. However, a common aberration was found to be a translocation on the short arm of chromosome #19. After tumor resection, both children are alive without any evidence of tumor disease.

Abdominal Neoplasms↗

A complex translocation in a 5-year-old boy with acute myeloblastic leukemia.

A complex translocation [t(2;10;11)(q34;q11;q13)], an extra chromosome #8, and a duplication of 17q were the major findings in blast cells found in the bone marrow of a 5-yr-old boy with AML-M2 both before treatment and during relapse. The child died 8.5 mo after diagnosis, despite intensive combination chemotherapy.

Child, Preschool↗

(11; 14) translocation in three boys with acute lymphoblastic leukemia of T-cell immunophenotype.

Three boys, 12, 15 and 5 years old are presented with acute lymphoblastic leukemia resp. Non-Hodgkin's lymphoma with leukemic transformation. Blast cells could be characterized as being of T-cell origin. Hand mirror variant was the predominant morphologic feature of the blast cells in two patients. Chromosome analysis of the leukemic blast cells revealed a pseudodiploid (modal chromosome number = 46) karyotype in two patients and a pseudotetraploid (modal chromosome number = 92) in one patient. A chromosome translocation (11; 14) with breakpoints at (p 13; q 13) (within the human T-cell receptor alpha chain locus!) was found in the leukemic cells of all three cases plus an additional t (7; 9) (q 22; p 13) in one patient.

Adolescent↗

Tumour karyotype may be important in the prognosis of human neuroblastoma.

When comparing clinical and tumour cytogenetic data on 14 neuroblastoma patients in different stages of disease we found a high incidence of 1p abnormalities (12/12), homogeneously staining regions/double minutes (9/12) and 2p abnormalities (4/12) in 12 unresectable and metastatic tumours (clinical stages III and IV). In contrast, these features were absent in clinical stage II tumours (2/2) with good prognosis. The coincidence of 1p aberrations with poor outcome of disease will be discussed.

Child, Preschool↗

Treatment of childhood idiopathic thrombocytopenic purpura with Rhesus antibodies (anti-D).

We have recently reported that a rise of platelet numbers in ITP can be induced by blockade of the RES with antibody-coated red blood cells. We now present a collaborative study in which 15 Rhesus-positive children with ITP (nine boys and six girls aged 1-15 years) were treated with low-dose anti-D. Ten patients had chronic ITP (duration 6-47 months), five had acute ITP. Doses of 28-50 micrograms anti-D/kg bodyweight per course were given intravenously. In all patients clinical signs of bleeding ceased and platelet counts were elevated. An excellent, good or fair response with platelet increments of greater than 100, 50-100, or 20-50 X 10(9)/l, respectively, was observed in 19, 7, and 12 out of 45 courses in chronic ITP, and in 4, 1, and 2 out of 8 courses in acute ITP. The platelet increase (greater than 40 X 10(9)/l) persisted for 10 to over 360 days in chronic ITP. There were no untoward side reactions. Haemoglobin values remained stable in all patients but laboratory signs of mild, compensated haemolysis ensued. The direct antiglobulin test became positive in all cases due to anti-D IgG. Previous therapy of patients with chronic ITP included high-dose immunoglobulins and prednisone. These regimens were both effective but remissions were short. We conclude that anti-D therapy is an effective and safe form of treatment in childhood ITP.

Adolescent↗

Infantile multisystem inflammatory disease: another case of a new syndrome.

A 4-year-old girl with neonatal onset of chronic diffuse urticarial rash, head enlargement, protruding eye balls, bilateral arthritis of the knees, growth and mental retardation, and signs in blood and cerebrospinal fluid of chronic inflammation is presented and compared to two similar cases reported by us previously. Including this new patient there are now 14 documented cases with this specific inflammatory syndrome whose aetiology remains unknown. In the present case, however, elevated antibody titres against I.ric. Borrelia antigen were found in the serum.

Arthritis↗