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Biomedical subjects

F R Davey

Publications and source records attributed to F R Davey.

At least 73 records · Page 4Linked to original sources

Serum immunoglobulins and lymphocyte subsets in chronic lymphocytic leukemia.

The concentrations of serum immunoglobulins were correlated to the stage of disease and the proportions of peripheral blood lymphocyte subsets in 25 untreated patients with B-cell chronic lymphocytic leukemia (CLL). Diminished levels of at least one serum immunoglobulin were present in 77% of all patients with CLL and 73% of patients with Stage 0 disease. The mean concentration of IgG, IgM, and IgA decreased with advancing stage of CLL. The percentages of total T, T-helper (TH), and T-suppressor (TS) cells in the peripheral blood were less in patients with CLL than in healthy persons, but the absolute concentrations of total T, TH, and TS cells were greater in patients with CLL than controls (P less than 0.02). The absolute number of B-cells (P less than 0.01) and null cells (P less than 0.001) was also increased in patients with CLL, particularly those patients in advanced stages of CLL. These findings suggest that the hypogammaglobulinemia associated with CLL first occurs during the earliest stage of disease and may be related to the alterations in the proportion of peripheral blood lymphocytes.

Adult↗

Comparison of bleeding times performed on the arm and the leg.

The standardized bleeding time (SBT) is used to assess hemostatic function in patients suspected of having coagulation disorders. Because injury to the arm or the presence of intravascular cannulae often preclude the determination of SBTs on the upper extremity, the authors compared the SBT on the arm with the bleeding time on the leg to ascertain the efficacy of the lower extremity for this test. Thirty healthy volunteers were enrolled in the study. Bleeding times were performed on the forearm and on the medial aspect of the calf. The subjects then ingested 650 mg of aspirin, and the tests were repeated two hours later on the contralateral extremities. The mean preaspirin SBT (5.6 +/- 1.7 minutes did not differ significantly from the mean bleeding time on the leg (5.8 +/- 2.3 minutes) (P greater than 0.50), nor was there a significant difference between the mean postaspirin bleeding time on the arm (10.2 +/- 4.3 minutes) and that on the leg (9.9 +/- 3.7 minutes) (P greater than 0.50). On the basis of this study, the authors conclude that the arm and leg are equally reliable sites for determining bleeding times in normal persons and are equally sensitive for detection of aspirin-induced prolongation of bleeding.

Adult↗

T6 monoclonal antibody reacts with blasts from cases of common antigen acute lymphocytic leukemia.

The expression of the T6 antigen on malignant lymphoid cells has been considered strong evidence in support of T-cell lineage and thymic stage of differentiation of the neoplastic cells. Thus, the authors have used the T6 monoclonal antibody for the last three years in the immunophenotyping of blasts from 60 consecutive cases of acute lymphocytic leukemia (ALL) and 8 cases of T-cell lymphoma. Blasts from 12 of 46 (26%) cases of common type ALL, 4 of 7 (57%) cases of T-cell ALL, 2 of 3 (66%) cases of lymphoblastic lymphoma, and 1 of 5 (20%) cases of peripheral (postthymic) T-cell lymphoma were positive for the T6 antigen. The authors conclude that the expression of T6 antigen on malignant lymphoid cells may not always indicate T-cell lineage.

Antibodies, Monoclonal↗

Evaluation of coagulation disorders in patients with diseases of Waldeyer's ring.

The presence of pre-existing hemostatic disorders in a surgical patient may pose difficulties in the care of patients during and after surgery. To reduce the risk of excessive hemorrhage, this article has stressed the value of a thorough medical history, physical examination, and appropriate laboratory assays before surgery. When these measures reveal no evidence of a coagulation disorder, the surgeon can have confidence that the patient's hemostatic system has the appropriate resources to prevent excessive bleeding during surgery. However, if the coagulation screening procedure suggests that an abnormality exists, specific diagnostic assays must be performed before any necessary surgery to determine the exact nature of the coagulopathy. When this information is present, specific forms of blood component therapy can be given to minimize the risk of excessive hemorrhage during the operative period.

Adenoidectomy↗

Immunophenotyping of non-Hodgkin's lymphomas using a panel of antibodies on paraffin-embedded tissues.

The use of monoclonal and polyclonal antibodies for the immunophenotyping of non-Hodgkin's lymphomas in paraffin-embedded tissue has been limited by the fact that most antigens on lymphoid cells are denatured by histologic fixation, dehydration, and embedment. In this article the authors have analyzed a small panel of antibodies which represent exceptions to this rule, in that they identify denaturation-resistant determinants on leukocyte antigens in paraffin-embedded tissue. Monoclonal antibodies L26 [corrected] and 4KB5 label preferentially B cells, monoclonal antibody UCHL1 stains predominantly T cells, and monoclonal antibody MAC 387 reacts with granulocytes and some macrophages. A polyclonal antiserum raised against purified CD3 (T3) antigen, a T-cell-specific molecule, was also employed. This antibody panel was used to immunophenotype routinely processed tissue biopsy specimens from 61 non-Hodgkin's lymphomas (all of which had been previously phenotyped in cryostat sections). The lineage of the neoplastic cells was correctly identified in 32 of 34 (94%) cases of B-cell lymphoma, in 19 of 19 (100%) cases of T-cell neoplasm, and in 2 of 4 (50%) cases of histiocytic malignancy. It is concluded that this combination of antibodies is helpful in immunophenotyping non-Hodgkin's lymphomas when only paraffin-embedded tissue sections are available, although additional reagents of higher specificity are required to improve the identification of lymphomas.

Antibodies, Monoclonal↗

Prognostic significance of mean cell volume in non-Hodgkin's lymphomas.

Cell volumes of neoplastic lymphocytes collected from lymph nodes of 53 patients with non-Hodgkin's lymphoma were compared to lymphocytes from 18 patients with reactive hyperplasia. The mean cell volume (MCV) and the modal volume (MV) of neoplastic lymphocytes were larger than the MCV and MV of lymphocytes from reactive hyperplasia. The cell volumes of neoplastic lymphocytes from patients with non-Hodgkin's lymphoma were more heterogeneous within and among cases than observed in volumes from lymphocytes of patients with reactive hyperplasia. The cell volumes of neoplastic lymphocytes corresponded to subgroups within the Rappaport Classification and the Working Formulation. Cell volumes of neoplastic cells from low-grade lymphomas were smaller than intermediate grade lymphomas which in turn were smaller than high-grade lymphomas. When cases of NHL were placed into three subtypes based on the MCV, large cell lymphomas had a significantly shorter survival then small and intermediate cell lymphomas at 12 months. However, a stepwise multiple regression analysis failed to demonstrate any independent value of cell volume in the prediction of survival.

Adult↗

Use of surface marker analysis to predict outcome of adult acute myeloblastic leukemia.

In order to investigate the clinical significance of surface antigen analysis in acute myeloblastic leukemia (AML), the blasts from 196 patients with AML were analyzed prospectively with a panel of 16 monoclonal antibodies. The antibodies were selected to identify differentiation-associated antigens of either the myeloid lineage (MY9, PM-81, AML-2-23, MY7, MCS-1, MY8, Mo1, MY1, MY4, Mo2), T cell lineage (T101, T11), B cell lineage (B1, B4) or multiple lineages [J5 (CALLA), HLA-DR]. Independent morphological review and classification by French-American-British (FAB) criteria was performed in 161 of the 196 cases. One or more myeloid surface antigens were detected on the blasts of 195 cases, while B and T cell markers were detected on 0% to 2% of cases. When both blood and marrow samples were studied on the same patient, very few differences were noted between the antigenic profiles of the paired specimens. The frequency of expression of individual myeloid antigens ranged from 91% (PM-81) to 29% (Mo2). Expression of individual antigens was found to correlate significantly with several clinical parameters including FAB classification, cytochemical staining for alpha naphthyl acetate esterase, leukocyte count, and the presence of extramedullary disease at presentation. Two myeloid antigens (MY4 and MY7) predicted for a low rate of complete remission (CR) to standard induction chemotherapy. MY4+ cases (37% of the total population) had a CR rate of 53%, while M4- cases had a CR rate of 69% (P = .03). MY7+ cases (57% of the total population) had a CR rate of 55% while MY7- cases had a CR rate of 73% (P = .01). Neither MY4 nor MY7 antigen expression was correlated with patient age. Paired combinations of antigens were also examined. The [MY4- MY7-] phenotype was exhibited by 32% of all cases and was associated with an 82% CR rate while the CR rate of all other cases was 54% (P = .001). The expression of three antigens (HLA-DR, MY8, Mo1) was associated with a decreased continuous complete remission (P less than .05, median follow-up time of 19 months). Expression of MY8 antigen was also associated with decreased survival (P = .03). These results confirm earlier reports of antigenic heterogeneity in AML, and indicate that immunologically defined subgroups of AML patients which are of potential clinical significance can be identified.

Antibodies, Monoclonal↗

T lymphocyte colonies are the progeny of single cells.

T lymphocyte colonies, arising from phytohemagglutinin (PHA) stimulated mononuclear cells cultured in a semi-solid agar matrix, could be the progeny of single cells (monoclonal) or of multiple cells (polyclonal). We have conducted several studies to determine if these colonies are monoclonal or polyclonal in origin. Normal human peripheral blood mononuclear cells from male-female, HLA-A and B disparate donor pairs were incubated for 18 h in RPMI 1640 containing PHA and fetal calf serum (FCS) and then cultured in a two-layer semi-solid agar system. After 5 days of incubation, the clonality of the colonies was assessed by in situ Y chromatin analysis, and by analysis of HLA-A and B locus antigens. Overlayers were stained with quinicrine dihydrochloride and the number of cells in the T cell colonies with Y chromatin enumerated using fluorescence microscopy. In other studies, colonies were picked from the agar with a capillary pipette and expanded in culture media. After 17 days of culture, cells were harvested and HLA-A and B phenotypes were determined. The results indicate that 87% of the T cell colonies had cells of either male or female origin. In addition, 90% of the colonies possessed HLA-phenotypes of only one donor. We conclude that Y chromatin and HLA analysis of individual colonies from cocultures suggest the monoclonality of T lymphocyte colonies.

Adult↗

The inheritance of Felty's syndrome in a family with several affected members.

A family in which 3 siblings had Felty's syndrome is described. All affected family members shared the common haplotype HLA-A2, B15, Cw3 and DR4. In addition, all affected siblings possessed the A2 and ABO phenotype. Four unaffected siblings possessed either the HLA-A2, B15, Cw3 and DR4 haplotype or the A2 ABO phenotype or neither but not both. We believe our data support the hypothesis that multiple genetic factors are involved in the predisposition of family members to Felty's syndrome.

Adult↗

Defective autologous mixed lymphocyte reactions in patients with renal insufficiency--evidence for cellular and serum factors.

The autologous mixed lymphocyte reaction (AMLR) was studied in 10 patients who were azotemic from renal diseases not considered to be immunologically mediated. These patients were not on chronic dialysis. The AMLR was significantly depressed in patients with azotemia when compared to the AMLR in normals. When the AMLR was performed utilizing lymphocytes from normals, the proliferative response was markedly decreased if azotemic serum was substituted for normal serum. However, when the AMLR was performed utilizing lymphocytes from azotemic patients, the proliferative response did not significantly improve if normal serum was substituted for azotemic serum. In addition, the proliferative responses of T cells to concanavalin A (Con A) and phytohemagglutinin (PHA) were not significantly depressed in azotemic patients when compared to normal controls. These data suggest that the AMLR is abnormal in azotemic patients because of an intrinsic defect in the mononuclear cells, possibly in the stimulating non-T cells, and an inhibitory factor in the serum.

Humans↗

Cell volumes of lymphoblasts in patients with acute lymphocytic leukaemia.

Cell volumes of lymphoblasts from 75 cases of acute lymphocytic leukaemia (ALL) and lymphocytes from 33 normal individuals were determined using a Coulter Counter Model H4 Channelyzer. The average mean cell volume (MCV) and the model volume (MV) of lymphoblasts were larger than the MCV and MV of normal lymphocytes (P less than 0.01). In addition, the cell volumes of lymphoblasts from patients with ALL were more heterogeneous than normal lymphocytes. When the volumes of lymphoblasts were compared to the FAB classification, lymphoblasts from cases of L3 were larger than those from L2 and the latter were larger than lymphoblasts from the L1 subtype. When the volumes of lymphoblasts were compared to an immunological classification, lymphoblasts from cases of B cell ALL were larger than those from non-B, non-T and T cell ALL. The volume of lymphoblasts, however, showed no significant predictive value in the determination of complete remission, duration of first remission, or survival.

Adolescent↗

The autologous mixed lymphocyte reaction in cord blood lymphocytes: altered kinetics and magnitude of proliferative response compared to the adult autologous mixed lymphocyte reaction.

In the autologous mixed lymphocyte reaction (AMLR) T lymphocytes proliferate in response to stimulation by autologous non-T mononuclear cells. The AMLR has characteristics of a cell mediated immune response, and is thus thought to play a role in immune regulation. Cord blood lymphocytes often function differently than do adult lymphocytes. To determine if the AMLR in cord blood differed from that of adults, the kinetics and magnitude of the proliferative response in the AMLR was studied in 20 cord bloods and 14 adults. The magnitude of the AMLR was significantly lower in the cord cells compared to the adult response on all days tested except days 1 and 2. On the first 2 days of culture the cord cells had a higher proliferative response than the adult cells, but this could be accounted for by the high spontaneous proliferation in the cord cells.

Adult↗

Adult acute lymphoblastic leukemia phenotypes defined by monoclonal antibodies.

Pretreatment peripheral blood and/or bone marrow blasts from 90 adults with acute lymphoblastic leukemia (ALL) were analyzed as part of a prospective treatment protocol study. Specimens were tested by immunofluorescence cytofluorometry for reactivity with the following monoclonal antibodies (MoAbs): BA-1 (B cell antigen); T101, OKT11 (pan-T cell antigens [T]); 3A1 (T cell antigen); MCS-2 (myeloid antigen); J5 common ALL antigen (CALLA); BA4 (Ia antigen [Ia]); BA-2 (lymphohematopoietic antigen). Four major phenotypic groups were identified: B lineage ALL (BA-1+T-) (64%), T lineage ALL (T+BA-1-MCS-2-) (13%), unclassified ALL (BA-1-MCS-2-CALLA-T-) (9%) and myeloid antigen ALL (MCS-2+CALLA-T-) (7%). An additional group of patients, miscellaneous ALL (7%), was comprised of cases with unusual marker profiles. In B lineage ALL, all cases tested were Ia+MCS-2-, and the vast majority were CALLA+ (84%). In T lineage ALL, 42% expressed CALLA or Ia positivity. In unclassified ALL, the predominant phenotype was Ia+BA-2+. In myeloid antigen ALL, two of four tested were 3A1+ and all cases evaluated were BA-1-. Patients with myeloid antigen ALL were older (median age, 66 years) than patients in the other groups. The T lineage ALL group had higher leukocyte counts (median WBCs, 183,000/microL) and an increased incidence of anterior mediastinal mass at presentation. All patients received identical induction therapy. In CALLA+B lineage ALL, 30 of 46 (65%) achieved a complete remission. While the number of patients evaluated was small, 9 of 9 CALLA-B-lineage ALL and only two of six myeloid antigen ALL cases responded with a complete remission. The data suggest that these MoAbs are useful in the characterization of adult ALL.

Adult↗

Lymphocyte response to pokeweed mitogen in chronic lymphocytic leukemia.

The response of lymphocyte subpopulations to pokeweed mitogen (PWM) was studied in normal volunteers and patients with B-cell chronic lymphocytic leukemia (CLL). Since unfractionated peripheral blood mononuclear (PBM) cells from CLL patients consist of a markedly increased proportion of B-lymphocytes and a decreased proportion of T-lymphocytes, enriched fractions of CLL B-cells and CLL T-cells were cultured in 1:1 proportions in autologous and allogeneic combinations with normal B-cell and T-cell-enriched fractions. Cultures containing normal B-cells with either autologous or allogeneic normal T-cells responded well to PWM. CLL T-cells were capable of providing a helper function for both proliferation and differentiation of normal B-cells, which was not significantly different from that provided by allogeneic normal T-cells. CLL B-lymphocytes were unresponsive to PWM when cultured in the presence of either autologous CLL T-lymphocytes or allogeneic normal T-lymphocytes. The responsiveness of CLL B-cells was not restored by the addition of normal peripheral blood monocytes to the cultures. These experiments indicate that there is an intrinsic B-cell defect which prevents CLL B-lymphocytes from responding to PWM.

Aged↗

Non-Hodgkin's lymphoma limited to the larynx.

A case of primary laryngeal non-Hodgkin's lymphoma is detailed, with a review of the reports in the English literature on this rare site of presentation. Symptoms at onset generally include hoarseness, and may be observed up to 60 months prior to diagnosis. Four of the five cases classified by the Rappaport system are of diffuse histology. The histologic distinction of true lymphoma from pseudolymphoma, which may mimic lymphoma both grossly and microscopically, is reviewed. Local radiotherapy is a curative treatment of choice, with 16 of 18 cases disease-free throughout follow-up.

Aged↗

Functional diversity within the suppressor phenotype as defined by monoclonal antibody in T-cell prolymphocytic leukemia.

A patient with T-cell prolymphocytic leukemia (T-PLL) is described. The malignant T-cells from the patient were predominantly Leu-2-positive, indicating a suppressor phenotype. The cells were then tested to determine their functional capabilities. The patient's Leu-2-positive cells initially suppressed B-cell proliferation, as predicted by their phenotype but later functioned as T helper cells in the pokeweed mitogen system without a change in phenotype. The cells also responded inadequately to alloantigen and mitogen despite addition of exogenous T-cell growth factor (TCGF). Leu-2-positive prolymphocytes from the spleen of the patient were constitutive producers of TCGF. Surface phenotype using monoclonal antibody was inadequate to predict T-cell function of the cells from this patient with T-PLL. In addition, these data suggest there may be functional subpopulations within the OKT8+ phenotype. Constitutive TCGF production by malignant post-thymic T-cells may represent a mechanism by which these cells sustain their own growth.

Antibodies, Monoclonal↗

Granulocytic sarcoma of the hard palate: report of the first case.

A case of granulocytic sarcoma of the hard palate in an elderly woman is presented. The diagnosis was suspected on the basis of histologic findings in routine tissue sections and confirmed by cytochemical and electron microscopic studies. No systemic evidence of myeloid leukemia or of any other myeloproliferative disorder was documented in the patient, who died of an unrelated cause shortly after diagnosis.

Aged↗

Association of HLA-DR antigens with the autologous mixed lymphocyte reaction.

A study was performed to evaluate the association of HLA-DR antigens with the proliferative response of T cells in autologous mixed lymphocyte cultures. Peripheral blood mononuclear cells from 100 normal healthy individuals were typed for HLA-DR antigens and autologous mixed lymphocyte cultures were established. A low proliferative response from autologous cultures was found with individuals bearing HLA-DR3 antigens and in individuals with only one identifiable HLA-DR antigen. In contrast, a strong proliferative response was associated with HLA-DR6 and two identifiable HLA-DR antigens. These data are consistent with the hypothesis that HLA-DR3 antigens are associated with a weak immune response gene and HLA-DR6 antigens are associated with a strong immune response gene.

Adult↗