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Biomedical subjects

G Ucci

Publications and source records attributed to G Ucci.

At least 55 records · Page 3Linked to original sources

Flow cytometric determination of ploidy and proliferative activity on isolated bone marrow particles and on total bone marrow aspirate.

The nuclear DNA content distribution of peripheral blood (PB) and bone marrow (BM) cells was determined by propidium iodide flow cytometry in 33 patients who underwent BM aspiration for diagnostic purposes. Two types of BM samples were taken during every aspiration procedure: whole BM aspirate, composed of BM particles contaminated by PB cells; isolated BM particles. Proliferative activity was calculated as the percentage of cells with DNA content intermediate between the diploid (2n) and the tetraploid (4n) values (2n-4n%). Ploidy was expressed as the ratio between the modal channel of the G0-G1 peak of the probe and that of an internal reference standard (DNA index, DI). The 2n-4n% was very close to zero in all PB samples. It was significantly greater in BM particles (21.2 +/- 6.6%) than in whole BM aspirate (16.6 +/- 5.5%, p less than .0005), with a close correlation (r2 = 66; p less than .0001) between the two values. Aneuploid stem lines were found in BM but not in PB. The DI of BM stem lines were similar in whole BM aspirate and BM particles, but the percentage of aneuploid cells was usually higher in BM particles. The reduced proliferative activity and the lower percent of aneuploid cells found in whole BM aspirates, with respect to BM particles, can be attributed to the contamination of BM tissue by PB, which had a very low proliferative activity and did not show aneuploidy. BM particles are therefore an easily obtained and reliable sample for routine evaluation of proliferative activity and ploidy of BM cells by DNA flow cytometry.

Aneuploidy↗

High-degree abnormalities of nuclear DNA distribution in SIg negative acute lymphoblastic leukemia with vacuolated blasts.

Among 65 consecutive patients with untreated adult acute lymphoblastic leukemia (ALL), six had peculiar clinical and cytologic features. Bone marrow and circulating blasts were large and showed prominent vacuolization, with variable degree of granular periodic acid-Schiff positivity in the cytoplasm. All patients had marked spleen and liver enlargement with cholestasis and without either lymph node or central nervous system disease. They achieved complete response to chemotherapy, and their median survival was longer than 12 months. Blast cells were studied for immunologic markers, propidium iodide flow cytofluorometric DNA content, and in vitro tritiated thymidine labeling index (3H-TdR LI). These showed a "null" phenotype in two cases, contained intracytoplasmic immunoglobulins (Cy mu) in two and were positive for CALL and Ia antigens in two others (one of which also contained Cy mu). Surface immunoglobulins (SIg) were found on less than 12% of cells, and T-cell markers were absent. In five cases, one or two stem lines with highly abnormal modal DNA content were found to coexist with diploid blasts. The 3H-TdR LI was high (8.5%-15.5%). Abnormal cell lines, after being cleared by chemotherapy, were found again at relapse. Additional cell lines appeared during the course of the disease in one patient, having different sensitivity to cytostatics. These cases of ALL apparently derive from B-cells not yet expressing SIg and have an exceptionally high incidence of aneuploid cell lines.

Adolescent↗

Multisystemic disease with intracranial hypertension and autoimmune cytopenia in chronic active hepatitis.

A 14-year-old girl with postinfectious chronic hepatitis developed a life threatening autoimmune multisystemic illness with arthralgias, intracranial hypertension, Coomb's positive hemolytic anemia and hemorrhagic diathesis (due to antiplatelet and antifactor X antibodies). Mannitol and immunosuppressive therapy abolished acute symptoms. During the first year of follow-up, two attempts of decreasing prednisone below 15 mg/day caused recurrence of the hemolytic anemia and appearance of low titer antinuclear antibodies, while doses above 15 mg/day caused an increase in transaminase levels. Daily prednisone dose was therefore fixed at 15 mg. The patient was well and, although signs of mild hemolysis persisted, there was no anemia. Transaminases were found greatly elevated on two occasions. An autoimmune multisystemic steroid sensitive disease was seemingly initiated by a postinfectious steroid irresponsive chronic hepatitis.

Adolescent↗

Peptichemio, vincristine and prednisone versus melphalan and prednisone as induction therapy in multiple myeloma.

Seventy-five patients with previously untreated multiple myeloma were randomly treated with the association of Peptichemio, Vincristine and prednisone (PTC-VCR-P) or of melphalan and P (MPH-P) for first induction therapy. After induction, all responsive patients received MPH and P until relapse, while unresponsive patients received it until unequivocal evidence of disease progression was observed. A second induction therapy with PTC-VCR-P was then administered, except to patients resistant to this association at first induction (who received combination chemotherapy which included cyclophosphamide and adriamycin). The response rate was 58% in the PTC-VCR-P and 41% in the MPH-P group (P greater than 0.05). The PTC-VCR-P responsive patients experienced a median duration of response shorter than MPH-P responsive patients (20.3 vs 39.7, P = 0.041). Median survival from the start of treatment was 26.2 months in the PTC-VCR-P and 54.1 months in the MPH-P group of patients (P = 0.039). Stage I and II myelomas had the same response rate to PTC-VCR-P and to MPH-P, but their survival was shorter on PTC-VCR-P than on MPH-P (P = 0.014). Stage III myelomas responded more frequently to PTC-VCR-P than to MPH-P (P less than 0.02) and there was a trend to survive longer on PTC-VCR-P than on MPH-P (22.0 vs 12.5 months, P greater than 0.05).

Antineoplastic Combined Chemotherapy Protocols↗

Rate and time of DNA synthesis of human leukaemic blasts in bone marrow and peripheral blood.

We have evaluated DNA synthesis rate (S rate) and time (Ts) and tritiated thymidine labelling index (LI) of peripheral blood (PB) and/or bone marrow (BM) leukaemic blasts (Bl) in nineteen cases of acute leukaemia (twelve non-lymphoblastic, AnLL, and seven lymphoblastic, ALL), in one case of non-Hodgkin's leukaemic lymphoma and in a case of plasma cell leukaemia. The LI of PB-Bl was significantly lower than that of BM-Bl (range 0.1-6.2% and 1.9-19.5%, respectively; P less than 0.01). The S rate was higher for PB-Bl than for BM-Bl (range 3.5-11.3 and 2.5-9.5 mol X 10(-18)/min; P less than 0.02) and the Ts of PB-Bl was shorter than that of BM-Bl (range 7.6-22.1 and 10.8-34.7 hr, respectively; P less than 0.02). In eight cases where S rates of both BM-Bl and PB-Bl were available, a linear correlation (r = 0.82; P less than 0.01) was found between the two parameters. This suggests that the DNA synthetic rate is a property of the leukaemic cell line in individual patients and differs from case to case. It further indicates that the environmental influences on the DNA synthesis rate in BM or PB are always of the same order of magnitude. From the results of this study we speculate that the DNA synthesis rate of leukaemic blasts is slowed down in the BM by environmental factors such as cell density.

Acute Disease↗

Adult acute non-lymphoblastic leukaemia: reliability and prognostic significance of pretreatment bone marrow S-phase size determined by flow cytofluorometry.

46 adult patients with non-lymphoblastic acute leukaemia (AnLL) had pretreatment proliferative activity of bone marrow (BM) blasts determined simultaneously with propidium iodide DNA flow cytofluorometry (as the percentage of cells with DNA content intermediate between the diploid and the tetraploid values, 2n-4n cell %) and in vitro tritiated thymidine cytoautoradiography (as the labelling index, LI). They were then treated with the same chemotherapy regimen, including 2-3 courses of sequential vincristine, arabinosylcytosine and adriamycin, for response induction, and monthly courses of different cytostatics for maintenance. Median 2n-4n cell % was 9.9 and median LI was 5.9. A close linear relationship (r = 0.913, p less than 0.001) between the two parameters was found. Patients having a 2n-4n cell % greater than 15.6 responded more often to chemotherapy than patients having a lower percentage (p less than 0.05) but also experienced a shorter duration of first response (p less than 0.05). Overall survival was longer in patients with 2n-4n cell % greater than 15.6 (p less than 0.02). Multiple regression analysis indicates that 2n-4n cell % is a statistically significant (p less than 0.05) independent factor correlating with duration of response in adult AnLL.

Acute Disease↗

Analysis of human myeloma cell population kinetics.

Pretreatment plasma cell 3H-thymidine labeling index (LI) was related to chemotherapy response in 37 multiple myeloma patients treated with alkylating agents. Response rate did not significantly differ in patients with high (greater than 3%), intermediate (2-3%) and low (less than 2%) LI values, and survival duration was significantly longer in patients with low LI irrespective of response to chemotherapy. Median response duration was distinctly shorter in patients with high and intermediate values (3 and 11 months, respectively) than in those with low values (30 months; p less than 0.01). LI at relapse was similar to that found at presentation in 5 out of 10 patients studied but was sharply increased in the other 5 who had an aggressive clinical course following initial response. Four of these latters showed a clonal evolution of bone marrow plasma cells, detected by changes in cell ploidy at flow-cytometric analysis.

Cell Cycle↗

Flow cytometric evaluation of proliferative activity and ploidy in myelodysplastic syndromes and acute leukemias.

Propidium iodide (PI) DNA distribution of bone marrow (BM) cells was studied by flow cytometry (FCM) in 36 patients without hematologic or malignant disease (normal BM) and in 172 patients with anemias (36 pts), myelodysplastic syndromes (MDS) (33 pts) and acute leukemia (AL) at diagnosis (60 pts), remission (24 pts) and relapse (19 pts). White blood cells from normal male subjects were used as an external diploid reference standard (median CV = 3.8). Patients with normal BM, anemias, MDS and acute leukemia at diagnosis had tritiated thymidine labeling index (LI) and most with MDS and AL had also evaluable cytogenetics performed on the same BM sample used for FCM. In normal BM, median aliquot of cells with PI-DNA content intermediate between the diploid and the tetraploid value (2n-4n cells %) was 15.7. The ratio between the fluorescence intensity of the G0/1 peak of normal BM cells and the fluorescence intensity of the G0/1 peak of the reference standard (FI ratio) ranged from 93 to 1.05 (mean +/- 2SD). The 2n-4n cell % was higher than normal in anemias (p less than .001), lower in leukemias (p less than .001) and widely scattered in MDS. A linear correlation was found between 2n-4n cell % and LI, with 2n-4n cell % value higher than LI. The FI ratio was lower than normal in anemias (p less than .05), higher in AL with normal cytogenetics (p less than .02) and broadly scattered in MDS with normal cytogenetics. From our experience, PI-DNA-FCM is a simple and adequate method to evaluate proliferative activity in hematologic diseases. Nevertheless, caution must be taken in attributing small changes in FI ratio to aneuploidy, since they are found in anemias and in MDS and AL with normal cytogenetics, possibly due to differences in PI uptake by different cell types.

Acute Disease↗

Clinical trial of high doses of Bay I 7433 (Copovithane).

Bay i 7433 (Copovithane) is a biological response modifier with antitumour activity in vivo, but no cytotoxic or cytostatic effect in vitro. A clinical trial of the compound at doses of 15g/m2/week was carried out for six weeks in 10 patients with various forms of cancer. Tolerance was good: no systemic toxicity was observed but local inflammation occurred in two cases at the site of injection. No objective antitumour response was observed.

Adult↗

Proliferative characteristics and ploidy of human brain tumors by DNA flow cytometry.

We studied nuclear DNA distribution by flow cytometry in 59 human brain tumors. Samples were frozen at -20 degrees C immediately after surgery and unicellular suspensions were obtained with a mechanical dissociation technique. Nuclear DNA was stained with propidium iodide. Normal human brain tissue was used as a diploid reference standard. In 86.3% of benign tumors an unimodal DNA distribution with a DNA index usually within the diploid range was found. Among malignant tumors, 64% had un unimodal DNA distribution with diploid or near-diploid modal DNA content. The remaining 36% showed an additional cell peak with a DNA index ranging from 1.15 to 1.92. The percentage of S-phase cells was higher in malignant (median = 3.8) than in benign tumors (median = 1.9) (p less than .001), without correlation to histological tumor subtype.

Aneuploidy↗

Severe pericarditis as a presenting sign of bronchogenic carcinoma.

An exudative pericarditis was the only sign of an adenocarcinoma arising from the right main bronchus of the lung for two and a half months. No metastases were found at the time of diagnosis. Pericarditis relapsed quickly after repeated pericardiocenteses, and systemic chemotherapy did not influence its course. Cardiac tamponade caused the death of the patient.

Adenocarcinoma↗

Proliferation kinetics of bone marrow cells in congenital dyserythropoietic anemia type II.

The proliferation kinetics of erythropoiesis and of myelopoiesis have been studied in a case of congenital dyserythropoietic anemia type II (HEMPAS) by means of quantitative 14-C autoradiography, Feulgen cytophotometry and 59-Fe ferrokinetics. Increased total erythropoietic activity and ineffective erythropoiesis was demonstrated by ferrokinetics. Quantitative 14-C autoradiography showed a generally delayed proliferation rate of erythroid cells, most evident in the polychromatic compartment. A deficiency of cell production of 25% was detected among the polychromatic erythroblasts. Part of this fraction is represented by cells still capable of passing to the successive stages of maturation. We conclude that only part of the deficiency of cell production in the polychromatic compartment represents real cell destruction. Most of the measured ineffectiveness is confined to later stages of maturation, such as orthochromatic erythroblasts and marrow reticulocytes.

Adult↗

Propidium iodide staining of cytoautoradiographic preparations for the simultaneous determination of DNA content and grain count.

A new method is described for staining cell nuclei with propidium iodide in preparations that have been processed for autoradiography. The permeability of the stripping film to the dye molecule has been studied, as have the staining conditions, in order to optimize the stoichiometry of the DNA-dye interaction. A procedure has also been set up to allow the simultaneous measurement of DNA content and grain count on the same cell.

Anemia, Hemolytic↗

DNA content analysis of peripheral blood B-lymphocytes in plasma cell malignancies.

A double fluorescence assay has been employed for the detection of cell surface and/or cytoplasmic immunoglobulins (Ig) and the measurement of nuclear DNA content in the same cell. Following staining for Ig by means of FITC conjugated antibodies directed against heavy or light chains, cell suspensions or cytospin preparations were ethanol fixed and stained with a propidium iodide-RNAse solution. In this way, the cytometric DNA content of circulating B-lymphocytes was analyzed in three patients suffering from plasma cell malignancies with an excess of peripheral blood B-lymphocytes and evidence of aneuploid bone marrow plasma cells. Aneuploid circulating B-lymphocytes with the same DNA stem-line as bone marrow plasma cells were found in two patients with advanced disease but not in the only one we studied at presentation. Aneuploid lymphocytes had surface immunoglobulins bearing the same light chain as the M-protein. In addition, a significant percentage (23%) of cells lacking either surface or cytoplasmic immunoglobulins proved to be aneuploid in plasma cell leukemia. Nuclear DNA measurement combined with surface or cytoplasmic marker analysis appears to be a reliable method for studying neoplastic lymphoid precursor cells in plasma cell malignancies.

Aneuploidy↗

Rate of M-component changes and plasma cell labeling index in 25 patients with multiple myeloma treated with peptichemio.

Twenty-five consecutive patients with previously untreated multiple myeloma were studied for bone marrow plasma cell labeling index, response to peptichemio induction therapy, and rate of M-component (MC) changes during the course of the disease. They received intermittent melphalan or cyclophosphamide as maintenance therapy and peptichemio associated with vincristine at first relapse. The response rate (76%) was independent of clinical stage, evaluated according to Merlini et al and to Durie and Salmon. Among responsive patients, rapid responders (half-life of MC decrease less than 47 days for IgA and IgG and less than 29 days for light chain myelomas) had a bone marrow plasma cell labeling index significantly higher (P less than 0.01) than that of slow responders. Rapid responders had a median survival of 15 months, while slow responders had a median survival of 42 months (P less than 0.05). The difference in survival between the two groups was accounted for mainly by the difference in duration of first response and the different rates of MC increase following it. Both of these parameters were directly related to the half-life of MC decrease at response in IgA and IgG myelomas. The duration of second response and the half-life of MC increase following it were shorter than the duration of first response and than the half-life of MC increase at first relapse.

Antineoplastic Combined Chemotherapy Protocols↗

In vivo production of childhood acute lymphoblastic leukemia cells in relation to ploidy and immunological subtype.

Eighteen pretreatment cases of acute lymphoblastic leukemia (ALL) in children were investigated by quantitative autoradiography in order to determine the labeling index (LI) as well as the DNA synthesis time (ts). The ploidy of the leukemic blasts was evaluated by Feulgen-microphotometry. The group consisted of 12 cases expressing the common ALL (CALL) antigen only, while 6 showed varying degrees of development along the T-cell axis. The latter subgroup was taken together and termed T-ALL for the sake of simplicity. By dividing LI by ts the fractional birth rate (FBR) was derived representing the percentage of the total leukemic cell mass newly formed per unit of time. The present study confirms a previous investigation in which a higher LI was detected in association with hyperdiploidy. It shows that ts is simultaneously prolonged, while the DNA synthesis rate remains unchanged. This proves that in hyperdiploid cases the longer ts is caused by a larger amount of DNA to be synthesized. The FBR is the same for eu- and hyperdiploid, as well as for CALL and T-ALL cases, and there is no correlation between the FBR and the white blood cell count. So far, ALL is the only type of leukemia in which a prolongation of ts has been demonstrated in comparison to normal human lymphatic cells. This prolongation is not caused primarily by differences in ploidy. The type of growth is accumulative, since the relative rate of cell production is lower than normal. As a finding of practical importance, the labeling index is shown to correlate quite closely with the FBR. In this cell system the LI can thus be used as a parameter reflecting the rate of relative cell production.

Adolescent↗

Pluripotent stem cells do not completely maintain normal human steady-state haemopoiesis.

Since the classical work on the regulation of canine erythropoiesis by Alpen & Cranmore (1959), it has been generally accepted that recognizable bone-marrow cells are continuously replaced from sources of unrecognizable precursors. Although many features of pluripotent stem cells (PSC) and committed haemopoietic precursors have been determined, direct demonstration of a continuous influx, under normal steady-state conditions, from PSC into the recognizable bone-marrow cell compartments is still lacking. There is abundant evidence that PSC, in a number of species, including primates, resemble atypical or immature ('transitional') lymphocytes. By utilizing the technique of quantitative 14C-autoradiography, we have measured the activities of DNA and protein synthesis in individual bone-marrow cells of two healthy humans. A positive relationship was established between the protein synthesis rate and rate of movement through the cell cycle in all proliferative compartments. Lymphoid cells, considered to contain the fraction of PSC, were found in the lower range of this relationship. These low metabolic rates exclude fast growth as well as short cell-cycle times. In view of the low frequency of the potential PSC in the human bone marrow, amounting to less than 2%, these cells cannot be considered to represent a source continuously supplying the pool of rapidly proliferating, recognizable blast cells in the bone marrow under steady-state conditions. Some self-maintenance of a subcompartment within the pool of recognizable normal bone-marrow blast cells is therefore suggested.

Adult↗

Flow cytometric DNA content in myelodysplastic syndromes.

DNA flow cytometric analysis of unfixed bone marrow cells stained with propidium iodide was carried out in 33 patients with untreated primary myelodysplastic syndromes. Patients with stable clinical course for up to 3 years had higher fractions of cells in S and G2 phases (22.7 +/- 12.4% and 12 +/- 3.6%) than those who developed acute leukemia and/or died early in the course of disease (14.4 +/- 8.5% and 6.6 +/- 4%). Median survival was more than 36 mo in patients with S + G2 cell fraction higher than 24%, and 14 mo in the remaining 16 patients with lower values (P less than 0.01). Analyses repeated after 3-24 mo showed no major changes in cell proliferation pattern in ten out of 11 patients. The remaining patient had sharp decrease in S and G2 cell fraction 3 mo before the transition into acute leukemia. The DNA index (DI) of bone marrow cells was calculated to assess ploidy. However, comparative evaluation of cytologic, cytogenetic, and flow cytometric data suggest that, under our experimental conditions, the DI may be influenced by factors such as the degree of chromatin compactness.

Adolescent↗