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Biomedical subjects

H M Golomb

Publications and source records attributed to H M Golomb.

At least 19 recordsLinked to original sources
PubMed1992

The impact on survival by adjuvant chemotherapy and radiation therapy in stage II non-small-cell lung cancer.

Forty-nine consecutive patients with pathologic Stage II non-small-cell lung cancer treated over a 15-year period were retrospectively reviewed. The treatment strategy evolved during the period of review. Early patients were treated with surgery alone (S); subsequent patients were treated with adjuvant radiation therapy (SR); and more recent patients were treated with postoperative chemotherapy and radiation therapy (SRC). Fifteen patients received S alone, 10 patients received SR, and 24 patients received SRC. The median survival time (MST) of all 49 patients was 20 months, and the estimated 5-year survival was 25%. The MST of patients in each of the three treatment arms was S-6 months; SR-19 months; and SRC-25 months. The majority of patients died from systemic relapses or second primary lung cancers. The addition of adjuvant therapy (SR, SRC) significantly improved the MST of patients compared to surgery alone (S). The overall survival of patients did not change between treatment arms.

Adult↗
PubMed1992

Hairy cell leukemia 1992.

Hairy cell leukemia (HCL) is an uncommon chronic lymphoproliferative disorder, its treatment requires continuous update. Splenectomy as first line therapy has few indications; recombinant alfa interferon (IFN) leads to a high overall response rate but there are few bone marrow remissions; deoxycoformycin (dCF) or pentostatin leads to a higher complete bone marrow response rate than with IFN but follow-up biopsies show persistence of hairy cells; 2-chlorodeoxyadenosine (2-CdA) is a purine analog that after a single seven day intravenous infusion leads to a complete response rate. 2-CDA will probably become the drug of choice for first line therapy for HCL.

Cladribine↗
PubMed1992

The treatment of hairy cell leukemia: an update.

The treatment of hairy cell leukemia (HCL) requires continuing update. The role for splenectomy is extremely limited. Alfa-interferon therapy has been available and utilized for five years; there have been few complete remissions. The experience with Pentostatin has resulted in a majority of clinical complete remissions after several months of therapy, but persistence of a small percentage of hairy cells in the bone marrow. The most recent therapeutic agent, 2-chloro-deoxyadenosine (2-CDA) is given for seven days and results in a complete remission in the great majority of patients with no evidence of persistent bone marrow disease. If this trend persists, 2-CDA will become first line therapy for HCL as it may cure the disease.

2-Chloroadenosine↗
PubMed1992

Interferon treatment for hairy cell leukemia: an update on a cohort of 69 patients treated from 1983-1986.

This report documents the follow-up information on 69 hairy cell leukemia (HCL) patients treated with interferon alpha-2b (IFN) as primary treatment from 1983-86. Follow-up through October 1991 shows only 11 patients have died. Forty-one of the 57 patients completing the intended 12 or more months of initial IFN treatment were eventually considered IFN failures. Thirty-nine required retreatment (38 received a second course of IFN and one received pentostatin). Two patients died without further therapy for HCL. The median time to interferon failure was 33 months. Sixteen patients are alive and have not required further treatment after completing their initial 12 or more months of interferon. Eight patients underwent a third course of interferon therapy at a median time after completion of a second course of IFN of 1.3 years. Seven patients developed a second malignancy; three of these patients developed a high-grade lymphoma between 3.5 and 6.5 years after initiation of interferon therapy. We conclude that although interferon provides excellent palliation, most patients will eventually require further treatment with interferon or chemotherapy. Future trials in HCL must be aware of second malignancies as a common cause of death.

Adult↗
PubMed1979

Fatty acid differences amongst leukemia cell types, with special reference to hairy cell leukemia: a preliminary report.

Fatty acid analyses of malignant cells from hairy cell leukemia patients revealed a profile which was rich in arachidonate and relatively low in linoleate and oleate. This profile was distinct from that of mononuclear cells derived from patients with other lymphoproliferative diseases or myeloproliferative disorders, and may reflect the unique membrane morphology of the hairy cell.

Arachidonic Acids↗
PubMed1979

Hairy cell leukemia: differences in phagocytic capacity of cells in vitro.

Hairy cells from eight patients with hairy cell leukemia were evaluated with both light and transmission electron microscopy for their capacity to phagocytose zymosan, latex, staphylococcus aureus, and pseudomonas aeruginosa. In two patients, there was no phagocytosis of any of these substances; cells from three patients phagocytosed only latex; two, all except pseudomonas; and one, all 4 substances. Hairy cells became relatively smooth while in culture with staphylococcus, but no surface changes were noted during incubation with the other substances. Of the eight patients studied, one died of pseudomonas pneumonia and sepsis; pseudomonas was the only substance which her hairy cells did not phagocytose. The one patient whose hairy cells phagocytosed all 4 test substances developed a disseminated Mycobacterium intracellulare infection; culture of his hairy cells with this atypical myocbacterium showed no phagocytosis. Hairy cells have different phagocytic capabilities from patient to patient, and the evaluation of these capabilities in vitro might provide early identification of potential infectious complications.

Adult↗
PubMed1979

Evolution of karyotypes in Philadelphia (Ph1) chromosome-negative chronic myelogenous leukemia.

Ten of 55 patients with chronic myelogenous leukemia (CML) diagnosed between 1972 and 1977 were found to lack the Philadelphia (Ph1) chromosome. Serial clinical, morphologic, and cytogenetic studies of patients with Ph1-negative CML showed that 30% of them had chromosomal abnormalities. Two had an extra chromosome No. 8 at the time of blast crisis, with a morphological picture of myeloblasts in the bone marrow. A third patient had a 6:14 translocation initially Abnormalities of chromosome No. 14 are frequently seen in lymphoproliferative disorders, and the bone marrow and peripheral blood contained a significant population of lymphoblasts as well as myeloblasts. The median survival for the 10 patients was 19 months. The exact nature of Ph1-negative CML is not yet clear; disease appears to be a distinct entity among the myeloproliferative disorders.

Aged↗
PubMed1979

Hairy cell leukemia: an autopsy study.

Autopsy material from 5 patients with hairy cell leukemia was examined. In addition to the expected widespread involvement of the hematopoietic system and of the liver, all of the patients had various amounts of pulmonary infiltration by leukemic cells. This infiltration was so severe in one instance that the resulting pulmonary insufficiency was the cause of death. Other areas of hairy cell infiltration included the peripancreatic connective tissue in all cases, kidneys in 3 cases, pericardium in 2 cases, and skin in 1 case. Association of plasma cells with the infiltrating neoplastic cells was prominent. In one patient, foci of large, bizarre cells were found in several lymph nodes and in the pericardium. Whether these cells represent transformation of the hairy cells into a larger, less differentiated cell type, or the emergence of a second hematopoietic neoplasm, is unknown.

Adult↗
PubMed1979

Coexistence of leukemic reticuloendotheliosis and histiocytic lymphoma: a case report.

A 65-year-old woman had pancytopenia, splenomegaly, and an inaspirable bone marrow. Diagnostic evaluation demonstrated that she had both leukemic reticuloendotheliosis (LRE), or hairy cell leukemia, and an additional lympho-reticular neoplasm, most likely a "histiocytic" lymphoma. The diagnosis of LRE was based on the histopathology of spleen tissue and of a bone marrow biopsy specimen. The diagnosis of diffuse "histiocytic" lymphoma was based on the histopathology of a splenic hilar and a mesenteric lymph node, tumor nodules in the kidney and spleen, and tissue from a mass obstructing a ureter. This is the first well-documented association of a second lympho-reticular neoplasm with LRE. Even relatively gently treatment of the "histiocytic" lymphoma resulted in fatal pancytopenia, illustrating the restricitons on therapy imposed by the marrow impairment due to the LRE.

Aged↗
PubMed1979

Pathologic stage I and II Hodgkin's disease, 1968--1975: relapse and results of retreatment.

Sixty-seven previously untreated patients with Hodgkin's disease, pathologic stages I and II, seen during a 7-year period were evaluted with respect to initial staging and treatment, as well as relapse and retreatment results. The initial treatment consisted of radiation therapy (RT) to an involved field (IF) or an extended field (EF) for patients with stages IA and IIA, or RT and, in recent cases, combination chemotherapy [cyclophosphamide, Oncovin, procarbazine, and prednisone (COPP)] for patients with stages IB and IIB. Nineteen of the 67 patients relapsed (28%), including 11 of 56 patients with stages IA and IIA (20%) and 8 of 11 patients with stages IB and IIB (73%). Seventeen of the 19 relapses occurred within 24 months after completion of the initial therapy (89%). The relapse-free survival at 5 years was 75% for the A patients and 25% for the B patients. The actuarial survival of stage IA and stage IIA patients at 5 years was 91%; there was no significant difference between patients treated initially with either IF or EF. The actuarial survival at 5 years for the patients with stages IB and IIB was 88%, as most responded to a second program of induction therapy. No correlation could be found between the pattern of relapse and the initial pathologic stage or the mode of treatment.

Adolescent↗
PubMed1979

Chromosome analysis of primary large bowel tumors: a new method for improving the yield of analyzable metaphases.

Colon tumors were processed immediately after surgical resection. Using L-Arterenol and sodium citrate in combination with standard chromosome culture techniques, 12 of 17 consecutive tumors (75%) had countable figures ranging from 5 cells to 59 cells. Seven of the 12 cases had over 25 countable cells. Chromosome counts did not vary more than +/- 4 for any one case. Seven tumors were karyotyped, 6 with banding techniques. One of these specimens had mosaic patterns. The chromosome counts varied: 2 were hypodiploid; 1 was pseudodiploid and 4 were hyperdyploid. There were some similarities in the karotypes although no identical karyotypes were seen in this series.

Adenocarcinoma↗
PubMed1979

The role of gallium-67 scanning in the clinical staging and preoperative evaluation of patients with carcinoma of the lung.

Gallium-67 scanning was evaluated in 100 patients with proved carcinoma of the lung. It was valuable in separating primary from secondary lung tumors, determining the extent of contralateral hilar or mediastinal lymph node involvement, and detecting distant organ metastases. In addition to multiplane whole-body Ga-67 tomographic scanning, colloid liver scans, bone scans, and computerized axial tomography scans of the brain were obtained to determine the presence of distant metastasis. The gallium scan detected 11 of 12 occult metastases and identified 7 of 7 liver, 9 of 14 brain, 4 of 4 soft tissues, 1 of 4 contralateral lung, and 9 of 11 bone metastases. The whole-body gallium scan accurately detected or excluded extrathoracic metastatic disease in 11 of 12 patients examined postmortem within three months of a gallium scan. An approach is recommended using gallium scanning along with chest roentgenograms for clinical staging and preoperative evaluation of patients with carcinoma of the lung. Specific organ scans should be reserved for the occasional symptomatic patient with a negative gallium scan or for clarification of an indeterminate gallium scan.

Bone Neoplasms↗
PubMed1979

B cell acute lymphoblastic leukemia (ALL) with a 14q+ chromosome abnormality.

An adult patient with acute lymphoblastic leukemia associated with a 14q+ marker chromosome is presented. The abnormality resulted from a translocation of material from the long arm of chromosome 11. The leukemic cells were found to be B cells on the basis of surface immunoglobulins, lack of receptors for sheep erythrocytes, and a characteristically low level of adenosine deaminase activity. In other patients with ALL studied by us or reported by others in whom chromosome banding was done, a 14q+ chromosome was present in only one instance, also a case of B cell ALL. These two cases are the only examples of B cell ALL studied with chromosome banding reported to date. The frequent occurrence of a 14q+ chromosome in other malignant lymphoproliferative diseases of B cell origin suggests that a general association may exist between the 14q+ abnormality and B cell neoplasms. Cytogenetic analysis may therefore be useful in defining subtypes of ALL and in relating specific chromosomal abnormalities to lymphoproliferative disorders.

Adenosine Deaminase↗