Biomedical subjects
Publications and source records attributed to H Wehinger.
5 patients with ALL under protocol Freiburg 71 suffered bone marrow relapse. They received a conservative reinduction treatment with vincristine-prednisone +/- daunorubicin, followed in one case by L-asparaginase. Complete remission was achieved in 4, partial remission in 1. The duration of complete remissions was 1 to 11+ months.
In ALL the first complete remission would be terminated by CNS-relapse in two thirds of the patients if they received a modern chemotherapeutic treatment without meningosis-prophylaxis. The incidence of meningosis is reduced to 10% by prophylactic irradiation of the cranium (60Co, 2400 rd) and intrathecal methotrexate shortly after hematological remission has been achieved. Non-Hodgkin's lymphomas may be complicated by CNS disease, especially if the risk of spread to the bone marrow is high. Therefore, meningosis-prophylaxis should be included into treatment programs for malignant lymphomas of the lymphocytic poorly differentiated type beyond stage I, especially if the mediastinum is involved. CNS-prophylaxis cannot be recommended for patients with malignant lymphomas in pathological stage I. For the rest of the patients with malignant lymphomas guidelines cannot be given at the present time, because sufficient empirical data are lacking.
In 56 children with acute lymphoblastic leukemia (ALL) T and B lymphocytes and immunoglobulins (IgG, IgM, and IgA) were studied before, during, and after therapy. At the time of diagnosis T lymphocytes were normal, the number of B lymphocytes was increased, and immunoglobulins usually were normal. Only two of 30 children had abnormally low immunoglobulin levels. Under therapy a progressive lymphopenia was observed. B cells were depressed most extensively. IgG and IgA levels showed a nadir during early treatment, i.e. after remission induction for IgG and 4-8 months after diagnosis for IgA. IgM was markedly elevated after meningosis prophylaxis. After cessation of therapy lymphocytes increased with an intense rebound of B cells. The recovery was not fully completed after one year free of therapy.
Reye's syndrome is characterized by severe encephalopathy and fatty infiltration of the liver. Probably this is a polyetiological syndrome. In most cases the disease is preceded by influenza B or varicella infection. As known to date, damage to mitochondria is the essential feature. Therapy is symptomatic. A review is given of the clinical symptoms and of the many unsolved problems of pathogenesis.
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A simple semiquantitative slide test to assess the phagocytic activity of periphera polymorphonuclear leukocytes is described. Leukocytes are isolated from one drop of blood and latex particles are offered for phagocytosis. Cellular capacities and serum opsonins can be assessed separately. In the presence of pooled adult serum no defect of phagocytosis was seen in preterm and full-term newborns nor in pediatric patients with infectious or other diseases. In 4 of 7 premature newborns a definite deficiency of serum opsonins was demonstrated. In in vitro studies complement (plus possibly other heat-labile factors) promoted phagocytosis. Phagocytic rates were depressed by endotoxin and phenylbutazone.
A boy 13 year-old suffered an extremely severe and prolonged attack of hemorrhagic chickenpox with visceral involvement, the diagnosis being confirmed by isolation of varicella-zoster-virus (VZV). There was no other compromising disease. All preceding vaccinations including two against smallpox had been uneventful. The severity of the attack could not be ascribed to any persistent cellular or humoral immunodeficiency. The patient developed a good antibody response. The course of serological reactions to VZV infection was studied extensively using the different techniques of complement fixation and immunofluorescence for IgG, IgM, and IgA antibodies. Therapy was conducted cautiously using cytosine arabinoside (Ara-C) between the 10th and 17th day of disease; the temperature fell and VZV multiplication ceased, strongly suggesting a beneficial influence on the patient, who recovered completely.
Lymphoblasts from ten patients with ALL or stage IV malignant lymphoma were studied cytochemically and investigated for rosette-forming capacity with sheep red blood cells (SRBC) as a T cell surface marker. SRBC binding capacity and acid phosphatase or beta-glucuronidase were tested simultaneously in single lymphocytes isolated from normal blood donors. Our results suggest that the presence of acid phosphatase (and beta-glucuronidase) represents a functional state of lymphocytes or lymphoblasts qualitatively independent of T cell differentiation, but quantitatively more pronounced in T cells than in B lymphocytes or non-T lymphoblasts.
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The authors report on an infant with myeloproliferative syndrome of the myelomonocytic type. The findings fulfilled the criteria for juvenile chronic myeloid leukemia except that there was no increase of fetal hemoglobulin and no depression of erythrocyte carbonic anhydrase I. In one half of the bone marrow cells a Ph1-chromosome was found. During the course of the disease the Ph1-positive clone was successively replaced by cell lines with different chromosomal aberrations. The relationship between the cytogenetic mosaicism and the clinical and laboratory findings is discussed.
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