[Marrow transplantation: preliminary results at the University Hospital Center].
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Biomedical subjects
Publications and source records attributed to J Bury.
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A total of 44 patients were treated with intensive induction chemotherapy for acute nonlymphocytic leukemia (ANLL). A complete remission (CR) was obtained in 29/44 (66%) patients. Serum zinc (Zn) and copper (Cu) were studied as possible prognostic factors in the determination of the chance of a patient attaining remission. Pretreatment Zn was higher in patients attaining a remission (0.99 +/- 0.05 microgram/ml) than in patients failing to attain a CR (0.78 +/- 0.06 microgram/ml) (P = 0.0216). There was no further difference between the two groups during aplasia. However, when response to treatment was evaluated about day 28, the difference reappeared: 1.06 +/- 0.05 microgram/ml for CR patients vs 0.77 +/- 0.07 microgram/ml for failures (p = 0.0012). Pretreatment Cu was higher in responding (1.44 +/- 0.07 microgram/ml) than in nonresponding (1.06 +/- 0.05 microgram/ml) patients (p = 0.0002). The difference between the two groups remained highly significant at days 7, 14, 21, and 28. At the time of response evaluation, the values were 1.46 +/- 0.05 microgram/ml for CR patients vs 1.19 +/- 0.08 microgram/ml for non-CR patients (P = 0.0070). We conclude that the measurement of serum Zn and Cu may be helpful in the prediction of response to chemotherapy in patients treated for ANLL.
The purpose of this study was to analyze the distribution and composition of the HDL subclasses in students whose parents suffered from a premature coronary heart disease (CHD), in comparison with a control group without any familial history of CHD. In the first part of this study, we observed significantly lower apo A-I concentrations in the cases than in the controls. Since there was a significant difference in smoking habits between cases and controls, and since we wanted to study the effect of a parental history of premature CHD on the composition of the HDL subclasses independently of smoking, the present study was conducted on the 17 pairs of non-smokers male cases and controls. In agreement with the results on total serum, we observed lower apo A-I concentrations in the HDL2b and HDL2a + 3a fractions in the cases compared to the controls. The apo A-II and cholesterol levels in these fractions were not significantly different between the 2 groups. The selective decrease of apo A-I in the HDL subclasses with the lowest density might be due to a decreased number of particles containing only apo A-I, with which a protective effect against atherosclerosis might be associated.
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During A-ALL induction treatment, HD-ara-C (2.5 g/m2 IV, day 1), does not produce any beneficial effect, whereas the hematologic toxicity is increased. A 3-month consolidation phase comprising intermittent MTX, ara-C and 6-TG is not significantly affecting either DFI or survival in A-ALL. The association of HD-ara-C and m-AMSA appears to be a promising salvage therapy for the 20% A-ALL refractory to first induction therapy. The quality of autologous bone marrow graft, harvested after HD-ara-C, seems to be impaired as suggested by a delayed recovery of PMN and platelets. HD-ara-C (3 g/m2 X N) given the days before cyclophosphamide and TBI as conditioning treatment for BMT does not seem to induce prohibitory additional toxicity. Whether HD-ara-C was given four to six times or eight to 12 times gave no significant difference in early toxicity.
A case of solitary plasmacytoma of the thyroid is reported. A monoclonal component (IgG lambda) was identified in the serum of the patient and disappeared after total thyroidectomy and radiotherapy. The use of the immunoperoxidase technique on thyroid, bone marrow, and lymph node specimens allowed us to demonstrate the production of IgG lambda by the tumor, and to rule out the possibility of multiple myeloma. Previously reported cases are reviewed (15 cases). The diagnostic criteria, the association with thyroiditis, and the treatment of this rare disorder are discussed.
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In this study the lipid and apoprotein profiles were investigated in newborns at 0, 7, and 30 days of life. The plasma lipoproteins were separated both by ultracentrifugation and gel filtration in order to compare the patterns obtained by the two techniques. At birth, the apo E concentration is comparable to that measured in adults, but its distribution among lipoproteins is significantly different as more than 80% of the plasma apo E belongs to high-density lipoproteins (HDL). At 7 and 30 days the plasma apo E concentrations are close to the values at birth, but a significant redistribution occurs from HDL to very low-density lipoproteins. By analogy with apo B, the plasma apo CIII concentration is low at birth and increases between 0 and 7 days by a factor of about two. Plasma triglycerides increase significantly during the first week of life so that the apo CIII increase is most pronounced in very low-density lipoproteins. These lipoproteins therefore become enriched in apo E, apo CIII and triglycerides between 0 and 7 days. At birth, a distinct HDL fraction, enriched in apo E, apo AII and cholesterol (HDLE), could be detected. To compensate for the low LDL levels, this HDLE fraction might function as an additional source for cholesterol delivery to peripheral tissues via the apo (B, E) receptor. At later age, low-density lipoprotein synthesis is enhanced, apo E is transferred to very low-density lipoproteins, and cholesterol delivery via the HDLE becomes less important.(ABSTRACT TRUNCATED AT 250 WORDS)
A specific, sensitive and accurate, non competitive enzyme-linked immunosorbent assay was developed for the quantitation of human apolipoprotein C-II. Using apolipoprotein C-II and apolipoprotein C-III immunosorbent columns, monospecific anti-apolipoprotein C-II antibodies were prepared for coating and for the preparation of a peroxidase-antibody conjugate. The assay is sensitive down to 0.25 ng apolipoprotein C-II per assay and precise, with mean intra- and inter-assay coefficients of variation of 3.1% and 7.9% respectively. The apolipoprotein C-II concentrations in normolipaemic and hyperlipaemic plasma were not affected by delipidation, and increased only slightly after treatment with detergents or urea. The mean plasma apolipoprotein C-II concentration in a group of 30 normolipaemic subjects, was 33.1 +/- 7.5 mg/l. All hypertriglyceridaemic subjects had significantly elevated apolipoprotein C-II plasma concentrations, which were most pronounced in Fredrickson type III and type V patients. The apolipoprotein C-II profiles, obtained by column fractionation of 6 normolipaemic and 11 hypertriglyceridaemic plasmas, demonstrated a shift of apolipoprotein C-II towards the triglyceride-rich lipoproteins in hypertriglyceridaemic subjects.
We developed a sensitive, specific "sandwich"-type enzyme-linked immunosorbent assay in which affinity-purified antibodies are used for coating and also for preparing an antibody-peroxidase conjugate to quantify apolipoprotein E in serum and in its lipoprotein fractions. This technique is rapid (results within 5 h), precise (mean intra- and interassay CVs 4.3 and 8.2%, respectively), accurate, and simple to perform. Sample pretreatment did not enhance apo E immunoreactivity. For 47 normolipidemic subjects, the mean apo E concentration was 38.11 (SD 11.1) mg/L. Above-normal apo E concentrations were measured in all types of hyperlipoproteinemia, especially types III and V. Apo E correlated with triglyceride (r = 0.58) and cholesterol concentrations (r = 0.60). As determined by gel filtration, hypertriglyceridemia was associated with a redistribution of apo E towards the triglyceride-rich lipoprotein fractions, which contained 77.1% (SD 16.8%) of total plasma apo E in Fredrickson type V patients, compared with 12.5% (SD 6.3%) in normal persons.
Among 95 consecutive patients with acute nonlymphocytic leukemia (ANLL), 61 were treated with a high-dose chemotherapeutic induction regimen consisting of daunorubicin, vincristine, and cytosine arabinoside (DOA). The complete remission (CR) rate was 66%. Although young patients responded better than older patients, only sex was found to be of prognostic significance for achieving CR (84% CR in men versus 47% in women, P less than 0.005, independent of age). Patients in CR received consolidation, monthly maintenance therapy, and late intensification for a period of 2 years. Median remission duration was 57 weeks and median survival, 93 weeks. Projected CR rate at 5 years was 30%. CR and survival duration were significantly longer in patients 40 to 60 years old when compared with younger and older patients (P = 0.023). They were also longer in male than in female patients (P = 0.018), but this may be due to an effect of age. In the 34 patients who did not receive DOA treatment because of age or poor clinical conditions, there was no survival beyond 57 weeks, except in a 73-year-old woman who reached a spontaneous remission during acute infection. ANLL characteristics at presentation revealed a tendency toward a smaller tumor mass (P less than 0.05) and rarer Auer rods present (P = 0.03) with increasing age. Features and treatment of ANLL in elderly patients are discussed in view of the poor results obtained with conservative management.
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