Search PubMed⌕ Search

Biomedical subjects

J M Bennett

Publications and source records attributed to J M Bennett.

At least 289 records · Page 16Linked to original sources

The analytic basis for the use of platelet estimates from peripheral blood smears. Laboratory and clinical applications.

Estimation of the platelet count from examination of peripheral blood smears is a widely practiced procedure, but statistical validity to judge the accuracy of the technic has been lacking. More than 400 patients' platelet estimates and counts were analyzed to develop a simple working formula to permit a reasonably accurate platelet estimate. Smear-to-smear and technician-to-technician variabilities were defined, and the influences of different microscopes on the platelet estimates were demonstrated. Platelet estimates can be used as a rapid, convenient measurement suitable for providing useful information for clinical judgement of a patient's platelet status providing that the method's limitations are recognized.

Blood Cell Count↗

Phase II study of adriamycin and bleomycin in patients with multiple myeloma.

Twenty-seven patients with far-advanced multiple myeloma, resistant to standard agents, were treated with either adriamycin (eight patients) or bleomycin (19 patients). Adriamycin was given iv at a dose of 60 mg/m2 every 3 weeks and bleomycin was administered im at a dose of 15 mg/m2 weekly. Drug toxicity was modest. One partial response was seen with each agent, both occurring in "good-risk" patients.

Aged↗

Chemotherapy of non-Hodgkin's lymphomas: Eastern Cooperative Oncology Group experience.

The addition of prednisone to the two-drug combination of cyclophosphamide and vincristine increases the number of complete remissions (CR). Patients who had CRs in at least two of the studies, EST 0168 and EST 3472, lived significantly longer than those who had partial remissions. In EST 0168, the survival time correlated strongly with the nodal pattern and cell type, confirming results of Rosenberg and co-workers. EST 1472 confirmed the activity of BCNU in lymphocytic lymphomas; when both agents are combined with prednisone, the induction potential of BCNU is equal to that of cyclophosphamide. In the histiocytic lymphomas, BCNU added to CVP increases the percentage of CRs but it does so at the expense of considerable toxicity. EST 0871 demonstrated that low-dose bleomycin and hexamethylmelamine are active agents in lymphoma and should be combined with other effective combinations in an attempt to improve the CR rate. Finally, our current studies demonstrate that the failure rate in the diffuse or unfavorable lymphomas is higher than that in the more favorable nodular forms.

Altretamine↗

Increased concentrations of serum free fatty acids falsely increase serum thyroxine as determined by competitive protein-binding.

Markedly increased concentrations of free fatty acids after a fatty meal and heparin injection already have been shown to falsely increase thyroxine values measured by competitive protein-binding techniques, where ethanol extraction in used. We report here the effect of lesser increases. In 10 patients receiving heparin during hemodialysis we found significant increases in serum thyroxine by competitive protein-binding (mean, 20 nmol/l) and in free fatty acid concentrations (164 micronmol/l). Thyroxine measured as iodine did not change significantly. In seven subjects who had fasted for 27 h, we also noted significant increases in thyroxine by competitive protein-binding (mean 63 nmol/l) and in free fatty acid concentrations (624 micronmol/l). In a single subjects, serial measurements showed a close association of the two variables and the overall correlation between the increases was good. This artefact limits the value of many currently used thyroxine methods because it imposes restrictions on transport of samples and selection of patients.

Binding, Competitive↗

Carcinocythemia (carcinoma cell leukemia). An acute leukemia-like picture due to metastatic carcinoma cells.

Observation of a unique population of cells on a Wright-stained blood smear of a patient with metastatic breast carcinoma prompted a study to determine their origin. The primary carcinoma contained a marker, the presence of "signet cells." These were demonstrated in direct peripheral smears and buffy coat preparation of peripheral blood and confirmed histochemically by showing positive periodic acid-Schiff, alpha-napthol and beta-glucuronidase reactions. "Carcinocythemia" is suggested as a name for this unusual process observed over a six month period. Studies of the patient's immunocompetence, of circulating cell surface immunoglobulins and karyotype analysis were made. Postmortem examination revealed retroperitoneal fibrosis, splenic atrophy and extensive metastatic carcinoma but no evidence of leukemia. The cells will be contrasted to those seen in a second patient who appeared to have acute myelocytic leukemia complicating extensive cancer involving the bone marrow. The observations suggest that a leukemia-like blood picture due to circulating cancer cells may occur during the course of metastatic breast carcinoma.

Acute Disease↗

Immune markers in adult acute leukemia.

Three cases of adult acute leukemia were examined for immunologic markers. Incubation of leukemic cells with anti-D (IgG)-coated erythrocytes was used for the identification of monocytes; sheep erythrocytes were employed for T-cells and fluorescein-conjugated anti-mixed immunoglobulins for B-cells. It was shown that IgG receptors (monocytes) were present on immature cells with predominant monocytic components; T- and B-cell markers were absent in the mono- and myelocytic leukemias.

Adult↗

Proposals for the classification of the acute leukaemias. French-American-British (FAB) co-operative group.

A uniform system of classification and nomenclature of the acute leukaemias, at present lacking, should permit more accurate recording of the distribution of cases entered into clinical trials, and could provide a reference standard when newly developed cell-surface markers believed to characterize specific cell types are applied to cases of acute leukaemia. Proposals based on conventional morphological and cytochemical methods are offered following the study of peripheral blood and bone-marrow films from some 200 cases of acute leukaemia by a group of seven French, American and British haematologists. The slides were examined first independently, and then by the group working together. Two groups of acute leukaemia, 'lymphoblastic' and myeloid are further subdivided into three and six groups. Dysmyelopoietic syndromes that may be confused with acute myeloid leukaemia are also considered. Photomicrographs of each of the named conditions are presented.

Acute Disease↗

Cyclophosphamide and CCNU in the treatment of inoperable small cell carcinoma and adenocarcinoma of the lung.

Two hundred and fifty-eight patients with small cell carcinoma and 185 patients with adenocarcinoma were centrally randomized to receive either cyclophosphamide (1000 mg/m2 every 3 weeks) iv or cyclophosphamide (700 mg/m2 every 3 weeks) iv plus CCNU (70 mg/m2 every 6 weeks) orally. Those patients who were initially treated with the single agent were then treated with CCNU (130 mg/m2 every 6 weeks) at the time of cyclophosphamide failure. Objective tumor regression occurred more frequently with the combination regimen in patients with small cell carcinoma (43% vs 22%, P = 0.002), but no difference in response rates was apparent in patients with adenocarcinoma. In both cell types patients survived somewhat longer following treatment with the combination. The overall incidence of severe toxicity was equal for the two regimens in both cell types; however, the therapeutic index of the combination was superior to that of the single agent in small cell carcinoma. Severe drug toxicity was more frequent in small cell carcinoma patients with extensive disease, and survival was reduced in both cell types with extensive disease. Survival was better for ambulatory patients in both cell types and women survived longer than men. In women with small cell carcinoma, ambulatory status also was associated with a higher incidence of tumor regression. In patients with small cell carcinoma those who had prior lung surgery survived longer than those without prior surgery. Previous radiation therapy was associated with a reduced incidence of objective regression in men with small cell carcinoma. In both cell types patients with tumor regression lived longer than nonresponders; however, objective disease stability was associated with improved survival only in patients with adenocarcinoma. Stratification in future studies should consider extent of disease, performance status, sex, and prior therapy.

Adenocarcinoma↗

Adult acute leukemia. The Rochester (NY) Experience.

A ten-year retrospective study of adult acute leukemia was performed in nonieukemia-specialized centers to determine prognostic factors, length and quality of survival, cause of death, and response to different modes of therapy. Of 200 patients, 9.5% achieved complete remission, 14.0% obtained partial remission, and no response was present in 76.5%. Patients who were 50 years old or more (64.5%) had a significantly lower response rate (P less than .005) and survival (P less than .05) than the younger age group. Aggressive chemotherapy significantly improved the response rate, as well as survival (P less than .001). Quality of life was similar for responders and nonresponders, both spending only one fourth of their survival time in the hospital. Infection as the leading cause of death. The overall ten-year response rate of 23.5% represents a realistic rate in nonleukemia-specialized centers in which the treatment of adult acute leukemia is variable.

Acute Disease↗

Inappropiate ADH secretion associated with massive vincristine overdosage.

A patient with acute lymphocytic leukemia is described who developed meningeal leukemia 14 months after the initial diagnosis was made. As part of his antileukemic therapy, at that time, he received prednisone and vincristine, given prophylactically to maintain a bone marrow remission. He inadvertently received 15 mg of vincristine instead of 1.5 mg. Following this overdosage he developed pancytopaenia, mild neurotoxicity and subsequently a grand mal seizure associated with the delayed onset of hyponatremia. This was presumed to be due to the inappropriate secretion of antidiuretic hormone (ADH) secondary to vincristine toxicity. This responded to fluid restriction and anti-epileptiform therapy.

Adolescent↗

N-acetyl-beta-glucosaminidase activity in normal and malignant leukocytes.

An improved cytochemical method demonstrating N-acetyl-beta-glucosaminidase in peripheral blood and bone marrow leukocytes is described. A significant elevation in enzyme activity in circulating monocytes from patients with solid tumor malignancies was observed. In a large series of cases of acute nonlymphocytic leukemia, elevated levels were found in the vast majority of those leukemias that had a predominant monocytic component identified either morphologically or by standard cytochemical methods. This reaction would appear to be useful as a monocyte marker.

Acetylglucosaminidase↗