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Biomedical subjects

J P Hester

Publications and source records attributed to J P Hester.

At least 55 records · Page 3Linked to original sources
PubMed1986

Piperazinedione, total body irradiation, and autologous bone marrow transplantation in chronic myelogenous leukemia.

Eleven patients with Philadelphia chromosome (Ph1)-positive chronic myelogenous leukemia (CML) in blast crisis (ten patients) or accelerated disease (one patient) were treated with piperazinedione (PIP) and fractionated total body irradiation (TBI) followed by autologous bone marrow transplantation (ABMT). Three patients were transplanted with marrow from which the Ph1 clone had been eradicated by prior intensive chemotherapy. All patients responded with disappearance of blasts in bone marrow and peripheral blood. Six patients achieved a second chronic phase lasting 3 to 14 months (median, 6 months). Two patients had incomplete recovery, and three patients failed to engraft and died from infection. Transplantation with Ph1-negative bone marrow did not improve response duration or survival. Recurrence of blast crisis and incomplete engraftment continue to be the two major problems in this patient group, and more active regimens need to be investigated.

Adult↗
PubMed1986

Transfusion of Rh-incompatible blood components to cancer patients.

To study the effects of Rh0D incompatible transfusion of platelets and/or granulocyte concentrates, we analyzed the transfusion history of 118 oncology patients. Patients received a mean 36.2 units of random platelets, a mean 6.2 concentrates of single donor platelets, and a mean 8.4 concentrates of granulocytes. Patients were not treated with anti-Rh0D specific immunoglobulin following the incompatible transfusions. The patients were followed for a mean 9.4 months to detect the appearance of Rh0D antibodies. Of the 118 patients, 3 were lost to follow-up. Of the remaining 115, 2 cases (1.74%) developed anti-Rh0D following administration of the incompatible transfusions.

Blood Group Incompatibility↗
PubMed1985

Continuous-flow techniques for platelet concentrate collection: a step toward standardization and yield predictability.

This study chronicles leukocyte- and erythrocyte-depleted platelet concentrate collection by a dual stage channel in which three variables: 1) donor peripheral blood platelet concentration, 2) total blood processed, and 3) collection volume were statistically correlated with platelet yield as determined by a multiple regression analysis of single variables. Platelet concentration in the final yield was related to donor precount and collection rate, and could be varied as indicated for individual applications. Total blood processed was established by procedure time, which in turn was defined by citrate-induced calcium changes in the donor. Reduction in peripheral blood platelet concentration averaged 24% for a mean platelet yield of 3.8 X 10(11). An average of 40% of transfused platelet concentrates were recovered in recipient peripheral blood 1 hr posttransfusion and were hemostatically effective, as determined by correction of bleeding time. Platelet yields and patient response were sustained during current collection procedures, verifying the principles described during the investigative period.

Adult↗
PubMed1985

Chronic myelogenous leukemia: a multivariate analysis of the associations of patient characteristics and therapy with survival.

The prognostic importance of patient pretreatment clinical and laboratory features was investigated in a group of 303 patients with Philadelphia chromosome-positive benign-phase chronic myelogenous leukemia. Intensive chemotherapy was given to 97 patients, and 78 underwent an early elective splenectomy. The overall median survival time, dated from hospital admission, was 39 months. Patient characteristics associated with shortened survival were age 60 years or older, black race, the presence of hepatomegaly, splenomegaly, symptoms, weight loss, and poor performance status. Adverse blood and bone marrow parameters were anemia, thrombocytosis or thrombocytopenia, a high proportion of peripheral blasts plus promyelocytes or of basophils, a high proportion of marrow blasts or basophils, decreased marrow megakaryocytes, and cytogenetic abnormalities in addition to the Philadelphia chromosome. Several of these factors were interrelated. A multivariate regression analysis demonstrated that the combination blood basophilia, race, additional cytogenetic abnormalities, age and marrow basophilia had the strongest predictive relationship to survival time. This resulted in a model segregating patients into low-, intermediate-, and high-risk groups, with median survivals of 53, 39, and 25 months, respectively. Another model was derived that did not include the marrow features and identified splenomegaly and platelet counts as adding to the prognosis prediction by blood basophilia, race, and age. Evaluation of the effect of therapy, after adjusting for differences in prognostic characteristics, showed that intensive chemotherapy was associated with survival prolongation among patients at intermediate and high risk of death. We conclude that a combination of pretreatment factors identifies different risk subcategories in patients with chronic myelogenous leukemia and is helpful in assessing overall prognosis and treatment effect.

Adult↗
PubMed1984

Response of chronic myelogenous leukemia patients to COAP-splenectomy. A Southwest Oncology Group study.

Eighty-seven patients from 18 institutions with a confirmed diagnosis of chronic myelogenous leukemia were registered on a Southwest Oncology Group protocol for multiagent induction and single-agent maintenance chemotherapy, with randomization to an immunotherapy arm. Elective surgical splenectomy was performed for 42 patients at the completion of 3 months of induction therapy. Final analysis of the study revealed statistically significant survival advantages were correlated with age, splenectomy, the absence of hepatic leukemic infiltrate at the time of splenectomy, and race.

Adolescent↗
PubMed1984

The function and structure of granulocytes collected using the IBM 2997 separator.

The effect of oral methylprednisolone and the sedimenting agent, hydroxyethyl starch, on granulocyte recovery, morphology, and function was studied in a volunteer donor programme. Using the IBM 2997, 10 litres of whole blood were processed, with an average procedure time of 2.4 hours and a collection volume of 300 ml. Donors not receiving methylprednisolone (n = 80) had a mean total granulocyte count of 3.5 X 10(9)/litre (range 1.6-5.3 X 10(9)/litre) and mean granulocyte yields were 1 X 10(10) (range 0.2-3.0 X 10(10)). Those receiving 48 mg oral methylprednisolone 6-8 hours before the procedure (n = 320) had a mean granulocyte count of 6.3 X 10(9)/litre (range 3.2-11.4 X 10(9)/litre) and significantly superior mean granulocyte yields of 2.0 X 10(10) (0.3-6.5 X 10(10)) (P less than 0.05). For both groups the mean packed cell volume of 0.08 litre/litre (range 0.02-0.17) and platelet contamination 1.9 X 10(11) (range 0.3-5.0 X 10(11)). In all these procedures, hydroxyethyl starch was added to the blood entering the centrifuge channel. In none of the procedures were any untoward symptoms experienced by the donors. Light microscopy and ultrastructural studies showed no difference between control granulocytes and those collected following the addition of hydroxyethyl starch or after oral methylprednisolone. Similarly, granulocyte function measured with a random migration, chemotaxis, phagocytosis, and intracellular killing was not significantly different between control cells and those exposed to the sedimenting agent or the adrenocorticosteroids (P greater than 0.10). It is concluded that donor premedication with methylprednisolone significantly enhances granulocyte yields in the presence of hydroxyethyl starch and neither agent has any demonstrable effect on granulocyte morphology or function.

Blood Donors↗
PubMed1983

Mononuclear cell (MNC) collection by continuous-flow centrifugation (CFC).

Mononuclear cell separation and collection by continuous-flow centrifugation relates to centrifugal acceleration, total blood processed, peripheral blood concentration, and probable mobilization from extravascular sites during the procedure. At low-G forces, 70-80% of mononuclear cells are cleared. As G forces are increased, 95-100% of mononuclear cells can be cleared, but excessive platelet depletion occurs. An average of three billion cells were harvested from 2-3 liters of blood, rising to nine billion when 6 liters were processed. The total blood processed is defined by citrate infusion rates and ionized calcium changes. Large quantities of mononuclear cells were collected from normal donors without any significant depletion. If the objective of harvesting mononuclear cells is depletion, intensive schedules may be needed.

Blood Component Removal↗
PubMed1983

Altered heterogeneity of monocytes in acute myelomonocytic leukemia.

Human peripheral blood monocytes isolated from normal donors and patients with acute myelomonocytic leukemia (AMML) were separated on a discontinuous density gradient of bovine serum albumin (BSA) into five fractions. Cells from each fraction were assayed for cell surface markers, prostaglandin E2 (PGE2) production, ability to affect proliferation in response to antigen by autologous peripheral blood lymphocytes previously depleted of monocytes, and ability to regulate immunoglobulin (Ig) synthesis by allogeneic B-lymphocytes. Fractions 1-5 from normal donors contained 11, 10, 23, 34, and 22%, respectively, of the total number of monocytes. In contrast, in 6 patients with AMML fraction 3 was considerably larger (52%) than any other fraction, in 1 patient comprising 87% of her monocytes. Cells from each fraction differed markedly in accessory function. In general, cells from fraction 3 were poorer as helper cells than cells from other fractions. They also produced after stimulation larger amounts of PGE2 than did cells from other fractions of the gradient. These data show that PBL contain a subpopulation of monocytes, which either helps poorly or suppresses in vitro immunologic function of T-cells (proliferation) and B-cells (lg synthesis), and that this subpopulation is increased in the blood of patients with AMML.

B-Lymphocytes↗
PubMed1982

Donor symptomatology and safety in blood cell separation procedures.

Increasing demands for platelet and granulocyte concentrates collected by cell separation technology for replacement strategies requires expanding available donor pools, related or unrelated by recruiting additional donors or increasing the frequency with which a donor is processed. The expanding application of cell separation devices for plasma or red cell exchange as a therapeutic modality for many medical diagnoses now exposes patients with altered physiology to technology and procedures originally designed for healthy blood component donors. Some possible risks from the technology and/or procedure are discussed. Donor symptomatology from the chemical agents used in blood processing and a relationship to scheduling frequency are introduced.

Adult↗