Search PubMed⌕ Search

Biomedical subjects

J P Hester

Publications and source records attributed to J P Hester.

At least 73 records · Page 4Linked to original sources
PubMed1981

Chemoimmunotherapy of adult acute leukemia.

Sixty-two adult patients with acute myeloid leukemia were treated with a chemotherapy program of Adriamycin, Cytosine Arabinoside (Ara-C), vincristine, and prednisone (Ad-OAP). Immunotherapy with BCG by scarification was administered before and/or during remission induction therapy. Maintenance chemoimmunotherapy consisted of Ara-C, vincristine, prednisone, and BCG. Patients still in remission after 12 months received late intensification chemotherapy for three courses before discontinuing chemotherapy. Forty-four (71%) patients achieved a complete remission (CR). The CR rate for patients less than 50 years of age ws 84% (32/38). Age was strongly predictive for response and survival. An additional 14 patients with acute lymphoid leukemia were treated with the same program; ten patients responded, all have relapsed and died. Nine patients with AML remain alive 4 1/2-6+ years from diagnosis.

Adolescent↗
PubMed1981

Meningeal involvement in Philadelphia chromosome-negative chronic granulocytic leukemia.

A patient with Philadelphia (Ph1) chromosome-negative chronic granulocytic leukemia (CGL) had meningeal involvement three months after diagnosis. Leukemic blast cells had been noted in pleural fluid three weeks earlier. Her bone marrow remained in the benign phase. Three months of intensive therapy were required to clear the CSF of malignant cells. Myeloblastic transformation of bone marrow occurred 25 months after diagnosis, and attempts at induction of remission were unsuccessful. The CSF cytologic findings again were positive for leukemic cells the day before death, 29 months after diagnosis. Leukemic cells were found infiltrating the meninges at autopsy. This case illustrates that meningeal involvement may occur during the benign phase of Ph1 chromosome-negative CGL. Most previously reported cases of meningeal involvement by CGL have involved patients possessing the Ph1 chromosome, and in most cases meningeal involvement has followed malignant transformation of the bone marrow.

Adult↗
PubMed1981

Cross cellular contamination in plateletpheresis, leukapheresis and plasma exchange.

Continuous flow cell separation procedures in the IBM-2997 single stage and dual stage channels allow collection of components for replacement transfusions and therapeutic exchange of plasma or depletion of leukemic leukocytoses or thrombocytoses. Minimal cross cellular contamination with red cells and lymphocytes is achieved for platelets collected in the dual stage channel through blood path design. A reduction in cross cellular contamination is minimized in the single stage channel by procedural guidelines which reflect the principles of whole blood response to centrifugal acceleration in this system

Blood Transfusion↗
PubMed1979

Autologous bone marrow transplantation in relapsed adult acute leukemia.

From March, 1976 to February, 1979, 28 cases of adult acute leukemia of which 24 were evaluable were treated in irreversible relapse with high dose chemotherapy (piperazinedione) and supra-lethal total body irradiation (TBI) in conjunction with autologous bone marrow transplantation (ABMT). The marrow cells grafted were collected and stored in liquid nitrogen at the time of remission. In 12 patients the marrow cells were fractionated using discontinuous albumin gradients in an attempt to separate normal cells from residual leukemic cells. Twelve patients achieved complete remission (CR); in 9 additional patients signs of engraftment were evident but death occurred before achievement of CR. Seven of 12 AML patients, which were treated with bone marrow transplantation as first treatment of their relapse, achieved CR. Four of 5 patients with ALL, whose bone marrows were collected during first remission, reached CR. The median CR duration was 4+ months and the median survival of the patients reaching CR was 6+ months. Autologous bone marrow transplantation offers a good chance of CR (66%), when marrow is collected during first remission and used as first treatment for AML in third relapse and ALL in second relapse.

Adolescent↗
PubMed1979

Principles of blood separation and component extraction in a disposable continuous-flow single-stage channel.

A single-stage disposable channel and seal that provides for leukocyte and granulocyte collection by continuous-flow cell separation (CFCS) has been designed by the IBM Corporation. This paper describes (1) the separation characteristics of whole blood as it responds to varying gravitational (G) forces and flow rates through the channel; (2) the mechanism by which the buffy coat accumulates and is extracted; (3) the efficiency of extraction; (4) those donor and procedural variables that contribute to the final yield; (5) posttransfusion increment response in patients; and (6) the functional integrity of the cells collected.

Blood Cells↗
PubMed1978

Response of malignant melanoma to plasma exchange, surgical debulking, and Corynebacterium parvum.

A 48 year old man with extensive cutaneous and subcutaneous metastatic malignant melanoma responded to treatment by repeated plasma exchanges, partial surgical debulking of tumor masses, and intravenous Corynebacterium parvum. Circulating immune complexes were measured by the serum C1q binding method. Tumor regression coincided with serum C1q binding reduction to normal levels. Clinical relapse was preceeded by recurrent elevation of serum C1q binding activity.

Binding Sites↗
PubMed1977

Chronic myelogenous leukemia: management of splenectomy in a high-risk population.

Splenectomies have been performed on 58 patients with chronic myelogenous leukemia (CML) during the last 16 years. For the 27 patients operated upon during the first 12 years, the operative mortality was 26%. Four patients also had to be re-explored for bleeding and three required drainage of subphrenic abscesses. There has been no operative mortality in the 31 patients operated using a standardized procedure during the last four years but two had to be re-explored for bleeding and one required drainage of a subphrenic abscess. The operative risks for leukemic patients are infection, perhaps related to granulocyte abnormalities and hemorrhage in patients with thrombocytopenia or qualitative platelet abnormalities. When the splenectomy in patients with CML is timed with the patient's chemotherapy cycle, the use of local antibiotics and platelet concentrates should permit a safe operation. Survival rates were not comprised even when the patients had their splenectomy during CML-blast crisis.

Adolescent↗
PubMed1977

Frequency of HLA antigens in chronic myelocytic leukemia.

Histocompatibility antigen (HLA) phenotypes of 34 patients with Ph1+ chronic myelogenous leukemia (CML) were evaluated for association with HLA antigens. Two control populations were compared to the CML patients: 142 normal volunteer platelet donors, and 160 normal donors of granulocyte transfusions. HLA typing was done by lymphocyte microcytotoxicity tests for nine antigens on sublocus A and 15 antigens on sublocus B. HLA-B7 and HLA-B12 were decreased in CML patients compared to both platelet and granulocyte donors. There was increased frequency of HLA-A3 in patients (41%) as compared to controls (25% and 33%); HLA-B5 - patients = 20%; controls 8% and 6%; and HLA-BW17 - patients = 17%; controls = 6% and 3% (P = 0.01). Median survival was 24+ months and independent of HLA. HLA-B5 and HLA-BW17 were significantly increased in patients with CML compared to two normal control populations. No increase in HLA-B8 was seen. Decreased frequency of HLA-B7 and B12 was noted. The significance of these differences is being evaluated.

Chromosome Aberrations↗
PubMed1977

Transcatheter splenic arterial occlusion: an experimental study in dogs.

Three techniques of transcatheter splenic arterial occlusion were evaluated in dogs. Angiographic, hematologic, and morphologic studies were done up to 9 weeks postocclusion. All animals showed hematologic changes characteristic of depressed splenic function; the degree and duration of these changes depended upon the technique. Alterations in histology including vascular congestion, infarction, and fibrosis, were also dependent upon the method used and the time elapsed after occlusion. Celiac angiography demonstrated the extent of collateral circulation and degree of recanalization of the occluded vessels. Potential clinical applications are discussed.

Angiography↗
PubMed1976

The problem of splenectomy in a leukemic patient population.

An attempt has been made in an experimental group of 20 patients, with leukemia or one of the myeloproliferative disorders, to devise a safe method of splenectomy by timing the operation to coincide with optimal response to chemotherapy, preoperative bowel preparation with antibiotics to minimize infections, and availability of platelet concentrates, matched for HL-A antigens when possible, to control massive hemorrhage. The results in this experimental group were compared with a historical control group of 26 patients. Two-thirds of all the patients had chronic myelocytic leukemia, and the mean weight of the spleens removed was just over 1,800 grams. Operative mortality was 35% in the historical group and zero in the more recent group, six of whom were operated on while in blastic crisis. Splenectomy can be done safely in leukemic patients, and is not contraindicated. Future planned studies will determine its possible therapeutic role in reducing tumor burden.

Adolescent↗