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Biomedical subjects

J Richmond

Publications and source records attributed to J Richmond.

At least 73 records · Page 4Linked to original sources

Follow-up studies on the immune status of patients with Hodgkin's disease after splenectomy and treatment, in relapse and remission.

Sixty-two patients with Hodgkin's disease have been followed for one year from the start of treatment. Immunological assessments were repeated after intensive treatment, in patients relapsing and in those in remission at one year. In patients achieving remission, overall cellular immunity, after deteriorating with therapy, particularly cytotoxic chemotherapy, returned to pre-treatment levels in remission when there was little evidence of cellular immune disturbance. Serum IgG and IgM levels fell with intensive chemotherapy in splenectomized patients. IgA and IgM levels were lower (irrespective of splenectomy or therapy status) in remission than at presentation or after treatment. Relapse or non-response was usually associated with deteriorating cellular immunity. Herpes zoster/varicella and candida infections (seen in 6 patients) were preceded by, or associated with, deterioration of cellular immunity.

Adult↗

Sensitisation to Hodgkin's disease spleen tissue in patients with malignant lymphoma: follow-up study.

The leucocyte migration responses of patients with malignant lymphoma to an unidentified factor in Hodgkin's spleen tissue were serially studied and related to clinical progress. Initial sensitisation responses did not correlate with presenting histological or clinical status or with subsequent clinical progress. Enhancement of responses after treatment, however, was associated with good clinical progress. In patients who relapsed, sensitisation to spleen factor diminished, whereas responses were preserved at one year in those in maintained remission. Sensitisation to the splenic factor may be a useful index of response to treatment in patients with malignant lymphoma; diminishing sensitisation may indicate relapse.

Cell Migration Inhibition↗

Pituitary function in patients receiving intermittent cytotoxic and corticosteroid therapy for malignant lymphoma.

Diurnal variation in plasma-cortisol was studied immediately before and after intermittent steroid therapy in seven patients receiving monthly courses of quadruple chemotherapy for Hodgkin's or non-Hodgkins lymphoma over a period of 6 months. The serum-thyroid-stimulating-hormone (T.S.H.) response to intravenous T.S.H.-releasing factor was also measured before and during the first course and before the second and fourth courses. The morning plasma-cortisol concentration fell significantly over 6 months when measured immediately before the start of each course. The mean evening cortisol concentration also fell over this period. In most patients the T.S.H. response showed a downward trend during treatment, although in two patients the response returned to normal whilst they were still undergoing therapy.

Adult↗

Cellular immunity to Hodgkin's splenic tissue measured by leucocyte migration inhibition.

Patients with lymphoreticular malignancy were shown by a leucocyte migration inhibition technique to have cellular immunity to Hodgkin's splenic tissue. Migration was significantly inhibited in 31 out of 55 patients with Hodgkin's lymphoma and 19 out of 39 patients with other types of lymphoma. Inhibition was also shown in only three out of 29 patients with other malignancy, one out of 23 normal volunteers, and one out of 25 patients with non-malignant disease. The splenic factor that inhibits leucocyte migration, which has yet to be isolated and identified, may be a helpful diagnostic tool in patients with suspected lymphoma.

Cell Migration Inhibition↗

Changes in immune status in patients undergoing splenectomy for the staging of Hodgkin's disease.

The immune status of 17 patients with Hodgkin's disease was studied before and after splenectomy (undertaken in staging laparotomy) and during chemotherapy or after radiotherapy. The findings were compared with those in 19 patients not selected for splenectomy. Serum IgA and IgM levels became significantly lower after treatment in the splenectomy group. Cell-mediated immunity was depressed mainly in patients receiving quadruple cytotoxic chemotherapy. Neutrophil function was normal or enhanced and was unchanged after splenectomy and treatment despite changes in neutrophil counts. Three patients who underwent splenectomy suffered fatal septicaemia. These results suggest that humoral immunity is depressed by treatment in patients who have undergon splenectomy, and the benefits of early accurate staging must be weighed against the likelihood of infective complications.

Adult↗

Neutrophil function in lymphoreticular malignancy.

Neutrophil function has been assessed in 62 patients with lymphoreticular malignancy by means of the NBT test and an in vitro micro-organism killing technique. Normal or enhanced phagocytosis was found, the greatest enhancement being found in patients with disseminated disease (in the absence of infections). Candicidal capacity alone was depressed in 7 patients but 4 of these showed depressed cell-mediated immunity to Candida antigen. Splenectomy, radiotherapy and chemotherapy did not alter phagocytic function.

Antigens, Fungal↗

Planned splenectomy in treatment of idiopathic thrombocytopenic purpura.

The results of a policy of treatment in idiopathic thrombocytopenic purpura based on previous observations on the natural history of the disease and its response to corticosteroids are described. The results of splenectomy were better when the history was less than 100 days. Three patterns of response to splenectomy were observed: complete remission, symptomatic remission, and relapse. The prognosis can be determined by the level of the platelet count six weeks after splenectomy. Corticosteroid treatment for more than three weeks before splenectomy noticeably increased the incidence of complications after operation. Splenectomy can safely be performed in pregnancy. The decision to operate should be made on the maternal condition and its response to corticosteroids.

Adolescent↗