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L J McCarthy

Publications and source records attributed to L J McCarthy.

10 recordsLinked to original sources
PubMed1991

Hepatitis C.

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False Positive Reactions↗
PubMed1990

Characteristics of engraftment after repeated autologous bone marrow transplantation.

The rate of engraftment after autologous bone marrow transplantation (ABMT) is extremely variable and largely unpredictable. To identify factors influencing engraftment, we studied 35 patients with refractory germ cell tumors undergoing high-dose chemotherapy with carboplatin (900-2000 mg/m2) and etoposide (1200 mg/m2) with bone marrow rescue. Prior to the initiation of chemotherapy, bone marrow sufficient for two marrow infusions was harvested (range 0.86-4.82 x 10(8) nucleated cells per kg). All 35 patients received half of the collected bone marrow 3 days after the last dose of chemotherapy; 23 responders received a second round of the same chemotherapy followed by infusion of the second half of the bone marrow. Eighteen patients could be compared for the two transplant episodes. The "rate of engraftment" was defined as the unweighted mean of four parameters: 1) the number of days until the absolute granulocyte count surpassed 0.2 x 10(9)/liter, 2) the number of days until the absolute granulocyte count surpassed 0.5 x 10(9)/liter, 3) the number of days until the last platelet transfusion, and 4) the number of days until the reticulocyte count surpassed 25 x 10(9)/liter. No significant correlation was found between rate of engraftment and such factors as the number of nucleated cells per kg infused, the dose of chemotherapy, extent of prior chemotherapy, tumor response to the high-dose chemotherapy, age of the patient, or the days of granulocytopenic fever (all p greater than 0.20). In contrast, a close correlation was found for the number of units of platelets (p = 0.005) and red blood cells (p = 0.006) transfused following each of the two transplants. There was no significant difference between rate of engraftment after first and second transplantation. Comparison of these data with the results obtained in reported ABMT with separate harvests suggests that the characteristics of the infused marrow determine the rate of engraftment after ABMT. This model of repeated transplantation could provide an important tool for assessing the therapeutic efficacy of hematopoietic growth factors.

Bone Marrow Transplantation↗
PubMed1979

Fatal benign phenytoin lymphadenopathy.

A 71-year-old man had status epilepticus and was treated with phenytoin (Dilantin) sodium. Subsequently, an absolute eosinophilia developed, which increased and reached its zenith immediately before the patient died. At autopsy, anasarca and an interstitial nephritis characterized predominantly by eosinophils and occasional focal necrotizing arteriolar glomerular lesions were found. Portal areas also contained an eosinophilic infiltrate. It has been previously stressed that exfoliative dermatitis is often the initiating sign of an allergic hypersensitivity reaction with phenytoin therapy. In view of this, we would suggest that a potential first sign of such an underlying reaction may be the development of an otherwise unexplained absolute eosinophilia.

Aged↗
PubMedDate not supplied

Blood shortage.

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Blood Donors↗
PubMedDate not supplied

The use of exchange transfusions: a potentially useful adjunct in the treatment of fulminant falciparum malaria.

Fulminant falciparum malaria with greater than 500,000/mm3 parasites in the peripheral blood portends a poor prognosis. We recently managed a patient who had greater than 1.2 million/mm3 parasitized erythrocytes in her peripheral blood, following initially inadequate antimalarial therapy, with exchange transfusion in addition to conventional chemotherapy. This patient recovered from her disease despite severe cerebral involvement and acute failure. We feel that exchange transfusion was a useful adjunct and should be considered in patients with life threatening falciparum malaria when conventional measures fail to control the disease.

Adult↗