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Biomedical subjects

M E Beard

Publications and source records attributed to M E Beard.

At least 91 records · Page 5Linked to original sources
PubMed1980

Richter's syndrome with identification of marker chromosomes.

A case is presented of a man with Richter's syndrome with diffuse histiocytic lymphoma following a ten-year history of untreated chronic lymphatic leukemia. He did not respond to therapy. The lymphoma cells had 61 chromosomes with aneuploidy of 13 chromosomes and 11 structurally altered chromosomes. Only chromosomes 8, 9, 12, 14, and 18 were diploid and without abnormality. Significantly, part of chromsome 1q was duplicated as in the partial trisomy of 1q reported to characterize a number of hematologic neoplasms. A large marker chromosome with subterminal centromere was a tandem duplication of chromosome 4q.

Aneuploidy↗
PubMed1980

Control of thrombocytosis by plateletpheresis using a cell separator.

Three patients with marked thrombocythaemia secondary to myeloproliferative disorders were treated with plateletpheresis using an Aminco cell separator and myelosuppressive agents. Immediate control of the raised platelet count was achieved by plateletpheresis and long-term control by the concomitant cytotoxic therapy. The indications for plateletpheresis in patients with marked thrombocytosis are discussed.

Adult↗
PubMed1980

Bone marrow transplantation for severe aplastic anaemia.

An eight-year-old girl with severe acquired aplastic anaemia received a bone marrow transplant from her 11-year-old brother. The bone marrow graft is firmly established, but the patient has mild chronic graft versus host disease affecting liver and skin. The indications for bone marrow transplantation in aplastic anaemia are discussed.

Anemia, Aplastic↗
PubMed1980

Acute onset of folate deficiency in patients under intensive care.

Four patients with ruptured abdominal aortic aneurysm developed thrombocytopenia and marked megaloblastic changes within 3-10 days of surgery. In 2 patients, direct evidence of folate deficiency within marrow cells was obtained by measuring deoxyuridine suppression in short-term bone marrow cultures. The results suggest that folate deficiency was limited to marrow tissue. Folate deficiency localized to the bone marrow offers an explanation for the extremely rapid onset of thrombocytopenia in these patients. The significance of these findings with regard to folate metabolism is discussed. The importance of recognizing this potentially fatal complication of critical illness is emphasized, because it should be readily prevented by folic acid therapy.

Acute Disease↗
PubMed1979

Pregancy complicated by acute myeloid leukaemia.

Combination cytotoxic chemotherapy was used to treat a case of acute myeloid leukaemia presenting in the 25th week of pregnancy with a sustained complete remission of the leukaemia and the successful delivery of a normal infant. The management of leukaemia presenting in pregnancy is discussed.

Adult↗
PubMed1979

Jogger's heat stroke.

Two patients developed heat stroke following jogging. Transient disturbance of cerebral function was the most dramatic clinical feature. Although haemorrhagic complications were not seen, marked changes in the haemostatic system occurred with both thrombocytopenia and a reduction of clotting factors synthesised by the liver. No evidence of disseminated intravascular coagulation was found. Heat stroke must now be added to the list of jogging hazards.

Adult↗
PubMed1979

Familial relative polycythaemia due to haemoglobin Heathrow.

Eleven affected members of a New Zealand family carrying the high oxygen affinity haemoglobin Heathrow are described. The detection of high oxygen affinity abnormal haemoglobins may be difficult as haemoglobin and red cell mass may both fall within the normal range and no abnormality may be detected on haemoglobin electrophoresis or by haemoglobin stability tests. The importance of oxygen affinity studies to establish the diagnosis is emphasized.

Adult↗
PubMed1978

Comparison of combined and single-agent chemotherapy in non-Hodgkin's lymphoma of favourable histological type.

Sixty-six untreated patients with advanced non-Hodgkin's lymphoma of favourable histological type were allocated alternately to initial treatment with cyclophosphamide, vincristine, and prednisolone or with chlorambucil. The complete remission rate was higher in the group receiving combination chemotherapy, but the overall response rate was the same for both groups. The mean duration of complete remission was the same as that of good partial remission, and was the same for both treatments. The duration of remission was influenced by histological type and extent of disease at presentation, but not age. Those who responded to the initial treatment (whether with complete or with good partial remission) survived significantly longer than did non-responders. It is concluded that neither treatment is satisfactory and that new treatment programmes are needed for patients with a favourable prognosis, especially young patients with extensive disease.

Adult↗
PubMed1978

Combination chemotherapy for acute lymphoblastic leukaemia in adults.

Fifty-one adults with acute lymphoblastic leukaemia were entered into a trial of intense initial chemotherapy and early "prophylaxis" of the central nervous system (CNS). Initial treatment with OPAL (Oncovin (vincristine), prednisolone, adriamycin (doxorubicin), and L-asparaginase (colaspase)) followed by craniospinal or cranial irradiation and intrathecal methotrexate produced remission in 36 patients (71%). Seventeen of these patients relapsed three to 18 months after the start of remission; the remainder had been in remission for 12 to 52 months by the end of the study. The predicted median duration of complete remission was 18.5 months. None of the four patients who initially had clinical evidence of CNS disease, three of whom also had leukaemic cells identical to those found in Burkitt's lymphoma, achieved remission. Those patients who initially had hepatomegaly or splenomegaly had a shorter remission than those without. The predicted median survival was 27 months in those who achieved complete remission, one month in those who did not, and 21 months overall. The addition of colaspase and doxorubicin to vincristine and prednisolone and the use of early CNS treatment clearly improved the remission rate among adults with acute lymphoblastic leukaemia, though the presence and length of remission was affected by the extent of disease at presentation. Burkitt-like leukaemia, which had a poor prognosis, is probably a separate disease and may benefit from a different therapeutic approach.

Adolescent↗
PubMed1978

Combination chemotherapy for advanced non-Hodgkin's lymphoma of unfavourable histology.

Thirty previously untreated adults with diffuse histiocytic and diffuse undifferentiated lymphoma were treated with a combination of adriamycin, vincristine, prednisolone, and L-asparaginase. Complete remission was achieved in 11 out of 12 cases with stage III and 7 out of 18 cases with stage IV disease (P less than 0.005). Bone marrow infiltration, clinical central nervous system involvement, and massive intra-abdominal disease all influenced the prognosis adversely. Complete remission was followed by cranial irradiation and intrathecal methotrexate, and maintained with weekly cyclophosphamide and methotrexate and daily 6-mercaptopurine. The duration of remission was significantly longer for patients with stage III disease (the median of which has not been reached), than for patients with stage IV disease (P = 0.007). Survival was significantly longer for patients in whom complete remission was achieved than for those in whom it was not (P = 0.001), and also for patients with stage III than for those with stage IV disease (P = 0.02).

Adolescent↗
PubMed1978

Haemoglobin A2 levels in vitamin B12 and folate deficiency.

Haemoglobin A2 levels were measured in 50 patients with vitamin B12 deficiency, 50 patients with folate deficiency, and six patients with combined deficiencies of these vitamins. All were normal except for three patients with vitamin B12 deficiency, who had a slightly elevated Hb A2 level; this fell to normal after vitamin B12 therapy. It is concluded that haemoglobin A2 levels are usually normal in vitamin B12 or folate deficiency. However, raised levels of haemoglobin A2 may be found, but these are not as high as is found in beta thalassaemia trait and should not cause difficutly in diagnosis.

Folic Acid Deficiency↗
PubMed1978

Thrombocytopenia and iron deficiency anaemia in a patient with alpha1-thalassaemia trait. Response to iron therapy. Case report.

Iron deficiency anaemia secondary to menorrhagia was observed in a woman of Greek Cypriot origin. Moderate thrombocytopenia was also present. Treatment with parenteral and oral iron produced a transient thrombocytosis, the platelet count then returning to normal. Subsequent analysis revealed that she also carried the alpha1-thalassaemia trait. Previous reports of thrombocytopenia responsive to iron treatment are reviewed.

Adult↗
PubMed1978

Pure red cell aplasia.

Complete or near complete remission of acquired pure red cell aplasia, not associated with thymoma, occurred in response to prednisone (six occasions), prednisone and cyclophosphamide (twice), cyclophosphamide alone (once) and splenectomy (once). These results were observed in four patients and confirm the value of cyclophosphamide and possibly splenectomy in patients resistant to prednisone in acquired red cell aplasia. In two of these patients, bone marrow progression from a state of ineffective erythropoiesis with many red cell precursors to that of red cell aplasia was observed. This indicates that some acquired refractory anaemias characterized by ineffective erythropoiesis may have the same pathogenesis as acquired red cell aplasia. The absence of demonstrable antibodies active against erythroblasts may merely reflect the insensitivity of currently available techniques. However it is possible that non-humoral immune mechanisms may be involved in the production of some forms of acquired red cell aplasia responsive to immunosuppressive drugs.

Adult↗
PubMed1977

Health expenditure.

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Anemia, Aplastic↗
PubMed1977

Early central nervous system involvement in adults with acute non-myelogenous leukaemia.

Of 47 consecutive patients aged 15-60 years with acute non-myelogenous leukaemia (ANML) (40 acute lymphoblastic leukaemia (ALL); 5 acute Burkitt-like leukaemia (ABLL), 2 acute undifferentiated leukaemia (AUL) treated with a standard chemotherapy protocol (OPAL), 31 achieved complete remission (28/40(70%) of patients with ALL). CNS leukaemia occurred in 4/16 non-remitters, and in 6 patients who achieved complete remission (CR). CNS leukaemia occurred in all 5 patients with acute Burkitt-like leukaemia. 4/28 patients with ALL achieving CR had evidence of CSF involvement on cytocentrifuge examination shortly after CR. The apparent risk of early CNS disease suggests that prophylactic CNS therapy should be given early in the treatment of acute non-myelogenous leukaemia.

Adolescent↗