Biomedical subjects
Publications and source records attributed to M E Beard.
Differential and density equilibrium centrifugation have established the presence of alpha-hydroxy acid oxidase in microbodies of the kidney of the rat. The enzyme has been demonstrated in cells of the distal convoluted tubule by a microscopic cytochemical method. This enzyme, like certain others in microbodies, produces hydrogen peroxide.
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Thirty consecutive patients with acute lymphoblastic leukaemia (ALL) who received treatment at Christchurch Hospital between 1972 and 1982 were reviewed. Complete remission (CR) was achieved in 80 per cent with a median survival of 65 weeks. Eleven of 30 patients had one or more of the following features--B cell ALL, a mediastinal mass, the Philadelphia chromosome (Ph1) and age 60 years or older at diagnosis. Although CR was obtained in 8 of these patients none survived three years. The remaining 19 patients were regarded as 'good risk' and treated by moderate intensity chemotherapy schedules. CR was obtained in 16 of these patients (84 per cent) and the estimated 5 year survival was 62 per cent with 6 patients remaining in remission from 5 to 9 years from diagnosis. These results demonstrate the value of objective and reproducible clinical and laboratory findings in defining a subset of ALL patients which may not require high intensity chemotherapy schedules.
The subdivision of the B lymphoid leukaemias by conventional techniques is subjective and poorly reproducible, with a range of cytological diagnoses available for cases which are not typical examples of chronic lymphatic leukaemia or acute lymphoblastic leukaemia. The monoclonal antibody FMC-7 recognizes a determinant on a subpopulation of B lymphoid cell and stains follicular B cells. Routiune FACS analysis of chronic lymphoid leukaemias with a panel of monoclonal antibodies identified a subset of lymphoproliferative disorders (20 of 88) which were FMC-7 positive. a careful 'blind' cytological assessment of this subset gave some support for the suggestion that they were examples of lymphoproliferative disease of follicular origin. Eight cases, however, were considered cytologically typical of CLL. The wider application of this antibody, particularly in sequential studies over a longer time scale may improve objectivity in the classification of this group of diseases.
The Philadelphia chromosome (Ph') is found in the blood cells of about 90% of patients with chronic myeloid leukaemia (CML) and usually results from the reciprocal chromosome translocation t(9;22). This translocation relocates the proto-oncogene c-abl, normally found on chromosome 9q34, to within the breakpoint cluster region (bcr) on chromosome 22q11 (refs 3-8). The juxtaposition of c-abl and the 5' portion of bcr appears to be the critical genomic event in CML and results in a novel 8-kilobase (kb) fused abl/bcr transcript and a c-abl-related protein of relative molecular mass 210,000 (ref.11). About 10% of adult patients diagnosed as CML lack the Ph' chromosome; they represent a heterogeneous group of disorders which are difficult to diagnose precisely. We have examined five patients with CML whose leukaemic cells have a normal karyotype. We report here that two of the patients showed the same genomic change as occurs in Ph'-positive CML, but the change resulted from a mechanism other than chromosomal translocation. The remaining three patients showed no genomic rearrangement. This genomic diversity correlated with the clinical differences between the patients.
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