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Biomedical subjects

M J Borowitz

Publications and source records attributed to M J Borowitz.

At least 91 records · Page 5Linked to original sources

An immunotoxin for the treatment of T-acute lymphoblastic leukemic meningitis: studies in rhesus monkeys.

Monoclonal antibody WT1 (anti-CD7), conjugated to ricin A chain, was administered intrathecally to rhesus monkeys to test its suitability for use in the therapy of leukemic meningitis. The WT1-SMPT-dgRTA conjugate was cytotoxic to CEM (T-lymphoblastic leukemia) cells in vitro with an ID50 of 53 pM. Immunoperoxidase testing showed no binding of WT1 to normal human tissues other than lymph nodes. Thirteen animals received one or more intrathecal 60-micrograms doses of WT1-SMPT-dgRTA. All monkeys receiving repeated doses developed a cerebrospinal fluid (CSF) pleocytosis (primarily eosinophils), which was generally resolving by 3-4 weeks after therapy. Pharmacokinetic studies showed a half-life of 99 min, consistent with CSF clearance by bulk flow. Peak CSF immunotoxin concentrations exceeded the ID50 for CEM cells by more than 2 log units and a concentration exceeding the ID50 was maintained for as long as 24 h. All eight monkeys receiving repeated doses of immunotoxin developed serum antibodies against both WT1 and ricin A chain. In six of these monkeys antibodies were also present in the CSF. Both anti-WT1 and anti-(ricin A chain) antibodies were able to inhibit in vitro cytotoxicity of the immunotoxin for CEM cells; however, only anti-WT1 antibodies could block immunotoxin binding to the cell surface. No monkey developed anti-immunotoxin antibodies fewer than 7 days after the initiation of therapy, suggesting that repeated doses could be administered for up to 1 week without inhibition of clinical activity.

Animals↗

Monoclonal antibody L/1C2 reactive with a human carcinoma associated antigen.

A murine IgG3 monoclonal antibody which defines a human carcinoma associated antigen is described. The antibody, designated L/1C2, was made against a human lung squamous cell carcinoma line designated USCLS-1. It reacts with the surface of 15 of 16 viable human carcinoma cell lines and was detected in 70 of 78 frozen sections of human carcinomas. Melanoma cell lines and frozen sections of melanomas and a lymphoma were unreactive. Normal tissue reactivity included vessels, plus some ducts, glandular structures, and epithelial surfaces. Similar normal tissue reactivity patterns were seen with Rhesus monkey tissue samples. Immunoprecipitation studies indicate that L/1C2 reacts with a glycoprotein doublet which migrates in the range of 110,000 to 140,000 Mr under reducing conditions. Fluorescence analysis suggests this antigen is internalized following reaction with the L/1C2 antibody. Using in vitro human tumor cell growth inhibition assays, it was possible to achieve significant growth inhibition with L/1C2, while another target cell-reactive antibody in the same assay had no inhibitory effect.

Adenocarcinoma↗

Clinicopathologic and cytogenic features of CD34 (My 10)-positive acute nonlymphocytic leukemia.

The authors performed membrane antigen phenotyping on 75 patients with acute nonlymphocytic leukemia with a panel of myeloid-associated monoclonal antibodies. The 34 patients (45%) with CD34-positive leukemia were not significantly different from the 41 with CD34-negative leukemia with respect to age, hemoglobin, white blood cell count, or platelet count at presentation, but their blasts were more likely to lack the CD15 or CD33 antigens and to have FAB M1 or M2 morphologic characteristics. CD34-positive leukemia was more likely to arise after chemotherapy. Patients with CD34-positive leukemia were less likely to enter a complete remission even when analysis was limited to those patients receiving a high-dose induction-type chemotherapy regimen. Giemsa-banding karyotyping studies were obtained in 55 of the cases. In 30 of these cases (56%) clonal karyotypic abnormalities were demonstrated. Although the karyotypic abnormalities and phenotypes were varied, there was a high degree of association between the karyotypic abnormalities monosomy 7/del (7q) and the CD34-positive phenotype; this antigen was expressed on blasts from eight of the nine patients displaying this abnormality. Monoclonal antibody phenotyping of myeloid leukemia with reagents such as anti-CD34 may help to define biologically interesting subsets of ANLL with distinct clinicopathologic expression.

Antigens, Differentiation↗

Tissue distribution and cellular location of the antigens recognized by human monoclonal antibodies 16.88 and 28A32.

Results from a previous study (M. V. Haspel et al., Cancer Res., 45: 3951-3961, 1985) indicated that it was possible to isolate a high proportion of human monoclonal antibodies reactive with cell surface, tumor-associated antigens when the hybridomas were obtained from fusions utilizing peripheral blood lymphocytes from patients immunized with autologous tumor cells. The assignment of membrane reactivity was made from immunoperoxidase studies which used air-dried, nonpermeabilized Cytospin preparations of colon tumor cells. Tumor specificity was assessed by immunohistological assays by using frozen sections of normal and malignant human tissues. We now describe a series of studies using two of these antibodies, 16.88 and 28A32, in which further information was obtained concerning the tumor specificity and cellular location of the target antigens reactive with these monoclonal antibodies. Data were acquired from a variety of experimental techniques which included quantitative and qualitative immunofluorescence on live and permeabilized cells, RBC-rosetting assays, immunoperoxidase studies on Cytospin and frozen tissue sections, and immunoblot procedures. These studies show that the 16.88 and 28A32 human monoclonal antibodies bind to antigens which (a) are located in the cell cytoplasm and are not expressed in detectable levels on the cell surface, and (b) are found in many normal and malignant cell types.

Antibodies, Monoclonal↗

T-cell receptor antibodies in the immunohistochemical studies of normal and malignant lymphoid cells.

Three anti-T Cell receptor (TCR) antibodies, BF1, BF2, and WT31 were studied for their specificity and usefulness as immunohistochemical reagents. These antibodies were all satisfactory in the staining of normal peripheral lymphoid tissues and cortical thymic lymphocytes were reactive with BF1 and BF2 but not with WT31. Hassall's corpuscles in two of three thymuses studied reacted with all three antibodies. BF1 was superior to the other two antibodies, especially for lymphoid cells in cytospin preparations. Fifty-five lymphomas, 24 nonlymphoid malignancies, seven established cell lines, and five cases of large granular lymphocyte (LGL) proliferation with neutropenia were studied. The majority of non-T-cell lesions did not react with the antibodies. An occasional case showed weak reactivity which could be easily distinguished from the usual strong reaction with T-cells. Tumor cells from over 90% of snap frozen peripheral T-cell lymphomas reacted with BF1 and BF2. BF1 was the preferred antibody since it gave a stronger and more consistent reaction. It was also the antibody of choice in identifying T-lymphoblastic lymphomas. Michel's solution fixed tissue showed markedly diminished or absent reactivity with BF2 and WT31, but BF1 reactivity was less affected. Some unusual T-cell phenotypes, with respect to the pattern of expression of BF1 antigen and CD3, were observed. BF1 and anti-CD3, in combination, would be useful in identifying T-cell lesions with aberrant or unusual TCR-CD3 phenotypes.

Antibodies, Monoclonal↗

Detection of an oncofetal antigen (DU-PAN-2) in sera of patients with non-malignant hepatobiliary diseases and hepatomas.

DU-PAN-2 is a high-molecular-weight glycoprotein defined by a murine monoclonal antibody (MAb) elicited against a human pancreatic adenocarcinoma cell line. This MAb recognizes an oncofetal antigen present on the surface of normal pancreatic and bile-duct epithelium, normal bronchus epithelium, and some adenocarcinomas. Elevated levels of the antigen (greater than 400 U/ml) have been detected in the serum of 79% of patients with adenocarcinoma of the pancreas and in a small percentage of patients with other adenocarcinomas, by means of a competition radioimmunoassay. Here, we have studied DU-PAN-2 antigen levels in sera of patients with a spectrum of hepatobiliary diseases and controls. Serum DU-PAN-2 antigen was elevated in 59% of 112 patients with non-malignant hepatobiliary diseases and in 50% of hepatoma patients. None of 50 healthy controls had elevated serum DU-PAN-2 levels. Patients in every category of hepatobiliary disease studied had elevated median serum DU-PAN-2 levels; the highest median levels were seen in patients with primary biliary cirrhosis (1,296 U/ml) and the lowest in stable cirrhosis (300 U/ml). Elevated serum DU-PAN-2 levels in one patient with primary biliary cirrhosis and in one patient with hepatoma returned to normal following liver transplantation. Serum DU-PAN-2 levels did not correlate well with alkaline phosphatase, 5'-nucleotidase, bilirubin, or alpha-fetoprotein. Using an immunoperoxidase technique on formalin-fixed, deparaffinized liver sections, we showed that DU-PAN-2 MAb reacted heterogeneously with bile-duct epithelium but never stained hepatocytes or hepatoma cells. While serum DU-PAN-2 levels may be useful in detecting and monitoring pancreatic adenocarcinoma, they are not specific for this disease.

Antigens, Neoplasm↗

Effect of recombinant human granulocyte-macrophage colony-stimulating factor on hematopoietic reconstitution after high-dose chemotherapy and autologous bone marrow transplantation.

Recombinant human granulocyte-macrophage colony-stimulating factor (rHuGM-CSF) has been reported to increase the leukocyte count in subhuman primates subjected to total-body irradiation and in patients with the acquired immunodeficiency syndrome. We administered this substance to 19 patients with breast cancer or melanoma treated with high-dose combination chemotherapy and autologous bone marrow support. Groups of three or four patients were treated with 2.0, 4.0, 8.0, 16.0, or 32.0 micrograms per kilogram of body weight per day of glycosylated rHuGM-CSF by continuous intravenous infusion for 14 days, beginning three hours after bone marrow infusion. Total leukocyte and granulocyte recovery was accelerated in these patients as compared with 24 historical controls matched for age, diagnosis, and treatment. Leukocyte counts (mean +/- SD) obtained 14 days after transplantation were 1511 +/- 1003 per microliter in patients given 2 to 8 micrograms per kilogram per day, 2575 +/- 2304 in those given 16 micrograms, and 3120 +/- 1744 in those given 32 micrograms, as compared with 863 +/- 645 per microliter in the controls. No consistent effect on platelet counts was noted. Toxic effects were generally mild and not clearly dose-related in patients given 2 to 16 micrograms per kilogram per day. Edema, weight gain, or myalgias occurred in all patients given 32 micrograms per kilogram; marked weight gain, generalized edema, pleural effusions, and hypotension developed in two patients, one of whom also had acute renal failure. Our results indicate that rHuGM-CSF can accelerate myeloid recovery after high-dose chemotherapy and autologous bone marrow transplantation, over a range of doses that can be tolerated. In this setting the ability to increase the dose is limited by the development of myalgias and fluid retention.

Adult↗

Aberrant expression of monoclonal antibody-defined colonic mucosal antigens in inflammatory bowel disease.

Human proximal colon from patients with inflammatory bowel disease and from controls was studied by two techniques to detect tumor-associated antigen expression. A panel of four murine monoclonal antibodies that recognize tumor-associated antigens was used to test purified colonic mucins for epitope expression by radioimmunoassay and to test formalin-fixed, deparaffinized sections of colon by the immunoperoxidase technique. The panel included monoclonal antibodies 19-9, B72.3, DU-PAN-2, and CSLEX1. Colonic mucins were purified from uninvolved surgical specimens by gel filtration with Sepharose 4B and cesium chloride-guanidine hydrochloride density gradient ultracentrifugation. Purified mucins from uninvolved colonic mucosal specimens from 4 of 7 patients with ulcerative colitis expressed one or more of these epitopes by radioimmunoassay, whereas mucins from 6 disease controls did not. Reactivity patterns were heterogeneous. Immunoperoxidase testing demonstrated staining with two or more antibodies in 14 of 18 involved inflammatory bowel disease segments, whereas control sections rarely stained with these antibodies, with the exception of 19-9. Sections of uninvolved mucosa from 4 of 9 patients with ulcerative colitis stained with two or more antibodies. Staining patterns were heterogeneous. The results demonstrate that colonic expression of tumor-associated epitopes occurs frequently in involved segments from both patients with ulcerative colitis and with Crohn's disease, whereas only patients with ulcerative colitis frequently expressed these epitopes in uninvolved segments.

Antibodies, Monoclonal↗

Characterization of the human tumor and normal tissue reactivity of the KS1/4 monoclonal antibody.

The tissue and tumor distribution of the antigen recognized by monoclonal antibody KS1/4 was determined by a combination of immunoperoxidase techniques, flow cytometric analyses and solid phase enzyme-linked immunoassays. These data document that the KS1/4 antigen is expressed in many epithelial malignancies and normal epithelial surfaces suggesting that this antigen represents an epithelial/epithelial malignancy marker.

Antibodies, Monoclonal↗

Leukemias and lymphomas of thymic differentiation.

Neoplasms of thymic T-cell derivation include two closely related malignancies: T-cell acute lymphoblastic leukemia (T-ALL) and T-cell lymphoblastic lymphoma. The recognition of these tumors as distinct biologic entities dates back to the early 1970s, when patients with these diseases were found to have tumor cells that formed spontaneous rosettes with sheep erythrocytes. In the last decade, however, the growth of new technologies and availability of new reagents has enabled us to characterize this group of diseases with more precision. When studied with a panel of monoclonal antibodies, there is tremendous phenotypic diversity in the types of T-cell leukemias that are encountered. In spite of this diversity, a few general facts have become apparent. To a first approximation, thymic T-cell malignancies can be related to stages of normal T-cell development. Surprisingly, in spite of the overall similarity between T-ALL and T-lymphoblastic lymphoma, the antigenic phenotypes encountered suggest a biologic difference between these two diseases. Although there is not currently any single reagent that permits recognition of T-ALL or lymphoblastic lymphoma in all cases, a combination of technologic approaches using conventional morphology and histochemistry, immunologic studies, and, in some cases, newer genetic studies should permit great precision in the definition of this disease. The clinical picture of T-cell ALL or lymphoblastic lymphoma has traditionally been one of a poor prognosis disease with high WBC count, bulky adenopathy, and mediastinal mass. Although encountering this clinical presentation should suggest the T-cell phenotype, not all patients with T-cell leukemia will fit this stereotype. Clinical studies have also served to provide support for the expanding biologic definition of T-cell neoplasia, particularly insofar as it has been demonstrated that patients with T antigen-positive but E rosette-negative ALL behave like other patients with T-cell disease. In short, patients with thymic T-cell malignancies not only have distinctive biologic characteristics to their blasts, but also have a distinctive pattern of clinical presentation, response to therapy, and sites of relapse. These differences have prompted the search for specific therapies and also directed approaches to understanding the variable clinical outcome of patients with these malignancies.

Antibodies, Monoclonal↗

Asynchronous antigen expression in B lineage acute lymphoblastic leukemia.

Cell surface phenotypes of 113 B lineage acute lymphocytic leukemia (ALL) cases, defined by the presence of HLA-DR and at least one B-cell-specific antigen (either CD19, CD20, or CD22), were compared with antigen-defined stages of normal B lymphocyte development. The cases were first evaluated for expression of HLA-DR, CD19, CD34, CD10, CD20, and CD22 by indirect one-color immunofluorescence. Pairwise comparisons of cell surface marker expression were performed for each leukemic sample: no correlations were observed for paired antigen expression on the leukemic samples using antigens expressed either early or late during normal B lymphoid development. Complete immunophenotypes of the cases were then compared with normal B-cell developmental stages. Sixteen different complete immunophenotypes were observed on the leukemias that were not found in normal marrow; at least 78% of the cases demonstrated such "asynchronous" combinations of B lymphoid-associated differentiation antigens. Several samples were subsequently studied by two-color immunofluorescence, and the presence of doubly labeled cells with "asynchronous" antigen combinations was confirmed. These results indicate that the majority of B lineage leukemias exhibit "developmental asynchrony," as compared with normal marrow B cells. The data further suggest that ALL cases do not accurately represent cells arrested at the stage where the leukemogenic event occurred. Rather, ALL appears to be a disease in which there may be maturation of leukemic blasts; but this maturation is "asynchronous" when compared with the normal developmental process.

Adult↗

A phase I study of T101-ricin A chain immunotoxin in refractory chronic lymphocytic leukemia.

Four patients with chronic lymphocytic leukemia refractory to alkylating agents were treated with T101-ricin A chain immunotoxin (T101-RTA) as part of a phase I study. Over a 4-week period, each patient received eight intravenous infusions of 3 mg/m2 T101-RTA over 1 h. All infusions were well tolerated. Patients had mild fevers but no other systemic toxicities. In vivo binding of T101-RTA was detected by FACS analysis using anti-mouse Ig-FITC or anti-A chain-FITC antibody conjugates. Saturation of circulating leukemic cell-associated target antigen was achieved in three of the patients. Available CD5 sites per cell dropped precipitously at the completion of infusions in all four patients, returning to within 30% of baseline by 24 h. Pharmacokinetic studies revealed rapid clearance of T101-RTA, with wide interpatient variability in peak serum levels (the highest levels in those patients who saturated their circulating CD5 antigen with immunotoxin). Although no patient developed detectable levels of antimurine antibodies, one patient did have a rising titer of anti-ricin A chain antibody associated with declining peak serum levels of immunotoxin. All patients had a rapid fall in WBC count of less than 24-h duration after each T101-RTA infusion, most likely secondary to the antibody portion of immunotoxin. No sustained benefit could be demonstrated in any patient, possibly because in the absence of an enhancing agent the leukemic cells of all four patients were resistent to T101-RTA at concentrations up to 2,000 ng/ml in vitro.

Aged↗

Correlation of monoclonal antibody phenotyping and cellular DNA content in non-Hodgkin's lymphoma. The Southeastern Cancer Study Group experience.

Flow cytometric measurements of DNA ploidy and synthetic (S) fractions are quantitative parameters that can aid in the diagnosis and classification of non-Hodgkin's lymphomas (NHL). Although the S-fraction correlates with histologic classification, the relationship between specific immunologic phenotypes and DNA ploidy is less well known. We investigated this relationship in 106 cases of NHL. Samples from 17 SEG institutions were sent for flow cytometry and for frozen section immunoperoxidase phenotyping. DNA histograms were analyzed for ploidy changes and cases classified by degree of abnormality. Ninety-eight cases were B-cell and eight were T-cell. B-cell tumors were subdivided by expression of antigens CD24, CD10, CD5, HB31, CD22, CD20, and transferrin receptor. Among B-cell tumors there was no correlation between degree of aneuploidy and phenotype, but B-cell tumors displayed a higher degree of aneuploidy than T-cell tumors (P less than 0.02). There was no difference between the S-fractions of B-cell and T-cell lymphomas. However, the transferrin receptor was more often expressed when the S-fraction was higher than 5%. Cases with S-fractions higher than 5% were more likely to lack any of the Pan-B antigens CD19, CD22 or CD20, and also were more frequently CD24 negative. We conclude that T-cell and B-cell NHL differ in degree of aneuploidy, and that monoclonal antibody phenotyping and DNA ploidy analysis independently define subgroups of B-cell NHL. Within B-cell lymphomas phenotype also correlates with grade of NHL as defined by the S-fraction.

Aneuploidy↗

Immunologic and clinicopathologic features of common acute lymphoblastic leukemia antigen-positive childhood T-cell leukemia. A Pediatric Oncology Group Study.

The immunologic and clinicopathologic features of common acute lymphoblastic leukemia antigen (CALLA)-positive and CALLA-negative T-acute lymphoblastic leukemia (ALL) and of CALLA-positive non-T, non-B ALL (common ALL) of childhood were compared. Twenty-seven percent of children with T-ALL had blasts that expressed CALLA. This expression was not associated with a significantly different incidence of expression of sheep erythrocyte-rosette receptors, glucocorticoid receptors, peanut agglutinin receptors, or T-cell antigens. CALLA-positive T-cell blasts were more likely to express a p24 leukemia-associated antigen (CD9, 50% versus 8%) and Ia antigens (39% versus 8%) than were CALLA-negative blasts. Patients with CALLA-positive and CALLA-negative T-ALL had similar clinicopathologic features at diagnosis. In contrast, compared to patients with common ALL, patients with CALLA-positive T-ALL were older, had higher leukocyte counts, and an increased incidence of splenomegaly, lymphadenopathy and mediastinal mass, similar to patients with CALLA-negative T-ALL. Patients with CALLA-positive T-ALL were more likely to achieve a complete remission (95% versus 83%, P = 0.055) and tended to have an increased duration of event-free survival (P = 0.07) than did patients with CALLA-negative T-ALL. The expression of T-cell antigens is more important than the expression of CALLA in defining biologically similar subgroups of childhood ALL. Preliminary evidence suggests that within T-ALL the expression of CALLA may be prognostically important.

Antigens, Neoplasm↗

Familial Hodgkin's disease. A clinical and laboratory investigation.

A three to sevenfold increased risk of Hodgkin's disease has been noted in families of patients. We report the first family in which all four of a four member sibship had Hodgkin's disease. In these four sibling cases, we were able to explore markers of infectious etiologic factors by measuring antibodies to Epstein-Barr virus (EBV) and human T-cell lymphotropic virus (HTLV), and possible genetic risk factors by human leukocyte antigen (HLA) typing and chromosome analysis. All three men were diagnosed within six months of their 30th birthday. HLA typing revealed that all four siblings share the DR5 antigen, and two siblings share HLA-B27. Chromosome analysis on peripheral lymphocytes revealed no abnormalities. A detailed, structured interview failed to elicit evidence of unusual exposures. The EBV antibody titers are probably within the normal range and none of the family had antibodies to HTLV-III. Observations on this family suggest that genetic factors play a greater role than environmental factors in the etiology of familial Hodgkin's disease.

Adolescent↗

The transglutaminase in vascular cells and tissues could provide an alternate pathway for fibrin stabilization.

A thrombin-independent transglutaminase (TG) has been identified in vascular cells and tissues from human, rabbit, rat, porcine, and bovine sources. The vascular TG had several properties that were similar but not identical to guinea pig liver TG. Both enzymes had similar chromatographic and electrophoretic properties, preferentially cross-linked the alpha-chains of fibrinogen, and reacted with polyclonal and monoclonal anti-guinea-pig liver TG antibodies. However, the TG from adult bovine aortic endothelial (ABAE) cells exhibited a novel Ca2+/Mg2+ dependence for enzymatic activity that was distinct from that of purified guinea pig liver TG. The mol wt of the vascular TG (79 +/- 3 kd) determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) was slightly lower than the purified guinea pig liver TG (85 +/- 9 kd). The TG antigen was detected by immunohistochemical techniques in association with the endothelial and smooth muscle cells of arteries, veins, venules, and capillaries. The TG antigen also codistributed with the fibronectin antigen along the hepatic sinusoids. The ABAE cell TG cross-linked alpha 2-plasmin inhibitor to fibrinogen and caused the modified fibrinogen to be 40-fold more resistant to plasminolysis. A thrombin-independent TG in vascular cells of blood vessels could provide an alternate pathway to inhibit fibrinolysis and promote fibrin stabilization.

Animals↗

Immunoglobulin and T cell receptor gene rearrangements in human lymphoma and leukemia.

DNA samples from blood leukocytes or tumor biopsies of 45 patients with phenotypic B or T cell neoplasms were analyzed for rearrangements of the immunoglobulin (Ig) or T cell receptor (TCR) genes by Southern blot hybridization analysis. Rearrangements of the Ig heavy chain joining region genes (JH) were present in DNA from each of 28 B cell lymphomas and leukemias; 14 of 21 of these tumors also had rearrangements of the Ig kappa light chain joining (JK) or deleting element (KDel) genes. Conversely, 16 of 17 T cell lymphomas and leukemias had rearranged TCR beta chain genes. One B cell and one T cell tumor had rearrangements of both Ig and TCR genes. There was a strong correlation between the rearrangements of specific genes and the immunophenotype of the tumor: JH rearrangement without TCR beta chain rearrangement occurred only in B cell tumors; TCR beta chain rearrangement with or without JH rearrangement occurred only in T cell tumors, with one exception; and JK and KDel rearrangements were found only in B cell tumors. Thus, rearrangements of the Ig heavy and light chain genes and the TCR beta chain genes were found to be highly sensitive markers of monoclonal human lymphomas and lymphoid leukemias, with the type of gene rearrangements well correlated with the cell lineage of these neoplasms.

Antigens, Neoplasm↗