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Biomedical subjects

M M Reid

Publications and source records attributed to M M Reid.

At least 37 records · Page 2Linked to original sources
PubMed1999

Posttransplantation B lymphoblastic leukemia with Burkitt-like features.

BACKGROUND: Posttransplantation Epstein-Barr virus-associated lymphoproliferative disease (PTLPD) occurs as a spectrum of disease ranging from benign, polyclonal, localized lymphoid hyperplasia to malignant, monoclonal, disseminated lymphoma, sometimes involving the bone marrow. To our knowledge, PTLPD has not been previously reported to present as acute lymphoblastic leukemia. METHODS: We report the case of a boy who developed PTLPD in the form of acute lymphoblastic leukemia 6 years after cardiac transplantation. He had greater than 90% bone marrow invasion by Epstein-Barr virus-positive B lymphoblasts with Burkitt-like features and a t(8;14) translocation. RESULTS: He was successfully treated with combination chemotherapy but unfortunately died, 6 months after completing treatment, from ischemic heart disease. CONCLUSIONS: B lymphoblastic leukemia may occur as a manifestation of PTLPD and should be included in the classification of these diseases. Bone marrow examination should be an essential part of the investigation of patients suspected of having PTLPD.

Administration, Oral↗
PubMed1999

Glucocorticoid resistance and the AP-1 transcription factor in leukaemia.

Glucocorticoids have been used in the treatment of acute lymphoblastic leukaemia (ALL) for many years, initially as the only agent and then as part of multiagent chemotherapy. In ALL 20% of patients are resistant to glucocorticoids at presentation but this rises to greater than 70% on relapse. It has recently been reported that the glucocorticoid receptor inhibits activity of the AP-1 transcription factor by the ligand-dependant binding of glucocorticoid receptor (GR) to the fos and jun components of AP-1. Since AP-1 is necessary for cell proliferation, the upregulation or over-expression of AP-1 may be a mechanism of resistance to glucocorticoids. The aim of the study was to investigate whether AP-1 levels correlate with in vitro glucocorticoid resistance. In vitro sensitivity to glucocorticoids was measured using the MTT assay. AP-1 levels were quantified using gel shift analysis: a consensus sequence for the AP-1 binding site was synthesised, labelled with 32P and incubated with nuclear extracts of leukaemic blasts from 14 ALL and 26 CLL patients. Leukaemic blasts were treated with prednisolone or with vehicle alone before preparation of nuclear extracts. The gels were dried and bands quantified using a phosphorimager, using an appropriate internal standard and correcting for protein loading and cytoplasmic contamination of nuclear extracts. The patient samples fell into two distinct groups with respect to their sensitivity to glucocorticoids: AP-1 levels were significantly higher (p < 0.02) in sensitive blasts than resistant ones. There was no significant change in AP-1 levels after treating blasts for 4 hours with 0.2 mM prednisolone. No change was seen in CLL samples. These data show that glucocorticoid resistance is not associated with increased AP-1. Conversely, glucocorticoid resistance in these samples was apparently associated with decreased AP-1 levels in ALL samples. Whether this has any causal relationship to glucocorticoid resistance is unknown. Clearly, further studies on the role of AP-1 and related transcription factors is essential for understanding the control of proliferation and apoptosis in ALL.

Adult↗
PubMed1999

Iron nutritional status in preterm infants fed formulas fortified with iron.

AIMS: To prospectively evaluate the iron nutritional status of preterm infants fed either a term (0.5 mg/dl iron) or preterm (0.9 mg/dl) formulas fortified with iron after hospital discharge. METHODS: Healthy low birthweight preterm infants were randomly assigned into three groups at the time of hospital discharge. Group A were fed an iron fortified preterm formula (0.9 mg/dl iron) until 6 months corrected age; group B, a fortified term formula (0.5 mg/l iron) until 6 months corrected age group C, the preterm formula between hospital discharge and term, then the term formula until 6 months corrected age. RESULTS: Seventy eight infants were followed up to 6 months corrected age. Iron intake from formula differed significantly between the groups (A, 1.17 mg/kg/day (SD 0.32) > C, 0. 86 mg/kg/day (SD 0.40) = B, 0.81 mg/kg/day (SD 0.23); p < 0.0001). Haemoglobin concentrations were similar to those of iron sufficient preterm infants of the same postnatal age, and term infants of the same postmenstrual age (after 3 months of age). There were no significant differences in haemoglobin concentration (p = 0.391), plasma ferritin (A vs B, p = 0.322), or in the incidence of iron deficiency (A vs B, p = 0.534). CONCLUSIONS: Iron fortified formulas containing between 0.5 and 0.9 mg/dl iron seem to meet the iron nutritional needs of preterm infants after hospital discharge.

Analysis of Variance↗
PubMed1999

Deterioration in performance in obtaining bone marrow trephine biopsy cores from children. European Neuroblastoma Study Group.

AIM: To complete an audit of bone marrow trephine biopsy adequacy in children MATERIAL: 605 specimens from children with neuroblastoma submitted by 25 centres were reviewed centrally. This reassessment ran between January 1995 and August 1998. RESULTS: 25% of specimens (95% confidence interval (CI) 21% to 29%) were inadequate compared with 17% (95% CI 14% to 20%) in a previous study. Variation between individual centres' performance remains high (5-54% of specimens inadequate). Had five centres performed as well as previously, the inadequate biopsy rate would have been unchanged from that found in the previous study. There was no important improvement in any centre's performance. Earlier suggestions about change in practice have had no discernible impact on centres' ability to obtain adequate bone marrow trephine biopsies from children. CONCLUSIONS: The responsibility for improving the rate of adequate biopsies lies with individual centres. Reporting pathologists might help by making even more positive attempts to influence operators within their own centres.

Biopsy↗
PubMed1998

Methadone treatment in the Scottish context: outcomes of a community-based service for drug users in Lothian.

Few studies investigating the effectiveness of methadone treatment for opiate dependence have emanated from the UK. The core feature of treatment offered by Lothian Health's Community Drug Problems Service involves the prescribing of methadone by the client's general practitioner. Of a cohort of 494 daily users of opiates attending the service, 39% remained in treatment for at least 12 months. Up to 2 years in-treatment follow-up revealed significant improvement in injecting and criminal behaviour. There were no HIV seroconversions reported during the treatment period. There was no improvement in injection equipment sharing, condom use, illicit drug use or employment status. 'Satisfactory' discharge was achieved for 40% of those in treatment for at least 6 months. These results are largely consistent with the outcomes of methadone programmes elsewhere.

Adolescent↗
PubMed1997

Granulocytic sarcoma with translocation (9;11)(p22;q23): two cases.

Granulocytic sarcomas are localized deposits of myeloid leukemia cells that may precede or occur concurrently with disseminated disease. In either event, the origins of the cells comprising the malignancy are the same. Published reports of granulocytic sarcomas have described, in the majority of cases, a morphology typical of AML-M2 and the presence of the t(8;21)(q22;q21) typical of that FAB type. In a smaller number of cases, the inv(16)(p13q22) characteristic of AML-M4 has been recorded in cells with a myelomonocytic appearance. We report two patients with granulocytic sarcomas showing monocytic morphology in which the malignant cells showed t(9;11)(p22;q23) typical of AML-M5. This abnormality is seen in up to 7% of childhood AML, but has not previously been reported in granulocytic sarcoma. The detection of this cytogenetic abnormality facilitated the precise characterization of the malignant cells and selection of the most appropriate therapy, emphasizing the value of cytogenetic analysis in cases of granulocytic sarcoma.

Acute Disease↗
PubMed1997

In vitro T cell depletion using Campath 1M for mismatched BMT for severe combined immunodeficiency (SCID).

Bone marrow transplantation is the only curative treatment for children with severe combined immunodeficiency (SCID). In the absence of an HLA-identical sibling, haploidentical parental donor marrow can be used provided it is depleted of T cells to prevent otherwise inevitable GVHD. Campath 1M has been successfully used for this procedure in several centres. In our centre 17 SCID patients plus one with combined immunodeficiency (CID) were transplanted with Campath 1M T cell-depleted bone marrow. Progenitor cell recovery, before and after T cell depletion, was monitored using granulocyte-macrophage colony-forming cell assays (GMCFU) and CD34 analysis. The numbers of GMCFU/kg transplanted correlated with engraftment and survival post-transplant and monitoring CD34+ cell numbers in the T cell-depleted marrow pretransplant may be an additional indicator of successful engraftment. Use of a buffy coat marrow preparation with restriction of the number of T cells to < 5 x 10(5)/kg was associated with graft failure in four and death in five of eight children, probably because too few stem cells were infused. T cell depletion of a mononuclear cell preparation of donor marrow with no arbitrary ceiling of infused T cells is highly effective at preventing clinically important GVHD and cured nine out of 10 children transplanted with such material.

Antibodies, Monoclonal↗
PubMed1997

Behavioural adjustment in school of very low birthweight children.

The school-based behavioural adjustment at 7-8 years of a cohort of 243 prematurely born, very low birthweight (< 1501 g) children and their normal birthweight controls is reported. The findings indicate that the children born preterm (both male and female) were rated by their teachers as expressing more behaviour problems than their controls, and were less well adjusted to the school environment. The deficits noted in the preterms applied across the social classes, with no amelioration noted in preterms of higher social class. It is speculated that the problem behaviours reflect a failure in self-regulatory functions.

Attention Deficit Disorder with Hyperactivity↗