Hospital blood donor panels.
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Biomedical subjects
Publications and source records attributed to N G Slater.
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Demethoxydaunorubicin (DMDR), a new anthracycline available both for intravenous and oral administration, was given in 14 cases of leukaemia, non-Hodgkin's lymphoma (NHL) and multiple myeloma (MM) replacing either daunorubicin (DNR) or doxorubicin (DOX) in conventional chemotherapy regimes. In acute leukaemia (6 myeloblastic and 1 common lymphoblastic) there were 5 complete (CR) and 2 partial (PR) remissions; one patient, previously brought into remission with a regime including i.v. DMDR was thereafter maintained in CR with oral DMDR. Among the patients treated with the oral DMDR, 2 NHL cases were treated; 1 patient had a sustained remission of 12 months so far, with DMDR alone; another patient had a CR with a combined regime. In MM, one patient with very advanced disease treated with i.v. DMDR/CHOP did not respond, but three cases treated with oral DMDR plus other drugs showed a partial remission. Toxic effects were limited to brief episodes of nausea and vomiting in a few i.v. treated patients; a prolonged bone marrow depression was observed in one case only. No cardiotoxic effect was recorded.
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Epidoxorubicin (EDX) was administered to a group of 26 patients with acute leukaemia or lymphoma, replacing either daunorubicin or doxorubicin (DXR) as a component of multiple-chemotherapy regimens. In 10 patients with acute non-lymphocytic leukaemia treated at presentation, 5 complete and 4 partial remissions were obtained. All patients with lymphoma of different types responded at least partially: in a group of 14 cases, 8 in relapse and 6 at presentation, there were 10 complete and 4 partial remissions. It is of interest that such results were obtained in patients of high median age with dosages of EDX much lower than those employed for DXR.
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Five patients are reported with sickle cell syndromes (HbSS, HbSC and HbSthal) in whom rapid exchange transfusion led to resolution of life-threatening infarctive crises. The technique appears to be of value in the management of severe complications of sickle cell syndromes.
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An in vitro study of the effect of red-cell changes due to iron deficiency on whole-blood viscosity has been made on samples from patients with polycythaemia treated by venesection. When the PCV of the samples was adjusted to a standard value of 0.45, whole-blood viscosity was unrelated to decreasing MCH. In contrast, when samples were adjusted to a standard Hb concentration of 14 g/dl, whole-blood viscosity rose exponentially with decreasing MCH. This increase in whole-blood viscosity was shown to be a function of the increasing PCV that accompanies the falling MCH at this standard Hb value. It is suggested that in polycythaemia not due to hypoxia, hyperviscosity can be satisfactorily corrected by venesection controlled by monitoring the PCV alone. Other consideration may apply in hypoxic polycythaemia and these are discussed.
It has been suggested that blood viscosity is involved in the control of cerebral blood flow (CBF) (Thomas et al. 1977a, b, Humphrey et al. 1979). CBF, using the intravenous Xenon133 technique, blood viscosity and haematocrit were measured in 21 patients with elevated viscosity due to paraproteinaemia and found to be the same as in normal subjects. However, the paraproteinaemic patients were anaemic with a mean haematocrit of 0.342. This degree of anaemia would normally be associated with a high CBF. The paraproteinaemic patients were then compared with a group of 10 anaemic patients with matched haematocrits but without paraprotein bands. The whole blood and plasma viscosities were significantly higher in the paraproteinaemic patients and the CBF was significantly lower. The haematocrit, and therefore oxygen carriage, was similar in the two groups. It is likely that in the anaemia of paraproteinaemia the expected increase in CBF did not occur because of the limiting factor of increased viscosity. This suggests that in this instance viscosity rather than oxygen carriage is a major determinant in the control of CBF. This is further emphasized by the better correlation between CBF and blood viscosity than between CBF and haematocrit. It seems likely that viscosity and oxygen carriage are independent variables in the control of CBF.
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An immunofluorescence test for antibodies to native DNA, using the kinetoplast of Crithidia luciliae as substrate, has been assessed in comparison with the Farr precipitation technique, on a total of 395 sera from sixty-three patients with systemic lupus erythematosus, 185 other hospital patients and sixty healthy controls. The immunofluorescence test appears to have great specificity as a diagnostic test for SLE, though lacking the sensitivity of the Farr technique. Like the latter, it is altered by immunosuppressive treatment, and in patients with SLE nephritis on immunosuppression it does not show good correlation with activity of renal disease. Its specificity and simplicity nevertheless make it a valuable clinical test.