Biomedical subjects
Publications and source records attributed to P C Raich.
Acute megakaryoblastic leukemia occurred in an adolescent. There was considerable bleeding despite only moderate thrombocytopenia, and both platelet structure and platelet function were abnormal. To our knowledge, platelet dysfunction has only once been documented in this acute leukemia, although in other leukemias with megakaryocytic predominance, notable bleeding has been observed in the absence of thrombocytopenia.
Infiltration of the prostate by acute granulocytic leukemia can cause diagnostic and therapeutic difficulties. After stabilization of hematologic findings, the diagnosis can be made safely by needle biopsy of the prostate. The prostate may be one of the so-called sanctuary areas where chemotherapy does not affect the leukemic infiltrate. This process may be a source of reactivation of leukemia in patients who had achieved a hematologic remission. This report describes a patient who had successful eradication of acute myelomonocytic leukemia from the prostate by radiation therapy while in hematologic remission. Better surveillance for leukemic infiltrate of the prostate is needed, including needle biopsy when appropriate. Radiation may be an effective therapy for this manifestation of leukemia.
Cytochemical reactions with a panel of special stains were explored in peripheral blood and lymph node cells of animals with the adult, calf, and thymic types of bovine lymphosarcoma as well as lymphosarcoma in sheep induced with the bovine leukosis virus. These results were compared with normal lymphoid cells. Cytochemical methods included Sudan black B, periodic acid-Schiff, acid phosphatase and three esterases. Cells from ovine lymphosarcomas and a thymic type of bovine lymphosarcoma were distinctively positive to the alpha naphthyl acetate esterase reaction. These cytochemical reactions which were obtained with standard cytochemical methods should aid in the characterization and classification of lymphoproliferative disorders in animals, especially when combined with immunologic surface markers.
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Nineteen patients with advanced refractory lymphoma and 12 patients with acute leukemia, including seven in blastic crisis of chronic myelogenous leukemia (CML), were treated with vindesine in combination with prednisone. Of 16 evaluable patients with lymphocytic or histiocytic lymphoma, one achieved complete remission (6%) and eight achieved partial remissions (50%). Median duration of response was 12 weeks (range, 4-72+). Four of six evaluable patients in blastic crisis of CML showed definite improvement in blood cell counts and symptoms. The major dose-limiting toxic effect was bone marrow suppression, while neurotoxicity was seldom cause for dose modification. The study shows vindesine and prednisone to be active in heavily pretreated patients with non-Hodgkin's lymphoma and blastic phase of CML.
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A case report of a patient with lymphomatoid granulomatosis presenting initially as a reactivated Epstein-Barr virus infection is presented. Epstein-Barr virus is proposed in the possible role of establishing of an immunologically compromised state that may have set the stage for dissemination of this disease process. Of interest is the fact that successful chemotherapeutic management of the disease was accomplished using prednisone and cyclophosphamide. Furthermore, this clinical success was reflected in a decreasing Epstein-Barr virus early antigen-antibody titers accompanied by increasing antivirus capsid antigen titers; hence, it appears that laboratory markers of the response of lymphomatoid granulomatosis to treatment are available in the form of soluble immune complexes, antibodies to Epstein-Barr virus-coded antigens early antigens, Epstein-Barr nuclear antigens and/or virus capsid antigens as well as the active E rosette assay for T-cells. Finally, these data, although supporting the role of Epstein-Barr virus in the pathogenesis of lymphomatoid granulomatosis, suggest the need for further study in additional patients to verify the results.
Vindesine, a new vinca alkaloid, was administered to 20 patients with advanced refractory breast cancer in a phase II trial. The drug was given at a dose of 3 mg/m2 by iv bolus each week for 6 consecutive weeks, and responding patients were maintained on a dose of 4 mg/m2 every 2 weeks. Nineteen patients were evaluable for disease response; partial remissions were obtained in five patients, for a response rate of 26%. Leukopenia was the major dose-limiting toxic reaction, but most patients were able to tolerate this schedule without difficulty. Neurotoxicity was mild and did not require dose reduction.
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Eleven patients with advanced multiple myeloma refractory to standard chemotherapy were treated with a regimen of sequential hemi-body radiotherapy consisting of 800 rad midplane in a single dose to each half. 9/10 patients experienced significant relief of skeletal pain and there were 5/11 objective tumor responses with one complete remission. Treatment-related morbidity was significant and consisted primarily of nausea and emesis, bone marrow suppression, and pneumonitis. This therapy is helpful in the management of advanced myeloma, and should be studied earlier in the course of the disease.
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The degree to which anticancer drugs suppressed incorporation of tritiated thymidine into leukaemic cells was measured in 26 patients with acute leukaemia. Subsequent achievement of remission correlated best with suppression by cytosine arabinoside (ara-C). 6 of 7 patients with acute myelocytic and myelomonocytic leukaemia whose cells demonstrated suppression by ara-C of 3H-thymidine incorporation of 15% or less of control counts subsequently achieved remission, while 4 of 6 patients whose cells showed smaller degrees of inhibition did not achieve remission. Patients with acute lymphocytic leukaemia showed a similar pattern.
The anemia of chronic renal disease has been attributed primarily to a decrease in erythropoietin (EP) production. Results of this study show that measurable levels of plasma EP can be demonstrated in a majority of patients with end-stage renal failure who are undergoing long-term hemodialysis. These levels were not related to the type of renal disease, nor were they greatly affected by androgenic therapy or by nephrectomy. Although EP elevations in such patients were somewhat less than in nonuremic patients with comparable anemia, the presence of measurable EP levels suggests that impaired end-organ response may play a role in the anemia of chronic renal failure.