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Biomedical subjects

P Reizenstein

Publications and source records attributed to P Reizenstein.

At least 145 records · Page 8Linked to original sources
PubMed1982

Modifying the biological response in acute myeloid leukemia. II. Effect of BCG and leukemic cells on lymphocyte response to mitogens, and on helper and suppressor activity.

Lymphocyte response to mitogens and to lymphocyte suppressor and monocyte helper activity was studied in 18 patients with acute myeloid leukemia in complete remission, and in 17 healthy controls. Ten patients were maintained with chemotherapy alone (CT), and eight received chemoimmunotherapy with BCG + leukemic cells (CIT). In late remission the mitogen responsiveness was increased in CT patients and decreased in CIT patients. No significant difference in lymphocyte suppressor activity could be demonstrated between patients and controls, or between CT and CIT. When autologous CIT monocytes were added to mitogen-stimulated lymphocytes they acted as helper cells. CT monocytes, in contrast, seemed to act as suppressor cells. Control monocytes also acted as helper cells, but to a significantly lesser degree than CIT monocytes.

Concanavalin A↗
PubMed1982

Intracellular potassium in man. A comparison of in vivo and in vitro measurement techniques.

In order to evaluate different methods of estimating intracellular content of potassium, determinations of potassium were made in erythrocytes, in muscle biopsy specimens and in the total body. The total body potassium (TBK) was related to body weight (Bwt), lean body mass (LBM), dry LBM, soft fat-free solids (SFFS), total body water (TBW) and calculated intracellular fluid (ICF). Sixty-two healthy subjects and 80 patients with various diseases and therapy known to influence the potassium metabolism were studied. Statistically significant correlations were found between potassium content in muscle biopsies related to fat-free solids and TBK/Bwt (r = +0.56, P less than 0.05), TBK/LBM (r = + 0.58, P less than 0.01), dry LBM (r = + 0.54, P less than 0.05) and TBK/SFFS (r = + 0.68, P less than 0.01). A correlation was found between muscle potassium related to intramuscular water and TBK/TBW (r = + 0.47, P less than 0.05). No correlations were found between EK and TBK/LBM, TBK/dry LBM or TBK/ICF. Between EK and serum potassium a negative correlation (r = -0.31, P less than 0.05) was found in a group of untreated hypertensives. It is concluded that the quotients of TBK (TBK/LBM, TBK/TBW and TBK/SFFS) might be used in the study of intracellular potassium--at least in the study of patient groups.

Adipose Tissue↗
PubMed1982

Female superiority.

The median expected survival in Swedish women is 10% longer than that in men and still increasing, while that in men stopped going up 10 years ago. Women have a better prognosis than men in chronic myelocytic leukemia, in acute lymphatic and myeloid leukemias, in multiple myeloma and in malignant lymphoma given immunotherapy. There are some early indications that women may be more resistant than men to malignant transformation induced by radiation or smoking.

Cell Transformation, Neoplastic↗
PubMed1982

Correlation between precancerous bronchial metaplasia and cigarette consumption, and preliminary results of retinoid treatment.

Vitamin A and its derivatives, so-called retinoids, can prevent squamous metaplasia induced not only by vitamin A deficiency but also by carcinogenic hydrocarbons. An aromatic retinoid, such as ET1, has been shown to prevent chemically induced papillomas in mice and to amplify certain immunologic reactions. Heavy smokers, 106 volunteers, were submitted to fibrobronchoscopy with bronchial biopsies. An index of metaplasia (IM) was calculated on the basis of microscopical examination of a total of 9,633 sections of 1,010 biopsies. Despite the subjectivity of the estimates of cigarette consumption, this was significantly (P less than 0.02) and positively correlated to the IM. Eighty-five percent of the women had a low IM as compared to only 42% of the men (P less than 0.01), although there was no significant difference in the reported cigarette consumption. Fifty-two subjects had an IM greater than 15% and were given 25 mg ET1 orally daily for 6 months. The bronchoscopy was repeated in 30 patients following completion of the 6-month treatment. The IM was significantly (P less than 0.01) reduced after treatment.

Adult↗
PubMed1981

[Splenectomy in idiopathic thrombopenic purpura and in myelofibrosis. A retrospective study of platelet increase, hemorrhagic complications and mortality].

In a retrospective study of 39 splenectomies, patients with increased blood cell breakdown (13 cases of idiopathic thrombocytopenic purpura (ITP), 5 cases of hereditary spherocytosis, 2 of Felty's syndrome and 2 of autoimmune hemolytic anemia) were compared with those patients also presenting decreased blood cell production [14 cases of myelofibrosis (MF) with splenomegaly and 3 cases of advanced chronic myelogeneous leukemia (CML)]. Platelet regeneration post-operatively was significantly (p less than 0.01) more rapid in the ITP than in the MF group. Only 1/22 patients in the ITP group had major post-operative complications as compared to 10/17 in the MF group. None of the patients in the ITP group died within 25 days of operation as compared to 5/17 in the MF group. Only 3/22 patients in the ITP group lost more than 800 ml of blood during the operation as compared to 8/17 with MF. No statistically significant higher blood loss was found in patients with less than 30 x 10(9) platelets/l preoperatively, compared to those with higher platelet counts. However, correlation between the splenic weights and amount of blood loss was statistically significant (p less than 0.01). Thus, splenectomy seems much better tolerated in patients with ITP, even if platelets are low, than in patients with myelofibrosis.

Adult↗
PubMed1981

Glucocorticoid receptor concentrations and terminal transferase activity as indicators of prognosis in acute non-lymphocytic leukaemia.

Activity of terminal deoxynucleotidyl transferase (TdT), adenosine deaminase, and 5'nucleotidase and the cellular concentration of glucocorticoid (dexamethasone) receptor were determined in 25 patients with acute non-lymphocytic leukaemia. All patients were treated according to a common protocol. Increased activity of TdT (greater than 0.1 unit/microgram DNA) was found in 11 patients. This group of patients was shown to have higher remission and survival rates (p = 0.06) compared with patients with low activity of TdT. The glucocorticoid receptor concentration of the leukaemic blast cells ranged from 0 to 0.94 fmol/microgram DNA. Thirteen patients had blast cells with a glucocorticoid receptor concentration over 0.22 fmol/microgram DNA. These patients had significantly increased remission and survival rates (p = 0.006) compared with those with a low receptor concentration. This finding cannot be explained by a difference in sensitivity to glucocorticoids since these were not used as therapeutic agents. Adenosine deaminase and 5'nucleotidase activities both varied within two orders of magnitude. No correlation could be found between activities of these enzymes and remission or survival rate. These results show that measurements of TdT activity and the glucocorticoid receptor concentration yield valuable prognostic information in acute non-lymphocytic leukaemia.

5'-Nucleotidase↗
PubMed1981

Long survival in acute myelogenous leukaemia: an international collaborative study.

A group of 82 adult patients with acute myelogenous leukaemia had survived in continuous first remission for more than three years was studied. These long-surviving patients were being treated at 12 referral centres in Europe and the USA, and they were compared with other patients with acute myelogenous leukaemia from 10 of these centres. There was no clear difference in the amount of induction chemotherapy or the time taken to achieve remission. Immunotherapy was not found to improve chances of long-term survival. The 82 patients were also compared with a group of 115 patients who had no appreciable difference in the number of blood or marrow myeloblasts between these two groups at presentation, but the long survivors had significantly higher initial platelet counts and were slightly younger. The long survivors also tended to have a lower total white cell count at presentation and lower granulocyte counts; there was no obvious explanation for these differences. Eight of the 82 patients relapsed from three to four years after remission and two (of 69 patients) after four to five year. Thereafter relapse was rare, and it seems likely that some of the 40 patients who have survived for five years or more are cured.

Adolescent↗
PubMed1981

Busulfan, antimetabolites, radiotherapy, and cost of treatment in chronic myelocytic leukemia. A non-controlled, non-randomized monocenter study with historical controls.

The possibilities were studied of achieving remission more quickly, of preventing conceivably alkylator-induced blastic transformation, and of prolonging survival in chronic myelocytic leukemia (CML) by replacing busulfan induction of remission by antimetabolite induction. The promise of the project was not considered to merit a prospective, controlled, randomized multicenter study, and therefore a retrospective, non-controlled, non-randomized pilot study was elected. One antimetabolite-treated group (cytosine arabinoside and thioguanine) and two busulfan-treated patient groups were studied. One of the latter two groups received splenic irradiation in addition to busulfan. No statistically significant differences between the busulfan groups were found in the time to achieve remission, the length of the first, unmaintained remission, the frequency of blastic metamorphosis or the cost of treatment. The actuarial survival curves of all three groups were similar. The antimetabolite induction was well tolerated and led to a statistically significantly more rapid remission than busulfan. However, the remission was significantly shorter, and no significant difference in the frequency of blastic metamorphosis was found between the groups. The median cost (from diagnosis to death) of hospitalization, visits, treatment, and part of the loss of production was approximately 106 000 Sw. cr. in the busulfan + radiotherapy group, 116 000 in the busulfan group, and 178 000 in the antimetabolite group. It is suggested that a prospective, randomized, controlled study could confirm that the present antimetabolite induction may lead to a more rapid remission induction in CML without more side-effects. However, to prevent early relapse, antimetabolite induction should be combined with busulfan maintenance treatment.

Busulfan↗
PubMed1981

Relapse of acute myeloblastic leukemia lasting for four years. Production by leukemic cells of colony-stimulating activity and non-production of leukemia-associated inhibitor.

A 36-year-old woman with acute myeloblastic leukemia (M2) achieved complete remission in Feb. 1973, after ten weeks of chemotherapy with rubidomycin-cytosine arabinoside. She received weekly immunotherapy with bacillus Calmette-Guerin and allogeneic non-irradiated blast cells and monthly chemotherapy with thioguanine-cytosine arabinoside as maintenance. The bone marrow remained normocellular for 20 months. A first relapse occurred after this period. A second remission was achieved by seven courses of different cytostatic combinations. A second relapse, refractory to all cytostatic combinations tried, occurred in June 1976. She was thereafter in relapse until her death in July 1980. Autopsy showed extensive leukemic infiltration in bone marrow, liver, spleen, pericardium, stomach, and lymph nodes. Cytochemistry, surface markers, the capacity to stimulate lymphocytes, the in vitro growth pattern (colony-forming unit culture) of bone marrow and biochemical analyses did not give any remarkable results. In contrast, the peripheral blood cells produced a normal amount of colony-stimulating activity, which is significantly more than that produced by the blood from other leukemia patients. In liquid culture, the peripheral blood cells from this patient also seemed to live longer and mature more than cells from other leukemia patients. Finally, the peripheral leukemic cells from this patient seemed to produce far less leukemia-associated stem cell inhibitor than cells from other leukemia patients. The normal colony-stimulating activity production by leukemic cells and the absence of leukemia-associated stem cell inhibitor may therefore explain the long survival of this patient in relapse.

Adult↗
PubMed1980

Immunotherapy versus chemotherapy of acute myeloid leukemia: response to PHA, allogeneic lymphocytes, and leukemic myeloblasts of remission lymphocytes from leukemia patients.

Lymphocytes were studied from 51 patients with acute myeloid leukemia (AML) in remission given chemotherapy (CT) maintenance alone or given chemoimmunotherapy (CIT) with BCG and viable allogeneic leukemic cells. CT lymphocytes reacted significantly more to PHA (P less than 0.05) if taken later than 100 days after remission than if taken earlier. CIT lymphocytes reacted less. Thus, the late CT lymphocytes reacted significantly more to nonspecific stimulators (PHA and allogeneic lymphocytes, P less than 0.01) than did late CIT lymphocytes or control lymphocytes. In consequence, the ratio of reactions to specific (leukemic myeloblasts) over nonspecific stimulators was significantly higher in CIT (P less than 0.01) than in CT lymphocytes. Results may indicate nonspecific immunostimulation during CT, and also some relative specific sensitization to allogeneic myeloblasts during CIT.

Antigens, Neoplasm↗
PubMed1980

Predicting response to combination chemotherapy in acute myeloblastic leukemia--- a way to individualize treatment.

Cytostatics are toxic, and individual variations in drug metabolism large. Therefore the possibility to predict which cytostatic combination should be abandoned because it will not lead to a remission was studied in 58 leukemia patients. A simple following of changes in white blood cell, platelet and blast cell numbers in peripheral blood (combined into so-called chemotherapy points) makes it possible to predict which patients in the presenting phase of AML will achieve remission, but this was possible neither in the relapse phase of AML, nor in promyelocytic or monocytic leukemias. All 27 patients in the initial phase of AML, who later were to achieve remission, had less than 12 chemotherapy points, and 9 of 11 patients who did not achieve remission had over 13 points. Therefore the cytostatic combination should be changed in patients who, after two courses of treatment, have over 13 points.

Antineoplastic Agents↗
PubMed1980

Response to treatment in acute non-lymphatic leukaemia: prognostic value of colony forming and colony stimulating capacities of bone marrow and blood cells compared to other parameters.

Growth of bone marrow and mononuclear white blood cells (MWBC) in soft-agar cultures was studied in 26 patients with untreated acute non-lymphocytic leukaemia (ANLL). Marrow and MWBC from 30 healthy volunteers served as controls. All ANLL patients revealed an abnormal growth in vitro. Patients with an increased number of clones in marrow cultures and large cluster predominance ('excessive growth') responded poorly to therapy with only one of 10 patients entering remission. On the contrary, only two of the 15 patients with a decreased clone number ('low growth') failed to achieve remission. The number of colonies and clusters in both bone marrow and blood cultures was significantly lower at presentation in patients who later entered remission than in those who did not. The correlations between the number of colonies and clusters in the blood and the marrow cultures were statistically significant. No significant correlations were found between prognosis or colony formation, on one hand, and the production of colony stimulating activity (CS)bA), by bone marrow and blood cells of ANLL patients, on the other. Nor could such correlations be found between prognosis, blood cell counts, and age. It is concluded that the growth pattero cytostatic drugs and particularly in selecting patients with a high probability to respond poorly to current cytostatic regimes.

Acute Disease↗
PubMed1980

Causes of death in leukemia and lymphoma with modern treatment.

An attempt was made to see if new forms of treatment of fungal and bacterial septicemia, or new cytostatic combinations have changed the causes of death in leukemia and lymphoma. Autopsies were studied of 16 cases with acute leukemia, 2 with chronic granulocytic leukemia and 24 with lymphoma. 10 of the 18 patients with leukemia and 10/14 lymphoma patients died although they had no, or only slight, tumor infiltration in the bone marrow and parenchymatous organs; only 1/18 leukemias had extensive infiltration. There was a statistically significant correlation between the extent of marrow and organ infiltration. Cardiac failure (5/18 patients) was almost as common as the main cause of death as septicemia (7/18) in leukemia. The corresponding figures in lymphoma were 5/24 and 9/24, respectively. The present findings contrast with earlier ones, where more septicemia and tumor infiltration were found at autopsy, and less cardiac failure was observed. 15 of 16 cases with septicemia at autopsy had terminal fever. Bacteriological and histological signs of septicemia at autopsy agreed satisfactorily. There was a surprising absence of agreement between terminal granulocytopenia and septicemia; 13 of 16 patients with septicemia had over 0.1 x 10(9) and 10 over 0.5 x 10(9) granulocytes/liter blood.

Agranulocytosis↗
PubMed1979

Overprescribing iron tablets to elderly people in Sweden.

Iron should not be prescribed to middle-aged men or older women with anaemia unless the possibility that the iron deficiency is caused by a gastrointestinal tumour has been considered. Thus the prescribing of iron to elderly people was investigated by studying four different prescription statistics and by reviewing records. Over one in 10 women aged over 65 were prescribed iron tablets. Men and women in the oldest age groups were prescribed iron most frequently. The reasons for prescribing iron were examined at a rural health centre. Out of 327 records of patients who were prescribed iron during 1975, 157 were randomly selected and reviewed. Only 18 out of 48 (38%) patients aged 45-75 (men) and 55-75 (women) and 29 out of 109 (27%) aged over 75 years had probable or possible iron-deficiency anaemia as established from the records. Only nine (19%) of the younger patients had a plausible reason for the anaemia other than a bleeding tumour. Ten (9%) of the older patients were considered to be inoperable cases. Thus, according to the records, only 18 (17%) of the patients over 75 years and nine (19%) of those in the younger age group have been prescribed iron. About 70% of all the patients were considered not to have iron deficiency; 7% had had iron deficiency previously, and 20% probably had anaemia as a result of chronic disease; for 43% no real reason for the iron prescription could be found in the record. Thus it is concluded that iron is overprescribed in Sweden, particularly for elderly people. It should not be prescribed until the possibility of a bleeding gastrointestinal tumour has been excluded.

Aged↗