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Biomedical subjects

R A Binder

Publications and source records attributed to R A Binder.

At least 19 recordsLinked to original sources
PubMed1998

A comparison of efficacy of sargramostim (yeast-derived RhuGM-CSF) and filgrastim (bacteria-derived RhuG-CSF) in the therapeutic setting of chemotherapy-induced myelosuppression.

A randomized, double-blind, multicenter study in 181 afebrile cancer patients with ANC levels < 500/microL receiving myelosuppressive chemotherapy was undertaken to compare sargramostim (yeast-derived recombinant human granulocyte-macrophage colony-stimulating factor, RhuGM-CSF) and filgrastim (bacteria-derived recombinant human granulocyte colony-stimulating factor, RhuG-CSF) in the treatment of chemotherapy-induced myelosuppression. Patients received daily subcutaneous (SC) injections of either agent until ANC levels reached at least 1500/microL. There was no statistical difference between treatment groups in the mean number of days to reach an ANC of 500/microL, but the mean number of days to reach ANC levels of 1000/microL and 1500/microL was approximately one day less in patients receiving filgrastim. Fewer patients in the sargramostim arm were hospitalized, and they had a shorter mean length of hospitalization, mean duration of fever, and mean duration of i.v. antibiotic therapy compared with patients who received filgrastim. Both growth factors were well tolerated. No patient was readmitted to the hospital after growth factor was discontinued. Sargramostim and filgrastim have comparable efficacy and tolerability in the treatment of standard-dose chemotherapy-induced myelosuppression in community practice.

Adult↗
PubMed1997

Randomized trial comparing the tolerability of sargramostim (yeast-derived RhuGM-CSF) and filgrastim (bacteria-derived RhuG-CSF) in cancer patients receiving myelosuppressive chemotherapy.

A prospective, randomized, double-blind, multicenter study in cancer patients receiving myelosuppressive chemotherapy was undertaken to evaluate and compare the tolerability of sargramostim (yeast-derived recombinant human granulocyte-macrophage colony-stimulating factor, RhuGM-CSF) and filgrastim (bacteria-derived recombinant human granulocyte colony-stimulating factor, RhuG-CSF) in the prophylaxis or treatment of chemotherapy-induced neutropenia. In all, 137 evaluable patients received sargramostim (300 micrograms; 193 mg/m2) or filgrastim (481 mg; 7 mg/kg) once daily by self-administered s.c. injection, usually beginning within 48 h after completion of chemotherapy. With the exception of a slightly higher incidence of grade 1 fever (< 38.1 degrees C) with sargramostim, there were no statistically significant differences in the incidence or severity of local or systemic adverse events possibly related to the growth factors. Although the study was not designed to evaluate efficacy directly, there also were no statistically significant differences between treatment groups in total days of growth factor therapy, days of hospitalization, or days of i.v. antibiotic therapy during the treatment period. Both sargramostim and filgrastim were comparably well tolerated when given by s.c. injection in this group of patients, and no clinically significant differences between the growth factors were demonstrated.

Chi-Square Distribution↗
PubMed1993

Phase II study of fluorouracil, leucovorin, and interferon alfa-2a in metastatic colorectal carcinoma.

PURPOSE: To test the activity of a regimen of interferon alfa-2a (IFN alpha-2a) 5 x 10(6) U/m2 subcutaneously (SC) days 1 through 7 combined with leucovorin 500 mg/m2/d intravenously (IV) over 30 minutes and fluorouracil (5-FU) 370 mg/m2/d through IV push 1 hour after leucovorin days 2 through 6 in a phase II study. PATIENTS AND METHODS: Forty-six patients with a good performance status (PS) with measurable colorectal cancer and no prior therapy for metastatic disease were entered. Cycles were repeated at 3-week intervals if toxicity had resolved. The 5-FU dose was increased by 15% if toxicity was mild, and decreased by 15% for grade 3 to 4 nonhematologic or grade 4 hematologic toxicity. RESULTS: Three complete responses (CRs) and 21 partial responses (PRs) were seen among 44 assessable patients (54%; 95% confidence interval, 39% to 70%). A moderately strong association was noted between PS and response: PS O (n = 26), two CRs and 15 PRs (65%); PS 1 (n = 13), one CR and six PRs (54%); PS 2 (n = 5), zero CRs and zero PRs (0%; two-tailed P = .026). With a median follow-up duration of 18.8 months, the median time to treatment failure (TTF) and survival were 7.8 months and 16.3 months, respectively. Doses were escalated to 425 mg/m2/d 5-FU in 10 patients, but only four tolerated the higher dose. When expressed as the most severe degree of toxicity experienced by each patient across all cycles, grade 3 to 4 toxicity of the following types was observed; mucositis, 37%; diarrhea, 40%; rash, 7%; fatigue, 14%; granulocytopenia, 13%. Dose-limiting toxicity at 370 mg/m2/d 5-FU eventually occurred in 28 patients (61%). Twelve patients (26%) required an IFN alpha-2a dose reduction for constitutional toxicity. CONCLUSION: This regimen has promising activity in advanced colorectal cancer, particularly in patients with an Eastern Cooperative Oncology Group (ECOG) PS of 0 to 1.

Adult↗
PubMed1987

Cold autoimmune hemolytic anemia with auto-anti-AI specificity: 51chromium survival studies.

A 65-year-old woman was found to have severe autoimmune hemolytic anemia. The patient was group A1, Rho(D) positive. The direct antiglobulin test was strongly positive with anti-C3 and negative with anti- IgG. The serum contained two distinct IgM antibodies, auto-anti-I and auto-anti-AI. Both were reactive at 22 degrees C. However, the anti-AI also was reactive in saline and in albumin at 37 degrees C. An eluate revealed anti-AI and a weak anti-I. Sequential 51Chromium survival studies were done with group OI and AI red cells. The group OI red cells survived normally (97% at 24 hours) while the group A1I red cells were removed in a "two-component" pattern characteristic of IgM complement-fixing antibodies (62% survival at one hour, 49% at 24 hours). Based on these observations, the patient was subsequently transfused without incidence with six group O units of washed red cells prior to splenectomy. Although auto-anti-AI has been previously reported, this is the first case to demonstrate the use of 51Cr survival studies to determine its clinical significance.

Journal Article↗
PubMed1980

Cloning of human lymphocytes reactive with autologous leukemia cells.

The primed lymphocyte typing test has been used to detect leukemia-associated antigens, but interpretation has been difficult because of significant levels of reactivity with normal cells. Elimination of unwanted reactivities could be accomplished by (a) use of the patient's own lymphocytes as responders to the leukemia cells and (b) cloning of the responding cells. Cloning of antigen-activated human lymphocytes can be accomplished through the use of T-lymphocyte growth factor, which permits the long-term growth of antigen-activated lymphocytes. In the study reported here, the remission lymphocytes of a patient with acute myelogenous leukemia were sensitized in culture to the patient's own leukemic myeloblasts and then grown from wells containing one or a few replicating units. Sufficient cells of three clones were growth for further testing of specificity: one responded only to the sensitizing myeloblast but not to normal cells tested; one responded to the sensitizing myeloblasts and one allogeneic myeloblast but not to normal cells; and one responded to none of the cells tested, although it proliferated vigorously with growth factor alone. These results demonstrate the feasibility of cloning human lymphocytes putatively responsive to leukemia-associated antigens in order to improve their discriminatory capacity in the primed lymphocyte typing test. The response pattern observed was that expected of a clone responding to a leukemia-associated antigen.

Antigens, Neoplasm↗
PubMed1980

Leukemia: a spectrum of diseases.

A number of advances that have appeared with regard to acute and chronic leukemias in the hematologic literature of the last several years have been reviewed. This field is rapidly expanding, and major advances are being made on a regular basis. Hopefully, in the future the use of the word "cure" can be used without apprehension in larger numbers of patients with these disease processes.

Bone Marrow Transplantation↗
PubMed1979

Disseminated intravascular coagulation in sickle cell crisis.

We conclude that DIC can occur as a result of sickle cell crisis in the absence of sepsis and we recommend that patients with sickle cell disease, particularly those with hemoglobin SC disease, presenting in crisis should be considered at risk for the development of disseminated intravascular coagulation. With symptomatic treatment and improvement of the crisis, our patient's coagulopathy resolved.

Adult↗
PubMed1979

T and B lymphocytes in pregnant women.

The peripheral blood of 27 women in their third trimester of pregnancy and of 16 control subjects was studied for total WBC counts and total numbers and percentages of T and B lymphocytes, including quantitation of the major immunoglobulin subtypes of the B lymphocytes. Although significant differences were found for percentages of total lymphocytes, T Lymphocytes, and B lymphocytes, the absolute numbers varied only slightly between the 2 study groups. A higher percentage and a higher absolute number of IgG-bearing B lymphocytes were found among pregnant women than among controls. It is concluded that significant quantitative alterations in circulating T and B lymphocytes do not occur in the third trimester of pregnancy; therefore, the concept of impaired cellular immunity, which has often been suggested to occur in this setting, is not supported. A review of the literature on T and B lymphocytes in human pregnancy is presented.

Adult↗
PubMed1977

Association of breast cancer with myeloproliferative disorders.

Three cases of myeloproliferative disorders in patients with breast cancer are described. The first patient developed acute myeloblastic leukemia 26 years after her initial breast cancer; the second patient developed chronic myelogenous leukemia three years after the diagnosis of breast cancer; the third patient had polycythemia vera for nine years before cancer of the breast was noted. The literature dealing with the association of cancer and myeloproliferative disorders is reviewed. Possible explanations for this association are considered.

Acute Disease↗
PubMed1976

Burkitt's lymphoma involving the ovary and jaw.

Unilateral jaw and ovarian Burkitt's lymphoma occuring in an adult American female is reported. The patient was treated with a combination of surgery, radiation, and chemotherapy. The diagnosis, treatment, prognosis, and relapse patterns are briefly reviewed as they relate to the specialty of gynecology.

Adult↗
PubMed1975

Malignant histiocytosis in a patient presenting with leukocytosis, eosinophilia, and lymph node granuloma.

A patient with malignant histiocytosis presented with a number of unusual features including fever, leukemoid reaction, and eosinophilia. Other confusing findings included lymph node biopsies which showed reactive changes, noncaseating granuloma, and atypical Reed-Sternberg cells. These features are compared with cases appearing in the literature. The course was rapidly progressive despite combination chemotherapy.

Adult↗
PubMed1975

"B" cell origin of malignant cells in a case of American Burkitt's lymphoma. Characterization of cells from a pleural effusion.

Ninety-eight percent of the cells isolated from a malignant pleural effusion in a case of American Burkitt's lymphoma showed membrane fluorescence to antihuman IgM antisera, while only 2% of the cells formed spontaneous rosettes with sheep red blood cells. It is concluded that the Burkitt cells in the malignant effusion are derived from bursal equivalent lymphocytes. Epstein-Barr (E-B) viral titers to both viral capsule antigen and early antigen were not elevated. The significance of these findings is discussed.

B-Lymphocytes↗
PubMed1975

Nitroblue tetrazolium reduction test in pregnancy.

The use of the nitroblue tetrozolium (NRT) dye reduction test as a screening method for bacterial and fungal infections is now widely recognized. Levels have been reported to be falsely elevated in the pregnant state. This report includes a prospective study which showed that the results of this test in 124 pregnant women were indistinguishable from those of a normal control population. Seven of 8 elevated levels were attributable to infection or allergy. With this data, it is concluded that the NBT test can be used to screen for bacterial and fungal illnesses in a febrile pregnant patient as well as in the general population.

Bacterial Infections↗
PubMed1975

Immunoglobulin D myeloma and amyloidosis: immunochemical and structural studies of Bence Jones and amyloid fibrillar proteins.

Urinary Bence Jones protein and amyloid fibril protein isolated from the subcutaneous tissue of a patient with IgD myeloma and associated amyloidosis were subjected to physicochemical and immunochemical identification. Peptide maps and amino-terminal tetrapeptide composition obtained from the two proteins were comparable. Immunochemical cross-reactivity between the two proteins, with other lambda-type amyloid and Bence Jones proteins, and with a serum component was demonstrated. The results suggest that the source of the amyloid fibril protein is an intact circulating light polypeptide chain as well as smaller amino-terminal fragments.

Aged↗