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Biomedical subjects

R Hoffman

Publications and source records attributed to R Hoffman.

At least 289 records · Page 16Linked to original sources

Influence of T lymphocytes on hematopoiesis in a patient with T cell hypoplasia.

In this communication, we describe an unusual patient with a reported lifelong history of anemia. Investigation of the pathogenesis of this patient's bone marrow failure provided an interesting opportunity to determine the role of T cells in the regulation of human blood cell production. Phenotyping of the patient's mononuclear cells revealed severe T cell hypoplasia in both the peripheral blood and bone marrow. The patient's bone marrow was capable of producing 50-60% of the normal numbers of burst-forming units--erythroid (BFU-E) in the presence of optimal concentrations of erythropoietin, suggesting that marrow BFU-E formation is in part independent of T cells. Addition of small numbers of class I identical donor T cells enhanced BFU-E cloning efficiency to a level observed in normal controls. This enhancing effect was supplied by a T4+ (CD4) population of donor cells. The addition of donor T cells partially corrected the inability of patient marrow cells to produce megakaryocyte and mixed colonies. These studies suggest that prolonged T cell hypoplasia might deprive marrow progenitor and stem cells of a necessary enhancing effect that is required for sustained normal hematopoiesis. Such a T cell defect in rare instances may result in bone marrow failure.

Aged↗

Salvage chemotherapy for lymphoma with VP-16, ifosfamide, and cisplatin.

Between 1983 and 1985, we conducted a phase II clinical trial using VP-16, ifosfamide, and cisplatin (VIP) in patients with refractory lymphoma. Twenty-eight patients with bidimensional measurable disease were treated with VP-16 (75 mg/m2), ifosfamide (1.2 g/m2), and cisplatin (20 mg/m2) as daily intravenous infusions for 5 consecutive days. N-Acetylcysteine, 2 g orally every 6 h, was given as a uroepithelial protective agent. All patients had received extensive combination chemotherapy prior to beginning VIP (median number of regimens = 2). Of the 25 patients evaluable for response, 2 patients achieved complete remission and 7 achieved partial remission for an overall objective response rate of 36%. The length of responses ranged from 2 months to 13 months. The predominant toxicity of VIP was myelosuppression. Of 23 patients receiving more than one course of VIP, 17 (73%) had dose reductions or delays related to poor hematologic tolerance of therapy. Uroepithelial and renal toxicity were mild. VIP demonstrates therapeutic activity in refractory lymphoma and appears comparable to other ifosfamide/VP-16 based salvage regimens.

Adult↗

Detection of a human hematopoietic progenitor cell capable of forming blast cell containing colonies in vitro.

A progenitor cell CFU-B1 (blast cell colony forming unit) present in human bone marrow and capable of producing blast cell containing colonies in vitro was detected using a serum containing semisolid culture system. The CFU-B1 has the capacity not only to undergo self-renewal, but also commitment to a number of hematopoietic lineages. This progenitor cell therefore has characteristics which suggest that it is identical to or closely related to the human pluripotent hematopoietic stem cell. Pretreatment of marrow cells with 5 fluorouracil facilitated detection of CFU-B1 derived colonies. The formation of CFU-B1 derived colonies was dependent upon the addition of media conditioned by the human bladder carcinoma cell line 5637. The ability of 5637 CM (conditioned media) to support blast cell colony formation was in part but not totally ablated by pretreatment of the CM with an IL-1 alpha (interleukin-1) neutralizing antibody. This data suggests that IL-1 alpha plays a role in the regulation of primitive events occurring during human hematopoiesis. IL-1 alpha might be exerting these effects by either acting directly on the CFU-B1, causing marrow accessory cells to elaborate other cytokines or by synergizing with cytokines already present in 5637 CM.

Bone Marrow Cells↗

Enzyme-pattern-targeted chemotherapy with tiazofurin and allopurinol in human leukemia.

The hypothesis was tested that the increased IMP dehydrogenase activity in human myelocytic leukemic cells, and along with it guanylate biosynthesis, might be a sensitive target to chemotherapy by tiazofurin. 1. IMP dehydrogenase activity in normal leukocytes was 3.1 +/- 0.5 (means +/- S.E.) nmol/hr/mg protein and in leukemic cells it was elevated 15- to 41-fold. The activity of guanine phosphoribosyltransferase in normal leukocytes was 389 +/- 27 nmol/hr/mg protein and in the leukemic cells it increased 2.8- to 6.8-fold. 2. IMP dehydrogenase was purified 4,900-fold to homogeneity from rat hepatoma 3924A with a yield of 30%. The kinetic properties of the hepatoma enzyme were similar to those of the enzyme in human myelocytic leukemic blast cells because of the similarity of the Km's for IMP (23 microM), NAD (44 and 65 microM); the Ki for TAD was 0.1 microM in both enzymes. 3. There was a selectivity of the in vitro response to tiazofurin in human normal and leukemic leukocytes. When labeled tiazofurin was incubated with leukocytes from normal, healthy volunteers and from leukemic patients, the leukemic leukocytes made 20- to 30-fold more TAD and the GTP content decreased as compared to normal leukocytes. This procedure proved to be a suitable predictive test in a clinical setting because patients with positive tests responded to tiazofurin whereas those with negative ones did not. 4. The National Cancer Institute approved a chemotherapeutic phase I/II trial which concentrates on treatment of refractory acute myelocytic leukemia. Tiazofurin is infused in a 60-minute period with a pump to insure uniform delivery. A novel aspect of the trial was that it was directed primarily by the biochemical impact of tiazofurin on IMP dehydrogenase activity and GTP concentration and the tiazofurin doses were to be adjusted accordingly. Patients received allopurinol as a routine precaution against possible accumulation of uric acid in the kidney. 5. In the first eight patients, there was one complete remission, two entered the chronic phase, two entered into partial remission, one did not respond, and two were not evaluable. In the five patients who responded, there was a rapid, profound decrease in IMP dehydrogenase activity of the blast cells and a gradual decline in GTP concentrations. The blast cell count followed the decrease in the GTP concentration. The white blood cell count was largely preserved. 6. Bone marrow aspirates and peripheral blood samples showed that with tiazofurin treatment there was an induced differentiation of the myelocytes.(ABSTRACT TRUNCATED AT 400 WORDS)

Adenine↗

Evidence for the clonal nature of hypereosinophilic syndrome.

Hypereosinophilic syndrome (HES) is a disease process of unknown pathogenesis. Although some cases are believed to be primary hematologic malignancies, this issue remains unsolved. We present a case of HES in whom we have observed a clone of cytogenetically abnormal cells in the bone marrow in parallel with a clinical picture of a hematologic disorder characterized by progressive proliferation and organ infiltration by eosinophils. The cytogenetic abnormality 46,XY,t(7;12)(q11;p11) is previously unreported. Our case, plus other evidence present in the literature, supports the concept that HES is a hematologic malignant neoplasia.

Adult↗

Effect of recombinant and purified human haematopoietic growth factors on in vitro colony formation by enriched populations of human megakaryocyte progenitor cells.

Nonadherent low density T-lymphocyte depleted (NALT-) marrow cells from normal donors were sorted on a Coulter Epics 753 Dye Laser System using Texas Red labelled My10 and phycoerythrin conjugated anti HLA-DR monoclonal antibodies in order to obtain enriched populations of colony forming unit-megakaryocyte (CFU-MK). The CFU-MK cloning efficiency (CE) was 1.1 +/- 0.5% for cells expressing both high densities of My10 and low densities of HLA-DR (My10 DR+). This procedure resulted in an 18-fold increase in CE over NALT- cells. The effect of purified or recombinant human haematopoietic growth factors including erythropoietin (Epo), thrombocytopoiesis stimulating factor (TSF), interleukin 1 alpha (IL-1 alpha), granulocyte colony stimulating factor (G-CSF), granulocyte-macrophage colony stimulating factor (GM-CSF), macrophage colony stimulating factor (M-CSF or CSF-1) and interleukin MK colony formation by My10 DR+ cells was determined utilizing a serum depleted assay system. Neither Epo, TSF, CSF-1, IL-1 alpha nor G-CSF alone augmented MK colony formation above baseline (2.5 +/- 0.8/5 x 10(3) My10 DR+ cells plated). In contrast, the addition of GM-CSF and IL-3 each increased both CFU-MK colony formation and the size of colonies with maximal stimulation occurring following the addition of 200 units/ml of IL-3 and 25 units/ml of GM-CSF. At maximal concentration, IL-3 had a greater ability to promote megakaryocyte colony formation than GM-CSF. The stimulatory effects of GM-CSF and IL-3 were also additive in that the effects of a combination of the two factors approximated the sum of colony formation in the presence of each factor alone. The CFU-MK appears, therefore, to express HPCA-1 and HLA-DR antigens. These studies also indicate that GM-CSF and IL-3 are important in vitro regulators of megakaryocytopoiesis, and that these growth factors are not dependent on the presence of large numbers of macrophages or T cells for their activity since the My10 DR+ cells are largely devoid of these accessory cells.

Colony-Forming Units Assay↗

Characterization of a human hematopoietic progenitor cell capable of forming blast cell containing colonies in vitro.

A hematopoietic cell (CFU-B1) capable of producing blast cell containing colonies in vitro was detected using a semisolid culture system. The CFU-B1 has the capacity for self-renewal and commitment to a number of hematopoietic lineages. Monoclonal antibody to the human progenitor cell antigen-1 (HPCA-1) and a monoclonal antibody against the major histocompatibility class II antigen (HLA-DR) were used with fluorescence activated cell sorting to phenotype the CFU-B1. The CFU-B1 was found to express My10 but not HLA-DR antigen; experiments using complement-dependent cytotoxicity to eliminate DR positive cells confirmed this finding. Pretreatment of marrow cells with two chemotherapeutic agents, 5-fluorouracil and 4-hydroperoxycyclophosphamide facilitated detection of CFU-B1 derived colonies, while diminishing or totally inhibiting colony formation by other hematopoietic progenitor cells. CFU-B1-derived colony formation was dependent upon the addition of exogenous hematopoietic growth factors. Media conditioned either by the human bladder carcinoma cell line 5637 or lectin stimulated leukocytes, as well as recombinant granulocyte-macrophage colony stimulating factor, interleukin 3 or interleukin 1 alpha promoted blast cell colony formation. By contrast, neither recombinant erythropoietin, recombinant interleukin 4, purified macrophage colony stimulating factor or recombinant granulocyte colony-stimulating factor alone promoted blast cell colony formation.

Bone Marrow↗

Effect of recombinant and purified hematopoietic growth factors on human megakaryocyte colony formation.

The effect of a number of purified or recombinant hematopoietic growth factors, including recombinant erythropoietin (rEpo), thrombocytopoiesis stimulating factor (TSF), recombinant interleukin 1 alpha (rIL-1 alpha), recombinant granulocyte colony-stimulating factor (rG-CSF), macrophage colony-stimulating factor (CSF-1), recombinant interleukin 3 (rIL-3), and recombinant granulocyte-macrophage colony-stimulating factor (rGM-CSF), on megakaryocyte (MK) colony formation by normal human marrow cells in a serum-depleted assay system was determined. Neither rEpo, TSF, CSF-1, rIL-1 alpha, nor rG-CSF alone augmented MK colony formation. Both rGM-CSF and rIL-3 at optimal doses increased MK colony formation eightfold and tenfold, respectively, above baseline values. Addition of increasing amounts of either rGM-CSF or rIL-3 led to progressively greater numbers of MK colonies formed until plateau levels were reached. Both rGM-CSF and rIL-3 also led to a dose-related increase in the number of cells per MK colony formed in culture. These molecules were equivalent stimulators of MK colony formation when their effects at optimal concentrations were compared. The effects of rGM-CSF and rIL-3 were additive at suboptimal concentrations of rIL-3 in that colony formation by a combination of the two growth factors approximated the sum of colony formation by each growth factor alone. These data suggest that rGM-CSF and rIL-3 alone and in combination are important regulators of in vitro megakaryocytopoiesis at the progenitor cell level.

Cell Division↗

Analysis of phorbol ester stimulated human megakaryocyte development.

Megakaryocytes are relatively rare components of human bone marrow, making the study of their maturation difficult. Phorbol esters can act as differentiating agents in a number of cell systems including murine megakaryocytes. We report the effects of phorbol esters on the previously described long-term human megakaryocytic leukemia cell culture, EST-IU. While two nontransforming phorbols fail to affect these cells, the transforming phorbol 12-O-tetradecanoylphorbol-13-acetate (TPA) induces a phenotype with characteristics of more mature megakaryocytes in a dose-related manner. This phenotype includes an increased adherence to untreated plastic or glass, polyploidization, an increase in cell size, and increased expression of both platelet glycoproteins and factor VIII-related antigen. Two-color flow cytometric analysis allowed simultaneous determinations of DNA content and the expression of surface membrane antigens or alpha-granule constituents, providing evidence that nuclear, membrane, and cytoplasmic maturation occur in parallel in this cellular system. TPA-induced maturation of EST-IU cells provides an important new cellular model for the further study of human megakaryocyte development.

Antigens↗

Effects of hematopoietic growth factors on in vitro colony formation by human megakaryocyte progenitor cells.

In order to study the effects of recombinant and purified hematopoietic growth factors on megakaryocyte (MK) progenitor cells (CFU-MK), enriched populations of human CFU-MK were isolated utilizing fluorescence activated cell sorting after labelling of cells with monoclonal antibodies exhibiting specificity to the My10 (HPCA-1) antigen and the major histocompatibility (MHC) class II (HLA-DR) locus. The CFU-MK cloning efficiency (CE) was 1.1 +/- 0.5% for cells expressing both high densities of My10 and low densities of HLA-DR (My10 DR+). This procedure resulted in an 18 fold increase in CE over NALT- cells. The effects of natural or recombinant human hematopoietic growth factors including erythropoietin (Epo), thrombocytopoiesis stimulating factor (TSF), interleukin 1 alpha (IL-1 alpha), granulocyte colony stimulating factor (G-CSF), granulocyte-macrophage colony stimulating factor (GM-CSF), macrophage colony stimulating factor (CSF-1), and interleukin 3 (IL-3) on MK colony formation by My10 DR+ cells were determined utilizing a defined medium assay system. Neither Epo, TSF, CSF-1, IL-1 alpha nor G-CSF alone augmented MK colony formation above baseline (2.5 +/- 0.8 per 5 x 10(3) My10 DR+ cells plated). By contrast, the addition of GM-CSF and IL-3 each increased CFU-MK colony formation with maximal stimulation occurring following the addition of 200 units/ml of IL-3 and 100 units/ml of GM-CSF. At maximal concentration, IL-3 had a greater ability to promote megakaryocyte colony formation than GM-CSF.

Cell Division↗

Characterization of adult human marrow hematopoietic progenitors highly enriched by two-color cell sorting with My10 and major histocompatibility class II monoclonal antibodies.

Monoclonal antibodies, My10 (HPCA-1) and major histocompatibility class II (HLA-DR), were used to enrich and phenotype normal human marrow colony-forming unit: granulocyte-macrophage (CFU-GM), burst-forming unit: erythroid (BFU-E), and multipotential colony-forming unit: granulocyte-erythroid-macrophage-megakaryocyte (CFU-GEMM) progenitor cells. Nonadherent low density T lymphocyte-depleted marrow cells were sorted on a Coulter Epics 753 dye laser flow cytometry system with the use of Texas Red-labeled anti-My10 and phycoerythrin conjugated anti-HLA-DR. Cells were separated into populations with nondetectable expression of antigens (DR-My10-) or with constant expression of one antigen and increasing densities of the other antigen. More than 98% of the CFU-GM, BFU-E, and CFU-GEMM were found in fractions containing cells expressing both HLA-DR and My10 antigens. The cloning efficiency (CE) of cells in the DR-My10- cell fraction was 0.01%. In the antigen-positive sorted fractions, the CE was highest (up to 47%) in the fractions of cells expressing high My10 and low DR (My10 DR+) antigens and was lowest (2.5%) in the fraction of cells expressing low My10 and low DR (My10+DR+) antigens. Populations of cells varying in the density of HLA-DR, but not My10, antigens varied in the proportion and types of progenitor cells present. When My10-positive cells were sorted for HLA-DR density expression, the CE for CFU-GM was similar in the DR+ and DR++ fractions, but most of the BFU-E and CFU-GEMM were found in the DR+ fraction. Within the CFU-GM compartment, most of the eosinophil progenitors were found in the DR+ fraction, whereas a greater proportion of macrophage progenitors were detected in the DR++ fraction. CFU-GM and BFU-E in the fractions of cells positive for DR and My10 were assessed for responsiveness to the effects of recombinant human tumor necrosis factor-alpha, recombinant human interferon-gamma, and prostaglandin E1. Colony formation from CFU-GM was suppressed by the three molecules, and colony formation by BFU-E was suppressed by recombinant human tumor necrosis factor-alpha and interferon-gamma and enhanced, in the presence of T lymphocyte-conditioned medium, by prostaglandin E1 in all antigen-positive fractions.(ABSTRACT TRUNCATED AT 400 WORDS)

Alprostadil↗

Hematological and biochemical action of tiazofurin (NSC 286193) in a case of refractory acute myeloid leukemia.

A patient with refractory acute myeloid leukemia was treated with tiazofurin, an agent that causes inhibition of tumor cell proliferation by depressing GTP concentrations in the malignant cells. The initial dose of 1100 mg/m2 was ineffective clinically and biochemically. Dose escalations to 1650, 2200, and finally 3300 mg/m2 resulted in a marked decrease in the absolute number of blasts without causing bone marrow hypoplasia or marked neutropenia. The decrease in the peripheral blast cell count was observed subsequent to a decline in GTP concentrations in the leukemic cells to less than 30% of the pretreatment value. Consecutive bone marrow examinations showed a remarkable shift from myeloblasts to more mature myeloid elements, suggesting an in vivo differentiative action of tiazofurin. Although a total dose of 23,650 mg/m2 was administered over a 13-day period, only very mild side effects were noted. The absence of complications reported by others in Phase I trials with tiazofurin may be related to our slow administration of the drug by pump over a 1-h period in this trial. Tiazofurin appears to be a promising agent in the treatment of leukemia because of its selective action on leukemic cells and the availability of a rapid in vitro method capable of predicting sensitivity of leukemic cells to the agent and monitoring its activity during treatment by measuring thiazole-4-carboxamide adenine dinucleotide and GTP concentrations. These observations are being tested in a larger group of leukemic patients.

Antineoplastic Agents↗

Chronic T cell lymphoproliferative disorder and pure red cell aplasia. Further characterization of cell-mediated inhibition of erythropoiesis and clinical response to cytotoxic chemotherapy.

Two patients with pure red cell aplasia and a T cell lymphoproliferative disorder were studied in order to define the mechanism of suppression of erythropoiesis and the patients' response to cytotoxic therapy. In vitro assays demonstrated enhanced formation of both erythroid colonies and bursts following T-cell depletion. Erythroid colony formation was suppressed by the readdition of autologous T cells to a null cell fraction of marrow mononuclear cells. Media conditioned by the patients' T cells did not exhibit any inhibitory effect on erythroid colony formation by autologous T cell-depleted marrow cells. These in vitro results suggested that T cell-mediated suppression of erythropoiesis was responsible for the generation of pure red cell aplasia. In both patients, cyclophosphamide therapy resulted in clinical remissions manifested by normalization of the hematocrits associated with a reduction in circulating lymphocytes from more than 10,000/mm3 to under 500/mm3. Maintenance chemotherapy has caused persistent inhibition of lymphocyte counts along with durable remissions with normal hematocrits.

Aged↗

Cytogenetic findings in siblings with a myelodysplastic syndrome.

A brother and sister, both in their third decade, presented 6 months apart with severe pancytopenia. Bone marrow examination demonstrated morphologic changes, characteristic of the myelodysplastic syndromes, subtype refractory anemia with excess of blasts; cytogenetic studies revealed complex but different karyotypic abnormalities in both siblings. No history of exposure to mutagenic agents was obtained; there was no evidence of congenital anomalies in the family. Both siblings died within 18 months of diagnosis from complications related to their disease. This report describes the clinical course and discusses the cytogenetic findings for both siblings.

Adult↗

A variant t(X;15)(p11;q22) translocation in acute promyelocytic leukemia.

Nonrandom reciprocal translocations involving chromosomes #15 and #17 are characteristic anomalies in a great majority of cases of acute promyelocytic leukemia (APL). Other complex translocations in APL that invariably involve chromosome #17 also have been described. We describe a patient with clinical and morphologic characteristics of APL but with a previously undescribed acquired karyotype, t(X;15)(p11;q22). This is the first translocation in APL described in which chromosome #17 is not involved. Although a comparative structure/function analysis of potentially relevant genes to the translocation breakpoints in both t(X;15) and t(15;17) APL showed no major alterations, the enhanced expression of the c-Ki-ras oncogene observed in t(X;15) APL supports the concept of heterogeneity in APL at the cytogenetic and molecular levels.

Adolescent↗