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Biomedical subjects

R Hoffman

Publications and source records attributed to R Hoffman.

At least 307 records · Page 17Linked to original sources
PubMed1987

Effect of perturbation of specific folate receptors during in vitro erythropoiesis.

Although antisera to specific placental folate receptors inhibits the uptake of 5-methyltetrahydrofolate into cultured malignant human cells, little is known of the functional significance of folate receptors in normal human cells. Human bone marrow cells were therefore assayed for erythropoietic burst-forming units in the presence of an antihuman placental folate receptor serum and preimmune serum to determine the role of such a receptor in erythroid differentiation. When marrow cells were assayed in the presence of anti-receptor antiserum, there was (i) a threefold increase in erythropoietic burst formation and a twofold increase in the number of cells per erythroid burst; (ii) morphological evidence for nuclear/cytoplasmic dissociation of orthochromatic normoblasts composing erythroid bursts (megaloblastic erythropoiesis); (iii) intracellular folate deficiency with a 70% reduction of intracellular folate in antiserum treated cells as compared with control cells; and (iv) complete reversal of antiserum-induced changes on preincubation of antiserum with purified human placental folate receptor. These data support the conclusion that folate receptors on marrow cells provide an important function in the cellular uptake of folates during in vitro erythropoiesis. This process of folate uptake also appears to play a pivotal role in the differentiation and proliferation of erythroid progenitor cells.

Bone Marrow Cells↗
PubMed1987

Management of the myelodysplastic syndromes.

It is important to make the correct diagnosis of MDS and to exclude very carefully all other disorders that may induce dysplastic features in the bone marrow. In patients without excess of bone marrow blasts, cytogenetics and in vitro bone marrow cultures may aid in making the correct diagnosis. MDS patients without excess of bone marrow blasts or symptomatic cytopenia or cytogenetic abnormalities associated with poor prognosis should be followed on a regular basis with sequential examinations of blood counts and bone marrow specimens. In the absence of obvious disease progression, ie, increasing cytopenia or increasing percentage of marrow blasts, patients should only receive supportive care. An increase in RBC requirements alone is insufficient reason to start cytotoxic therapy. Once progression of the disease has been well documented, cytotoxic treatment is indicated. There is no reason to delay treatment until these patients have progressed to overt AML. In patients over the age of 50, the best available therapy is low-dose cytarabine with a 30% probability of a good response; this therapy requires careful supervision and the availability of intensive supportive care. In patients under 50 years with progressive disease, or with clear evidence of a poor prognosis, allogeneic BMT is the therapy of choice if a HLA-identical sibling can be identified. In those patients who lack a HLA-identical sibling, intensive combination therapy is the treatment of choice and should preferably include high-dose cytarabine. Intensive consolidation therapy will be necessary for a durable remission. Trials with inducers of differentiation remain experimental. Results to date have been disappointing.

Bone Marrow Transplantation↗
PubMed1987

A trial of recombinant alpha 2 interferon in the myelodysplastic syndromes: I. Clinical results.

Interferon has been reported to have differentiation promoting effects in certain model systems. Because of this and other potentially beneficial effects, a trial of recombinant alpha 2 interferon was undertaken in myelodysplastic syndromes. The study population consisted of 14 patients, subclassified as two refractory anemia (RA), one RA with ring sideroblasts (RARS), nine RA with excess blasts (RAEB), and two chronic myelomonocytic leukemia (CMMoL). The planned dosage schedule was 2.0 MU/M2 t.i.w. sc x 2 weeks q 4 weeks for at least two cycles. No patient achieved the prospective remission criteria, which included sustained blood count improvements. Transient improvements of platelet counts of greater than 50% in baseline were noted in six patients, and a transient antileukemic effect was noted in one patient with CMMoL. Myelodysplastic syndrome patients were found to be sensitive to the count suppressing effects of alpha 2 interferon with greater than 25% suppression of granulocytes, platelets, or reticulocytes transiently noted in 11 patients and decreasing bone marrow cellularity noted in two while on treatment. Because of these effects, dosage adjustments were frequently instituted in the RA, RARS, and RAEB patients. The average dosages and durations of treatment received were thus 1.48 MU/M2 x 19.4 injections for patients with RA, RARS, and RAEB and 2.25 MU/M2 x 27 injections for the CMMoL patients. Progression to acute myeloid leukemia or RAEB in transformation was noted in five patients, and increasing leukocytosis was noted in one CMMoL patient while on protocol. It cannot be determined at this time whether these transformations were accelerated by alpha 2 interferon or represent selection bias in this study population. Although some evidence of beneficial effects was noted, alpha 2 interferon in this dosage and schedule is not a useful treatment for myelodysplastic syndromes.

Bone Marrow↗
PubMed1987

Lymphokine-activated killer (LAK) cells can be focused at sites of tumor growth by products of macrophage activation.

Successful adoptive cancer immunotherapy presumably depends on the accumulation of tumoricidal leukocytes at the sites of tumor growth. Large numbers of lymphokine-activated killer (LAK) cells can be generated in vitro by growth in high concentrations of interleukin-2 (IL-2), but relatively few arrive at the tumor site after intravenous injection. We hypothesize that the delivery of LAK cells to tumor sites may be augmented by previously demonstrated lymphocyte-recruiting factors, including activated macrophage products such as interleukin-1 (IL-1) and tumor necrosis factor. 111Indium-labeled LAK cells were injected intravenously into syngeneic mice bearing the macrophage activator endotoxin (LPS) in one hind footpad, and saline solution was injected into the contralateral footpad. Significantly more activity was recovered from the LPS-bearing footpad at all times during a 96-hour period. Recombinant IL-1 also attracted more LAK cells after injection into tumor-free hind footpads. Furthermore, LAK cells preferentially homed to hind footpads that were bearing 3-day established sarcomas after intralesional injections of LPS, IL-1, or tumor necrosis factor when compared with contralateral tumor-bearing footpads injected with saline solution alone. In preliminary experiments, mice with hind-footpad tumors appeared to survive longer after combined systemic IL-2 and LAK therapy if intralesional LPS was administered. These studies demonstrate that macrophage activation factors that have been shown capable of attracting circulating normal lymphocytes can also effectively attract LAK cells from the circulation. By the stimulation of macrophages at the sites of tumor growth, more LAK cells can be attracted. It is hoped that by "focusing" the migration of LAK cells to tumors, LAK cells and IL-2 would effect tumor regression more efficiently and with less toxicity.

Animals↗
PubMed1987

New insights into the regulation of human megakaryocytopoiesis.

It is apparent that multiple cellular stages and biologic processes can be identified during megakaryocytopoiesis that are potentially subject to control by hematopoietic growth factors and marrow accessory cell populations. Two classes of megakaryocyte progenitor cells, the colony forming unit-megakaryocyte (CFU-MK) and the burst forming unit-megakaryocyte (BFU-MK), have now been detected in normal human bone marrow cells. The BFU-MK by virtue of the greater cellular content of its resultant colonies and the delayed time of appearance of these colonies appears to be a more primitive progenitor cell with a greater proliferative potential than the CFU-MK. A number of hematopoietic growth factors including megakaryocyte colony stimulating factor, (MK-CSF), recombinant erythropoietin (EPO) and granulocyte macrophage colony stimulating factor (GM-CSF) are each capable of increasing cloning efficiency of human megakaryocyte progenitor cells. It is presently unknown whether these factors act directly on the CFU-MK or whether they stimulate marrow accessory cells to elaborate growth factors that influence CFU-MK proliferation. In order to answer this question, the effect of these growth factors on the cloning efficiency of a human megakaryocytic cell line, EST-IU, was examined. Each of these factors was capable of increasing leukemia cell colony formation. One can conclude from these studies that MK-CSF, EPO, and GM-CSF act directly on cells of the megakaryocytic lineage. The physiologic significance of the lineage nonspecific effects of EPO and GM-CSF on megakaryocytopoiesis is yet to be determined. On the basis of these observations, a model of human megakaryocytopoiesis was suggested. Several factors appear able to influence multiple steps in megakaryocytic development, whereas others influence only specific stages or cellular events occurring during megakaryocytopoiesis.

Anemia, Aplastic↗
PubMed1987

Phase II trial of aminothiadiazole in previously treated and untreated patients with advanced colorectal carcinoma: an Illinois Cancer Council Trial.

Eighty-three patients with advanced colorectal carcinoma were entered on a phase II trial of weekly iv aminothiadiazole (125 mg/m2) plus daily oral allopurinol (300 mg). There were five partial responses. Median survival of all patients on study was 36 weeks from entry (48 weeks for those without prior therapy and 34 weeks for those with previous chemotherapy). Toxicity was generally mild and consisted predominantly of stomatitis. In the dose given, aminothiadiazole has limited activity against metastatic colorectal cancer.

Clinical Trials as Topic↗
PubMed1987

Effects of megakaryocyte colony-stimulating factor on terminal cytoplasmic maturation of human megakaryocytes.

Suspensions of enriched human megakaryocytes (MK) devoid of MK progenitors (CFU-MK) undergo complete cytoplasmic maturation in vitro. MK were cultured in the presence of normal human AB serum (NABS) to mimic "normal" development. The rate of maturation was not statistically altered by higher concentrations (10%-20%-30%) of NABS, or by the addition of bovine serum albumin (1.5%-3.0%), but was accelerated in the presence of aplastic anemia serum (AAS). Sera from eight different patients with severe aplastic anemia were effective in accelerating terminal differentiation. MK-CSF, a glycoprotein isolated from AAS, specifically augments MK colony formation by two- to sixfold. Similar doses of MK-CSF were ineffective in altering terminal cytoplasmic maturation. Anti-MK-CSF, a polyclonal antibody prepared against purified MK-CSF, neutralizes the ability of both purified MK-CSF and AAS to promote MK colony formation. However, AAS adsorbed with anti-MK-CSF still retained its ability to accelerate terminal differentiation. Apparently, AAS contains at least two separate humoral factors, which can regulate in vitro human megakaryocytopoiesis: MK-CSF, which stimulates proliferation of the progenitors (CFU-MK), and a maturation factor, which accelerates cytoplasmic maturation of morphologically recognizable megakaryocytes.

Anemia, Aplastic↗
PubMed1987

In vivo macrophage-directed lymphocyte traffic requires macrophage activation.

Lymphocytes are attracted to activated macrophages in tissue. In the absence of exogenous activators, only syngeneic macrophages can become sufficiently activated, to produce lymphocyte attractants. Allogeneic macrophages require exogenous activation to accomplish lymphocyte recruitment. It is likely that graft rejection is initiated by a nonspecific inflammatory reaction within the graft. Once host macrophages have entered the graft they may be activated by the inflammatory process to produce lymphocyte attractants. As lymphocytes are called to the graft, those recognizing donor determinants may expand to effect graft loss.

Animals↗
PubMed1986

The influence of T lymphocyte subsets and humoral factors on colony formation by human bone marrow and blood megakaryocyte progenitor cells in vitro.

Cellular and humoral influences of T lymphocytes on human megakaryocyte colony formation in vitro were assessed by using a microagar system. Megakaryocyte colony formation from nonadherent low density T lymphocyte-depleted (NALDT-) bone marrow cells was increased significantly after the addition of aplastic anemia serum (AAS) or purified megakaryocyte colony-stimulating factor (Meg-CSF). The addition of conditioned medium obtained from phytohemagglutinin-stimulated T lymphocytes replaced, at least partially, the requirement for AAS or purified Meg-CSF for the growth of megakaryocyte colonies. The cellular influence of T lymphocytes and T lymphocyte subsets on megakaryocyte colony formation was assessed by removing either T cells from nonadherent peripheral blood mononuclear cells with monoclonal OKT4, OKT8, or OKT3 antibodies plus complement, or by adding back populations of bone marrow or blood T4+ or T8+ lymphocytes, isolated by means of fluorescence-activated cell sorting, respectively, to NALDT--bone marrow or -blood cells. When sorted T cell subpopulations were added to a fixed number of NALDT--bone marrow or -peripheral blood cells in the presence of AAS or Meg-CSF, T4+ cells enhanced megakaryocyte colony formation and T8+ cells decreased it. These studies demonstrate that although the stimulation of megakaryocytic progenitor cells by Meg-CSF may not require the presence of monocytes or T lymphocytes, T4+ lymphocytes enhance and T8+ lymphocytes down-regulate megakaryocyte colony formation induced by Meg-CSF. These observations suggest that the immune system is capable of modulating the proliferative response of human megakaryocytic progenitor cells to Meg-CSF.

Antibody Formation↗
PubMed1986

Selective sensitivity to tiazofurin of human leukemic cells.

This study reports the selective sensitivity to tiazofurin (2-beta-D-ribofuranosylthiazole-4-carboxamide, NSC-286193) of human leukemic leukocytes as compared to normal ones in bone marrow and peripheral blood samples by comparing the production of the active metabolite, thiazole-4-carboxamide adenine dinucleotide (TAD), from labeled tiazofurin and the depression of GTP concentration. When labeled tiazofurin was incubated with leukocytes obtained from healthy volunteers or from leukemic patients (acute non-lymphocytic leukemia or acute lymphoblastic leukemia), the TAD production was 27.0 +/- 8.3, 551.3 +/- 71.8 and 755.9 +/- 94.1 pmoles/10(9) cells per hr, respectively. Thus, the leukemic cells produced over 20-fold higher concentrations of TAD than the normal leukocytes. Incubation with tiazofurin in leukemic leukocytes decreased the GTP pools (to 48-79%), whereas there was no change in the normal leukocytes. These results indicate a selectivity of response to tiazofurin in human normal and leukemic leukocytes. The procedure reported in this work may be suitable as a rapid predictive test for the sensitivity of leukemic leukocytes to tiazofurin. Such a diagnostic test should be helpful in identifying neoplastic cells sensitive to tiazofurin in the Phase II trials now being developed.

Adenine Nucleotides↗
PubMed1986

The suppressive influences of human tumor necrosis factors on bone marrow hematopoietic progenitor cells from normal donors and patients with leukemia: synergism of tumor necrosis factor and interferon-gamma.

The influences of human tumor necrosis factor (TNF) (LuKII), recombinant human TNF-alpha, natural human interferon-gamma (HuIFN-gamma), recombinant HuIFN-gamma, and natural HuIFN-alpha were evaluated alone or in combination for their effects in vitro on colony formation by human bone marrow granulocyte-macrophage (CFU-GM), erythroid (BFU-E), and multipotential (CFU-GEMM) progenitor cells incubated at 5% CO2 in lowered (5%) O2 tension. TNF (LuKII) and recombinant TNF-alpha caused a similar dose-dependent inhibition of colony formation from CFU-GM, BFU-E, and CFU-GEMM. Day 7 CFU-GM colonies were more sensitive than both day 14 CFU-GM colonies and day 7 CFU-GM clusters to inhibition by TNF. BFU-E colonies and CFU-GEMM colonies were least sensitive to inhibition with TNF. The suppressive effects of TNF (LuKII) and recombinant TNF-alpha were inactivated respectively with hetero-anti-human TNF (LuKII) and monoclonal anti-recombinant human TNF-alpha. The hetero-anti-TNF (LuKII) did not inactivate the suppressive effects of TNF-alpha and the monoclonal anti-recombinant TNF-alpha did not inactivate TNF (LuKII). The suppressive effects of TNF did not appear to be mediated via endogenous T lymphocytes and/or monocytes in the bone marrow preparation, and a pulse exposure of marrow cells with TNF for 60 min resulted in maximal or near maximal inhibition when compared with cells left with TNF for the full culture incubation period. A degree of species specificity was noted in that human TNF were more active against human marrow CFU-GM colonies than against mouse marrow CFU-GM colonies. Samples of bone marrow from patients with non-remission myeloid leukemia were set up in the CFU-GM assay and formed the characteristic abnormal growth pattern of large numbers of small sized clusters. These cluster-forming cells were more sensitive to inhibition by TNF than were the CFU-GM colonies and clusters grown from the bone marrow of normal donors. The sensitivity to TNF of colony formation by CFU-GM of patients with acute myelogenous leukemia in partial or complete remission was comparable with that of normal donors. When combinations of TNF and HuIFN were evaluated together, it was noted that TNF (LuKII) or recombinant TNF synergized with natural or recombinant HuIFN-gamma, but not with HuIFN-alpha, to suppress colony formation of CFU-GM, BFU-E, and CFU-GEMM from bone marrow of normal donors at concentrations that had no suppressive effects when molecules were used alone.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1986

Transitory hypomegakaryocytic thrombocytopenia: aetiological association with ethanol abuse and implications regarding regulation of human megakaryocytopoiesis.

We studied a patient with a long history of ethanol abuse who presented to the hospital with profound weakness, anaemia and thrombocytopenia. Evaluation of these problems revealed the patient's bone marrow to be hypercellular but severely iron depleted and almost totally devoid of morphologically recognizable megakaryocytes. However, we were able to detect the presence of non-morphologically recognizable, immature megakaryocytes in the same sample using an immunochemical detection technique. This circumstance allowed us to study the relative importance of both megakaryocyte maturation and peripheral blood platelet count on the production of megakaryocyte colony stimulating activity (Meg-CSA), a putative regulator of the megakaryocyte colony forming unit (CFU-M). The results of our investigations disclosed a rapid decline in serum Meg-CSA levels which preceded recovery of the platelet count and appeared to coincide with the maturation of megakaryocytes into the morphologically recognizable pool. The effect of ETOH on the patient's CFU-M cloning efficiency was also studied. ETOH in amounts up to 454 mg/dl did not inhibit cloning of the patient's peripheral blood CFU-M in plasma clot cultures. Our results suggest that regulation of Meg-CSA production is a complex function which appears to be dependent on a number of factors including the level of megakaryocyte maturation in the marrow. We also speculate that ethanol associated thrombocytopenia may occasionally be brought about by a disruption in the process of megakaryocyte maturation at the level of a progenitor more mature than the CFU-M.

Aged↗
PubMed1986

Extended leukocyte parameters for hematology analyzers.

Newly introduced, extended leukocyte parameters on laser-based hematology analyzers permit normal samples to be readily identified allowing these samples to be excluded from manual analysis. This enables more hematology laboratory resources to be focused on abnormal specimens. A new reagent that lyses erythrocytes while leaving the optical properties of the leukocytes unaltered is used. A special optical bench measures both narrow-angle forward light scatter (an indicator of cell size) and wide-angle light scatter (an indicator of cell granularity). The two scatter measurements are combined to produce a histogram in which lymphocytes, monocytes, and granulocytes are clearly delineated. A microprocessor detects the separation between histogram peaks, sets the proper thresholds, produces the three-part count, and indicates abnormal samples on the basis of histogram peak position, shape, and resolution. In a clinical study correlations between instrument counts and manual leukocyte differentials were very good. The potential for reducing the number of manual differentials of normal samples is significant.

Autoanalysis↗
PubMed1986

Studies of human megakaryocytopoiesis using an anti-megakaryocyte colony-stimulating factor antiserum.

We produced an antiserum by immunizing rabbits with purified human megakaryocyte colony stimulating factor (Meg-CSF). With the use of an anti-Meg-CSF IgG fraction (AM-IgG), we detected immunoreactive Meg-CSF both in human aplastic anemia serum (AAS) and normal serum. Based on our immunological and biological analyses, Meg-CSF appeared to be antigenically as well as functionally distinct from human urinary erythropoietin (EPO) and thrombopoietic stimulating factor. The AM-IgG fraction was able to suppress the ability of both aplastic anemia serum and purified Meg-CSF to promote megakaryocyte colony formation. In addition, the supernatant formed after immune precipitation of the AAS with AM-IgG no longer possessed Meg-CSF-like activity. The AM-IgG did not suppress the ability of EPO, phytohemagglutinin-stimulated leukocyte conditioned medium (PHA-LCM), or PHA-LCM + EPO to promote erythroid, granulocyte-macrophage, or mixed colony formation, respectively. The use of this antibody has further defined the dependency of human megakaryocytopoiesis on Meg-CSF.

Anemia, Aplastic↗
PubMed1986

Establishment in long term culture of megakaryocytic leukemia cells (EST-IU) from the marrow of a patient with leukemia and a mediastinal germ cell neoplasm.

Megakaryocytes are the bone marrow cells that generate platelets. They are relatively rare cells, comprising between 0.03 and 0.06% of all nucleated marrow cells (R. L. Berkow et al., J. Lab. Clin. Med., 103: 811-818, 1984). The study of human megakaryocyte differentiation and function has been hampered by the small number of these cells available for study. Recently we have established a human cell line (EST-IU) from the marrow of a patient with an acute nonlymphocytic leukemia and a mediastinal germ cell tumor. While this cell line seems to express many of the phenotypic characteristics of human megakaryocytes, it does not appear to express any phenotypic properties associated with cells of the erythroid, lymphoid, granulocytic, or monocytic lineages. Transmission electron microscopy demonstrates frequent multinucleated cells. Staining for platelet peroxidase reactivity revealed darkening of the perinuclear envelope and the endoplasmic reticulum, a characteristic of cells of the megakaryocytic lineage. Indirect immunofluorescence assays reveal that EST-IU expresses reactivity with anti-platelet glycoprotein antisera, anti-Factor VIII-related antigen antisera, anti-Factor V antisera, anti-thrombocyte antisera, Tab (monoclonal anti-platelet glycoprotein IIb-IIIa), and anti-fibronectin antisera. Flow cytometry-derived DNA histograms demonstrate populations with multiple ploidies, ranging from approximately 4N to 32N. Based upon morphological and histochemical characteristics, antigenic expression, and nuclear characteristics, EST-IU cells appear to have a phenotype that closely resembles human megakaryocytes. This cell line should be useful in the further cell study of the molecular and cell biology of human megakaryocytopoiesis.

Acute Disease↗