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Biomedical subjects

R L Prentice

Publications and source records attributed to R L Prentice.

At least 55 records · Page 3Linked to original sources
PubMed1989

Cell death by apoptosis in acute leukaemia.

We have previously demonstrated that when freshly isolated childhood T-cell acute lymphoblastic leukaemia cells are incubated in growth medium after isolation from blood, chromatin is rapidly cleaved into nucleosomal sized fragments that are multiples of 200 bp. The fragmentation is similar to that observed in other types of cells undergoing apoptosis or programmed cell death. In this study we describe a more comprehensive approach to the study of DNA fragmentation in leukaemia. Fragmentation was observed in freshly isolated cells from patients with T-cell acute lymphoblastic leukaemia and in one with common acute lymphoblastic leukaemia. Frozen samples of T-cell acute lymphoblastic leukaemia, common acute lymphoblastic leukaemia, and acute myeloid leukaemia cells also showed fragmentation of DNA. However, no fragmentation was evident in normal leukocytes treated under the same conditions. Ultrastructural studies on the isolated leukaemia cells demonstrate that the chromatin cleavage observed biochemically is associated with morphological changes characteristic of apoptosis.

Cell Survival↗
PubMed1989

Surrogate endpoints in clinical trials: definition and operational criteria.

I discuss the idea of using surrogate endpoints in the context of clinical trials to compare two or more treatments or interventions in respect to some 'true' endpoint, typically a disease occurrence. In order that treatment comparison based on a surrogate response variable have a meaningful implication for the corresponding true endpoint treatment comparison, a rather restrictive criterion is proposed for use of the adjective 'surrogate'. Specifically, I propose that a surrogate for a true endpoint yield a valid test of the null hypothesis of no association between treatment and the true response. This criterion essentially requires the surrogate variable to 'capture' any relationship between the treatment and the true endpoint, a notion that can be operationalized by requiring the true endpoint rate at any follow-up time to be independent of treatment, given the preceding history of the surrogate variable. I then discuss this operational criterion in the examples of the accompanying papers and in the setting of trials aimed at the primary and secondary prevention of cancer.

Breast Neoplasms↗
PubMed1989

Further results on covariate measurement errors in cohort studies with time to response data.

The impact of covariate measurement errors on the estimation of relative risk regression parameters is discussed. First the dependence of the induced relative risk process on the cumulative baseline failure rate function is noted. Next induced relative risk models under some specific failure time and measurement error models are described, including the much simplified models that are appropriate under a 'rare disease' assumption. The presentation then turns to the joint estimation of relative risk parameters of primary interest along with measurement error parameters. A partial likelihood product is proposed for such estimation and asymptotic properties are indicated. Guidance is also presented as to the appropriate size of a 'validation' sample relative to the full cohort size. Finally some more general considerations are presented as to the usefulness and interpretation of deattenuated regression coefficients.

Analysis of Variance↗
PubMed1989

Validity of international, time trend, and migrant studies of dietary factors and disease risk.

A linear form relative risk model is used to identify circumstances in which various types of aggregate data lead to valid inferences on relative risk parameters. Upon making a random effects assumption, international or time trend data can lead to appropriate relative risk parameter estimation using iteratively reweighted least-squares procedures. Adequate confounding factor control, however, will typically require data on the distribution of confounding factors in each country or time period. For a simple interpretation of relative risk parameters one may also require data on the joint distribution of primary and confounding factors in each country or time period. Hence disease rate data need to be supplemented by dietary and risk factor survey data in order to avoid confounding bias. Measurement error in individual dietary assessment may, however, limit the ability to quantify the dependence of relative risk on dietary factors, unless the relative risk function is approximately linear in the dietary factors of interest. Most studies of migrant populations involve a comparison of migrant mortality rates with those of their countries of emigration and immigration, with little or no data collection on the dietary habits and risk factors of the migrants themselves. The potential of more comprehensive aggregate data and analytic migrant studies in the diet and disease area is briefly indicated. These issues and methods are illustrated using various types of data pertinent to the association between dietary fat and breast cancer.

Breast Neoplasms↗
PubMed1989

Spontaneous programmed death (apoptosis) of B-chronic lymphocytic leukaemia cells following their culture in vitro.

When B-chronic lymphocytic leukaemia (B-CLL) cells derived from peripheral blood were cultured in vitro, a substantial proportion of them spontaneously died by apoptosis. This type of cell death is morphologically and biochemically distinct from necrosis and has previously been found to occur under physiologic and certain pathologic conditions where cell deletion appears controlled and biologically meaningful. By 30 h of culture, approximately 20% of the unfractionated B-CLL cells were affected. There was no significant difference in the incidence of apoptosis in T-cell depleted and undepleted cultures or when either autologous or normal human serum was used. Furthermore, seeding densities of 2 x 10(6) and 5 x 10(5) cells/ml resulted in a similar incidence of apoptosis, indicating that cell density was unlikely to be a contributing factor in producing the death. The finding that B-CLL cells spontaneously die in vitro has at least two important implications. Firstly, previous work relating to some of the functions of B-CLL cells and their interactions with T cells may require re-evaluation. Secondly, an understanding of the mechanisms involved in the induction of apoptosis in this disease may have therapeutic consequences.

Blood Cell Count↗
PubMed1989

Designs for synthetic case-control studies in open cohorts.

Several designs are proposed for case-control studies within cohorts when the cohort is open to late entry. These and previously proposed designs are examined with respect to consistency and efficiency of relative risk parameter estimation, and a small simulation study is reported. If study costs increase in proportion to the total number of "at-risk" controls, the most efficient design, Design C, is as follows. For a case failing at time t, controls are selected at random (and without regard to "at-risk" status) from among cohort members who are (i) known not to have failed prior to t and (ii) have not been previously selected as controls. At each t, control sampling proceeds until a prespecified number of controls who are "at risk" at t have been obtained. The efficiency advantage of Design C over that of the standard case-control design proposed by Thomas (in Appendix to Liddell, McDonald, and Thomas, 1977, Journal of the Royal Statistical Society, Series B 140, 469-490) will often be small. If, on the other hand, the costs increase in proportion to the number of distinct "at-risk" controls, Design C is no longer the most efficient design. In this case, several alternative designs are proposed.

Biometry↗
PubMed1989

Comparison of three-day butoconazole treatment with seven-day miconazole treatment for vulvovaginal candidiasis.

In this multicenter, parallel, randomized, investigator-blind trial, we compared the safety and efficacy of a three-day regimen of 2% butoconazole vaginal cream with those of a seven-day regimen of 2% miconazole vaginal cream. Enrolled were 271 nonpregnant women with vulvovaginal candidiasis. Each patient administered her assigned study medication to the posterior vaginal fornix for three or seven consecutive nights. All 271 patients were included in the safety evaluation, and 225 (111 receiving butoconazole and 114 receiving miconazole) were included in the efficacy evaluation. Eight to ten days after treatment completion, 88% of the butoconazole-treated patients and 91% of the miconazole-treated patients were Candida negative; 80% of the butoconazole-treated patients and 82% of the miconazole-treated patients were considered clinically cured. Thirty days after treatment completion, 73% of the butoconazole-treated patients and 69% of the miconazole-treated patients remained Candida negative; 78% of the butoconazole-treated patients and 80% of the miconazole-treated patients remained free of clinical symptoms of vulvovaginitis. None of the differences between the two treatment groups was statistically significant. Six patients (four receiving butoconazole and two receiving miconazole) reported increased symptoms of vulvovaginal irritation, and three of them (two receiving butoconazole and one receiving miconazole) withdrew from the trial. Thus, the efficacy and safety of the three-day butoconazole treatment regimen were equivalent to those of the seven-day miconazole treatment regimen. The advantage of the shorter butoconazole treatment is increased patient compliance with maintenance of high efficacy.

Administration, Intravaginal↗
PubMed1988

Aspects of the rationale for the Women's Health Trial.

A 5.5-fold range in breast cancer incidence rates in 21 countries shows strong correlation with national estimates of per capita intake of dietary fat, but not with other caloric sources (proteins and carbohydrates). It is argued that certain breast cancer and hormone factors may contribute little to the explanation of such international variations in incidence of this neoplasm. It is further argued that experimental studies in animals support a specific role for dietary fat in the promotion of mammary tumors, but the effects of calories alone seem to be largely restricted to tumor initiation. Finally, data from international, migrant-population, and analytic epidemiologic investigations are used to motivate the basic relative risk assumption of study designs thus far proposed for the Women's Health Trial, and some continuing motivations for a dietary intervention (low-fat diet) trial are discussed.

Aged↗
PubMed1988

Correlated binary regression with covariates specific to each binary observation.

Regression methods are considered for the analysis of correlated binary data when each binary observation may have its own covariates. It is argued that binary response models that condition on some or all binary responses in a given "block" are useful for studying certain types of dependencies, but not for the estimation of marginal response probabilities or pairwise correlations. Fully parametric approaches to these latter problems appear to be unduly complicated except in such special cases as the analysis of paired binary data. Hence, a generalized estimating equation approach is advocated for inference on response probabilities and correlations. Illustrations involving both small and large block sizes are provided.

Adolescent↗
PubMed1987

DNA fragmentation in childhood T-cell acute lymphoblastic leukaemia.

DNA isolated from 12 patients with childhood acute lymphoblastic leukaemia (T-ALL), analysed by gel electrophoresis exhibited a degradation pattern of increasing nucleosome repeat size, similar to that observed when nuclei from normal control cells are incubated with micrococcal nuclease. None of a group of adult T-ALL showed this fragmentation, nor was the pattern observed in normal control T-cells, cells from patients with a number of other forms of leukaemia, or in B-lymphoblastoid cells under the same incubation conditions. This phenomenon appears to be related to the changes in DNA that occur in glucocorticoid-induced cell death in mouse thymocytes, radiation-damaged spleen cells, and in cytotoxic T-cells deprived of interleukin 2. The method described here promises to be a reliable, simple approach to the characterization of T-ALL in childhood and may aid in the clinical management of this form of leukaemia.

Adolescent↗
PubMed1986

Potentiation of hybridoma production by the use of mouse fibroblast conditioned media.

L-CM is a conditioned medium prepared from cultures of L-929 cells, a murine fibroblast line. It will promote the growth and antibody secretion of B cell hybridomas after fusion as well as facilitating cloning at limit dilution and the growth of cloned B cell lines in bulk culture. The medium is easy to prepare and stores well at 4 degrees C. It thus provides a convenient alternative to the use of feeder cells in the production of monoclonal antibodies.

Animals↗
PubMed1986

Biostatistical issues and concepts in epidemiologic research.

This paper describes recent developments in failure time regression, and the application of such methods to epidemiologic data. Relative risk and odds ratio estimation procedures are described under cohort and case-control sampling, and under some less standard designs for sampling within a cohort. Some special issues that arise in the analysis of vital data are also mentioned. While methods for descriptive analyses are emphasized some attention is also given to mechanistic models for carcinogenesis and their uses. Topics meriting further methodologic development are delineated throughout.

Epidemiology↗
PubMed1986

Rearrangements of T-cell receptor beta-chain genes in human leukaemias.

Rearrangements of the T-cell receptor (TCR), beta-chain genes and immunoglobulin (Ig) heavy chain genes in several T-cell leukaemias (T-ALL and ATL), and some B-cell and myelogenous leukaemias were investigated. Two out of 15 cases of T-cell leukaemia tested failed to show a rearrangement pattern of TCR beta genes although both expressed mRNA for this gene. The remaining 13 cases showed diverse patterns of rearrangements involving either C beta 1, C beta 2 or both. C beta 1 but not C beta 2 was deleted in some of the T-cell leukaemias. Polyclonal T cells from four normal individuals showed the germ line pattern and an additional two bands in Hind III digested DNA. Except for one, all cases of C-ALL (B-cell leukaemia) showed a rearranged JH locus which was not evident in any of T-cell leukaemias studied. One case of B-cell leukaemia showed a rearrangement of both TCR beta genes and JH genes. The results of these studies suggest that rearrangement of TCR and Ig genes occurs at a very early stage of differentiation of stem cells and does not appear to play a direct role in leukaemogenesis per se.

Antigens, Neoplasm↗
PubMed1986

On the application of linear relative risk regression models.

Motivations for considering linear relative risk models are described. These include covariate data reduction and the testing of additivity of covariate effects on the relative risk. A simulation study was conducted in order to study properties of asymptotic distributional approximations and iterative convergence properties. Parameter transformations and likelihood ratio approximations are considered for confidence interval calculation.

Analysis of Variance↗