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Biomedical subjects

R Woodruff

Publications and source records attributed to R Woodruff.

29 records · Page 2Linked to original sources
PubMed1978

Lymphoid blast crisis in chronic myeloid leukaemia and Philadelphia positive acute lymphoid leukaemia.

Membrane markers (anti-ALL and anti-Ia antisera) and an enzyme marker (terminal transferase) have been used to define an L-type or "lymphoid" type of acute transformation in chronic myeloid leukaemia and Ph1 positive acute leukaemia. Patients with L-type ("lymphoid") blasts responded to regimens including vincristine and prednisolone (VP). The markers showed better correlation with survival than did the morphology of blasts. The clinical course of patients was variable; elimination Ph1 positive clone (and hypoplasia), return to the chronic phase and relapses (including meningeal leukaemia) were observed. In contrast, patients with myeloid blasts ("M" type of blast crisis) failed to respond to vincristine and prednisolone.

Antineoplastic Agents↗
PubMed1978

The management of adult acute lymphoblastic leukaemia.

The important advances made in recent years in the therapy of adult ALL have been reviewed. The definition of bad-prognosis patients has been improved and includes those with T-ALL, ABLL, and Ph1+ALL, in addition to those presenting with evidence of extensive disease. In contrast to childhood ALL, induction chemotherapy should include another drug (or drugs) in addition to VCR and prednisolone, and one of the anthracycline drugs (ADR or DNR) has been employed most frequently in this context. Such therapy should result in a CR rate of 70 to 75%. Similar to the experience in childhood ALL, the improvement in haematological response rate has led to an apparent increase in CNS leukaemia, and the need for adequate CNS prophylaxis is stressed. Despite these improvements, the outlook for adults with ALL is not yet as good as it is for childhood ALL. Controlled studies involving large numbers of patients are urgently needed to provide answers to a number of questions. In induction therapy, the use of higher drug dosage, the use of more and other drugs, and the use of an individual patient's risk factors to determine drug dosage, must be assessed. The benefits of consolidation therapy and the optimal duration and intensity of maintenance therapy have yet to be established. Methods of CNS prophylaxis other than cranial irradiation and IT MTX must be carefully studied. These important questions require that adult patients with ALL should be concentrated in centres capable of providing optimal overall care and, at the same time, able to conduct the necessary clinical trials.

Adult↗
PubMed1978

Lymphoblastic transformation of Ph1-positive chronic myeloid leukaemia: therapeutic implications and relevance to haemopoietic stem cell theory.

A proportion of patients with blast crisis of CML have blast cells identical to those found in common non-T, non-B all, and whilst this disease is often referred to as lymphoid blast crisis (LBC), evidence is presented that it may in fact arise from a prelymphoid, pre-myeloid (pluripotential) stem cell. Recently developed membrane and enzyme markers (anti-ALL antiserum, TdT assay) have provided convenient diagnostic tests for the detection of LBC. The clinical and haematological features of LBC are reviewed: patients with LBC show a higher response rate to therapy with vincristine and prednisolone, and their survival may be significantly prolonged. The frequent occurrence of meningeal leukaemia suggests the need for prophylactic CNS therapy in LBC patients achieving remission.

Adult↗
PubMed1977

Multiple myeloma with massive Bence Jones proteinuria and preservation of renal function.

The case history of a patient having multiple myeloma with a remarkably high level of Bence Jones proteinuria (more than 20 g/day) is presented. The patient has responded well to therapy, and at no stage has he shown impairment of renal function as determined by creatinine clearance studies. A review of published reports has shown that such marked Bence Jones proteinuria at presentation is rare and is usually accompanied by renal impairment and a short survival. Additional presentation data from selected patients in the MRC First Myelomatosis Trial is presented. This suggests a higher incidence of marked Bence Jones proteinuria, and underlines the lack of correlation between the quantity excreted and the degree of renal impairment. The mechanisms by which Bence Jones protein may cause renal damage are discussed.

Bence Jones Protein↗
PubMed1977

Briquet's syndrome, hysterical personality, and the MMPI.

The authors compared the MMPI scores of 29 inpatients diagnosed by other authors as having hysterical personality and 21 outpatients diagnosed by the authors as having Briquet's syndrome. The two groups of patients differed significantly in age, on the MMPI lie scale, and on the MMPI hypochondriasis scale but not on any of the other MMPI scales. The authors discuss the implications of these findings for further defining the differences and similarities between hysterical personality and Briquet's syndrome.

Adolescent↗
PubMedDate not supplied

The effect of body weight and age on frequency of repairs in lower-limb prostheses.

INTRODUCTION: Overweight patients sometimes present a practical problem for provision of lower-limb prostheses. Most information about the effect of body weight on the endurance of prostheses is based on laboratory tests. This is a retrospective study based on an audit to study the effect of body weight and age on the frequency of repairs. SUBJECTS: One hundred and sixteen patients were involved (98 male), age 16-96 years, mean=58.7 years; weight 47-140 kg, mean=88 kg; 68 were transtibial amputees and 48 were transfemoral amputees. Causes of amputation were trauma (49), peripheral vascular disease (29), and others (38). Amputation was done 1-66 years prior to assessment, mean=13.66 years. Period of use of current prostheses was 0.5-28 years, mean=3.5 years. RESULTS: One hundred and one repairs were done in a period of 6 months. The number of repairs was found to correlate significantly with weight (P value<0.001) and inversely with age (P value=0.003). No significant correlation was found between repairs and gender, cause of amputation, or level of amputation. CONCLUSION: Body weight and age of amputee are determining factors in the frequency of repairs of lower-limb prostheses. However, a larger study for a longer period will be needed to confirm our finding.

Adolescent↗
PubMedDate not supplied

Treatment of acute nonlymphocytic leukemia with neocarzinostatin.

Neocarzinostatin (NCS) is a polypeptide antibiotic which has been shown to have antileukemic activity in Japanese trials. Twenty-two patients, who were in relapse with acute nonlymphocytic leukemia refractory to other agents, were studied with two dose schedules of NCS. Schedule 1, 2000-8000 units/m2/day by continuous infusion for 5-10 days, was given to 12 patients and schedule 2, 2000-6000 units/m2/day by iv bolus every 8 hours, was given to ten patients. Clearing of peripheral blast cell was seen in nine of 12 patients treated with schedule 1 and in four of ten patients treated with schedule 2. Bone marrow effect was variable and appeared to be dose-related. No unequivocal complete remissions were seen with either schedule. NCS perturbations of cycling bone marrow cells were studied in two patients receiving the drug by continuous infusion. Both of these patients showed G2 accumulation of marrow cells following treatment. Immunochemically detectable levels of drug were seen in three patients treated with continuous infusion. In summary, NCS has antileukemic effect in patients with acute nonlymphocytic leukemia refractory to other agents. However, its role in the therapy for acute leukemia required further evaluation.

Acute Disease↗