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Biomedical subjects

T Ruutu

Publications and source records attributed to T Ruutu.

At least 73 records · Page 4Linked to original sources
PubMed1987

An outbreak of invasive aspergillosis in a haematologic unit.

Within a period of 15 months 8 cases of invasive pulmonary aspergillosis were seen in a haematologic unit; 7 of them between January and October 1984. No previous cases of invasive aspergillosis had been encountered during the existence of the unit since 1979. Environmental studies did not prove a single likely source for the fungal spores. Previous window renovation with concomitant fiber deposits on ventilation grids, poor sealing of air filter fittings in patient rooms, occasional ventilation through windows in the ward, and low speed of booster fans in the ventilation system may have created a condition favourable for the entry of Aspergillus fumigatus spores into the patient rooms. Environmental sanitation including cleaning of the ventilation ducts and change of filters in the ventilation system stopped the outbreak. Two sporadic cases have appeared during a follow-up period of 26 months.

Acute Disease↗
PubMed1987

Primary infection with HIV in a severely immunosuppressed patient with acute leukemia.

A 47-year-old female with acute myeloid leukemia received HIV positive platelets during induction chemotherapy. 18 days later, coincident with the recovery of the bone marrow function, she developed an erythematous rash, mild lymphadenopathy, and nausea which disappeared within 10 days. A week later mild CSF pleocytosis consisting of mature lymphocytes and macrophages together with elevated CSF protein levels (1,080 mg/l) were observed suggesting mild aseptic meningitis, and the HIV was concomitantly isolated from CSF. The CSF abnormalities have improved and the patient is well and in remission after 3 cycles of chemotherapy. This case expands the clinical spectrum of HIV infection to include a primary syndrome during immunosuppression from an unrelated cause.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Invasive pulmonary aspergillosis: a diagnostic and therapeutic problem. Clinical experience with eight haematologic patients.

Eight patients with haematologic malignancies contracted fatal invasive aspergillosis during an outbreak. Five patients were neutropenic. Bronchofiberoscopic examination with microbiology specimen brush and bronchoalveolar lavage yielded Aspergillus fumigatus in only 2/5 patients examined. The specific diagnosis reached during lifetime in 5 patients was based on a combination of invasive procedures (lung biopsy in 2, percutaneous lung puncture in 1), the presence of a lung abscess (3 patients), seroconversion (1 patient), and purulent maxillary sinusitis caused by A. fumigatus together with repeated abundant growth of A. fumigatus in the sputum (1 patient). Six patients received amphotericin B. The infection was temporarily controlled only in 2 bone marrow transplant recipients whose granulocyte counts recovered. In 3/8 patients the pneumonia was of polymicrobial aetiology, Mycobacterium tuberculosis (2 patients), Pneumocystis carinii (1 patient), and Legionella pneumophila (1 patient) being the other microbes involved. 3/4 bone marrow transplant recipients with aspergillosis had been transplanted for chronic myeloid leukaemia, supporting the previously reported association of bone marrow transplantation for chronic myeloid leukaemia and the risk of invasive aspergillosis. Improved diagnostic methods for earlier definitive diagnosis of invasive aspergillosis as well as more efficacious and less toxic antifungal agents are needed to allow early treatment.

Adult↗
PubMed1987

Failure to prevent cytomegalovirus infection by cytomegalovirus hyperimmune plasma: a randomized trial by the Nordic Bone Marrow Transplantation Group.

Bone marrow transplantation recipients who were cytomegalovirus (CMV) seropositive and/or had a CMV seropositive donor were randomized for treatment with CMV hyperimmune plasma (n = 27) or no treatment at all (n = 27). The CMV hyperimmune plasma had neutralization titers greater than 250 and enzyme-linked immunosorbent assay titers greater than 18,000. Plasma (200 mg/kg body weight) was given on four occasions (during 2 days) from day 3 to day 76 after transplantation. Patient characteristics were similar in the two groups. After transplantation, the median CMV titers increased with greater than 100% in the group receiving the CMV plasma and decreased to less than 50% in the controls (p less than 0.01). Asymptomatic CMV infections occurred in 26% of the patients in the plasma group and 33% of the controls. The frequency of patients with symptomatic CMV infections was also the same in the two groups (51% vs 33%). Three patients each in the two groups developed CMV-associated interstitial pneumonitis. Patient survival and causes of death were similar in the two groups. To conclude, no beneficial effect of CMV hyperimmune plasma was seen in patients at high risk of developing CMV infections.

Antibodies, Viral↗
PubMed1987

Molecular characterization of chromosome 7 long arm deletions in myeloid disorders.

Partial deletion of the long arm of chromosome 7 is a common abnormality in the bone marrow cells of patients with myelodysplastic syndrome (MDS) or acute nonlymphocytic leukemia (ANLL). This study was undertaken to characterize the chromosome breakpoints in molecular terms and to determine if hemizygosity or submicroscopic deletions occur in patients without any cytogenetically detectable abnormality of chromosome 7. We studied restriction fragment length polymorphisms with 10 chromosome 7-specific DNA probes in separated WBC fractions. No molecular abnormalities occurred in lymphocyte-derived DNA. Several probes located in band 7q22 or distally thereof detected deletion of one allele in granulocyte-derived DNA from all four patients with chromosome 7 long arm deletion. In the granulocytes of one patient heterozygosity for the T cell receptor beta chain gene (in band 7q35) indicated that the deletion was interstitial. NJ-3, a proalpha2(I)collagen gene probe (in band 7q21-22) detected heterozygosity in the granulocytes of one patient. No hemizygosity or deletions were found in four patients with two normal chromosomes 7. These results confirm that mature granulocytes but not lymphocytes are derived from the abnormal clone. Interstitial deletions exist, and the extent of deleted genomic material varies among patients.

Acute Disease↗
PubMed1986

Megakaryocyte colony formation by bone marrow progenitors in myelodysplastic syndromes.

Megakaryocytic colony formation by precursor cells from the bone marrow was investigated in 10 patients with a myelodysplastic syndrome. All but one exhibited abnormal colony formation: four showed no colony formation at all, while a decreased number of colonies was noticed in five. All of the patients showed defective colony formation by erythroid progenitors, but only four showed clearly abnormal granulocyte-macrophage colony formation. The defect in megakaryocytic progenitors seems to be more akin to the defects occurring in erythroid progenitors than to the defects seen in the granulocyte-macrophage lineage.

Aged↗
PubMed1986

Effect of splenectomy on circulating haematopoietic progenitors in myelofibrosis.

The effect of splenectomy on peripheral blood CFU-GM and BFU-E numbers was studied in a patient with myelofibrosis. The numbers of CFU-GM and BFU-E were twice as high in the splenic venous blood as in the peripheral blood. The number of CFU-GM in peripheral blood decreased to 20% and that of BFU-E to 7% of the presplenectomy level at 1 wk after the operation. The progenitor numbers recovered to reach the presplenectomy level within 4-6 w after splenectomy. This effect of splenectomy was different from that seen in 3 patients with Hodgkin's disease, in whom increased numbers of progenitors were observed after a small initial notch.

Aged↗
PubMed1984

Acquired pure red-cell aplasia: a consequence of increased natural killer cell activity?

A 19-year-old man with severe pure red-cell aplasia is described. An unusually high proportion of this patient's lymphocytes were large granular lymphocytes (LGL), both in the blood (40%) and in the bone marrow (50%). His blood leukocytes displayed a strongly elevated natural killer (NK) cell activity in vitro against the erythroblastic leukemia line K562. The patient's non-T blood lymphocytes inhibited in vitro erythroid colony formation (BFU-E and CFU-E) but not the granulocyte-monocyte colony growth (CFU-GM) from autologous and allogeneic bone marrow. Neither T-cell-mediated cytotoxicity nor circulating antibodies against erythroid precursors could be demonstrated. The patient's haemoglobin values returned to normal levels after three weeks of glucocorticoid treatment and have since then remained stable with continued prednisone administration. Attempts to reduce the prednisone dose to less than 10 mg/day have led to relapses. It is tempting to suggest that the patient's disease might be caused by hyperactivity of cytotoxic non-T (NK) cells specific for K562 cells and early erythroid precursors.

Anemia, Aplastic↗
PubMed1984

Critical chromosome rearrangement in acute promyelocytic leukemia.

We report here a patient with acute promyelocytic leukemia (APL) who has two normal chromosomes #15 but a structurally abnormal chromosome #17. This case indicates that the critical point of rearrangement in APL is not necessarily in chromosome #15 but may, alternatively, be in chromosome #17.

Bone Marrow↗
PubMed1984

Erythroid and granulocyte-macrophage colony formation in myelodysplastic syndromes.

Colony formation by haematopoietic progenitors from the bone marrow was studied in 44 patients with a myelodysplastic syndrome. Erythroid progenitors BFU-E and CFU-E were cultured in methyl cellulose, and granulocyte-macrophage precursors CFU-GM in agar. 3 of 32 patients showed normal numbers of BFU-E colonies; in all the other cases the number of these colonies was below the normal range. CFU-E colony formation was subnormal in all cases. 23 of 44 patients grew normal numbers of colonies and clusters in CFU-GM cultures. These patients had refractory anaemia with ring sideroblasts (FAB-classification) or 5q-karyotype anomaly in the marrow. Patients lacking both of these findings exhibited reduced colony formation or excessive growth of colonies and/or clusters, with few exceptions. In conclusion, we found that erythroid colony formation was defective in all cases. Normal granulocyte-macrophage colony formation was associated with refractory anaemia with ring sideroblasts or the presence of 5q- karyotype anomaly.

Adult↗
PubMed1984

Abnormalities of chromosome 13 in myelofibrosis.

19 patients with myelofibrosis, primary or following polycythaemia vera were studied cytogenetically. Bone marrow cells, unstimulated and stimulated cells from peripheral blood were investigated. 7 patients were found to have clonal aberrations, 3 of whom had a structural rearrangement of chromosome 13. In 2 additional cases single mitoses with 13q- were found. Reviewing the files on patients previously studied in our laboratory, 2 more patients with 13q- markers were noted. Both had had haematologic disorders in which fibrosis of the bone marrow can be found, but this feature could not be evaluated retrospectively, because no biopsies had been taken. Our data and those found in the literature suggest that rearrangements of 13q12----q22 are often associated with myelofibrosis, both in its primary form or following polycythaemia vera.

Aged↗
PubMed1984

Immunological monitoring of bone marrow transplant recipients. I. Major leucocyte subclasses in the blood.

In the recipients of an allogeneic HLA-identical sibling transplant the blood leucocytes were reconstituted within 3 to 4 weeks but the level of lymphocytes remained low throughout the observation period of 20 weeks. Of the different lymphoid cell subsets, the large granular lymphocytes (LGL) reconstituted fastest, followed by DR-expressing lymphocytes. The reconstitution was accompanied by a significant lymphoid blastogenesis in the blood. The frequency of OKT4 and OKT8 lymphocytes was initially low; the number of OKT8-positive lymphocytes reached normal levels by the 6-8th week whereas the number of OKT4-positive lymphocytes and, consequently, the OKT4/8 ratio remained low. The responses to the T mitogens, phytohaemmagglutinin and concanavalin A, were strongly suppressed. Only a few significant changes were observed before and during acute graft-versus-host disease (aGVHD): the frequency of LGL, lymphoid blasts and OKT8-expressing lymphocytes was depressed before aGVHD and the frequency of lymphoid blasts remained depressed throughout the episode. We conclude that reproducible changes occur in the leucocyte subset frequencies during reconstitution, but the characteristic changes prior to and during aGVHD are not particularly prominent and hardly of diagnostic use.

Adult↗
PubMed1983

Chromosome 1q+ in erythroid and granulocyte-monocyte precursors in a patient with essential thrombocythemia.

A 55-year-old man with essential thrombocythemia had multiplication of bands q21 to q32 of chromosome 1 in all studied mitoses from bone marrow, from unstimulated blood, and from erythroid and granulocyte-monocyte colonies grown in vitro. The multiplication was in the form of triplication in 16 out of 20 mitoses from the marrow and in 4 of 6 mitoses from the blood; the rest showed a duplication of this region. All 20 mitoses from erythroid and granulocyte-monocyte colonies showed the abnormality in the form of duplication. These findings indicate most probably a clonal evolution, the triplication having arisen in the clone with the duplication. This may be associated with early leukemic transformation. The detection of the 1q+ aberration in two different types of hematopoietic colonies indicates the involvement of multipotent stem cells in at least this patient with essential thrombocythemia.

Adult↗