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Biomedical subjects

T Sheehan

Publications and source records attributed to T Sheehan.

36 records · Page 2Linked to original sources

The incidence of monoclonal gammopathy in a population over 45 years old determined by isoelectric focusing.

Immuno-isoelectric focusing (IIEF), a technique previously shown to be sensitive for the detection of paraproteinaemia, was used to test 200 individuals over the age of 45, without history of B cell neoplasm, for the presence of serum paraproteinaemia. 11% of these individuals had evidence of paraproteinaemia detectable by IIEF compared with only 2% by zonal and immunoelectrophoresis. A further 12% had oligoclonal immunoglobulins and the remainder had no qualitative abnormality of the immunoglobulin profile. These results are discussed with particular reference to the aetiology, diagnosis and monitoring of potential B cell neoplasm in high risk individuals or groups.

Aged↗

Improvement of post platelet transfusion increments following intravenous immunoglobulin therapy for leukaemic HLA-immunized patients.

3 patients with acute leukaemia, HLA antibodies and thrombocytopenia refractory to random donor platelet transfusions were treated with high-dose i.v. immunoglobulin. All 3 patients responded favourably with improved post-transfusion recovery of random platelets. In 1 patient, the recovery of transfused histocompatible platelets was also enhanced. Treatment was followed by reduction in the total lymphocyte count and marked changes in lymphocyte subsets in 1 patient.

Adult↗

The efficacy and toxicity of VAD in the treatment of myeloma and related disorders.

Impressive results have recently been reported in 29 cases of advanced refractory myeloma treated with 4-d infusions of Vincristine and Adriamycin (VAD). We report our own experience with this protocol in 13 cases of myeloma and related lymphoproliferative disorders. In 2 of these cases, VAD was used as first line treatment. Objective responses were seen in two-thirds of cases and the major complication of therapy was infection, predominantly bacterial in nature.

Antineoplastic Combined Chemotherapy Protocols↗

Patient education survey.

The aim of the survey was to collect information on patient education at the Wollongong Hospital. Two hundred and one randomly selected former patients were interviewed by telephone or in their homes. The results suggest that communication between the Wollongong Hospital staff and their patients was effective with over three-quarters of the patients interviewed reporting a full understanding of their diagnosis, medication, health problems and prognosis. Nevertheless, there were apparently some problem areas. These are discussed and recommendations made to overcome them.

Adolescent↗

The potential value of immuno-isoelectric focusing in the diagnosis and management of solitary plasmacytoma.

Immuno-isoelectric focusing is a highly sensitive method of detecting small quantities of monoclonal protein. We have previously reported the first demonstration of serum paraprotein in non-secretory myeloma using this technique (Sheehan et al. 1985). We now report a case of solitary plasmacytoma where this technique revealed a small concentration of serum paraprotein when conventional techniques failed, and discuss the potential value of focusing in plasma cell dyscrasia, with limited tumor cell mass. focusing in plasma cell dyscrasia, with limited tumour cell mass.

Aged↗

Haematological reconstitution following high dose and supralethal chemo-radiotherapy using stored, non-cryopreserved autologous bone marrow.

Eighteen patients with small cell carcinoma of the lung received high dose cyclophosphamide (180-200 mg/kg) intensification following five pulses of 'CHOP' chemotherapy (cyclophosphamide 750 mg/m2 i.v., adriamycin 50 mg/m2 i.v., vincristine 1.4 mg/m2 i.v., prednisolone 40 mg orally for 5 d). They received infusions of autologous bone marrow which had been stored at 4 degrees C for 34 h. Pancytopenia was predictable in onset and its duration acceptable. Recovery of neutrophils to greater than 1.0 x 10(9)/l was achieved in 17.5 +/-0.9 d (mean +/- SEM) and platelets to greater than 100 x 10(9)/l in 17.5 +/- 0.8 d. Four patients with acute myeloid leukaemia in complete remission received intensification with the supralethal combination of cyclophosphamide and total body irradiation followed by infusion of autologous marrow which had been stored at 4 degrees C for 54 h. Haematological reconstitution in these patients was acceptable but slower (greater than 1.0 x 10(9)/l neutrophils between days 26 and 40; greater than 20 x 10(9)/l platelets between days 23 and 77). Except in one case, normal peripheral counts were attained in all patients. It is concluded that bone marrow stored at 4 degrees C for up to 54 h is a simple and practical source of viable stem cells which have the capacity for acceptable haematological reconstitution.

Antineoplastic Combined Chemotherapy Protocols↗