Biomedical subjects
W Hill
Publications and source records attributed to W Hill.
Human parvovirus B19-associated disease in bone marrow transplantation.
Human parvovirus B19 can persist in immunocompromised patients and may produce severe clinical illness. In this retrospective study the incidence of B19-associated infections in bone marrow transplant patients was investigated. During 1 year 60 patients received bone marrow grafts (eight autografts and 52 allogeneic transplantations). In case of early onset, atypical or steroid-resistant erythrodermia the patients' blood and/or tissue specimens were screened for B19 infection by polymerase chain reaction (PCR). Additionally, specimens of patients with severe organ failure were tested. A total of 64 PCRs was performed in 27 patients. Seven patients with erythrodermia and one with vulvovaginitis proved to be PCR positive. In patients with organ failure B19 DNA was detected in the myocardium and liver. The incidence of B19 infections in this cohort was 15% and the B19-associated mortality rate 7%. In conclusion, parvovirus B19-associated infections may be more common in immunocompromised patients than previously anticipated.
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Successful treatment of patients with hairy cell leukemia (HCL) using a single cycle of 2-chloro-2'-deoxyadenosine (CdA).
2-Chloro-deoxyadenosine (CdA) is a new adenosine-deaminase (ADA) resistant purine analogue with high specificity for lymphoid cells. It was shown that CdA is very effective in hairy cell leukemia (HCL), refractory chronic lymphocytic leukemia and cutaneous T-cell lymphoma leading to lasting remissions in the majority of patients with HCL. We report the successful treatment of five patients with HCL at different stages of their disease using CdA, who were either previously untreated or had received interferon, splenectomy and deoxycoformycin (dCF), an ADA-inhibitor with high therapeutic efficacy in HCL. After one 7-day course of treatment, all patients reached remission. CdA was well tolerated and, only mild side effects such as skin rash, headache, fever, nausea were observed. Aplasia was pronounced in all instances with a slow recovery. The type of histomorphological procedure in preparing and evaluating bone marrow biopsies is emphasized to detect minimal residual infiltration by hairy cells.