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Biomedical subjects

A J Dodds

Publications and source records attributed to A J Dodds.

15 recordsLinked to original sources
PubMed1992

High dose chemotherapy and autologous bone marrow transplantation in advanced Hodgkin's disease.

OBJECTIVE: To present the use of high dose chemotherapy with autologous bone marrow transplantation as salvage therapy for advanced Hodgkin's disease in Australia. DESIGN: A prospective open study for patients whose disease was resistant to conventional treatment. SETTING: The bone marrow transplantation units of four Australian tertiary hospitals. PATIENTS: Seventeen patients (median age 30 years) entered and completed the study. The stage of the disease at initial diagnosis was I or II (seven patients), III (seven patients) and IV (three patients). Histological types were lymphocyte predominant (one), nodular sclerosis (12), mixed cellularity (three) and unknown (one). Therapy before consideration for transplantation included radiotherapy (13), mustine, vincristine, procarbazine and prednisone (MOPP--17 patients) or doxorubicin, bleomycin, vinblastine and dacarbazine (ABVD--13 patients) and other chemotherapy regimens (five). The median interval from diagnosis to transplantation was 29 months (range, 9-178 months). The patient's disease was classified as sensitive (nine) or resistant (eight) to treatment, depending on the response to the most recent course of chemotherapy. INTERVENTIONS: Morphologically normal autologous bone marrow was harvested and cryopreserved. The conditioning regimen given was cyclophosphamide, carmustine and etoposide (14) or busulphan and cyclophosphamide (three). The marrow was then infused. MAIN OUTCOME MEASURES: Remission (complete or partial), disease-free survival and overall survival. RESULTS: Over all, 10 of 17 patients (59%) entered or remained in complete remission and four of 17 (24%) achieved partial remission. The overall actuarial survival at 30 months was 70%. Eight of the nine patients with treatment-sensitive disease (89%) remain disease-free at a median of 22 months (range, 18-29 months) after transplantation. Two of the eight patients with resistant disease (25%) are disease-free at 20 and 28 months. There was one procedure-related death from haemorrhage and four disease-related deaths at six, seven, eight and 13 months after transplantation. CONCLUSION: Autologous bone marrow transplantation may provide an effective salvage therapy in advanced Hodgkin's disease, particularly for patients with treatment-sensitive disease and a low tumour burden.

Adult↗
PubMed1990

Peripheral blood and bone marrow findings in patients with acquired immune deficiency syndrome.

In 4 years (1984-1987), 183 bone marrow examinations were performed on 155 human immunodeficiency virus (HIV) antibody positive patients. One hundred and fifty three had category IV AIDS. One-third of the marrows yielded specific information. This included opportunistic infection, in particular Mycobacterium Avium Intracellulare Complex (MAI) (24%), malignancy (4%), consistent with ITP (9%) and iron deficiency (1%). In the remaining two thirds of the bone marrows the most frequent non-specific abnormalities were dyserythropoiesis, erythroid hypoplasia, reticuloendothelial iron block, granulomas, lymphoid aggregates, plasmacytosis and histiocytosis. Common peripheral blood findings were anemia, lymphopenia, anisocytosis, rouleaux and atypical lymphocytes. Peripheral blood and bone marrow examinations on 16 patients on AZT are included. These patients have more pronounced blood and bone marrow abnormalities. The causes of these abnormalities are multifactorial and include low T4 levels, severe viral and other infections and therapy with marrow toxic drugs.

Acquired Immunodeficiency Syndrome↗
PubMed1987

The development of the acquired immunodeficiency syndrome after bone-marrow transplantation.

Since bone-marrow transplant recipients receive considerable quantities of packed-cell, platelet and sometimes leukocyte transfusions, as well as the donor marrow infusion, it would be predictable that acquired immunodeficiency syndrome (AIDS) by blood-product transfusion would occur in this patient population. We report here two patients who received HLA-identical sibling bone-marrow transplants for acute non-lymphoblastic leukaemia during their first remission. Both developed category-A AIDS at days 342 and 546 after transplantation, respectively. Neither patient belonged to any known high-risk group for AIDS, other than having received a blood-product transfusion. One of the two patients is now known to have received blood from a donor who was human immunodeficiency virus (HIV) seropositive. Both patients developed Pneumocystis carinii pneumonia and other opportunistic infections, and both have died of AIDS without evidence of recurrence of their leukaemia. One patient had no chronic graft-versus-host disease (GVHD) and the other had mild chronic GVHD of the mouth. Since severe opportunistic infections are rare after transplantation in the absence of GVHD, their late occurrence after transplantation should raise the suspicion of AIDS. This complication is likely to have an adverse impact on the long-term survival of patients who received bone-marrow transplants between 1981 and the introduction of effective screening tests for HIV infection in blood donors.

Acquired Immunodeficiency Syndrome↗
PubMed1986

AIDS and prostitutes.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Aplastic anemia: analysis of two methods of treatment.

Between 1981 and 1985, 27 patients with aplastic anemia have been treated by immunosuppression with antilymphocyte globulin and prednisolone or allogeneic bone marrow transplantation. Fifteen have undergone bone marrow transplantation and have an actuarial survival at 54 months of 65% +/- 12% (95% confidence limits). There have been four deaths from graft rejection, septicemia (two), and graft-versus-host disease. Twelve have received antilymphocyte globulin and have an actuarial survival at 56 months of 67% +/- 21%. Five of these now have a normal blood count and two have had good partial responses and are self supporting. Of the five non-responders, three survived, two with persistent aplasia and one after allogeneic bone marrow transplantation. Two are dead, one of hemorrhage and one after mismatched bone marrow transplantation. In this study antilymphocyte globulin produced survival equivalent to bone marrow transplantation although only 58% of patients had a response to the antilymphocyte globulin. The advantages and disadvantages of these two methods of treatment are discussed.

Adolescent↗
PubMed1985

Red cell deformability and other haemorheological variables in stable coronary artery disease.

In this study, red cell deformability and other haemorheological variables were measured in 40 patients who underwent cardiac catheterization for the investigation of chest pain. The patients were divided into two groups - those with extensive disease and those with less extensive or no disease. Deformability was assessed by a filtration method. There were no significant differences in filterability, haematocrit, plasma viscosity or plasma fibrinogen between the two groups of patients. However, those with extensive disease had significantly higher blood viscosity than those with less extensive disease. Thus the study was able to demonstrate an association between blood viscosity and extent of coronary artery disease but not between the individual determinants of blood viscosity (red cell deformability, plasma fibrinogen and haematocrit) and extent of disease.

Adult↗
PubMed1979

Haemorrheological response to plasma exchange in Raynaud's syndrome.

Eight patients with Raynaud's syndrome were treated by weekly plasma exchange for four weeks using a Haemonetics Model 30 Blood Processor. The mean whole-blood viscosity at a shear rate of 0.77/s was significantly lower after treatment, and the mean index of red-cell deformability was significantly improved. In four patients studied serially the mean percentage fall in whole-blood viscosity after a single plasma exchange was 49% at 0.77/s but only 14% at 91/s. All patients noticed symptomatic improvement including healing of ischaemic digital ulcers. In six patients the number of digital arterial segments containing detectable blood flow was measured by directional Doppler; in all six the number increased. It is concluded that plasma exchange is an effective means of haemorrheological treatment and may be beneficial in patients with digital ischaemia.

Blood Flow Velocity↗
PubMed1979

Allogeneic bone marrow transplantation across the ABO barrier.

Allogeneic bone marrow transplantation in severe aplastic anaemia has been shown to be a worth-while procedure. A case in which a group O patient received a successful marrow transplant from a group B donor is reported. Major ABO incompatibility is not a contraindication to bone marrow transplantation.

ABO Blood-Group System↗
PubMed1979

Plasma exchange and Raynaud's phenomenon--its assessment by Doppler ultrasound velocimetry.

In a group of 47 patients with Raynaud's phenomenon, Doppler ultrasound velocimetry was used to establish the severity of the disease by detecting the patency of the digital arteries. In conjunction with small digital occlusion cuffs, digital artery systolic pressure was measured on either side of the finger. A significant variation in systolic pressure was detected in each finger, and on each side of individual fingers. A more sensitive index of the severity of the disease was noted when the digital systolic pressure was compared to the brachial systolic pressure. Plasma exchange, a potent method of lowering whole blood viscosity and plasma fibrinogen, was used to treat 18 of these patients. There was a significant improvement in digital vessel patency at both 21 degrees C and 13 degrees C after plasma exchange. Both the digital artery systolic pressure and the pressure index improved significantly after treatment.

Arteries↗
PubMed1979

In-vitro synthesis of an anti-BI cold agglutinin complicating a case of lymphoma.

A woman of 47 with lymphocytic lymphoma was found to have a high-titer cold autoagglutinin of anit-BI specificity. Her group B erythrocytes autoagglutinated of anti-BI specificity. Her group B erythrocytes autoagglutinated in vitro and the direct antiglobulin reaction was positive, but she had no symptom of cold intolerance, no evidence of hemolysis, and she could receive transfusions of compatible group O erythrocytes. In addition, evidence for synthesis of the autoantibody by the lymphoma cells was obtained by short-term bone-marrow culture.

ABO Blood-Group System↗
PubMed1976

Tranexamic acid and upper gastrointestinal haemorrhage--a double-blind trial.

The efficacy of antifibrinolytic therapy in the management of acute upper gastrointestinal haemorrhage has been investigated in a double-blind clinical trial. Two-hundred patients were studied using tranexamic acid, a potent antifibrinolytic agent. Of these, 103 were in the treatment group and 97 in the control group. Patients were analysed to determine severity of initial blood loss, transfusion requirements, together with the incidence of recurrent bleeding, surgical intervention, and death. Final diagnosis as to the site of bleeding was arrived at using endoscopy, barium studies, and the findings at operation and necropsy. The groups were well matched as regards severity of initial haemorrhage, age, sex, aetiological diagnosis, and precipitating factors. A significant difference was observed in the requirement for surgical intervention to control continuing or recurrent haemorrhage. Twenty-three of 97 in the control group and seven of 103 in the treatment group required surgery. There appeared to be a reduction in the transfusion rate after the first three days of hospitalization in the treatment group. There were no significant differences in mortality or in side-effects between the two groups.

Adolescent↗
PubMedDate not supplied

Red cell alloantibodies produced after bone marrow transplantation.

This article describes the production of red cell alloantibodies in 13 of 150 patients after bone marrow transplantation. New alloantibodies appeared 12 days to 11 months after the transplantation. The specificities of these antibodies were anti-N, -Jka, -E-like, -Kell-like, -M, -Leb, -Hl, -H and -A1. The posttransplantation production of antibody could be due to either the transfusion of mature lymphocytes along with the marrow, the ability of the grafted immune system to produce alloantibodies, or the viable immunocompetent cells remaining despite high-dose chemotherapy and irradation.

Antibody Formation↗