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Biomedical subjects

A Porwit

Publications and source records attributed to A Porwit.

At least 19 recordsLinked to original sources

Antibody reactivities to skeletal muscle proteins in a patient with lambda light chain secreting multiple myeloma, generalised amyloidosis and rhabdomyolysis.

Rhabdomyolysis is a rare complication in haematological malignancies, and a diverse range of factors has been implicated in the etiology of the syndrome. In the present study we analysed muscle morphology and antibody reactivities to skeletal muscle proteins in a patient diagnosed with lambda (lambda) light chain-secreting multiple myeloma (MM) and amyloidosis, who developed a progressive rhabdomyolysis. The muscle tissue analysis showed focal amyloid depositions and a low degree of atrophy and inflammation. Antibody reactivities against muscle proteins of approximately 42, 51 and 66 kD, respectively, were present in the patient's serum. The antibody specificities were revealed by lambda light chain- or IgM-specific antibodies. The results indicate a possible etiologic link between antibody reactivities towards muscle proteins and muscle tissue disorder in a patient with the unique combination of rhabdomyolysis, amyloidosis and MM of the light chain type.

Amyloidosis↗

Effects on human skin of repetitive ultraviolet-A1 (UVA1) irradiation and visible light.

BACKGROUND: Ultraviolet radiation (UVR) has a variety of effects on human skin. Best known are the effects of UVB (290-320 nm) and UVA2 (320-340 nm), which cause DNA damage and increased risk of cancer. However, the effects of UVA1 (340-400 nm) have been not completely investigated. METHODS: The effects of repetitive low doses of UVA1 and visible light were studied in 12 healthy individuals. A part of the buttock was exposed to 20 J/cm2 UVA1 and another part of 126 J/cm2 of visible light three times a week for 4 weeks. Repeated punch biopsies were taken during the 4 weeks of treatment and also 2 weeks after the last irradiation. The avidin-biotin-immunoperoxidase technique was used to investigate the expression of p53, p21WAF, bcl-2, Ki67 and cyclin A. RESULTS: By comparison to untreated skin, an increased expression of p53 but not p21WAF in keratinocytes was seen. The bcl-2 protein expression increased slightly after both UVA1 and visible light. An increased staining with Ki67 and cyclin A after UVA1 but not after visible light was observed as a sign of increased proliferation. CONCLUSION: These results suggest that suberythemal doses of UVA1 and even visible light may cause DNA damage.

Adult↗

Molecular cytogenetic characterization of acute myeloid leukemia and myelodysplastic syndromes with multiple chromosome rearrangements.

BACKGROUND AND OBJECTIVES: Multiple chromosome rearrangements (MCRs) are found in 5-10% of newly diagnosed patients with acute myeloid leukemia (AML) and 15-30% of patients with myelodysplastic syndromes (MDS). However, the initial causes of MCRs and the molecular mechanisms involved are largely unresolved. Nor are the karyotypic patterns well studied, mainly because of the difficulties of obtaining complete karyotypes by G-banding. In this study, we applied spectral karyotyping (SKY) and comparative genomic hybridization (CGH) to investigate further the resulting chromosome imbalances and rearrangements in AML and MDS bone marrow cells with MCRs. DESIGN AND METHODS: Bone marrow cells from 12 AML and 10 MDS patients with MCRs were collected at diagnosis and analyzed by G-banding, SKY and CGH. The patients' characteristics were also collected to pinpoint potential similarities and/or differences between the patients. RESULTS: Our results show that some MCRs seen in AML are similar to MCRs seen in MDS. These MCRs often result in chromosome loss of 5q, 7q and 17p and gain of chromosome 8. INTERPRETATION AND CONCLUSIONS: The characteristics associated with MRCs include old age, previous exposure to radio- and/or chemotherapy and a short survival time. Probably, these patients should be distinguished from AML patients with primary chromosome rearrangements among other unbalanced chromosome rearrangements. In our experience, SKY and CGH facilitated this process.

Acute Disease↗

Inverse correlation between Ink4-locus deletions and ICM-DNA hyperdiploidy in childhood acute lymphoblastic leukaemia, relation to clinical characteristics and outcome.

Malignant cells from 72 children with ALL were analysed to investigate the relationship between DNA-ploidy and deletion of the Ink4 locus containing the cell-cycle regulating genes p16ink4a, p15ink4b and p14ARF. Image-DNA cytometry (ICM) was used to assess DNA index (DI), and Southern hybridisation was carried out to detect deletions of the Ink4-locus in the leukaemic cells. A DNA content equal to or exceeding 1.16, indicating hyperdiploidy, was detected in 21/72 patients (29%), 1/72 (1.3%) showed DNA-hypodiploidy, and the remaining 50 patients (69%) had a DI within normal limits. Bi-allelic deletion of at least two of the coding sequences from the Ink4 locus was observed in 23/70 (33%) patients. Mono-allelic deletions within the locus were observed in 10/70 patients (14%), and 37/70 patients (53%) had normal signals for both sequences. Out of the 70 patients that could be analysed by both techniques only two had the combination of DNA hyperdiploidy and Ink4-locus bi-allelic deletion (p = 0.004). DNA hyperdiploidy was not associated with any specific clinical characteristics, but there was a trend for a better prognosis for patients with DNA hyperdiploidy (p = 0.09). Ink4-locus deletion was associated with T-cell phenotype and higher white blood cell counts at diagnosis and poor prognosis (p = 0.0015). Multivariate analysis confirmed that Ink4-locus deletion is an independent prognostic marker and a stronger determinant of outcome than DNA ploidy. When DNA ploidy and Ink4-locus deletions were combined, novel subgroups with significantly different outcome could be observed. A group with DNA index > or = 1.16 and no Ink4-locus bi-allelic deletions had an excellent prognosis (p-EFS 0.93 at 60 months), patients with Ink4-locus bi-allelic deletion and a DNA index < 1.16 fared worst (p-EFS 0.57) and patients with no Ink4 deletions and without hyperdiploidy had an intermediate outcome (p-EFS 0.79). The reason for the inverse correlation between DNA ploidy and Ink4 deletion and their combined impact on prognosis remains unclear, and possible reasons are discussed.

Actuarial Analysis↗

Diagnosis and subclassification of follicle center and mantle cell lymphomas on fine-needle aspirates: A cytologic and immunocytochemical approach based on the Revised European-American Lymphoma (REAL) classification.

BACKGROUND: Cytologic distinction between follicle center lymphoma (FCL) and mantle cell lymphoma (MCL) is difficult with cytomorphology alone and requires immunophenotyping. The current study describes the distinction between follicle center and mantle cell lymphoma made with fine-needle aspiration (FNA) material. METHODS: One hundred ten cases primarily diagnosed and classified on FNA material as centroblastic-centrocytic (CBCC) and centrocytic (CC) non-Hodgkin lymphomas (NHLs) (Kiel classification) were included in the study. An additional retrospective immunocytochemical analysis was performed on frozen cytospin preparations using the monoclonal antibodies Bcl-2, CD10, CD5, CD23, CD43, and immunoglobulin M. RESULTS: The initial diagnostic workup classified 106 cases as CBCC-NHL and 4 as CC-NHL. The immunophenotype Bcl-2(+), CD10(+/-), CD5(-), CD23(-/+), CD43(-) was observed in 93 of 106 previously reported CBCC NHLs. In 11 of 106 cytospin preparations, neoplastic B cells expressed the CD5 pan T marker and, as a group, showed the pattern Bcl (+/-), CD10(-/+), CD5(+), CD23(-), CD43(+), which is considered typical of MCL. Based on the additional immunocytochemical data, all but 2 of the tumors were reclassified as FCL (n = 93) and MCL (n = 15). The mean proliferation fraction measured by MIB-1 (Ki-67) immunoreactivity was 16.3% and 17.5% in FCL and MCL, respectively. The revised cytopathologic diagnosis correlated significantly (P < 10(-9)) with the histology of 65 patients who underwent surgical excision biopsy. CONCLUSIONS: Subclassification of follicle-derived low grade NHL can be established with high accuracy on FNA material if cytomorphology is corroborated by a complete immunophenotypic analysis, which can be performed on both fresh and frozen stored cytospin material. The currently used criteria can be applied to aspirated cells for a conclusive cytopathologic diagnosis of MCL, which is of great clinical importance. Cancer (Cancer Cytopathol)

Adult↗

Cladribine for untreated or early low-grade non-Hodgkin's lymphoma.

PATIENTS AND METHODS: Forty-four patients, with low-grade non-Hodgkin's lymphoma (LG-NHL) were included in a phase II study between June 1993 and May 1995 and treated with cladribine (CdA) 0.12 mg/kg as a 2 h i.v. infusion daily x 5, repeated after 28 days for up to 6 courses. Thirty-four patients were previously untreated and 10 had progressive disease after initial response to limited chlorambucil treatment. Five patients had also received involved field radiotherapy. Eight patients had mantle cell lymphomas, 22 follicle centre lymphomas, 5 lymphoplasmacytoid lymphomas, 4 small cell lymphocytic lymphomas, 4 marginal zone B-cell lymphomas and I had unclassified low-grade NHL. The response rate was 64%, with 11 (25%) CR and 17 (39%) PR while 5 (11%) patients progressed during treatment. The response rate was similar in previously treated and untreated patients. The median number of CdA courses delivered was 3 (1-6) in non-responding patients and 6 (2-6) in responders. Median survival from inclusion was not reached with a median follow-up of 40 months. The median time to progression was 7 mo for all patients, 25+ mo for CR and 16 mo for PR patients. Toxicity was sometimes severe with 2 treatment related deaths, one infectious related and one due to a mucocutaneous syndrome and pulmonary microembolism. In addition, 5 grade 3 or 4 infectious episodes were seen. Seven patients experienced grade 3 or 4 thrombocytopenia and 20 had grade 3 or 4 neutropenia. We conclude that the majority of patients with low-grade non-Hodgkin's lymphoma respond to CdA but that the adverse effects may be severe.

Adult↗

Intermittent infusion of cladribine (CdA) in previously treated patients with low-grade non-Hodgkin's lymphoma.

Thirty-six patients with previously treated low-grade non-Hodgkin's lymphoma (LG-NHL) were included in a phase II study between August 1990 and February 1994 and treated with 0.12 mg/kg CdA as a 2 h.i.v. infusion daily x V, q 28 days up to 6 courses. Twenty-three were refractory to previous chemotherapy while 13 were relapsed. Four patients had mantle cell lymphoma, 17 follicle centre cell derived lymphoma, 7 lymphoplasmacytoid lymphomas and, 8 had small lymphocytic lymphoma. The response rate was 42%, with 5 (14%) CR and 10 (28%) PR while 6 (16%) patients progressed during treatment. The median number of delivered CdA courses was 3 (1-6) in non-responding cases and 6 (2-6) in responders. The median time to progression was 9 mo for all patients, 23 mo for CR and 16 mo for PR patients. Toxicity was sometimes severe with 3 infectious deaths (1 pneumocystis carinii pneumonia, 1 gram negative septicemia, and 1 fungal pneumonia), and 6 grade 3 or 4 infectious episodes. We conclude that responses to CdA in this group of heavily pre-treated patients is impressive. However, toxicity is considerable and the rate of opportunistic infections is worrisome.

Cladribine↗

Confocal 3-dimensional DNA image cytometry in thick tissue sections.

We present a three-dimensional confocal DNA image cytometry (3-D CICM) method for analysis of DNA content in 30-40-microns-thick sections of routinely processed paraffin-embedded specimens. A comparison of DNA ploidy profiles obtained by 3-D CICM and conventional DNA image cytometry (ICM) on tissue sections sections showed significantly higher numbers of cells with high DNA content in DNA histograms by 3-D CICM. As estimated by 3-D CICM, the size of nuclei frequently exceeded the thickness of tissue sections used in conventional ICM, which suggested that many nuclei measured by this technique may be incomplete. This artifact was excluded in 3-D CICM by automatic rejection of cut nuclear profiles. This and the favorable ratio of tissue thickness to nuclear size in 3-D CICM permitted the DNA quantitation even in large cells with highly increased DNA ploidy values such as megakaryocytes and Reed-Sternberg cells of Hodgkin's disease. Additionally, 3D-CICM allowed evaluation or morphometric parameters and 3-dimensional reconstruction of studied cells.

Bone Marrow↗

Strength of binding between leukemic blasts and cytotoxic lymphocytes.

Strength of binding (Sb), a new parameter defined by the ratio of binding capacity and dissociation rate constants, was estimated and used for the characterization of conjugate formation between leukemic blasts and cytotoxic lymphocytes. Lymphokine activated killer (LAK) cells, i.e., interleukin-2 activated peripheral blood lymphocytes (PBL) displayed significantly (P < 0.001) higher Sb with leukemic blasts when compared to fresh, nonactivated PBL. Interaction of both fresh PBL and LAK effector cells with acute myeloid leukemia (AML) blasts was characterized by a significantly (P < 0.05) lower Sb when compared to the K562 cell line. Interaction of LAK effector cells with leukemic cell-lines of lymphoid origin (Daudi, Raji, and HuT78) was characterized by a significantly (P < 0.005) lower Sb than with K562 myeloid cell line. Sb for the interaction of natural killer (NK)-derived CD16+/CD56+ LAK with leukemic blasts was significantly (P < 0.001) higher than that of T-cell-derived CD3+LAK. We conclude that calculation of Sb provides a relatively simple and independent way to evaluate systems of interacting cells at a single time and may be used to compare results between different cell systems and laboratories.

Humans↗

Prognostic significance of proliferative and apoptotic fractions in low grade follicle center cell-derived non-Hodgkin's lymphomas.

BACKGROUND: The biologic parameters, DNA ploidy and proliferative activity, have been suggested as prognostic factors in non-Hodgkin's lymphoma (NHL). However, reports on the prognostic importance of these factors in follicle center cell-derived (FCC) centroblastic/centrocytic (CB/CC) NHL patients with long follow-up are scarce. METHODS: Apoptotic fractions were quantified in 60 patients with CB/CC NHL by in situ labeling of DNA strand breaks in nuclei [TdT-mediated dUTP/dATP in situ 3'OH--end labeling (TUNEL)]. The findings were related to S-phase and MIB-1 counts, DNA ploidy, and clinical outcome. RESULTS: In CB/CC NHL, the percentages of proliferating and apoptotic cells were lower than in reactive germinal centers (GC; P < 0.05; mean, 0.188 vs 3.263% and 19.05 vs. 69.4% for TUNEL and MIB-1 positive cells in CB/CC and GC, respectively). Significantly higher percentages of MIB-1 and TUNEL positive cells were observed in patients with complete remission when compared with the partial remission / no response group (P < 0.01). The size of proliferative and apoptotic fractions did not correlate with the overall survival of the patients. However, follicular and diffuse growth pattern, elevated serum lactic dehydrogenase, advanced stage, and age indicated a lower probability of 5- and 10-year survival. CONCLUSIONS: The investigation of proliferative and apoptotic fractions in FCC lymphomas may help to define groups of patients to who would benefit from aggressive, high dose therapy protocols and patients to whom less aggressive strategies can be applied safely.

Adult↗

Acute lymphoblastic leukemias from relapse engraft more rapidly in SCID mice.

It is generally believed that relapse of acute leukemia heralds progression of the disease into a more aggressive stage. The biological behavior of leukemic cells collected from four patients with adult acute lymphoblastic leukemia (ALL) prior to treatment and at relapse was studied after engraftment into 28 unconditioned mice with severe combined immunodeficiency (SCID). Leukemic cells engrafted in all but one mouse, with major differences observed in the growth and aggressiveness of the leukemias. Recipient mice of cells derived from all patients at relapse died more rapidly in overt leukemia than those which were injected with cells obtained prior to induction treatment (P=0.0002). SCID mice that received cells from one patient at the time of diagnosis also died in terminal leukemia. Other SCID mice however, that received cells from the remaining three patients prior to treatment developed occult leukemia that was detectable in the blood or bone marrow with the use of polymerase chain reaction (PCR) or flow cytometry only. Leukemic cells recovered from mice with terminal leukemia exhibited a larger proliferating fraction than cells originally injected (P=0.004). Our results demonstrate, that during the evolution from initial presentation to relapse, ALL cells may acquire biological properties which render them more aggressive in SCID mice.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

A method to compensate for light attenuation with depth in three-dimensional DNA image cytometry using a confocal scanning laser microscope.

A method to compensate for attenuation of detected light with increased depth of the collected optical section, and its application in three-dimensional (3-D) DNA image cytometry is described. The method is based on studying the stack of 2-D histograms that can be formed from each consecutive pair of sections in a stack of optical serial sections. An attenuation factor is calculated interactively and a new compensated section series is computed. Formalin-fixed paraffin-embedded rat tissue was stained with propidium iodide. Each cell nucleus is extracted by thresholding and its total intensity is calculated. The coefficient of variation (CV) of the total intensity of all cells in each stack is computed. For comparison the CV of the same cells is computed in the uncompensated stacks. This study shows a significantly lower CV for the compensated data, thus contributing to the accuracy of DNA quantification in 3-D DNA image cytometry.

Animals↗

DNA image cytometry and the expression of proliferative markers (proliferating cell nuclear antigen and Ki67) in non-Hodgkin's lymphomas.

We have analyzed DNA content and proliferative activity in morphologically defined cell subpopulations of 74 non-Hodgkin's lymphomas (NHL) and 29 reactive lymph nodes using DNA image cytometry and antibodies to proliferative markers (proliferating cell nuclear antigen (PCNA) and Ki67). Thirteen (18.6%) of 70 NHL cases were aneuploid. The follicular center cell-derived lymphomas with DNA aneuploidy had DNA indices (DI) predominantly in the tetraploid region, whereas aneuploid high-grade (HG) NHL presented DNA histograms with multiple aneuploid stemlines. In aneuploid centrocytic-centroblastic (CB/CC) NHLs, DNA aneuploidy was found exclusively in centroblasts, whereas centrocytes in these cases were diploid. Percentages of cells in S and G2/M phase in chronic lymphocytic leukemia (CLL), immunocytoma (IC), centrocytic NHL (CC), and centrocytes from CB/CC were low (< 5%), whereas the respective values for centroblasts in CB/CC and in malignant cells of HG NHL were similar to those of large lymphoid cells in the reactive lymph nodes (mean, 39.5%, 36.6%, and 53.5%, respectively). The mean percentage of PCNA positive cells in CLL, IC, and CC was 4.9%. In the follicles of CB/CC NHLs there was, on average, 56.9% of PCNA positive centroblasts and 8.1% of PCNA positive centrocytes. In HG NHL, the mean percentage of PCNA positive lymphoma cells was 27.9%. A positive correlation was found between percentages of cells in S and G2/M phase and cells positive for PCNA (P < 0.001). There was also a significant correlation between percentages of Ki67 (mean, 19.2%) and PCNA positive cells (mean, 17.7%) (P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

DNA content and expression of PCNA and p53 in Hodgkin's disease and Hodgkin's-like B-cell lymphoma.

DNA ploidy (by image cytometry) and expression of proliferating cell nuclear antigen (PCNA) and p53 tumor suppressor gene product (by immunohistochemistry) were investigated in 15 cases of Hodgkin's disease (HD) and 12 cases of HD-like B-cell lymphoma (HD-like NHL). Reed-Sternberg (RS) cells and their variants were DNA aneuploid in all cases. However, the fraction of hyperoctaploid tumor cells was higher in HD than in HD-like NHL. PCNA expression was high in neoplastic cells (> 50%) and variable (5-40%) in reactive lymphocytes in both HD and HD-like NHL. p53 positivity was found in RS cells and their variants in 64% of HD cases, but only in 25% of cases of HD-like NHL. Our results support the suggestion that HD-like B-cell lymphomas should be considered as highly malignant non-Hodgkin's lymphomas rather than Hodgkin's disease.

Adult↗

Growth of sensitive and drug-resistant human myeloid leukemia cells in SCID mice.

Drug resistance is a critical problem in the therapy of hematologic malignancies. Recent advances in the transplantation of human normal and transformed hematopoietic cells into severe combined immunodeficient (SCID) mice provide an opportunity to study the biologic and molecular events that mediate resistance. We studied the engraftment of several human myelogenous leukemia cell lines sensitive and resistant to amsacrine (mAMSA), vincristine, hycamptamine, methotrexate, or doxorubicine (KBM3/AMSA, K562/Vcr, HL60/Hy10, K562/MTX, HL60/Dox). The distribution and growth potential of these cells was evaluated using molecular and histologic techniques. Inoculation of 2 x 10(7) leukemic cells led to manifestation of disease, and subsequent tissue analysis showed evidence of leukemia. The survival of mice varied from 21 to 135 days. Terminally, the animals showed symptoms of wasting, development of local tumors, or both. Massive leukemic dissemination with infiltration of bone marrow and various organs including lungs, spleen, liver, ovaries, and brain was detected in most cases. No differences were observed in the tissue distribution of sensitive as compared to resistant leukemia cells. These findings demonstrated that human leukemic cells retain, in SCID mice, the clinico-pathologic picture of the original disease in humans. The development of numerous drug-resistant phenotypes in vitro does not alter the subsequent behavior of resistant cells in vivo when compared with sensitive counterparts. The levels of resistance are not modified by passage through SCID mice. This model offers an opportunity for developing new preclinical in vivo systems for modulation of drug resistance, and the combination of this in vivo model with gene transfer methods will also provide an important system for testing the molecular alterations involved in drug resistance and leukemic progression.

Acute Disease↗

Kinetic analysis of cytotoxic lymphocyte-target cell interaction as quantified by dual parameter flow cytometry.

The kinetics of conjugate formation between leukemic cell lines (K562 and Daudi) and lymphokine-activated killer (LAK) cells was studied. A flow cytofluorometry method using double immunofluorescence staining was applied. During the first 15 min of incubation of LAK effectors with leukemic targets, a rapid binding occurred, followed by a plateau phase lasting until 30 min of observation. A considerable, yet not statistically significant, between-donor variability was noticed. A mathematical model of conjugate formation kinetics, based on the analogy to enzyme kinetics, was formulated and validated. Parameters of the model were related to the binding capacity of effector and target cells, and to the lifetime of conjugates and free cells. The concordance of theoretical curves with experimental data proved that the described model can be considered as a useful tool for the evaluation of kinetic and dynamic characterization of conjugate formation between leukemic targets and LAK effectors.

Cell Adhesion↗

Binding of leukaemic blasts to various subpopulations of lymphokine-activated killer cells.

Conjugate formation by natural killer (NK)-resistant and NK-sensitive leukaemic cell lines with fresh and IL-2-stimulated (lymphokine-activated killer, LAK) peripheral blood lymphocytes (PBL) was studied by a flow cytofluorometry method with double staining. A significant difference in binding of NK-resistant T-cell lymphoma (HuT 78) and NK-sensitive myeloid (K562) blasts to fresh PBL was observed (P < 0.01). Activation of lymphocytes with IL-2 resulted in a significant increase of binding and killing of both K562 and HuT 78. However, in the case of blasts from NK-resistant cell line Daudi a similar conjugate formation with fresh PBL and LAK effectors was observed, despite a significant increase in killing. Various subpopulations of LAK effectors (CD3, CD16 and CD56 positive) displayed similar binding activity towards myeloid (K562) and lymphoid (Raji) blasts, which shows that conjugate formation occurs not only with NK-cell-derived, but also with T-cell-derived LAK cells. The blocking of CD71 antigen (transferrin receptor) on K562 blasts inhibited binding of cytotoxic lymphocytes, which was mostly due to the blocking of binding of CD56+ subpopulation. Our results indicate that the resistance of leukaemic blasts to cell-mediated cytotoxicity may depend on different (and probably several) steps of this process.

Antibodies↗

Conjugate formation by leukemic blasts from acute myeloid leukemia with cytotoxic lymphocytes.

Conjugate formation by AML blasts with fresh peripheral blood lymphocytes (PBL) and lymphokine activated killer (LAK) effectors was studied by flow cytometry. Leukemic blasts formed very low numbers of conjugates with fresh PBL and were resistant to natural killer (NK) cytotoxicity. When LAK effectors were used a significant increase in conjugate formation was observed, which in the majority of cases was followed by an increased killing. There was a positive correlation between the percentages of conjugates formed by AML blasts with LAK effectors and the susceptibility to lysis. No significant difference in binding activity between the CD3+ and CD56+ LAK subpopulations was found. There was no correlation between the expression of ICAM-1, LFA-3 and Transferrin receptor (CD71) and the conjugate formation. The blocking of CD71 on the control K562 cell line reduced the conjugate formation with LAK effectors but no such effect could be observed with CD71+ AML blasts.

Antigens, CD↗