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Biomedical subjects

C L Dannaher

Publications and source records attributed to C L Dannaher.

9 recordsLinked to original sources
PubMed1981

Chemotherapy of vinyl chloride-associated hepatic angiosarcoma.

The use of systemic chemotherapy was studied in a group of four patients who had hepatic angiosarcoma in association with exposure to vinyl chloride. All of the patients received Adriamycin 60 mg/m2 i.v. q3-4 weeks and in three patients this was combined with Cytoxan 600 mg/m2 and methotrexate 20 mg/m2. Three patients had an objective response lasting four, nine, and ten months. One patient had stable disease for ten months. Responding patients maintained an excellent performance status during therapy. Following evidence of progressive disease, patients died in three, four, and six months. Survival from the time of diagnosis was 11, 13, 15 and 53+ months. Sufficient data are not available from these patients to recommend a specific drug or combination for use in hepatic angiosarcoma, but our data indicate that chemotherapy can improve quality and duration of survival.

Adult↗
PubMed1981

Occupational carcinogenesis: the Louisville experience with vinyl chloride-associated hepatic angiosarcoma.

Hepatic angiosarcoma in man was first associated with exposure to vinyl chloride in Louisville, Kentucky, where it was identified in 10 persons from a single vinyl chloride polymerization plant; clinical manifestations are summarized herein. Following prolonged exposure to vinyl chloride, the onset of this disease is insidious and the clinical picture is that of nonspecific hepatic injury with mildly abnormal biochemical liver test results. Carcinoembryonic antigen and alpha fetoprotein are undetectable. Radionuclide and angiographic studies of liver show characteristic but nondiagnostic abnormalities. A definite diagnosis is usually made only by open liver biopsy. Treatment is unsatisfactory but chemotherapy seems to prolong survival. Average survival from diagnosis is about 12 months. Overt liver failure usually occurs only as a preterminal event and was the major cause of death in all of our patients. Preventive measures are now in effect in the plant. This experience illustrates the importance of the clinician in occupationally-related cancer.

Hemangiosarcoma↗
PubMed1981

IgM myeloma, a distinct entity in the spectrum of B-cell neoplasia.

The distinction between multiple myeloma and Waldenström's macroglobulinemia can usually be made on the basis of clinical, histologic, and immunologic findings. However, some patients have features of both diseases. Two patients who had IgM monoclonal gammopathies and plasma cell neoplasia are presented. Both had bone lesions, monoclonal IgMk, and bone marrow infiltration with plasma cells. The presence of plasma cells was verified by electron microscopy. Immunoperoxidase studies in both cases showed positive staining with mu and kappa antisera only, suggesting that these plasma cells were the source of the IgMk protein. Using the criteria of monoclonal IgM, plasma cell neoplasia, and bone lesions, 28 similar cases were found. The analysis of clinical data revealed an increased incidence of lytic bone lesions, decreased IgG and IgA, renal failure, hypercalcemia, and Bence-Jones proteinuria, as are commonly seen in multiple myeloma. It also demonstrated an increased incidence of hyperviscosity symptoms, lymphadenopathy, hepatosplenomegaly, and mucous membrane bleeding, as are often seen in Waldenström's macroglobulinemia. Other common findings were anemia and plasma cell leukemia. These data suggest that, although rare, IgM myeloma should be considered a distinct clinical entity in the spectrum of B-cell malignancies with characteristics of both multiple myeloma and Waldenström's macroglobulinemia.

Aged↗
PubMed1980

Basophilic leukemia.

We have described a patient with basophilic leukemia secondary to chronic granulocytic leukemia. Symptoms of hyperhistaminemia were aggravated after chemotherapy with hydroxyurea. Antihistamines (H1 receptor antagonists) controlled many of the symptoms related to hyperhistaminemia. Peptic ulcer disease with hemorrhage, however, is not controlled by H1 receptor blockade and was one of the contributing causes of death. Attempts to purify the leukemic basophils for chemical analysis met with only partial success. In treating patients with basophilic leukemia, supportive therapy for peptic ulcer disease as well as the use of cimetidine for gastric hyper acidity should be used routinely to avoid this potential complication of cytotoxic chemotherapy.

Basophils↗
PubMed1979

Metastatic carcinoma with carcinocythemia mimicking leukemia.

Carcinoma metastatic to the bone marrow may present with peripheral blood and bone marrow changes and a clinical picture difficult to distinguish from leukemia. It is important to make an accurate diagnosis since the management is different. We have described a patient with circulating primitive cells and diffuse marrow involvement by similar cells. The pathologic process may be identified without cell markers by careful attention to the pattern of distribution, as well as the cytologic features of the neoplastic cells in the bone marrow biopsy.

Biopsy↗
PubMed1979

The proliferative states of circulating granulopoietic stem cells in man.

The fraction of granulocyte-macrophage colony-forming cells (CFC) in DNA synthetic phase in blood from 25 normal adults and those in blood and bone marrow from 8 haematologically normal subjects were evaluated by in vitro culture of cells with and without prior exposure to 3H-thymidine (12.5 muCi) for 1 h at 37 degrees C. The exposure of blood cells from normal adults to 3H-thymidine resulted in 26 +/- 10% reduction in colony formation and in 14 +/- 10% reduction in cluster formation. There was no difference in the magnitude of reduction in colony formation following exposure to 3H-thymidine by cells in blood and those in bone marrow in 6 of the 8 haematologically normal subjects. These findings indicated that about one fourth of the circulating CFC in normal adults are in proliferative state and that significant difference in proliferative states between CFC in blood and those in bone marrow probably does not exist in the majority of haematologically normal subjects.

Adult↗
PubMed1979

Serum inhibitor activity of granulocyte-macrophage colony formation in patients with cancer.

The serum inhibitor activities of granulocyte-macrophage colony formation were evaluated by the in vitro culture technique in 60 patients with cancer and control subjects including 24 normal adults and 27 patients with a variety of nonneoplastic disorders. The inhibitor activity in cancer patients (mean, 59%) was significantly higher (p less than 0.001) than was that in normal adults (mean, 31%) and patients with nonneoplastic diseases (mean 36%). There was no difference in the inhibitor activity between the latter two groups of subjects. There was no correlation between the serum inhibitor activity in cancer patients and the histological type or primary site of tumor, the estimated duration of extent of disease, and serum albumin levels. Preliminary observations indicated that the inhibitor activity may be associated with serum lipoproteins. There was no significant difference in serum colony-stimulating activity among cancer patients, normal subjects, and patients with nonneoplastic diseases.

Adult↗
PubMed1978

Myelopoietic abnormalities in patients with metastatic carcinoma.

Myelopoiesis was assessed in 41 untreated patients with widespread cancer without evidence of infection. None of these patients had neutropenia, although leukopenia due to decreased concentrations of blood lymphocytes was observed in two. Sixteen patients (39%) had neutrophilia and 12 patients (29%), 5 of them with neutrophilia, had decreased marrow granulocyte reserve. Neither the blood neutrophil counts nor the marrow granulocyte reserve correlated significantly with the marrow myeloid mitotic indices, myeloid to erythroid ratio or the number of marrow colony-forming cells. There was no difference in the duration of the disease, the extent of systemic metastasis and the degree of malnutrition between patients with or without myelopoietic abnormalities. Our findings suggest that decreased marrow granulocyte reserve and neutrophilia are common in untreated patients with disseminated carcinoma.

Adult↗