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Biomedical subjects

C Pollard

Publications and source records attributed to C Pollard.

At least 19 recordsLinked to original sources
PubMed1995

Autologous bone marrow or peripheral blood stem cell transplantation followed by maintenance chemotherapy for adult acute lymphoblastic leukemia in first remission: 50 cases from a single center.

The aim of this study was to evaluate the use of maintenance chemotherapy after autotransplantation in adult acute lymphoblastic leukemia (ALL), and to compare the relative durability of marrow and peripheral blood stem cell grafts to chemotherapy. Fifty consecutive ALL patients received 200 mg/m2 melphalan alone or 110 mg/m2 melphalan with total-body irradiation in first remission, followed by autologous marrow (ABMT, n = 38) or peripheral blood stem cells (PBSCT, n = 12). After hematologic recovery, 6-mercaptopurine and methotrexate were administered for 2 years. 6-mercaptopurine could be given to 78.9% of ABMT recipients at a median daily dose of 33.5 mg/m2, and to 91.7% of PBSCT recipients at a median daily dose of 44.1 mg/m2. ABMT recipients started 6-mercaptopurine at a median of 58.5 days post-transplant, and PBSCT recipients at 32 days (P = 0.002). 52.6% of ABMT recipients and 75% of PBSCT recipients received weekly methotrexate. No graft failure was seen as a result of chemotherapy. The actuarial 5-year probabilities of overall survival, survival in first remission and relapse were 56.2, 53.2, and 30.6%, respectively. We conclude that administration of maintenance chemotherapy after autografting in adult ALL may reduce relapse. A randomized study is required to evaluate the relative efficacy of PBSCT vs ABMT, and the role of post-transplant maintenance chemotherapy.

Adolescent↗
PubMed1995

Allogeneic bone marrow transplantation for primary myelofibrosis.

The published experience of allogeneic bone marrow transplantation for primary myelofibrosis (PMF) is limited. Three patients (24-49 years) with PMF received allogeneic marrow grafts from HLA-identical sibling donors after conditioning with 110 mg/m2 melphalan and 1050 cGy total-body irradiation (TBI). Donor marrow was not depleted of T cells, and graft-versus-host disease (GVHD) prophylaxis comprised cyclosporine and methotrexate. None of the patients was splenectomized prior to the transplant. Two patients received G-CSF post-transplant to hasten neutrophil recovery. One patient died of multi-organ failure 23 days post-transplant. Hematopoietic recovery was relatively slow in the other two who had gradual resolution of the marrow fibrosis over several months. One of the two died of overwhelming pneumococcal sepsis within 2 weeks of stopping prophylactic penicillin 31 months post-transplant. The other patient is alive and well 20 months post-transplant with a Karnofsky score of 100% and no fibrosis of the marrow. We conclude that PMF is correctable by allogeneic BMT. Hematologic recovery post-transplant is slow, but counts may normalize with time without the need for splenectomy.

Adult↗
PubMed1994

Bacillus Calmette-Guérin immunotherapy for refractory interstitial cystitis.

OBJECTIVE: To determine whether or not patients with refractory interstitial cystitis who had failed conservative therapy might benefit from intravesical bacillus Calmette-Guérin (BCG) immunotherapy. METHOD: Five patients with refractory interstitial cystitis who had failed conservative therapy underwent six weekly treatments with intravesical BCG. All 5 patients were evaluated before therapy and quarterly thereafter by water cystometry and symptom questionnaire. RESULTS: The average number of medications used daily per patient decreased from 3.2 to 1.2 after therapy. Average volumes of both first desire to void and cystometric capacity doubled after BCG. Improvement in cystometric capacity, average daytime urinary frequency, nocturia, and global pain/discomfort were statistically significant (P = 0.0277, P = 0.0131, P = 0.0199, and P = 0.0317, respectively). Three patients experienced near total relief of their symptoms with six to twelve months' follow-up (average follow-up equals 33.6 weeks). CONCLUSIONS: Although the mechanism of action of BCG in interstitial cystitis is unknown, we recommend a double-blind placebo controlled trial to confirm these results and determine an optimal dosage and treatment schedule.

Adult↗
PubMed1994

[The "Soft Approach": a program of rehabilitation of chronically mentally ill elderly patients].

The authors report on "The Soft Approach", a program for chronic mentally ill elderly patients, which they have implemented in a gero-psychiatric unit in New York City. Using a professional team, their approach treats the medical problems, and the various degrees of dementia encountered, in a positive and coordinated effort centered around daily recreational and socializing activities; these include off-ward events and outings away from the hospital. The goals of the program are increased independence and eventual community living. The importance of their medication regime is stressed with patients throughout the program.

Activities of Daily Living↗
PubMed1994

Identifying speech and language delay.

Publication of the Hall report has prompted many health authorities to cut back on the range of routine child health screening programmes. In some areas health visitors are playing a less central role in child health surveillance. James Law and Carrie Pollard argue the need for routine screening of all children for speech and language delay, and that health visitors--with more adequate specialist training--should carry out these checks. Problems may persist for many years if not tackled in the pre-school years, they warn.

Child, Preschool↗
PubMed1991

Storage artifact increases helper T lymphocytes and helper-to-suppressor T lymphocyte ratio to normal levels in a patient with acquired immune deficiency related complex.

An increase in both the helper/suppressor T lymphocyte ratio and the absolute number of helper T lymphocytes from subnormal to normal values was observed on overnight storage of a lymphocyte preparation from a patient with acquired immune deficiency related complex. Storage of lymphocyte preparations did not significantly alter the helper/suppressor ratio for four additional patients with acquired immune deficiency related complex but produced increases for one patient with Crohn's disease and two patients with sickle cell disease. Overnight storage of heparinized blood at room temperature did not alter the helper/suppressor ratio for one healthy volunteer and one patient with acquired immune deficiency related complex but produced increases for one patient with Crohn's disease and one patient with acute infectious mononucleosis, resulting in a change from a subnormal to a normal value in the latter patient. We suggest that physicians and laboratory directors consider storage artifacts when evaluating results of tests for absolute numbers of helper T lymphocytes or helper/suppressor T lymphocyte ratios performed on patients.

AIDS-Related Complex↗
PubMed1989

Response to pneumococcal vaccine among asymptomatic heterosexual partners of persons with AIDS and intravenous drug users infected with human immunodeficiency virus.

Antibody responses to pneumococcal vaccine were studied in asymptomatic heterosexual partners of persons with AIDS and intravenous drug users seropositive for human immunodeficiency virus (HIV). Serum antibodies to 12 pneumococcal capsular antigens were measured by radioimmunoassay. Eleven intravenous drug users seropositive for HIV, 13 seronegative intravenous drug users, and 10 each seropositive and seronegative sexual partners received 23-valent pneumococcal vaccine. Additional unvaccinated matched seropositives served as controls. Antibody responses were significantly lower among subjects seropositive for HIV (P less than .05). Fourteen (88%) of 16 seropositive subjects with baseline type-specific antibodies to one or more pneumococcal antigens less than 300 ng of antibody nitrogen/ml (ngAbN/ml) demonstrated a rise in one or more of these antibodies to greater than 400 ngAbN/ml. No clinical deterioration or decrease in T4 cells attributable to vaccination was found. Although antibody responses to pneumococcal vaccine among HIV-infected subjects were impaired, most with antibody levels less than 300 ngAbN/ml developed titers of one or more type-specific antibodies to levels greater than 400 ngAbN/ml without notable adverse effects.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Lack of T cell antigen expression on hairy cells of B cell origin after in vitro exposure to PHA.

The malignant monoclonal population in hairy cell leukemia (HCL) has been variously ascribed to be of myeloid, B, or even T cell origin. Recent data have been interpreted as suggesting that hairy cells (HC) may concomitantly or serially express both B and T surface determinants, a phenomenon which, if verified, would be unique among the lymphoproliferative malignancies. Data described here, however, demonstrate that (1) at least the majority of HCL are phenotypically of B cell derivation, and (2) the initial B cell phenotype is retained and solely expressed on cultured as well as phytohemagglutinin (PHA) activated monoclonal malignant HC.

Adult↗
PubMed1983

Non-Hodgkin's lymphoma phenotyping: problems in the use of heterologous and monoclonal antibodies.

Cell suspensions or frozen sections of lymph node biopsies from 32 patients with non-Hodgkin's lymphoma (NHL) were studied for sheep erythrocyte (E)-binding under three conditions (Estandard, EAET, Egravity), Fc and C receptors, immunoglobulin (Ig) heavy and light chain class and reactivity with heterologous antisera to T cells (T-LCL), HLA-D (Ia-like) and common acute lymphocytic leukemia (c-ALL) antigens. Selected B and T cell lymphomas were also tested for reactivity with the monoclonal antibodies OKT 3, OKT 4, OKT 6, OKT 8, OKT 11A, Leu-1, Leu-2a, Leu-3a, Leu-4 and Leu-7. There were 26 B and 6 T lymphomas. Most B lymphomas were mu+ (81%), kappa+ (77%) and 31% were mu+ delta+. One of the T lymphomas arose in a patient with antecedent follicular small-cleaved (B) cell lymphoma. The most accurate marker for characterizing the immunologic phenotype in NHL was the clonal excess of kappa+ or lambda+ cells. Neither Estandard, EAET, Egravity or T-LCL were consistently reliable as sole reagents in identifying T-cell lymphomas, their individual scores often being lower than those of monoclonal pan-T cell reagents. HLA-D (Ia-like) antigen was noted in 89% of B and 50% of T lymphomas. The corresponding values for c-ALL antigen were 12 and 33%, respectively. The comparative scores in T-lymphomas between OKT 4 and Leu-3a for "helper-inducer" (HE) cells and OKT 8 and Leu-2a for "suppressor-cytotoxic" (SU) cells were not uniformly consistent. Four T lymphomas had a mixed HE/SU cell phenotype, one was HE, and another SU. Anti-T reactivity was detected in the neoplastic follicles of six of seven follicular lymphomas. The percentage of anti-T reactive cells within positive neoplastic follicles was usually small (5-15%) and of the same order as that noted within reactive lymphoid follicles (5-30%). High numbers (50-100%) of cells from five small lymphocytic B, three diffuse small cleaved cell B and six T cell lymphomas were also positive with one or more anti-T reagents, suggesting the presence of cross-reactive antigens that make phenotyping of lymphomas with monoclonal antibodies problematic. Reactivity with the monoclonal antibody Leu-7 (HNK-1), a putative NK-specific reagent, was seen in one of five B and three of five T lymphomas.

Antibodies, Monoclonal↗