Biomedical subjects

C Sundström

Publications and source records attributed to C Sundström.

At least 55 records · Page 3Linked to original sources

PubMed1997

Comparative analysis of detection systems for evaluation of PCR amplified immunoglobulin heavy-chain gene rearrangements.

Four different detection systems were compared for evaluation of polymerase chain reaction (PCR) amplified immunoglobulin heavy-chain gene rearrangements in acute lymphoblastic leukemia (ALL) and non-Hodgkin's lymphoma (NHL) of B-cell lineage. In 63.0% of the fragments detected by ethidium bromide stained agarose gel electrophoresis (Agarose-EtBr) the sensitivity was insufficient to separate the specific clonal population from the background of normal B cells. Using polyacrylamide gel electrophoresis (PAGE), PAGE combined with single-strand conformation polymorphism (PAGE-SSCP) and PhastGel-SSCP (Phast-SSCP) analysis with silver staining, the resolution was improved and the majority of the inconclusive amplicons were elucidated. However, Phast-SSCP displayed a slightly higher detection level compared to PAGE and PAGE-SSCP. According to our findings PAGE-SSCP and Phast-SSCP were superior to agarose-EtBr and PAGE in detecting new emerging clones and clonal evolution.

DNA, Neoplasm↗

PubMed1997

Molecular pathology in the diagnosis of hematologic neoplasia. Review article.

Over the past decade molecular genetic methods have played an increasingly important role in the diagnosis of hematologic malignancies. Moreover, they have provided a tool to analyze many of the non-random cytogenetic anomalies associated with hematologic neoplasias, contributing considerably to our understanding of several of those diseases, and to improving diagnostic accuracy. The rapid development of molecular genetics progressively allows the replacement of time-consuming and technically demanding procedures. Even more relevant are the new clinical applications that already include the search for valuable prognostic information and ways of evaluating minimal residual disease or recognizing early relapsing disease. This paper is a critical but necessarily simplified overview of the main contributions of molecular genetics to the field of hematopathology. We discuss the information provided by several molecular methods within different clinical contexts, covering common problems in diagnostic pathology as well as prognostic evaluation and therapy monitoring.

Chromosome Aberrations↗

PubMed1997

[18F] FDG PET in gastric non-Hodgkin's lymphoma.

The possibility of using [18F] FDG PET for assessment of tumor extension in primary gastric non-Hodgkin's lymphoma (NHL) was studied in 8 patients (6 high-grade and 2 low-grade, one of the MALT type) and in a control group of 7 patients (5 patients with NHL without clinical signs of gastric involvement, 1 patient with NHL and benign gastric ulcer and 1 patient with adenocarcinoma of the stomach). All patients with gastric NHL and the two with benign gastric ulcer and adenocarcinoma, respectively, underwent endoscopy including multiple biopsies for histopathological diagnosis. All patients with high-grade and one of the two with low-grade NHL and the patient with adenocarcinoma displayed high gastric uptake of [18F] FDG corresponding to the pathological findings at endoscopy and/or CT. No pathological tracer uptake was seen in the patient with low-grade gastric NHL of the MALT type. In 6/8 patients with gastric NHL, [18F] FDG PET demonstrated larger tumor extension in the stomach than was found at endoscopy, and there was high tracer uptake in the stomach in two patients who were evaluated as normal on CT. [18F] FDG PET correctly excluded gastric NHL in the patient with a benign gastric ulcer and in the patients with NHL without clinical signs of gastric involvement. Although the experience is as yet limited, [18F] FDG PET affords a novel possibility for evaluation of gastric NHL and would seem valuable as a complement to endoscopy and CT in selected patients, where the technique can yield additional information decisive for the choice of therapy.

Aged↗

PubMed1996

Characterization of a human basophil-like cell line (LAMA-84).

LAMA-84, a human leucocytic cell line, which upon establishment was described as having megakaryocytic, erythroid and granulocytic characteristics, was analysed for expression of various differentiation markers. In addition to some of the previously described phenotypic characteristics, this cell line was found to express mRNA for several proteins characteristic for basophilic leucocytes and mast cells. The authors show that LAMA-84 cells express mRNA for the mast cell tryptase, the proteoglycan core protein, carboxypeptidase A and the alpha and beta chains of the high affinity IgE receptor (Fc epsilon RI). The authors examined the potential of LAMA-84 to differentiate in serum-free medium or after DMSO or PMA treatment. Depending on the inducing factor, surface expression of the Fc epsilon RI alpha-chain was increased from 20% to 35-50% of the cells and mRNA levels for tryptase were increased in serum-free medium and after DMSO treatment. LAMA-84 was found to express CD13, CDw17, CD29, CD33, CD40, CD45 and CD117. Furthermore, mRNA for the eosinophil/basophil markers Charcot-Leyden crystal (CLC) protein and the major basic protein (MBP), as well as the erythrocyte differentiation marker alpha-globin, was detected. However, the authors observed only trace amounts of mRNA for another erythroid differentiation marker (glycophorin), trace amounts of the megakaryocytic marker GPIIIa, and no detectable level of GPIb alpha. By comparing the expression pattern of a panel of differentiation markers in LAMA-84, and a second human cell line (KU812) expressing a basophil phenotype, it is evident that these cell lines, which presently are the only two cell lines identified with basophilic characteristics, share a large number of phenotypic characteristics.

Antigens, Surface↗

PubMed1996

Stem cell factor, but not flt3 ligand, induces differentiation and activation of human mast cells.

We have examined the effect of human ligand for the flt3/flk2 tyrosine kinase receptor on the differentiation of human mast cells in suspension cultures. We also explored the effect of flt3 ligand (FL) on the human mast cell line HMC-1 and mRNA expression of flt3/flk2 on in vitro developed human mast cells and HMC-1. The growth of cord blood mononuclear cells in suspension cultures was increased when cells were cultured in the presence of FL compared with cells cultured in the presence of stem cell factor (SCF). When SCF and FL were combined, the total cell growth was increased further. Our data show that Fl by itself neither induced differentiation of mast cells nor acted in the SCF-dependent differentiation of human cord blood-derived mast cells (CBMC). Furthermore, no effects of FL were found on the proliferation of HMC-1 cells or the induction of early-immediate response genes in HMC-1 cells. In addition, neither HMC-1 cells nor CBMC expressed mRNA for flt3. As has been shown before, SCF and FL have little biological effect on their own but synergize well with a number of other hematopoietic growth factors. This study shows that a major difference between FL and SCF is that only SCF affects the differentiation and activation of mast cells.

Base Sequence↗

PubMed1995

A novel human B-cell line (U-2904) bearing t(8;14) and t(14;18) translocations.

Sequential activation of bcl-2 and c-myc appears to be involved in the pathogenesis of rare de novo acute lymphoid leukemias bearing both t(8;14) and t(14;18). Acquisition of t(8;14) by follicular-lymphoma cells with t(14;18) has also been related to the clinical transformation into an overt acute lymphoid leukemia in rare cases reported, and a role for c-myc involvement in the progression of some follicular lymphomas with t(14;18) has been suggested by the detection of c-myc rearrangements in association with histologic transformation. However, c-myc abnormalities different from those observed in Burkitt's lymphoma have been reported in diffuse large-cell lymphomas with breakpoints in 8q24, and a t(8;14) molecularly different from the classical one has been found in follicular lymphomas without t(14;18). We report the preliminary characterization of the EBV-negative cell line U 2904 established from a transformed follicular lymphoma that carries both t(8;14) (q24;q32) and t(14;18) (q32;q21) translocations. U 2904 cells have a mature B-cell phenotype, grow in agarose and are tumorigenic in nude mice. Rearrangements of both c-myc and bcl-2 confirmed the involvement of both oncogenes in the translocations which lead to abundant c-myc and bcl-2 transcripts. Two JH rearrangements and one C alpha rearrangement were observed which did not co-migrate with either c-myc or bcl-2 rearrangements. This is the first report of a cell line bearing both t(8;14) and t(14;18) derived from a follicular lymphoma after documented transformation into a centroblastic lymphoma without leukemic features. U 2904 provides further evidence for the involvement of c-myc in the progression of follicular lymphomas.

Animals↗

PubMed1995

The hematopoietic transcription factor PU.1 is downregulated in human multiple myeloma cell lines.

PU.1 is a hematopoietic transcription factor belonging to the Ets-family. It is identical to the Spi-1 oncogene, which is implicated in spleen focus-forming virus-induced murine erythroleukemias. PU.1 seems to be required for early development of multiple hematopoietic lineages, but its expression in mature cells is preferentially observed in cells of the B-cell-and monocyte/macrophage-differentiation lineage. It binds the so-called Pu box, an important tissue-specific regulatory DNA element present in a number of genes expressed in these cell lineages. We have analyzed the expression and activity of PU.1 during human B-cell development using a panel of B-cell lines representing different stages of maturation, from early precursors to differentiated plasma cells. PU.1 mRNA expression and PU.1 DNA binding activity, as measured by Northern blot analysis and electrophoretic mobility shift assay, respectively, were evident in cell lines representing pro-B, pre-B, and mature B cells. We could also show Pu box-dependent transactivation of a reporter gene in transient transfections in these cell lines. In contrast, in a number of multiple myeloma cell lines, representing differentiated, plasma cell-like B cells, PU.1 DNA binding activity, mRNA expression, and Pu box-dependent transactivation were absent or detectable at a very low level. In lymphoblastoid cell lines, which exemplify an intermediate stage of B-cell differentiation, a reduced expression and activity were observed. The findings in the human multiple myeloma cell lines represent the first examples of B cells with downregulated PU.1 expression and apparently contradict observations in the murine system in which PU.1 is expressed and active in plasmacytoma cell lines. At present, it is unclear whether the lack of PU.1 expression and activity in human multiple myeloma cell lines represents a malignancy-associated defect in these cells or exemplifies a normal developmental regulation in terminally differentiated B cells.

B-Lymphocytes↗

PubMed1995

Deoxythymidine kinase in the tumour cells and serum of patients with non-Hodgkin lymphomas.

The levels of deoxythymidine kinase in tumour cells (C-TK) and in serum (S-TK) were investigated and the tumour volume calculated in 89 patients with non-Hodgkin lymphoma (NHL), in order to ascertain the importance of C-TK and tumour burden as regards the S-TK levels. Among all patients, a correlation was seen between S-TK and tumour volume but not between S-TK and C-TK. However, within different tumour volume categories (small, medium-sized and large), there was a correlation between S-TK and C-TK. Multiple regression analysis supported this notion. C-TK correlated with the proliferation-associated parameters, S-phase fraction and mitotic index. As already known, S-TK was found to have a strong prognostic value. C-TK and tumour burden were also of prognostic value. In multivariate analyses, C-TK and tumour volume did not provide prognostic information in addition to S-TK, whereas, in the absence of S-TK, C-TK and tumour volume did provide additional information. It is concluded that the serum level of TK depends on both the tumour burden and the tumour cell proliferation rate. Based upon estimations of S-TK in patients assessed shortly after chemotherapy, we also suggest that S-TK reflects the number of proliferating cells that have died during the period immediately before sampling.

Cell Division↗

PubMed1995

Serum levels of interleukin-2 receptor (CD 25) in patients with Hodgkin's disease, with special reference to age and prognosis.

BACKGROUND: The serum levels of soluble interleukin-2 receptor (S-sIL-2R) have been shown to be related to clinical outcome in Hodgkin's disease (HD). sIL-2R may be involved in or aggravate the immunodeficiency seen in HD patients. This immunodeficiency is most pronounced in elderly patients. PATIENTS AND METHODS: S-sIL-2R was determined in 127 untreated patients with HD, diagnosed between 1979 and 1991, in order to evaluate its prognostic value in relation to other known prognostic variables with special emphasis on the elderly. RESULTS: S-sIL-2R levels were significantly higher in patients with stages III-IV and with B-symptoms (p < 0.001) but not in patients over 60 years of age. In multivariate analyses, S-sIL-2R, stage and S-orosomucoid were the most important prognostic factors in all patients and S-sIL-2R was the only prognostic factor in patients over the age of 60. CONCLUSIONS: The results indicate a future role for estimation of S-sIL-2R in the management of patients with HD.

Adolescent↗

PubMed1995

Predicting malignancy grade with PET in non-Hodgkin's lymphoma.

UNLABELLED: Our goal was to determine whether PET with 11C-methionine and/or 18FDG could predict malignancy grade in non-Hodgkin's lymphoma (NHL). METHODS: Twenty-three patients with high-grade, low-grade or transformed low-grade NHL were investigated. Standardized uptake values (SUV), transport rate and mass influx values were calculated both for the whole tumor [mean regions of interest, (ROI)] and for the tumor area with the highest levels of activity, comprising four contiguous pixels within each tumor and designated as a hot spot. RESULTS: Both 11C-methionine and 18FDG detected all tumors. In addition, 18FDG discriminated between high- and low-grade NHL, whereas 11C-methionine did not. With 18FDG, three transformed low-grade NHLs behaved in an intermediate manner. All quantitative uptake values correlated well with each other for both tracers, except for the mean ROI SUV and transport rate of 11C-methionine. Quantifications of mean ROI uptake and hot spots were strongly correlated. CONCLUSION: The results of this study together with previous findings from other studies indicate that 18FDG but not 11C-methionine can predict malignancy grade in NHL. Further studies with a larger series of patients are needed.

Adult↗

PubMed1995

Nonradioactive detection of monoclonal immunoglobulin heavy chain gene rearrangement with PCR-SSCP.

The rearrangement of the immunoglobulin heavy chain gene can be used as a marker of B-cell lineage and clonality. By using polymerase chain reaction (PCR) with variable-region and joining-region specific primers it is possible to detect the rearrangement of a small amount of clonal B cells, as described by several groups. The specific PCR product can be detected after amplification with gel electrophoresis and ethidium bromide staining. The DNA fragments obtained from different clones are, however, approximately of the same size, making it difficult to distinguish between the clones by simple electrophoresis and ethidium bromide staining, as described in many reports. Single-strand conformational polymorphism (SSCP) was evaluated as a method to detect specific clonal amplicons in a mixture of PCR-amplified products. Unique patterns were obtained for different B-cell clones, detectable in mixtures of 0.25% clonal cells in normal cells. It is concluded that SSCP is a valuable method for the specificity control of PCR in B-lymphocyte clonality analyses. The advantages of the described method over previously published techniques are increased specificity, simplicity without radioactivity, and rapidity.

Adult↗

PubMed1994

Detection of tumor-specific cytotoxic drug activity in vitro using the fluorometric microculture cytotoxicity assay and primary cultures of tumor cells from patients.

The semi-automated fluorometric microculture cytotoxicity assay (FMCA), based on the measurement of fluorescence generated from cellular hydrolysis of fluorescein diacetate (FDA) by viable cells, was employed for cytotoxic drug sensitivity testing of tumor cells from patients with hematological or solid tumors. In total, 390 samples from 20 diagnoses were tested with up to 12 standard cytotoxic drugs. The technical success rate for different tumor types ranged from 67 to 95%. Fluorescence was linearly related to cell number but variably steep depending on tumor type. Samples from most solid tumors thus showed higher signal-to-noise ratios than hematological samples. A wide spectrum of in vitro drug activity was obtained, with acute leukemias and non-Hodgkin's lymphomas being sensitive to almost all tested drugs, whereas renal and adrenocortical carcinomas were essentially totally resistant. Between these extremes were samples of breast and ovarian carcinomas and sarcomas. When in vitro response was compared with known clinical response patterns, a good correspondence was observed. The results indicate that the FMCA is a rapid and efficient method for in vitro measurement of tumor-specific drug activity both in hematological and in solid tumors. The assay may be suitable for new drug development and direction of phase-2 trials to suitable patients.

Antineoplastic Agents↗

PubMed1994

In vitro drug sensitivity testing of tumor cells from patients with non-Hodgkin's lymphoma using the fluorometric microculture cytotoxicity assay.

BACKGROUND: Tumor cell drug sensitivity is an important determinant of chemotherapy response. Its measurement in vitro would aid in therapy individualization and new drug development. MATERIALS AND METHODS: The fluorometric microculture cytotoxicity assay (FMCA), based on production by viable cells of fluorescent fluorescein after 3 days of culture, was used for cytotoxic drug sensitivity testing of 73 samples of tumor cells from patients with non-Hodgkin's lymphoma (NHL). RESULTS: The technical success rate was 92%, and FMCA data showed good correlation to the Disc assay. NHL samples were considerably more drug sensitive than were samples from in vivo resistant tumors. There was no obvious difference in drug sensitivity for high- vs. low-grade or untreated vs. previously treated low-grade NHL. For 26 patients, clinical outcome was correlated to in vitro response giving a sensitivity and specificity of 93 and 48%, respectively. Cross-resistance between standard drugs was frequent in vitro. Resistance modulators potentiated the effect of vincristine and doxorubicin in 10-29% of the samples, most frequently from previously treated patients. CONCLUSIONS: The FMCA seems to report clinically relevant drug sensitivity data for NHL, and thus it could serve as a tool for optimization of chemotherapy in the future.

Cell Survival↗

PubMed1994

Multiclonality and altered RFLP patterns for immunoglobulin heavy-chain and T-cell receptor genes in relapsing lymphomas.

BACKGROUND: Alteration of morphological appearance as well as of clinical behaviour is common in relapsing non-Hodgkin's lymphomas. The aim of this study was to investigate the stability of the genes encoding the immunoglobulin heavy-chain and the T-cell receptor during the course of the disease in relapsing non-Hodgkin's lymphomas. MATERIAL AND METHODS: Nineteen patients with relapsed or progressive non-Hodgkin's lymphomas were analysed with respect to alterations of the restriction fragment length polymorphism (RFLP) pattern for Ig heavy chain (IgH) using probes for the C mu and J regions and for T-cell receptor (T-beta, T-gamma chain) genes. DNA was extracted from tumour material taken at different occasions during the course of the disease. RESULTS: All 19 cases showed clonal rearrangements of the IgH locus, and 2 cases showed simultaneous rearrangement of the genes coding for the T-cell receptors. Three or more rearranged bands, indicating more than one malignant clone, were detected in 1 case at the time of the diagnosis and in 5/19 (26%) cases in DNA from samples taken at relapse, all 6 cases showing discordant or transformed morphology. Altogether, in 11 out of 19 cases (58%), changes of the IgH rearrangement pattern could be visualized by RFLP. In all these cases except one, the new RFLP pattern included at least one rearranged band from the pattern of the first taken sample. In one case a clonal T-gamma receptor gene rearrangement was detected in a diagnostic sample but not in a sample taken at relapse. In 4 out of 6 cases with transformed lymphomas, clonal changes were observed at time of transformation. Evolution of clones with different RFLP patterns in different compartments were observed in 1 out of 6 studied cases. CONCLUSIONS: The present study illustrates that non-Hodgkin's lymphomas are unstable in their IgH genome. The observations of clonal evolution, multiclonality, and different clones in different compartments offer an explanation to the troublesome situation when treating relapsed lymphomas.

Cloning, Molecular↗

PubMed1994

Phenotypic characterization of the human mast-cell line HMC-1.

The cell line HMC-1, derived from a patient with mast cell leukaemia, is the only established cell line exhibiting a phenotype similar to that of human mast cells. This paper reports on a detailed characterization of the expression of a panel of markers for various types of immature and mature haematopoietic cells in the HMC-1. We also studied the potential of HMC-1 to differentiate upon treatment with conditioned media from the human T-cell line Mo, retinoic acid or DMSO. HMC-1 was found to express several mast cell-related markers. A high expression of Kit, the receptor for stem-cell factor, was detected. The majority of the cells were stained with a MoAb against the mast cell-specific serine protease tryptase. Of particular interest was the finding that beta-tryptase mRNA, but not alpha-tryptase mRNA, was expressed in HMC-1. Using enzyme-histochemistry we were able to show that the beta-tryptase was enzymatically active, indicating that tryptase can form active homotetramers. Both heparin and chondroitin sulfate were found to be present in approximately equal amounts. HMC-1 lacked surface expression of the high-affinity IgE receptor, which was confirmed by the absence of mRNA of the alpha- and beta-chains of the IgE-receptor complex. However, a strong expression of the gamma-chain of the IgE-receptor complex was detected. A positive staining of the monocyte/macrophage marker CD68 was obtained, as well as a strong hybridization signal for the eosinophilic/basophilic-related differentiation marker the Charcot-Leyden crystal. Treatment of HMC-1 with conditioned media from the human T-cell line Mo, retinoic acid or DMSO induced only moderate changes in the surface or intracellular expression of the studied markers. The agents tested neither induced any of the monocyte/granulocyte markers examined, nor expression of the Fc epsilon RI alpha-chain.

Amino Acid Sequence↗

PubMed1994

Diagnostics of malignant lymphomas with ultrasound guided 1.2 mm biopsy-gun.

In a retrospective analysis of 129 ultrasound-guided biopsy-gun biopsies (USGB) from patients with known or suspected malignant lymphoma, a histopathological diagnosis was obtained in 101 (78%) instances and no further procedures for histological verification were required. In the 28 cases with initially non-diagnostic results, 14 new USGBs were performed and a diagnosis was obtained in 11. Thus, a total success rate of 87% was achieved. The correct diagnosis was confirmed with either surgery, autopsy, or radiological or clinical follow-up (median 40 months). The diagnoses were categorised as Hodgkin's disease and high-grade or low-grade non-Hodgkin's lymphoma. Further subtyping of the lymphoma was possible in a few cases only. Immunohistochemistry was utilised only in a minor proportion of the cases (25/129), but refined the diagnosis in several instances. The biopsy-gun method was safe and minor adverse effects were seen in two patients only.

Adolescent↗

PubMed1993

In vitro testing of chemotherapeutic drug combinations in acute myelocytic leukaemia using the fluorometric microculture cytotoxicity assay (FMCA).

The fluorometric microculture cytotoxicity assay (FMCA) was employed for analysing the effect of different chemotherapeutic drug combinations and their single constituents in 44 cases of acute myelocytic leukaemia (AML). A large heterogeneity with respect to cell kill was observed for all combinations tested, the interactions ranging from antagonistic to synergistic in terms of the multiplicative concept for drug interactions. However, an 'additive' model provided a significantly better fit of the data compared to the effect of the most active single agent of the combination (Dmax) for several common antileukaemic drug combinations. When the two interaction models were related to treatment outcome 38% of the non-responders showed preference for the additive model whereas the corresponding figure for responders was 80%. Overall, in 248 of 290 (85%) tests performed with drug combinations, there was an agreement between the effect of the combination and that of the most active single component. Direct comparison of Dmax and the combination for correlation with clinical outcome demonstrated only minor differences in the ability to predict drug resistance. The results show that FMCA appear to report drug interactions in samples from patients with AML in accordance with clinical experience. Furthermore, testing single agents as a substitute for drug combinations may be adequate for detection of clinical drug resistance to combination therapy in AML.

Adult↗

PubMed1993

Decreasing autopsy rate in Sweden reflects changing attitudes among clinicians.

The autopsy rate has declined in the last 20 years in Sweden and is now approximately 30%. Clinical autopsies constitute about 18% and medico-legal autopsies somewhat more than 10%. There is an obvious geographical variation in clinical autopsy rate, whereas the variation in medico-legal autopsy rate is narrower. The difference in autopsy frequency between males and females seemed to be mainly dependent on the higher number of medico-legal autopsies among males. In order to explore the reasons behind the decline in autopsy rate we accomplished a study of the autopsy rate in 1986 and 1991 in three Swedish hospitals of various types and sizes. The hospitals studied were one university hospital and two community hospitals of different sizes. The autopsy rate varied between 0 and 100% among the different departments within these hospitals and also varied considerably between wards within the same department. The number of clinical autopsies declined between 1986 and 1991 in all three hospitals. The fall was greatest in the university hospital and in the larger of the two community hospitals. However, in these two hospitals departments with active research of clinico-pathological relevance maintained or even increased their autopsy rate during this period. The decline in autopsy rate in general and the difference in rate between hospitals, departments and wards could be explained neither by the Autopsy Act of 1976, or by the reluctance of relatives to give consent to the autopsy of a relative. A change in attitude toward and interest in the autopsy activity of clinicians seemed to be the major explanation for the decline of the autopsy.

Adolescent↗