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Biomedical subjects

D C Heaton

Publications and source records attributed to D C Heaton.

49 records · Page 3Linked to original sources

Cytogenetic studies of acute promyelocytic leukemia.

Translocation t(15;17) is reported in bone marrow cells from six of seven patients with active acute promyelocytic leukemia (APL). One patient who showed t(15;17) at final relapse did not show it in directly prepared or cultured cells taken from a previous relapse. Bone marrow samples from two patients showed only cells with a normal karyotype in the direct preparation, whereas more than 60% of cells cultured for 24 hr showed t(15;17). R-Banding, G-banding, and an attempt at high-resolution banding indicated the break points t(15;17)(q24;21) for one of our patients.

Adult↗

Bone marrow transplantation for acute leukaemia and severe marrow aplasia: an analysis of five patients.

Five patients, three with severe aplasia and two with acute leukaemia have been treated by bone marrow transplantation (BMT). Four are alive and well with excellent graft function. One showed engraftment but died of acute graft-versus-host disease (GVH); this patient and his donor were hepatitis B antigen positive. Three show evidence of mild chronic GVH, two patients requiring control by immunosuppressive therapy. Bone marrow transplantation (BMT) has now become an established method of treatment in severe aplasia and in acute leukaemia and our results serve to emphasise this. The clinical and organisational problems associated with BMT are discussed.

Adolescent↗

Right atrial catheters for long-term venous access.

Thirty-two Hickman central venous catheters were placed in patients suffering mainly from blood disorders. The catheters remained in situ for an average of 64 days. In 20 patients the catheters were removed either because they were no longer needed (14) or at death (6). In five patients they are still in position. Complications in seven patients led to the catheter being removed and these included four patients with catheter related sepsis. The use of these catheters allows safe long-term access to the venous circulation even in the neutropenic, immunosuppressed patient.

Bacterial Infections↗

The peripheral blood picture in thyrotoxicosis.

The haematological results of 200 patients with uncomplicated thyrotoxicosis is reviewed. Although more than half of the patients showed a normal blood picture, several abnormalities were detected. In 37 percent of patients the erythrocytes showed microcytosis, and 8.5 percent were mildly anaemic. An absolute lymphocytosis was found in 11 percent and neutropenia was present in 2.5 percent of patients. The prevalence of treated pernicious anaemia was 1.5 percent.

Adolescent↗

Acute promyelocytic leukemia: cytogenetics and bone-marrow culture.

Six patients were diagnosed as having acute promyelocytic leukemia (APL) according to FAB criteria. One patient conformed to the M3 variant. Informative cytogenetic results (G-banding) on five of the patients showed that three of them, including the M3 variant, had the 15;17 translocation in bone-marrow or blood cells. Cells with the translocation were accompanied by cells with a normal karyotype in all patients and no other chromosomal abnormality was present. This first report of the 15;17 translocation from the South Pacific region is relevant to the uneven geographical distribution of APL patients with the translocation. Five of the six patients including the M3 variant, showed a distinctive pattern of cell growth in agar culture characterized by a profusion of small, uniform clusters containing 6-20 cells with the appearance of promyelocytes. The remaining patient had a pattern of cell growth more typical of M2 acute leukemia. This cell growth pattern may be useful in diagnosing and monitoring the course of APL.

Aged↗

Transient leukemoid proliferation of the cytogenetically unbalanced +21 cell line of a constitutional mosaic boy.

A newborn without any signs of Down's syndrome was found to have an acute proliferation that remitted without drug therapy. Chromosomal analysis of blood, bone marrow, and skin cells revealed that the child was a constitutional mosaic with normal cells and a low number of cells in which one no. 21 chromosome was replaced by a probably isochromosome for the no. 21 long arm: 46,XY/46,XY,i(21q). The abnormal cell line of the mosaic appeared to be selectively involved in this proliferation.

Acute Disease↗

Bone marrow transplantation for severe aplastic anaemia.

An eight-year-old girl with severe acquired aplastic anaemia received a bone marrow transplant from her 11-year-old brother. The bone marrow graft is firmly established, but the patient has mild chronic graft versus host disease affecting liver and skin. The indications for bone marrow transplantation in aplastic anaemia are discussed.

Anemia, Aplastic↗

Adolescent and adult lymphoblastic leukaemia: prognostic factors and response to treatment.

Thirty consecutive patients with acute lymphoblastic leukaemia (ALL) who received treatment at Christchurch Hospital between 1972 and 1982 were reviewed. Complete remission (CR) was achieved in 80 per cent with a median survival of 65 weeks. Eleven of 30 patients had one or more of the following features--B cell ALL, a mediastinal mass, the Philadelphia chromosome (Ph1) and age 60 years or older at diagnosis. Although CR was obtained in 8 of these patients none survived three years. The remaining 19 patients were regarded as 'good risk' and treated by moderate intensity chemotherapy schedules. CR was obtained in 16 of these patients (84 per cent) and the estimated 5 year survival was 62 per cent with 6 patients remaining in remission from 5 to 9 years from diagnosis. These results demonstrate the value of objective and reproducible clinical and laboratory findings in defining a subset of ALL patients which may not require high intensity chemotherapy schedules.

Adolescent↗

A cytological analysis of FMC-7 positive leukaemias.

The subdivision of the B lymphoid leukaemias by conventional techniques is subjective and poorly reproducible, with a range of cytological diagnoses available for cases which are not typical examples of chronic lymphatic leukaemia or acute lymphoblastic leukaemia. The monoclonal antibody FMC-7 recognizes a determinant on a subpopulation of B lymphoid cell and stains follicular B cells. Routiune FACS analysis of chronic lymphoid leukaemias with a panel of monoclonal antibodies identified a subset of lymphoproliferative disorders (20 of 88) which were FMC-7 positive. a careful 'blind' cytological assessment of this subset gave some support for the suggestion that they were examples of lymphoproliferative disease of follicular origin. Eight cases, however, were considered cytologically typical of CLL. The wider application of this antibody, particularly in sequential studies over a longer time scale may improve objectivity in the classification of this group of diseases.

Antibodies, Monoclonal↗

Genomic diversity correlates with clinical variation in Ph'-negative chronic myeloid leukaemia.

The Philadelphia chromosome (Ph') is found in the blood cells of about 90% of patients with chronic myeloid leukaemia (CML) and usually results from the reciprocal chromosome translocation t(9;22). This translocation relocates the proto-oncogene c-abl, normally found on chromosome 9q34, to within the breakpoint cluster region (bcr) on chromosome 22q11 (refs 3-8). The juxtaposition of c-abl and the 5' portion of bcr appears to be the critical genomic event in CML and results in a novel 8-kilobase (kb) fused abl/bcr transcript and a c-abl-related protein of relative molecular mass 210,000 (ref.11). About 10% of adult patients diagnosed as CML lack the Ph' chromosome; they represent a heterogeneous group of disorders which are difficult to diagnose precisely. We have examined five patients with CML whose leukaemic cells have a normal karyotype. We report here that two of the patients showed the same genomic change as occurs in Ph'-positive CML, but the change resulted from a mechanism other than chromosomal translocation. The remaining three patients showed no genomic rearrangement. This genomic diversity correlated with the clinical differences between the patients.

Adult↗

Jk(a-b-) red blood cells resist urea lysis.

Falsely high automated platelet counts in a patient with aplastic anemia were found to be due to increased resistance of the red blood cells to urea lysis. The patient's blood group Jk(a-b-). Further investigation revealed that this phenomenon occurred with all of eight bloods of the phenotype Jk(a-b-) but not with red blood cells of other phenotypes tested. We therefore report an association of a rare blood group phenotype with unusual red blood cell behavior in vitro.

Adult↗