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Biomedical subjects

D Catovsky

Publications and source records attributed to D Catovsky.

At least 91 records · Page 5Linked to original sources
PubMed1987

Splenic B cell lymphoma with circulating villous lymphocytes: differential diagnosis of B cell leukaemias with large spleens.

The clinical, haematological, morphological and histological features of a series of 22 patients presenting with splenic lymphoma with circulating villous lymphocytes were assessed and compared with those of patients with other forms of chronic B cell leukaemia in an attempt to differentiate this condition from hairy cell leukaemia, prolymphocytic leukaemia, and chronic lymphocytic leukaemia, with which this condition has many features in common. The disease was twice as common in men than in women, with a mean (SD) age at diagnosis of 72 (9) years, and the most consistent presenting feature was massive enlargement of the spleen, which showed white and red pulp disease with a plasmacytic component. Small monoclonal bands were found in 60% of cases.

B-Lymphocytes↗
PubMed1987

Cytochemical profile of megakaryoblastic leukaemia: a study with cytochemical methods, monoclonal antibodies, and ultrastructural cytochemistry.

A cytochemical study using: Sudan black B; alpha-naphthyl acetate (ANAE) staining; estimation of alpha-naphthyl butyrate (ANBE) esterase activity; acid phosphatase activity; and 5' nucleotidase activity was carried out in 15 cases of megakaryoblastic leukaemia. These included cases of M7 acute myeloid leukaemia and blast crises of chronic granulocytic leukaemia. The megakaryoblastic nature of the blasts was first established using two monoclonal antibodies against platelet glycoproteins, and by estimating the platelet/peroxidase reaction at ultrastructural level. Our findings suggest that megakaryoblasts have a typical cytochemical profile comprising positive ANAE staining and acid phosphatase activity with a predominant localisation in the Golgi zone and negative or weak ANBE activity. A similar positive cytochemical pattern was also found in five cases of erythroleukaemia (M6). The specificity of the 5'nucleotidase activity for megakaryoblasts was not confirmed. In most cases of megakaryoblastic leukaemia there was no 5'nucleotidase activity only two cases showed positive reactions--reactions were positive in several cases of myeloblastic and lymphoblastic leukaemia. We suggest that cytochemical methods may be useful in diagnosing M6 and M7 acute leukaemia because less than 40% of leukaemic cells react with specific monoclonal antibodies.

5'-Nucleotidase↗
PubMed1987

Splenectomy in advanced chronic lymphocytic leukaemia.

A group of 20 patients with stage C chronic lymphocytic leukaemia (CLL) and marked splenomegaly refractory to anti-leukaemia treatment was evaluated in relation to clinical course and survival after splenectomy, and compared with a control group of non-splenectomised CLL patients at the same disease stage. Patients in the former group showed a significant clinical improvement after splenectomy, being reallocated to, and maintained in, stages A (85%) or B (10%) for more than 24 months. Ten patients were still alive 24-135 months after splenectomy. The 10 deaths observed in the group of splenectomised patients occurred 4-69 months after surgery, due to disease progression and/or immunoblastic transformation (4 cases), infectious complications (3 cases) and unrelated causes (3 cases). Analysis of survival from diagnosis showed a significantly better prognosis for patients in the splenectomised group (median survival 10 years, as compared to 3.5 years for the control group). The same statistical difference, p less than 0.001, with better life expectancy for splenectomised patients, was observed when the survival was calculated from the time of progression to stage C. These results strongly suggest a beneficial role for splenectomy in advanced CLL with significant splenomegaly, when the accumulation of resistant lymphoid cells precludes an adequate control of the disease by conventional forms of treatment.

Evaluation Studies as Topic↗
PubMed1987

Markers of differentiated B cell leukaemia: CD22 antibodies and FMC7 react with different molecules.

FMC7, a monoclonal antibody used extensively to characterize B cell leukaemias of differentiated phenotype (prolymphocytic, hairy cell, and similar leukaemias) was compared directly with antibodies of the CD22 cluster, which also react with B cells at a late stage in differentiation. Detailed comparison shows that the reaction spectrum, though similar, is not identical. Differences were particularly prominent in chronic lymphocytic leukaemia (CLL) and non-Hodgkin's lymphoma (NHL). Binding studies show that the antibodies react with different antigenic determinants, and immunochemical studies show that they react with different molecules. The FMC7 antigen, not previously characterized, was shown to be a protein of apparent molecular weight 105,000, by immunoblotting after electrophoresis of membrane extracts.

Antibodies, Monoclonal↗
PubMed1987

A t(8;14)(q24;q32) in a T-lymphoma/leukemia of CD8+ large granular lymphocytes.

Chromosome studies in a case of T cell lymphoma/leukemia, in which a high proportion of the dividing cells had a t(8;14)(q24;q32) similar to that seen in Burkitt's lymphoma, are described. The tumor cells had a mature T cell phenotype (TdT-,CD3+,CD8+,CD4-) and were morphologically large granular lymphocytes and immunoblasts, both cell types with similar lysosomal granules in the cytoplasm. The immunoglobulin heavy chain gene and the T cell receptor beta chain gene were not rearranged, while the T cell receptor gamma chain gene was polyclonally rearranged. Mitoses were obtained only from spontaneously dividing cells in the absence of mitogens; 49 of the 50 metaphases analyzed were chromosomally abnormal and had a t(1;22)(q12;q13) and dup(1)(q31q32) in all of them; 48 metaphases had in addition a t(8;14)(q24;q32) which presumably arose during clonal evolution. The latter may be associated with the aggressive behavior of this T cell disorder by comparison with other proliferations of large granular lymphocytes. Although abnormalities involving 14q32 are characteristic of B cell disorders, they have also been described in T cell malignancies, suggesting that genes transcribed in T cells and/or oncogenic sequences significant in T cell neoplasia are present in 14q32.

Adult↗
PubMed1987

Cytogenetic studies on prolymphocytic leukemia. II. T cell prolymphocytic leukemia.

We report chromosome abnormalities in 15 cases of T cell prolymphocytic leukemia (T-PLL). All cases were characterized by clinical, morphological, and membrane marker analysis. The most frequent abnormality was an inv(14)(q11q32) observed in nine cases. The T cell receptor (TCR) alpha chain gene is localized to 14q11 and the immunoglobulin heavy-chain gene to region 14q32. Four cases also had translocations involving 14q11. Trisomy or multisomy for 8q resulting from an i(8q) or from rearrangements with 8p12 as the breakpoint was observed in nine cases, and a deletion of 6q was found in four cases. Trisomy or partial trisomy for 7q was observed in four cases, of which two had abnormalities of band 7q35 to which the TCR beta chain gene is mapped. The expression of Tac antigen, investigated in 27 cases of human T cell leukemia virus I-negative chronic T cell leukemia, which included the 15 cases of T-PLL, showed a good correlation with abnormalities of 7q35. Our studies on chronic T leukemias suggest that inv(14)(q11q32) and trisomy for 8q are abnormalities characteristic of T-PLL.

Antibody Diversity↗
PubMed1987

Immunoglobulin gene rearrangements in hairy cell leukemia and other chronic B cell lymphoproliferative disorders.

Immunoglobulin gene rearrangements have been investigated in 11 patients with hairy cell leukemia (HCL), 11 with prolymphocytic Leukemia (PLL), and 34 with chronic lymphocytic leukemia (CLL). Heavy and Light Ig chain gene probes have been used, and Ig genes were found in a rearranged configuration in all cases. Production of kappa and lambda light chains correlated with the respective gene rearrangements. With respect to the heavy chain locus, we found that in 6 of 21 cases of kappa-producing CLL only one allele was rearranged, whereas both alleles were rearranged in nearly all cases of lambda-producing CLL and either kappa- or lambda-producing HCL and PLL. Our data confirm the B cell nature of HCL and lead us to suggest that HCL derives from the clonal expansion of a cell at a later developmental stage than in CLL and PLL.

B-Lymphocytes↗
PubMed1987

Immunological reconstitution after bone marrow transplant with Campath-1 treated bone marrow.

Immunological reconstitution after allogeneic bone marrow transplant (BMT) was studied in 20 patients who received Campath-1 treated bone marrow. The peripheral blood lymphocyte phenotype was analysed with a panel of monoclonal antibodies at 3, 6 and 12 months. T cell proliferative capacity was evaluated by stimulation with PHA and Con A and in the mixed lymphocyte reaction (MLR). Natural killer (NK) cell activity was analysed against the K562 cell line at specified times after BMT in nine patients. Absolute numbers of T lymphocytes were reduced in all patients at 3 and 6 months. A marked decrease in the number of CD4+ cells persisted beyond 12 months. CD8+ cells regenerated more rapidly and reached normal at 6 months. No correlation was found between changes in lymphocyte subpopulations and the presence of graft-versus-host disease or cytomegalovirus infection. B cells recovered rapidly and maintained normal numbers throughout the study. A moderate increase in HNK1+ (Leu7) cells was observed at 3 and 6 months simultaneously with a low expression of NK15 (Leu11) and OKM1 antigens at 3 and 6 months, suggesting the presence of immature NK cells early after the transplant. A profound decrease of T cell proliferative capacity was observed both after mitogen stimulation and in the mixed lymphocyte reaction. NK cell activity was raised during the first month after transplant in all but one patient but no correlation was found with the presence of GVHD or cell marker analysis.

Adolescent↗
PubMed1987

Phase II study of mitoxantrone and cytarabine in acute myeloid leukemia.

Thirty-eight patients with acute myeloid leukemia (AML) were treated with mitoxantrone (Mto) combined with cytarabine (Ara-C). Five patients had received no previous treatment for acute myeloid leukemia, seven were refractory to treatment with standard first-line chemotherapy, eight had relapsed during treatment, and 18 had relapsed after treatment was stopped. Eleven of these relapses were early (within 6 months of stopping treatment). Mto was given for 5 days by iv bolus injection at a dose of 10 mg/m2 to 12 patients and at 12 mg/m2 to 26. Ara-C was given at a dose of 1 g/m2 twice daily by a 2-hour infusion for 3 days to 37 patients. One patient received Ara-C at a dose of 500 mg/m2 twice daily for 3 days. Toxicity was acceptable except for cerebellar toxicity in two patients, which was irreversible in one. Twenty-two patients (56%) achieved complete remission (CR), and four achieved partial remission (10%). Seventy-five percent of the patients who had relapsed during treatment and 58% of those who had relapsed after treatment was stopped achieved CR. Eleven patients remain in CR at a median time of 10 months (range, 3-17) after treatment. In five patients remissions have lasted greater than 1 year, one in a patient treated in second relapse and one in a patient treated in third relapse. Mto and Ara-C appear to be effective salvage therapy in acute myeloid leukemia and should be considered for incorporation into first-line induction regimens.

Adult↗
PubMed1987

Chronic lymphocytic leukemia and prolymphocytic leukemia: a clinicopathological reappraisal.

A series of 300 cases of chronic B-cell leukemia was studied in relation to clinical and laboratory features, and three groups were identified on the basis of the percentage of circulating prolymphocytes (%PROL): typical CLL less than or equal to 10% PROL, 174 cases; PLL greater than 55% PROL, 42 cases; and an intermediate group CLL/PL (11%-55% PROL), 84 cases. Some features of the CLL/PL group resemble those of PLL, such as a disproportionate splenomegaly in relation to the degree of lymphnode involvement. However, membrane markers suggested a closer affinity of CLL/PL with CLL [high percentage of M rosettes, expression of the P67 (T1) antigen, and low reactivity with the McAb FMC7], although high-density SmIg was found in one-third of CLL/PL, as well as in the majority of the PLL cases. Cells volume measurements demonstrated that the prolymphocytes of both PLL and CLL/PL are significantly larger than the homogeneous population of small lymphocytes of typical CLL. Followup studies of the PB picture in CLL and CLL/PL showed that the majority of patients maintain a relatively stable percentage of PROL, but a progressive prolymphocytoid transformation to a PLL-like disease may occur in some cases. On univariate analysis of survival, seven features of disease had a high prognostic values for the whole group of patients: %PROL, absolute number of PROL (ABS PROL), WBC, spleen size, M rosettes, SmIg intensity, and age. However, only ABS PROL (greater than 15 X 10(9)/l) and spleen size (greater than 8 cm) were shown to be independent prognostic features on a multivariate regression analysis. The median survival time of patients with PLL (3 years) was significantly shorter than the median of 8 years for patients with CLL. Within the heterogeneous CLL/PL group, patients with ABS PROL greater than 15 X 10(9)/l (two-thirds) had a median survival time as bad as for PLL patients, whereas the median has not been reached for those with ABS PROL less than 15 X 10(9)/l.

Humans↗
PubMed1987

Morphological heterogeneity of Leu7, Leu11 and OKM1 positive lymphocyte subsets: an ultrastructural study with the immunogold method.

The morphological features of normal peripheral blood lymphocytes reactive with three monoclonal antibodies (MoAb) against natural killer (NK) cells, Leu7, OKM1 (CD11b) and Leu11 (CD16) and with two anti-T cell MoAb, CD4 and CD8, have been analysed at ultrastructural level by an indirect immunogold method. Cells having the features of large granular lymphocytes (LGL) but also lymphocytes displaying different morphological characteristics (non LGL; e.g. high nucleo-cytoplasmic ratio and few cytoplasmic organelles) were seen reactive with each of the MoAb investigated. Leu7 identified a higher proportion of LGL (60-80%) than OKM1 (10-95%) and Leu11 (20-48%), and with a stronger binding. A distinct granular structure, recognized as parallel tubular arrays, was more characteristic of the Leu7+, CD8+ LGL and was less frequently seen in the OKM1 and Leu11 positive LGL subpopulation in four out of the five donors investigated. It is of interest that the Leu11 and OKM1 positive subsets, which correspond functionally to cells with greater NK function, had relatively less LGL than the Leu7 positive subsets, raising the issue of the true morphology of NK cells in man. The existence of a minority of CD4 positive LGL was confirmed. Our findings demonstrate that there is a degree of morphological heterogeneity within the normal NK lymphoid population as defined by the membrane phenotype and that certain variability among normal individuals regarding the proportion and structural features of the NK subpopulations may be present.

Antibodies, Monoclonal↗
PubMed1987

Splenic B cell lymphoma with "villous" lymphocytes in the peripheral blood: a disorder distinct from hairy cell leukemia.

The clinical and laboratory features of 23 patients with a characteristic form of splenic lymphoma with circulating "villous" lymphocytes (SLVL) are described and compared with those of other B cell disorders with preferential splenic involvement. SLVL affects predominantly men in their early 70's and is characterized by gross splenomegaly with little or no lymphadenopathy, presence of monoclonal gammopathy in two thirds of the cases, and infiltration of the peripheral blood by lymphocytes with a characteristic pattern of membrane irregularity. These lymphocytes are often confused with cells from hairy cell leukemia, from which they can be distinguished by a number of morphological features, by having a small cell volume, and by lack of expression of the HC2 and Tac antigens. The bone marrow is easily aspirated in the majority of cases and shows a relatively sparse infiltration. The spleen histology shows predominant white pulp involvement, although infiltration of the red pulp is seen in a small number of cases. The differential diagnosis of SLVL should also include hairy cell leukemia variant, prolymphocytic leukemia, and atypical forms of chronic lymphocytic leukemia.

Aged↗
PubMed1987

Monoclonal antibodies detecting plasminogen activators on the membrane of leukemic lymphoid cells of T-cell origin.

The specificities of six monoclonal antibodies produced against plasminogen activator of the human Bowes melanoma cell line are described. They have been used to detect membrane-bound plasminogen activator on cultured human lymphoid cell lines and in neoplastic human lymphocytic and myeloid cells of leukemic patients. These studies indicate that only certain phenotypic subsets of the T-cell lineage derived from patients with chronic lymphocytic leukemia or with Szezary syndrome express plasminogen activator on their surface membrane.

Animals↗
PubMed1987

Cytogenetic studies on prolymphocytic leukemia. 1. B-cell prolymphocytic leukemia.

We describe clonal chromosome abnormalities in 13 new cases of B-cell type prolymphocytic leukemia (B-PLL) investigated using pokeweed, lipopolysaccharide B, TPA (phorbol ester), and Epstein-Barr virus (EBV) as mitogens. B-PLL showed a much better response to all four mitogens when compared with B-cell chronic lymphocytic leukemia (B-CLL). A 14q+ was the most frequent abnormality and was observed in 7 of the 13 cases. A t(11;14)(q13;q32) was observed in 2 patients in this series and in 2 cases from a previous series of 9 patients studied in this laboratory, giving an incidence in B-PLL of 18% for this abnormality. The more frequent rearrangement of both IgH genes in B-PLL when compared to B-CLL may predispose to a higher incidence of 14q+ in B-PLL. Trisomy 12 which is a feature of B-CLL was observed in one case in the present series. Other abnormalities of chromosome 12 included 12p-(p12-13) in 2 cases and t(12;14)(q22;q32) in 1 case. The t(6;12) previously described as a specific abnormality in B-PLL was not observed in the 22 cases (13 present series, 9 previous series) studied in our laboratory.

Aged↗
PubMed1987

The U.K. experience with human lymphoblastoid interferon in HCL: a report of the first 50 cases.

The results of treatment of the first 50 patients with hairy cell leukemia given human lymphoblastoid alpha-interferon (Wellferon) are presented. All patients, irrespective of previous splenectomy or splenomegaly showed evidence of response. Side effects were minor. Surface marker studies provided no clear indication of the mechanism of action of alpha-interferon. It is concluded that Wellferon is highly effective in this disease.

Adult↗