Biomedical subjects
Publications and source records attributed to H Sabio.
Evidence is presented that neuroblastoma tumor cells in host bone marrow is susceptible to autologous lymphokine-activated killer cells (LAK). Thus, immunologic purging of bone marrow with LAK may be considered as a tool in the arsenal of bone marrow purging-for autologous bone marrow transplantation.
We have reported a case of localized thymic enlargement and uptake of gallium 67 in a child who had received antineoplastic chemotherapy. The enlarged thymus showed normal histology, a picture consistent with thymic rebound after nonspecific stress. This case further demonstrates the need to consider thymic rebound as a cause of gallium 67 uptake in children with neoplastic diseases.
To assess the neuroendocrine function of long-term survivors of childhood hematologic malignancies, 10 patients who had acute lymphocytic leukemia and two who had non-Hodgkins lymphoma (NHL) (mean age 13.5 +/- 1 year) were studied, who were treated with similar chemotherapeutic regimens with or without 2,400 rads of prophylactic cranial irradiation. Pharmacologic growth hormone (GH) stimulation tests and three graded doses of the GH-releasing hormone (1-40-OH-GRH, 0.1, 0.3, and 1 microgram/kg) were administered. Venous sampling for GH and gonadotropin determinations was done at 20-min intervals for 24 h, and a new computerized pulse detection algorithm was used to analyze pulses. All the patients who had neuroendocrine abnormalities were in the cranially irradiated group. Two of the 12 patients were GH deficient, and had abnormal 24-h secretory profiles, blunted GH responses to pharmacologic stimuli, and minimal responses to the three doses of GRH. The pulsatile properties of luteinizing hormone (LH) were normal in 10 of the 12 nongonadally irradiated patients, irrespective of previous cranial irradiation and pubertal stage, when compared with available normative data.(ABSTRACT TRUNCATED AT 250 WORDS)
Explore the source record for details and available documents.
From May 1979 to March 1983, 76 evaluable patients with lymphoblastic lymphoma (LBL) were treated by members of the Pediatric Oncology Group (POG). Forty-six children treated by the six-drug A-COP+ regimen (Adriamycin [doxorubicin; Adria Laboratories, Columbus, OH], vincristine, prednisone, cyclophosphamide, methotrexate, and hydrocortisone) were compared in a prospective randomized trial with 30 patients receiving the modified ten-drug LSA2-L2 (cyclosphosphamide, vincristine, methotrexate, Daunomycin [daunorubicin cerubidine; Wyeth Laboratories, Philadelphia], prednisone, cytarabine, thioguanine, asparaginase, hydroxyurea, and carmustine) regimen. After adjusting for stage (I and II v III v IV), there was no statistically significant difference (P = .19) between A-COP+ and LSA2-L2 regimens on the basis of 3-year survival and disease-free survival (62% v 72% and 53% v 58%, respectively for the two treatment regimens) but the power of analysis and thus the ability to detect a clinically meaningful difference in the outcome with the two regimens was limited by the small number of patients. Neither therapy was effective for most patients with stage IV disease, with failure occurring in six of seven children receiving A-COP+ regimen and eight of 11 patients receiving LSA2-L2. Although the LSA2-L2 regimen was more toxic during the induction of remission, the toxicity during maintenance was acceptable and similar for both treatments. CNS relapse was not a significant problem whether cranial radiation with intrathecal (IT) therapy (A-COP+) or IT therapy alone (LSA2-L2) were used. Our results confirm the overall effectiveness of the LSA2-L2 regimen in children with LBLs, especially those initially free of bone marrow or CNS involvement, but were inconclusive as to the inferiority or superiority of this regimen over the A-COP+ regimen.
Explore the source record for details and available documents.
This study details the case reports of two children who developed slipped capital femoral epiphyses (SCFE) after receiving external irradiation. The clinical and diagnostic features of postradiation SCFE are reviewed and discussed. Guidelines for the management of children who receive pelvic irradiation are presented.
Explore the source record for details and available documents.
A case of familial Pelger-Huet anomaly in a 3-year-old boy with acute lymphoblastic leukaemia is described. This unique association was investigated through trial observations of the peripheral blood smear and bone marrow obtained during the child's treatment with chemotherapy. The average lobe index (ALI) of neutrophils was 42 with no three-lobed forms at the time of the initial diagnosis. During antimetabolite maintenance therapy with 6-mercaptopurine and methotrexate the ALI was 1.87 and three-lobed forms were present. The behaviour of the P-HA cells to heat induced radial hypersegmentation of the nucleus was examined in other family members. The mechanism by which heat and folate deficiency induce neutrophil segmentation is preserved in the familial Pelger-Huet anomaly.
Explore the source record for details and available documents.
Endodermal sinus tumor of the vagina, a rare pediatric malignancy, was managed with primary chemotherapy (vincristine, dactinomycin, cyclophosphamide [VAC]) followed by local excision without radical surgery or pelvic irradiation. Treatment-related complications were acceptable, and there is no evidence of disease 30 months after discontinuing all therapy (50 months after diagnosis). As a treatment option, primary chemotherapy is viewed as a highly attractive alternative modality, preserving potential reproductive and sexual function in long-term survivors, and appears to be the treatment of choice.
The clinical and laboratory features of six children with arthritis as the presenting manifestation of acute leukemia are reviewed. Asymmetric arthritis involving the large joints of the extremities was the dominant clinical feature in all patients. Despite the presence of antinuclear antibody in three patients, other laboratory features, particularly hematologic abnormalities, served as clues to the diagnosis of leukemic arthropathy in most patients.
The association of immunosuppression and head and neck cancer is supported by numerous reports demonstrating impaired cell-mediated immunity, depressed T-cell function, decreased lymphocyte responsiveness, and elevated circulating immune complexes. Fanconi's anemia (FA) is a rare autosomal recessive syndrome characterized by progressive pancytopenia, skeletal abnormalities, hyperpigmentation, and other congenital anomalies. Increased chromosomal instability and defective DNA repair have been uniform findings. Several reports suggest associated immune deficiencies. There is an increased frequency of leukemia, hepatocellular carcinoma, and squamous cell carcinoma (SCC), including six cases of head and neck SCC. We reported a young girl with FA who developed SCC of the tongue. Initial studies suggest low lymphocyte counts, but normal lymphocyte responsiveness. More precise characterization of the immune system defects in malignancy prone, genetically determined syndromes may provide clues for the diagnosis and treatment of patients with the more usual but more variable risk factors for SCC of the head and neck.
Murine bone marrow was exposed to hyperthermia temperatures of 41.5 to 45.5 degrees C. The proliferation capacity of myeloid progenitor and committed precursors was assayed in vivo utilizing spleen colony formation and diffusion chamber (DC) techniques. The survival of both pluripotential (CFU-S) and committed myeloid (CFU-DG) stem cells decreased exponentially with an increase in the heating period. Progression from CFU-S to CFU-DG significantly altered thermal sensitivity in the temperature range examined. Proliferation of mature granulocyte-monocytes (G-M) in DC is more thermostable than their stem cell precursors. Heat inactivation energies (enthalpies) of CFU-S and CFU-DG were derived from the slope of the heating time survival curves. Enthalpy of CFU-S is 300 kcal/mole below 43 degrees and 105 kcal/mole above 43 degrees. The enthalpy of CFU-DG is 250 and 145 kcal/mole below and above 43 degrees, respectively.
A 21-year-old man who developed heavy proteinuria 8 years after remission of Hodgkin's disease treated with MOPP chemotherapy and radiation therapy is reported. Evidence of Hodgkin's disease could not be documented, and minimal changes were revealed by renal biopsy. Proteinuria persisted for 20 months and was followed by dysuria and the discovery of an inflammatory polyp of the bladder. The proteinuria decreased 1 month after excision of the polyp, and disappeared during the following year. Rather than indicating relapse of lymphoma, proteinuria in this patient resulted from a lesion not previously associated with Hodgkin's disease, but possibly resulting from long-term effects of therapy.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Multiple cutaneous xanthomas developed in a patient at the age of 10 months, and juvenile chronic myeloid leukemia (JCML) developed at the age of 30 months. The xanthomas were histopathologically consistent with a diagnosis of juvenile xanthogranuloma (JXG). A review of other cases of JCML with JXG indicates that the cutaneous lesions have many clinical and histopathologic similarities to sporadic JXG but are more often multiple or papular and confluent. In addition to JXG, a few children with JCML also have multiple café-au-lait spots and a family history of neurofibromatosis.