Biomedical subjects
Publications and source records attributed to K Kuliczkowski.
The case of acute lymphoblastic leukemia complicated by candidiasis of liver and bile ducts is described. After treatment with amphotericin B, flucytosine and fluconazole jaundice and fever disappeared. Liver function improved and Candida count in bile decreased. The patient died of pulmonary infection six months later.
Influence of sera of 15 patients with acute lymphoblastic leukaemia (ALL) and 28 with acute myeloblastic leukaemia (AML) on proliferation and differentiation of human leukaemic cell lines K-562 and HL-60 in a 3 days liquid culture was examined. Differentiation of K-562 cells was measured by the percentage of cells synthesizing Hb, and HL-60 cells by the percentage of cells with positive NBT test and positive NSE activity. Additionally the influence of differentiation inducers such as hemin for K-562 and DMSO and TPA for HL-60 was examined. It has been found that sera of patients with ALL and AML inhibit the proliferation of K-562 and HL-60 cells, induce the differentiation of K-562 cells, but inhibit the induction of differentiation by hemin. The sera of the examined patients inhibit the differentiation of HL-60 into granulocytes and monocytes, but do not affect the differentiation induced with DMSO and TPA.
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Drug resistance of marrow plasma cells had been measured in vitro before chemotherapy was started. Resistance to melphalan was found in 20, to BCNU in 27 and to epirubicin in 38 out of 65 myelomas. Nineteen myelomas were resistant to a single cytostatic, 14 to two cytostatics and further 13 to all three. Patients with plasma cells resistant to melphalan in vitro failed to reduce 50% of monoclonal Ig plasma level after therapy along the VBMCP (M2) protocol, whereas sensitive myelomas responded to this program satisfactorily. Patients with cells resistant to two or three cytostatics, beside a bad therapeutic response, had also a shorter survival time. Results in vitro were in conformity with in vivo effects in 78%.
The study was designed to investigate the usefulness of some biochemical indices for determination of lead toxicity. In exposed and control groups, the following parameters were measured: concentration of lead in the blood, level of free erythrocyte protoporphyrins and delta-aminolevulinic acid dehydratase activity of erythrocytes. Levels of sodium, potassium, calcium, magnesium, copper and zinc in the serum and erythrocytes as well as of iron in the serum were determined. The chelation test was performed and excretion of lead, coproporphyrins and delta-aminolevulinic acid (in 24 hour urine sample before and after EDTA injection) identified only in the exposed group. Absorption of lead was significantly higher in the exposed group (increased blood lead level (Pb-B), free erythrocyte protoporphyrin (FEP) and decreased erythrocyte ALA-dehydratase (ALA-D) activity. Levels of copper and calcium in the serum and red blood cells were significantly lower in comparison with the controls. Iron and sodium concentration in the serum as well as levels of potassium, magnesium and calcium in erythrocytes were significantly higher in the exposed group. The chelation test in the exposed group showed a significantly increased excretion of lead in 24 hour urine sample. Concentration of delta-aminolevulinic acid in 24 hour urine sample was lower after EDTA injection.
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Plasma cells derived from marrow aspirates of 21 untreated myeloma patients have been cultured in RPMI 1640 medium containing 3H-thymidine and melphalan. Thereafter plasma cell-labelling index was determined autoradiographically. In 20 patients melphalan caused a measurable decrease in the percentage of labelled plasma cells. Decreases in labelling index ranging from -4% to 3% have been considered as indicating the resistance of myeloma cells to melphalan in vitro. Decreases within this range have been found in 7 patients. In other 13 myelomas with chemosensitive marrow plasma cells, melphalan did reduce the labelling index to values ranging from 4% to 24%. Some clinical implications of the tests are discussed.
Natural killer (NK) cell activity was investigated in 108 patients with Hodgkin's disease (HD) during the course of the disease and in 50 healthy volunteers. NK activity of peripheral blood lymphocytes was evaluated against 51Cr labeled K562 cell line in 4 hr Cr release assay. The mean NK activity was highly significantly lower in patients before treatment and in patients in the active phase of the disease during treatment compared with controls, whereas in patients in complete clinical remission was significantly higher. However, in patients responding to treatment NK activity was increasing, reaching normal rate in remission and was exceeding further during remission duration. Nonresponders to treatment showed considerable decrease of NK activity to undetectable values. The pretreatment level of NK activity was not related to subsequent prognosis of the individual patient.
Sister chromatid exchange (SCE), percentage of first, second, third mitoses, blastic transformation index and mitotic index in patients with myelodysplastic syndrome (MDS) (3 with refractory anaemia, 2 with refractory anaemia with sideroblasts, 1 with refractory anaemia with excess of blasts, 4 with refractory anaemia with excess of blasts in transformation) and in 15 healthy volunteers were estimated. Three types of lymphocytes cultures were set up: first with phytohemaglutinin (PHA), second with PHA and bromodeoxyuridine (BRdU), third with BRdU. In healthy persons the SCE frequency was negatively correlated to proliferating rate index, but in MDS such correlation was not found. The lymphocytes cell cycle duration based on percentage of mitoses was longer in MDS patients than in controls. The results of our studies show the disturbances of lymphocytes during cell cycle division resulting in higher SCE frequency and lower proliferating rate compared to controls.
In 20 patients with non-Hodgkin lymphoma as the first treatment and in 10 patients with the same diagnosis as the second treatment (group II) has been applied the therapeutical protocol proposed by I. Koza et al., composed of 4 monthly cycles of cyclophosphamide, vincristine, bleomycin, methotrexate and prednisone and in the other 4 cycles of doxorubicin, vincristine bleomycin, prednisone. The diagnosis in the I group was: immunoblastic lymphoma in 13 cases, other high grade lymphomas in 5 and low grade lymphoma in 2 cases. In the group II half of the patients showed low or intermediate grade lymphoma but with maximal clinical advancement and resistance to previous therapy. Complete remission (CR) has been obtained in 12 patients of the I group, partial remission (PR) in 7, 1 patient did not respond to therapy. In 3 cases relapse of the disease has been noted, including 2 patients in whom relapse occurred before finishing therapy: the patients remained resistant to alternative one. In the group II the PR and CR has been obtained in 5 and 3 cases respectively: 2 patients with immunoblastic lymphoma resistant to previous therapy did not respond either. Among undesirable effects myelosuppression, mainly granulocytopenia has been mostly noted: infection and septic shock was a cause of death in 1 patient. In 2 patients severe polyneuropathy and in 2 other mucositis of the digestive tract was noted. The treatment used gives beneficial results as induction therapy in cases of immunoblastic lymphoma and enables obtaining remission in therapy resistant cases of low grade lymphoma.
The influence of low doses of harringtonine (Ht) on differentiation of blood cells from acute myeloblastic (AML) and lymphoblastic leukemia (ALL) patients diagnosed according to FAB classification was tested. Out of five cases of ALL only in one case differentiation into mature lymphocytes appeared. In two cases out of four of AML differentiation was seen in one case into more mature granulocytic series and in another one into monocytes. Two out of 3 acute myelomonocytic leukemias (AMMOL) differentiated, one into more mature granulocyte cells and one into monocytes. One of our patients with AML (M2) in relapse was treated with ht using HOAP (harringtonine, oncovin, adriblastine, prednisone) schedule with good but transient effect. Prior to therapy in vitro tests performed with ht showed differentiation of leukemic cells into more mature granulocyte cells.
The effect of LD Ara-C (10(-8) mol/l) (Ara-C), TPA (1.6 x 10(-7) mol/l) and 13-cis-retinoic acid (RA) (10(-6) mol/l) on the differentiation in liquid culture of bone marrow cells from 5 patients with acute lymphoblastic, 17 patients with acute myelogenous leukemia, 1 patient in myeloid and 1 in lymphoid crisis of chronic granulocytic leukemia was studied. Ara-C induced morphological and cytochemical differentiation into monocytic cells in 2 cases (M1, M5 type). TPA induced convincing morphological and cytochemical features of maturation into monocytic cells in 4 cases (two M1, one M2, and one M5 type) and into differentiated myeloid cells in 2 cases (M1, M4 type). RA in one case (M2 type) out of three AML studied induced cytochemical and immunocytochemical features of maturation. The results of the study indicate that although TPA is a better inducer of blast cell differentiation than Ara-C, however, neither is a potent differentiation agent of leukemic blasts in liquid culture. The heterogeneity of leukemic blasts within the same type of leukemia was confirmed by their different response to differentiating agents.
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Various immunological parameters were studied in 20 asymptomatic patients with hemophilia A, 3 patients with hemophilia B and 1 patient with von Willebrand disease. Patients were treated with cryoprecipitate or fresh frozen plasma. Significantly decreased mean percentage and absolute count (p less than 0.01) of peripheral blood E-rosette-forming cells compared to controls was found. There were normal mean percentages and absolute counts of lymphocytes, T-helper inducer, T-suppressor cytotoxic and natural killer cells. The proportion and absolute number of B cells was slightly increased. Significantly decreased natural killer cell activity (p = 0.02) of peripheral blood lymphocytes was observed. Our results indicate that asymptomatic patients with hemophilia may have early evidence of immunodeficiency.
Clinical and laboratory data were investigated in 80 patients diagnosed during the chronic phase of CGL. Comparison has been made between the group of 24 patients surviving longer than 5 years vs. a group of 56 patients surviving shorter than 5 years. Additionally, a group of 6 patients surviving longer than 10 years was analysed separately. According to our findings the most favourable prognostic factors at diagnosis are: young age, normal hemoglobin level, leukocytosis less than 60 X 10(9)/l, absence of splenomegaly indicating rather a small tumour mass in the body.
The authors reviewed the literature concerned with the action of low dose Ara-C on MDS and some forms of AL and demonstrated their own results in vitro and in vivo. In vitro bone marrow blast cells short-term liquid culture were performed with and without addition of low dose Ara-C. After 5 days culture morphological and also cytochemical changes could be observed often inconsistent with the original cellular type. In vivo 8 patients suffering from AL or MDS were treated with low dose Ara-C and among them marked improvement in 3 cases only was observed.
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