Biomedical subjects
Publications and source records attributed to K M Shepherd.
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Methods for the simultaneous detection of Cryptosporidium parvum oocysts and Giardia cysts from water are described and their relative recovery efficiencies are assessed for seeded samples of both tap and river water. Cartridge filtration, membrane filtration, and calcium carbonate flocculation were evaluated, and steps to optimize the concentration procedures were undertaken. Increasing centrifugation to 5,000 x g, coupled with staining in suspension, was found to increase the overall efficiency of recovery of both cysts and oocysts. Cartridge filtration for both cysts and oocysts was examined by use of 100-liter volumes of both tap and river water. Improvements in recovery were observed for Cryptosporidium oocysts after extra washes of the filters. Calcium carbonate flocculation gave the maximum recovery for both Cryptosporidium oocysts and Giardia cysts and for both water types. A variety of 142-mm membranes was examined by use of 10-liter seeded samples of tap and river water. Cellulose acetate with a 1.2-micron pore size provided the best results for Cryptosporidium oocysts, and cellulose nitrate with a 3.0-micron pore size did so for Giardia cysts.
High dose hydroxyurea (HU) was used in a pilot study to assess its efficacy in mobilizing Philadelphia (Ph) chromosome negative progenitor cells in chronic myeloid leukaemia (CML). Five patients received 12 g/M2 oral HU in divided doses. Side effects were minimal, allowing outpatient administration. Nine to fourteen days later 4 patients achieved a mean leukocyte nadir of 3.5 x 10(9)/L (Range 2.4-4.9) and a mean platelet nadir of 99 x 10(9)/L (Range 95-108). Peripheral blood mononuclear cells (PB-MNC) sampled prior to the HU priming were 100% Ph positive. Between 10 and 18 days post HU, 3 patients achieved a marked reduction (80-100%) in the number of Ph positive metaphases in PB-MNC collected by apheresis. One patient failed to achieve any Ph suppression. Polymerase chain reaction analysis (PCR) for the bcr-abl fusion product remained positive in all samples. Rapid rises in CFU-GM numbers were associated with a return to 100% Ph positive metaphases however slower rises represented recovery with predominantly Ph negative cells, allowing apheresis collection of these cells. We conclude that HU induces a reproducible leukocyte nadir with sufficient stem cell mobilization for potential autologous transplantation. Higher doses of HU together with early and intensive apheresis is required to maximize Ph negative progenitor cell harvests.
Sixty patients with malignancy were enrolled in a study of high-dose chemotherapy and peripheral blood stem cell transplantation (PBSCT). Stem cells were harvested prior to PBSCT using high-dose cyclophosphamide (CY) mobilization (4 or 7 g/m2) with collection of a median of 4.6 x 10(8)/kg mononuclear cells (range 0.2-9.5) and 21.6 x 10(4)/kg colony forming unit-granulocyte/macrophage (CFU-GM) (range 0.1-220). Forty-seven patients were mobilized once, 11 required two cycles and two required three cycles. Eight patients (13%) failed to reach the optimum CFU-GM target (greater than 15 x 10(4)/kg) following CY mobilization. A number of factors identified those patients who were likely to achieve optimum CFU-GM collections with CY mobilization. These included the use of the higher CY mobilization dose, a longer interval from last chemotherapy cycle to mobilization, and a higher premobilization bone marrow CFU-GM level. Patient's age, the degree of bone marrow infiltration, the nature of disease or the number of pre-mobilization chemotherapeutic cycles did not affect the ability to collect optimum CFU-GM numbers. Whilst the mobilization procedure was associated with moderate non-hematologic toxicity, significant hematological morbidity was observed primarily in patients mobilized using the 7 g/m2 dose. Refinements to the protocol, in particular the use of hematopoietic growth factors, are currently under investigation.
Thirty one peripheral blood stem cell mobilizations using cyclophosphamide, followed by leucapheresis, were performed in 25 patients with a variety of haematological malignancies. Cyclophosphamide at doses ranging from 0.25 g/M2/day x 4 days to 4 g/M2 on one day were given. Total doses of cyclophosphamide less than 4 g/M2 failed to induce a significant mobilization of stem cells into the peripheral blood. This compares to cyclophosphamide doses of 4 g/M2 given over one or two days where 70%-75% of patients yielded adequate stem cells for transplantation (greater than 20 x 10(4) CFU-GM/kg). Both the presence of tumour cells in the bone marrow and previous chemotherapy within 12 months of cyclophosphamide infusion significantly diminished the patients stem cell mobilizations. The rate of recovery of the patient's leucocyte count following cyclophosphamide was highly correlated to the peak level of PB CFU-GM and is a good indicator of the total stem cell yield. Fever in 50% of patients during the period of cytopaenia was the only complication seen in our patients and thus high dose cyclophosphamide is a suitable and safe agent for mobilizing haemopoietic stem cells.
The ability of a number of DNA binding drugs to block the action of selected restriction enzymes has been used to determine the nucleotide base binding preference of these drugs. The three alkylating agents studied all displayed guanine-cytosine (G-C) base binding preference which accords with previous results for cis-DDP and with the preferred sites of alkylation being the N7 and O6 of guanine bases. Adriamycin was markedly more reactive in this assay system compared to the alkylating drugs and in contrast to these drugs showed an adenine-thymine (A-T) base binding preference.
Platelets were harvested by a Hemonetics Model-30 discontinuous cell separator from 20 normal volunteers and were cryopreserved in the presence of 5% DMSO at a controlled rate of freezing of -1 degrees C/min and stored in liquid nitrogen for up to 3 months. A significant loss of platelets occurred at the platelet concentration step through adhesion of platelets to the bag walls. A small reduction in aggregation associated with this was also seen and may reflect some damage to the platelets during the pheresis procedure. A small, but significant loss of platelet aggregation was seen with all agents following cryopreservation. Mean percentage aggregation post-thaw for all the agents was 75.4% (range 74-78%) and platelet recovery was approximately 90%. No significant changes in aggregation or recovery were seen over the 3 months' storage period. The cryoprotectant DMSO was shown to have no deleterious effect on platelet function in vitro.
Buffy coat cells were collected by leukapheresis from 14 patients with C.G.L. and one patient with M.M.M. Six of the C.G.L. patients had received busulphan at intervals varying between 401 and 38 d before leukapheresis. Significantly more CFUc's could be collected per leukapheresis in untreated patients and in those patients not treated within 105 d prior to leukapheresis. Survival of CFUc's following freezing was significantly less in the 3 most recently treated patients. These results suggest that in C.G.L. patients recently treated with busulphan, both the number of CFUc's in the peripheral blood and the ability of these cells to survive the freeze thaw process are reduced. However, sufficient CFUc's could theoretically be collected, stored and recovered post-thaw from one leukapheresis to allow complete haematopoietic restoration in all but 2 patients.
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