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Biomedical subjects

M E Nesbit

Publications and source records attributed to M E Nesbit.

At least 163 records · Page 9Linked to original sources
PubMed1977

Total-body irradiation with a high-dose-rate linear accelerator for bone-marrow transplantation in aplastic anemia and neoplastic disease.

Nine children with various hematologic disorders underwent bone-marrow transplantation following total-body irradiation with 750 rads at a rate of 26 rads/min. from a 13-MeV linear accelerator in conjunction with cytotoxic drugs. This treatment was tolerated reasonably well, with acceptable side effects. Three patients were alive and well at 18, 11, and 7 months post-transplantation at the time this paper was written.

Anemia, Aplastic↗
PubMed1977

L-Asparaginase, vincristine, and prednisone for induction of first remission in acute lymphocytic leukemia.

L-Asparaginase was added to vincristine and prednisone for induction of first remission in 815 children with acute lymphocytic or acute undifferentiated leukemia. This combination resulted in an overall remission rate of 93%. The addition of L-asparaginse to the standard induction regimen using prednisone and vincristine did not significantly increase the morbidity or mortality rate during the induction period. The most common side effect was transient L-asparaginase-induced hyperglycemia. The safe administration of L-asparaginase i.m. and the dose efficacy of 6000 I.U./sq m were confirmed. For these reasons, L-asparaginase should be combined with vincristine and prednisone for the initial induction of children with acute lymphocytic or acute undifferentiated leukemia.

Adolescent↗
PubMed1976

Histiocytic medullary reticulosis in acute lymphocytic leukemia of T cell origin.

A patient with acute lymphocytic leukemia of T (thymic-derived) cell origin was successfully treated and was maintained in remission for four months by combined chemotherapy. He died following a seven-week, fulminant course with fever, refractory pancytopenia, and marked hepatosplenomegaly. The autopsy showed lymphoid leukemic infiltration and extensive histiocytic medullary reticulosis in various organs. The possible relations between these two lymphoreticular diseases are discussed.

Antineoplastic Agents↗
PubMed1976

Prognostic significance of surface marker analysis in childhood non-Hodgkin's lymphoproliferative malifnancies.

Blast cell surface markers for T- and B-lymphocyte characteristics were studied at diagnosis in 73 children with non-Hodgkin's lymphoproliferative malignancies. Three distinctive groups of patients were identified on the basis of the analysis of blast cells for surface immunoglobulin (SIg), sheep erythrocyte (sE) rosette formation, and complement receptors, The seven group I patients had monoclonal IgM on their blast cells, morphologic features of Burkitt's lymphoma, abdominal masses, and very short survival. The 13 group II patients had receptors for sE, complement, or both on their blast cells, mediastinal or nodal masses, and short survival. The distinction between leukemia and lymphoma based on the presence of bone marrow involvement at diagnosis is not prognostically useful in this group of patients. The blast cells of group II patients could not be morphologically distinguished from those of the group III patients. The 53 groups III patients had SIG, sE, and complement negative blast cells and could be further subdivided on the basis of while blood cell count. The nine group IIIA patients (greater than 100.0 X 10(9)/liter) had in general short survival, while most of the 44 group IIIB patients (less than than 100.0 X 10(9)/liter) have remained in complete remission. Positive surface markers, mass lesions, male sex, and age of diagnosis less than 2 years of greater than or equal to 10 years appear to be interrelated factors indicating poor prognosis. Elevated while blood cell count is a prognostic indicator independent of surface marker analysis or presence of mass lesions.

Adolescent↗
PubMed1976

Usefulness of cytosine arabinoside (NSC-63878) and prednisone (NSC-10023) in refractory childhood lymphoblastic leukemia.

One hundred forty-three children with refractory lymphoblastic and undifferentiated leukemia (ALL/AUL) were treated with cytosine arabinoside (Ara-C) and prednisone (Pred). The dose and duration of Ara-C was escalated during induction depending on the response seen in the peripheral blood and/or bone marrow. For those achieving a remission, Ara-C was also used to determine its maintenance capabilities. Of the 143 children, 79 attained a clinical remission, 45 having a complete bone marrow remission and 34 having a partial remission. Maintenance of remission with twice weekly Ara-C was short and did not appear to depend on the amount of Ara-C given during induction. The major toxicity of Ara-C was myelosuppression.

Bone Marrow↗
PubMed1976

Immunotherapy and chemotherapy in children with neuroblastoma.

Recent advances with immunotherapy in animal tumors suggested that trials with a combination of chemotherapy and immunotherapy in human malignant tumors might be worthwhile. A pilot program with Vibrio cholera neuraminidase-treated tumor cells plus BCG was tested in 3 patients who had had chemotherapy for disseminated neuroblastoma. Two of these children were in "complete remission" after radiation therapy and chemotherapy before the administration of immunotherapy. Relapse occurred in 5-6 months in all 3 patients. These disappointing results are discussed in relation to problems of current chemotherapy in disseminated neuroblastoma including results obtained at second-look operations in patients obtaining "complete remission."

Adult↗
PubMed1976

Extended field radiotherapy in non-Hodgkin's lymphoma.

Sixteen patients with laparotomy-proved Stages I-III non-Hodgkin's lumphoma were treated with high dose extended field irradiation. All patients obtained complete remission and 75% remain continually free of disease for 22+ to 63+ months. When the extent of disease is carefully delineated by a thorough staging procedure which includes laparotomy, irradiation alone may cure a high percentage of patients.

Adolescent↗
PubMed1975

Extramedullary involvement of the testes in childhood leukemia.

Thirteen out of 163 male children with acute leukemia developed extramedullary involvement of the testes. This represented an incidence of 8.0%. These 13 children experienced 19 separate episodes of enlargement. All episodes were treated with radiotherapy. The enlargement was unilateral in 9 episodes and bilateral in 10. The bone marrow (BM) was in complete remission in 13 episodes. In 8 of 13 patients the testis was the first site of relapse since the initial BM remission. Of the males with a WBC less than 20,000/mm3 on initial diagnosis of leukemia, 4.3% developed this testicular complication, as compared to 17.0% of those with a WBC equal to or greater than 20,000/mm3. The median time interval to testicular involvement was 13 months; to death, 9 months. Relapse at other sites usually followed testicular involvement. Autopsy findings did not appear to be dose-related. Radiotherapy was clinically successful when a total dose in the range of 1200 rads was used, and is the treatment of choice for this complication.

Bone Marrow Examination↗
PubMed1975

Oncornavirus-like particles from cultured bone marrow cells preceding leukemia and malignant histiocytosis.

Particles with the density and enzymatic activity characteristic of known oncornavirus have been previously described in bone marrow cells from patients with leukemia in relapse and in remission. We have confirmed these findings and studied two patients in whom preleukemia was among the diagnostic considerations. Following cultivation of bone marrow from these patients for 1 week in conditioned media with dexamethasone, a high-speed pellet of the supernatant fluid and disrupted cells was prepared and analyzed on a sucrose gradient for enzymatic activity characteristic of RNA-directed DNA polymerase (reverse transcriptase). Peaks of endogenous DNA polymerase activity showing ribonuclease sensitivity and/or stimulation with the synthetic template poly(rC)-(dG)12-18 were demonstrated in both patients at densities of 1.15 to 1.19 and 1.21 to 1.24 g/ml. Subsequently, diagnosis 2 and 4 months after initial evaluation revealed acute myelogenous leukemia and malignant histiocytosis, respectively. Prior studies have suggested a possible etiological significance of such particles in human leukemia. The demonstration of similar particles preceding clinically overt disease in these patients supports this hypothesis and offers the possibility of early diagnosis and treatment.

Adolescent↗
PubMed1975

The role of radiotherapy in renal involvement in acute childhood leukemia.

Twenty-one children with acute leukemia received irradiation to the renal area for the following reasons: hypertension (2 patients); oliguria (5 patients); mass-related symptoms (5 patients); and as an adjuvant to supportive medical management in preventing renal failure (9 patients). All but 2 patients exhibited bone marrow exacerbation. The results of treatment with radiotherapy are discussed. Total doses in the range of 600-1,200 rads are suggested.

Adolescent↗
PubMed1975

Acute monoblastic leukemia: diagnosis and treatment of ten cases.

During a large clinicopathologic study of acute nonlymphocytic leukemia (ANLL), ten patients were identified in whom the leukemic blasts demonstrated striking morphologic and cytochemical similarities and who seemed to form a specific subgroup of ANLL. The patients' leukemic blasts were studied in routine blood and bone marrow preparations and by cytochemical and ultrastructural techniques. In routine smears, the blasts showed no clear evidence of differentiation. Cytochemically, the blasts exhibited strongly positive nonspecific esterase activity, which was completely inhibited by incubation with sodium fluoride, and were myeloperoxidase and sudan black B negative. Ultrastructural features of the blasts were similar to those described for monocytic leukemias. Striking clinical features included the occurrence primarily in young patients, the high frequency of lymphadenopathy at presentation, and the high incidence of post-treatment disseminated intravascular coagulation. Complete remissions were frequently initially obtained with duanorubicin in combination with various other agents and later in the disease with VP16-213. Based on the cytochemical and ultrastructural features, we concluded that this form of ANLL was a variety of acute monocytic leukemia. Recognition of the entity is important for optimal therapy.

Acid Phosphatase↗