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Biomedical subjects

N F Lee

Publications and source records attributed to N F Lee.

5 recordsLinked to original sources
PubMed2000

Poor outcome in children with refractory/relapsed leukemia undergoing bone marrow transplantation with mismatched family member donors.

The utility of bone marrow transplantation for childhood leukemia in patients unable to achieve a remission prior to transplant is controversial. To address this issue, we analyzed a subset of patients with advanced leukemia entered on prospective transplant trials at our hospital. Fifty-eight patients with ALL or AML (age 1-19) were identified. They had failed standard chemotherapy and were in relapse (22 in 1st, 27 in 2nd, three in 3rd, and three in 4th) or had never achieved an initial remission (three) at the time of transplant. Fifty-two patients received marrow from mismatched family members (haplo or DR-identical), while six received marrow from matched siblings. Most patients received myeloablative therapy consisting of total body irradiation, etoposide, cyclophosphamide, and cytosine arabinoside. Marrow from mismatched donors was T cell depleted. Only one of 52 patients transplanted with a mismatched donor survived long-term while three of six patients transplanted in relapse with a fully matched sibling donor are alive 6-10 years post BMT. The major causes of death were infection (39%) and relapse (28%). Acute GVHD grade III-IV was noted in 7% of patients. A comparable group of patients with leukemia transplanted at our center in remission using similarly mismatched family member donors (haplo or DR-identical) had an event-free survival of 28%. In conclusion, our data suggest that BMT utilizing mismatched family member donors is a poor option for patients in relapse at the time of transplant. New treatment strategies need to be developed to effectively manage these patients.

Adolescent↗
PubMed1999

Ten-year experience of unrelated bone marrow donor transplants in children with malignant and non-malignant conditions.

Children who require a marrow transplant may receive such hematopoietic cells from one of many sources. This study reviews the experience of one center with 58 children who received marrow from unrelated donors over a 10-year period. These children had a variety of malignant and non-malignant diseases. During that time period, only three of these children had failed to meet engraftment criteria. All donor marrow specimens were T-lymphocyte-depleted using an antibody/complement methodology. No difference was demonstrated in outcome between donors who were perfectly HLA-DR DNA matched versus those who were only partially matched. The increased size of various marrow donor registries has increased the number of potential donors available for these patients. The lack of a requirement for perfect matching means that there is an ever-increasing number of donors available. No graft-versus-host disease (GvHD) or grade III-IV GvHD was associated with a poorer outcome. Stable, long-term engraftment with minimal morbidity has been demonstrated in these children as evidenced by stability of survival curves by two years after marrow transplant.

Adolescent↗
PubMed1985

Bulimia and depression.

Fifty-six adult females with DSM-III bulimia were evaluated for personal and family histories of other psychopathologies. Forty-three subjects (77%) evidenced mild depression of which 13 (23%) reported moderate-severe symptoms by the Beck Depression Inventory--a finding confirmed with Hamilton Rating Scale for Depression and the SCL-90-D scale. A personal history of affective disorder was found in 52%, while 59% reported first degree relative(s) with affective disorder. Subjects with first-degree relatives with drug dependence, alcoholism, or depression had an earlier onset of bulimia than those without such relatives. Bulimia may be symptomatically or pathophysiologically related to depression.

Adult↗
PubMed1980

Effect of fatty acid modifications of cultured hepatoma cells on susceptibility to complement-mediated cytolysis.

The fatty acid composition of Morris Hepatoma 7777 cells was modified by exposure to culture media that were supplemented with 0.1 to 0.36 mM oleic or linoleic acid for 5 days. Changes occurred in the fatty acid composition of both the cellular phospholipid and the neutral lipid fractions. Exposure to linoleic acid caused a large increase in the polyunsaturated fatty acid content of the cell lipids, whereas enrichment in monoenoic fatty acids occurred when the cells were exposed to high levels of oleic acid. Cellular phospholipid content decreased, cholesterol content did not change, and triglyceride content increased as a result of fatty acid supplementation. The fatty acid-modified cells showed increased susceptibility to complement-mediated cytolysis as compared with control cells grown in unsupplemented culture media. The extent of the increase in susceptibility to cytolysis depended on the degree of lipid modification and also on the cell number and antibody titer used in the assay. Cells enriched with linoleic acid were the most susceptible, but oleic acid enrichment also produced increased susceptibility to immune cytolysis. The kinetic study showed that the initial rate of cytolysis was higher in fatty acid-modified cells than in the control cells. There was no difference in the osmotic fragility of the control and fatty acid-modified cells. These results indicate that changes in the lipid composition of a target cell can influence its susceptibility to complement-dependent cytolysis.

Animals↗