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Biomedical subjects

P A Bryon

Publications and source records attributed to P A Bryon.

At least 19 recordsLinked to original sources
PubMed1992

[Prognostic factors, late relapse and outcome of patients with aggressive malignant lymphoma: long term results of LNH-80 protocol].

The 100 patients with aggressive malignant non Hodgkin lymphoma treated with the LNH-80 regimen were evaluated for long-term survival and quality of life. The LNH-80 regimen consisted of three intensive courses of adriamycin, cyclophosphamide, vindesine and bleomycin, followed by consolidation and final intensification, as previously described. Of the eighty-four patients who achieved CR after induction, fifty-two patients are alive in continuous complete remission with a median follow-up of 9.2 years. Twenty-nine CR patients (35%) relapsed. Sixty-six percent of the relapses occurred during the first 18 months following the end of treatment but late relapses were observed up to 7 years off-therapy. Factors adversely correlated with response in multivariate analysis were poor performance status, bone marrow involvement and the presence of more than one extranodal site. Factors adversely correlated with survival were age, high grade subtypes, and bone marrow involvement. The fifty-two long-term responders were evaluated for quality of life parameters such as working ability, sexual function, fertility and absence of long-term sequelae. Of the 41 patients who worked before disease, 66% had resumed their normal job and 24% had retired. Sexual activity was considered to be satisfactory by 66% of the patients. Eleven of the 15 patients (73%) who wanted children had between one and three children. Seven patients (14%) considered having mild long-term sequelae but all long-term survivors reported having an acceptable quality of life. Five of the patients who reached CR (6%) had a second neoplasia. The LNH-80 regimen allowed 52% of the patients to benefit from long-term disease-free survival with minor long-term toxicity.

Adolescent↗
PubMed1991

Follicular lymphomas: assessment of prognostic factors in 127 patients followed for 10 years.

Response to treatment, histologic progression, and survival of 127 patients with follicular lymphoma were analyzed according to histologic, clinical, and biological parameters. Histologic parameters were percentage of large cells (less than 10%, 41 patients; 10-25%, 38 patients; 25-50%, 11 patients; greater than or equal to 50%, 30 patients), percentage of diffuse areas, presence of intrafollicular proliferation or fibrosis, and mitotic scale. Eighty percent of the patients achieved complete remission (CR) with radiotherapy for localized stages and various chemotherapy regimens for disseminated stages. Three patients did not respond to treatment, and 23 were in partial remission (PR) at the end of treatment. Median survival time was 9.25 years. A constant death rate of 8% per year was observed without plateau. Histologic progression was observed in 32 patients; it occurred at a constant rate during the first six years and plateaued thereafter. Factors associated with low response rate were stage IV, B symptoms, high tumor mass, and two or more extranodal sites. Factors associated with histologic progression were bone marrow involvement and two or more extranodal sites. Factors associated with poor survival were advanced stage, two or more extranodal sites, bone marrow involvement, high lactate dehydrogenase level, and absence of interfollicular fibrosis. The percentages of large cells and diffuse areas had no influence on prognosis, nor had the type of treatment. Median survival has not been reached for CR patients and was four years for PR patients (P less than 0.0001). The LNH-84 prognostic index for aggressive lymphomas, based on tumor mass, number of extranodal sites, stage, and LDH level, is a clear-cut indicator of prognosis in follicular lymphomas too.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[Clinico-pathologic study of Kikuchi's necrotizing lymphadenitis. Report on 11 cases].

Histiocytic necrotizing lymphadenitis of Kikuchi is a rare benign disease. Characteristically, patients are young women with cervical adenopathy which may be associated with fever. Histologically, the involved lymph nodes show focal, well-circumscribed, paracortical, necrotizing lesions which contain karyorrhectic debris and aggregates of large mononuclear cells but no neutrophils. This disorder can be misdiagnosed as malignant lymphoma. The histological features seem to be related to delayed-type hypersensitivity but the antigenic stimulus is still unknown. The clinicopathological and immunohistochemical features of histiocytic necrotizing lymphadenitis in 11 patients are described. In necrotic areas, the majority of cells represent histiocytes and T cells (predominantly of CD8 phenotype). The involved lymph nodes were localized to several cervical sites (commonly jugular area).

Adolescent↗
PubMed1990

Massive mediastinal extramedullary hematopoiesis in hereditary spherocytosis: a case report.

A case of extramedullary hematopoiesis (EMH) with a massive mediastinal mass in a 72-year-old woman with hereditary spherocytosis is reported. Several cases of EMH have been described in nonsplenectomized adults with hereditary spherocytosis, and it is thought to be a consequence of long-term stimulation of erythropoiesis. The exact mechanism remains controversial. EMH should be considered in the differential diagnosis of an asymptomatic paravertebral mass.

Aged↗
PubMed1990

Break in the BCL1 locus is closely associated with intermediate lymphocytic lymphoma subtype.

The t(11;14)(q13;q32) is a recurring translocation associated with some chronic B-cell lymphocytic malignancies; the putative protooncogene BCL1, located at the chromosome band 11q13, can be involved during the translocation process. In order to determine if BCL1 rearrangement is associated with a particular subtype of lymphoma, we analysed 131 B-cell non-Hodgkin's lymphoma samples by Southern blot analysis, using a BCL1 probe. The BCL1 locus was rearranged in 9 out of 25 (36%) cases of intermediate lymphocytic cell lymphomas (ILL), in 1 out of 8 cases of diffuse small cleaved cell lymphoma, in 1 out of 12 cases of diffuse mixed cell lymphoma, and in 1 out of 21 cases of diffuse large cell lymphoma. In contrast, BCL1 was never found rearranged in any of the 46 follicular lymphomas analysed. The BCL2 gene was in germ-line configuration in all ILL. Sequential hybridization of Southern blots with JH, C mu, and BCLI probes identified comigrating fragments in only one case of ILL, which suggests that, in all the other cases, either the rearrangement of BCL1 did not result from a t(11;14) translocation or the break on chromosome 14 occurred outside the JH or C mu regions. These results indicate that rearrangement of the BCL1 locus may be closely associated with ILL and could be considered as a genotypic marker of this lymphoma subtype.

Blotting, Southern↗
PubMed1990

Peripheral T-cell lymphomas have a worse prognosis than B-cell lymphomas: a prospective study of 361 immunophenotyped patients treated with the LNH-84 regimen. The GELA (Groupe d'Etude des Lymphomes Agressives).

The prognostic significance of phenotype in malignant lymphomas (ML) is a matter of controversy. Here we analyze the clinical presentation, response to treatment, and survival of the 361 phenotyped patients with ML who were treated by the LNH-84 regimen. Histologic subtypes were diffuse-small cell in 10 patients, diffuse mixed in 69, diffuse large-cell in 177, immunoblastic in 94, and anaplastic large-cell in 11. One hundred and eight patients (30%) had a peripheral T-cell ML and 253 (70%) a B-cell ML. Most of B-cell MLs were of diffuse large-cell type, and the T-cell MLs were distributed among diffuse mixed and immunoblastic subtypes. T-cell MLs had an aggressive presentation with more patients having advanced stage (21% versus 41% stage II, 53% versus 45% stage IV, p = .0002), and B symptoms (58% versus 42%, p less than .01). The only significant difference in clinical manifestations were the higher frequency of gastrointestinal involvement in B-cell MLs (20% versus 2%, p less than .0001) and the more frequent spleen (39% versus 21%, p = .0005) and skin (19% versus 3%, p less than .0001) involvement in T-cell MLs. There was no difference in response to the LNH-84 regiment between the two subgroups, but T-cell ML patients relapsed at a higher rate (43% versus 29%, p less than .001). T-cell ML patients have a significantly shorter freedom-from-relapse (FFR) survival (median: 34 months versus not reached, logrank test: p = .002) and a non-significant shorter overall survival (median: 42 versus 50 months).(ABSTRACT TRUNCATED AT 250 WORDS)

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1990

Is there an accumulation of cells during G2 in some acute lymphoblastic leukaemias?

In some cases of acute lymphoblastic leukaemia (ALL) the percentage of cells in G2 + M is higher than anticipated when compared with the percentage in S phase. This increase in G2 + M, as detected by flow cytometry measurement of DNA content, may be due to an accumulation of cells, either in G2 or during the end of S phase; it may also be related to the existence of small tetraploid clones generally ignored by cytogeneticists. In order to identify possible subpopulations of cells with a DNA index greater than or equal to 2.0, we have compared the results of a cytogenetic analysis to the G2 + M values. We have also studied the distribution of S phase cells in 24 cases of ALL by incorporating 5-bromodeoxyuridine, labelling the cells by indirect immunofluorescence, and analysing them by flow cytometry after propidium iodide staining. The distribution of cells during S phase was quantified: no accumulation of cells was ever observed at the end of S phase. The question of the existence of small tetraploid clones, G2 arrested cells or cells with a G2 elongation remains open. However, we feel that it is more probable that, in this pathology, an elongation of the duration of G2 occurs.

Adolescent↗
PubMed1990

Determination of plasma cell labelling index with bromodeoxyuridine using a double immunoenzymatic technique.

Myeloma plasma cells were double stained using peroxidase and alkaline phosphatase labelled monoclonal anti-BrdU and anti-intracytoplasmic immunoglobulins. Samples were methanol fixed; DNA was denatured with formamide. The results allowed easy identification of plasma cells, their cytological examination and the calculation of percentage of plasma cells in S phase. Good correlation was found with the labelling index obtained with tritiated thymidine.

Bromodeoxyuridine↗
PubMed1989

The dendritic reticulum cell pattern in B cell lymphomas of the small cleaved, mixed, and large cell types: an immunohistochemical study of 48 cases.

An immunohistochemical study was designed to study the dendritic reticulum cell (DRC) patterns in 48 cases of B cell non-Hodgkin's lymphomas of the small cleaved, mixed, and large cell types, both follicular (20 cases) and diffuse (28 cases), in order to evaluate the possible influence of DRCs on homing and the differentiation of neoplastic B cells. Three DRC patterns were observed. In the follicular lymphomas, DRCs constituted nodular networks of variable density. In the diffuse lymphomas, DRCs were present either as isolated and scattered cells (17 cases) or constituted irregular meshworks of variable sizes (11 cases). These DRC patterns correlate with B cell immunophenotypes. Like follicular lymphomas, and unlike diffuse lymphomas without DRC networks, diffuse lymphomas with DRC networks constantly expressed the pan B antigens and one marker characteristic of normal germinal center cells, CD21 antigen, the C3d receptor. The finding of organized DRC networks in a significant number of diffuse lymphomas does not substantiate the hypothesis that DRCs may play a role in the homing of neoplastic B cells. The correlations observed between DRC patterns and B cell immunophenotypes suggest that the persistence and/or the development of DRC networks within follicular center cell-type lymphomas are related to the degree of functional differentiation of neoplastic B cells.

B-Lymphocytes↗
PubMed1989

Comparison between image and flow DNA cytometry in non-Hodgkin's lymphomas.

To assess the reliability of DNA estimation in cytological material, Feulgen lymph node imprints from 22 cases of malignant non-Hodgkin's lymphomas were examined by image cytometry (ICM) for both ploidy and cell kinetics, and the results obtained were compared with flow cytometry (FCM). The DNA distribution pattern was less accurate with ICM than with FCM; however, a high correlation was found between proliferative indices (r = 0.91) and between aneuploidy rates (agreement in about 86% of the cases) determined by FCM and ICM. Moreover, DNA tetraploid (or near-tetraploid) stem lines were more easily detected by ICM, due to the morphological selection of lymphomatous cells. The proliferation rate and the aneuploidy frequency according to morphological classification were in agreement with larger, previously reported studies with FCM. Therefore, ICM appears to supply additional complementary information to that obtained with FCM, particularly for the study of heterogeneous cell populations, which may be usefully applied to refine the large cell lymphoma subclassification.

DNA, Neoplasm↗
PubMed1989

Cell kinetics in acute lymphoblastic leukaemia: comparative analysis between adults and children.

Cell kinetics were studied in 124 patients with acute lymphoblastic leukaemia (ALL) by flow cytometry, comparing cell cycle characteristics between adults (57 cases) and children (67 cases). S, G2 + M and the low protein content fraction of G1 (LPC fraction) were determined and studied in relation to other clinical and biological features. No difference was found between adults and children in the distribution of these variables. The proliferative rates according to organomegaly, leukocytosis, the FAB cytological groups and the immunological groups did not present any significant differences between the two groups of patients. However, cell cycle did seem to have a very different prognostic value for adults and for children. G2 + M was a strong prognostic indicator for childhood ALL: duration of CR and survival were significantly longer when G2 + M was higher (P less than 0.01). In adults, survival was longer for intermediary (between 3.8 and 5.8%) and high (over 7.2%) G2 + M values (P less than 0.01). The negative correlation between S and G2 + M observed in adults and the absence of correlation in children raise the possibility of differences in duration of the different phases for the two groups and perhaps an accumulation of cells in G2 or tetraploidy in some cases.

Adolescent↗
PubMed1989

DNA assessment in thin sections of lymphomas by densitometric and stereological methods: comparison with imprint and flow cytometric results.

The nuclear DNA content was estimated in 2 microns sections of 18 lymphoma cases by two methods: (1) Feulgen densitometry using QTM 900 with correction by Bins' procedure which allows size-independent DNA distributions; (2) stereological unfolding as proposed by Cruz-Orive giving sphere-size distributions. A general correlation was found between results and DNA measurements obtained by imprint and flow cytometric techniques in the same specimens. When histologic DNA profiles were compared to cytologic histograms, a high correlation was found between the distribution of ploidy classes by correspondence analysis. However two highly proliferating lymphomas were erroneously classified as aneuploid. Conversely, sphere-size distributions allowed the identification of the majority of aneuploid lymphomas but failed to recognize proliferating ones. It appears that when cytologic specimens are not available, densitometric studies on sections may provide valuable information on DNA content, with complementary data obtained from stereological procedures.

Aneuploidy↗
PubMed1988

Image analysis applied to proliferating cells in malignant lymphoma.

This study describes a method for obtaining the distribution of a given cell type in histological sections, as revealed by a specific immunological marker. Two hundred fifty-six contiguous microscopic fields were analysed, and a cellular map was automatically constructed. The resulting images were stored on magnetic media for subsequent quantification and statistical tests. The method was applied to the analysis of 20 small cleaved-cell lymphomas in which the monoclonal antibody Ki-67 was used to mark proliferating cells. Clusters of proliferative cells were observed in both diffuse and nodular lymphomas. Cellularity and the percentage of marked cells were not significantly different in the two types of tumors.

Antibodies, Monoclonal↗
PubMed1988

The syndrome of abnormal chromatin clumping in leucocytes: a myelodysplastic disorder with proliferative features?

Five patients presenting extremely exaggerated chromatin clumping in leucocytes, associated with a loss of segmentation, are described. Peripheral cytopenia, a high percentage of circulating immature granulocytes (chiefly myelocytes) with variable leucocytosis, marrow hypercellularity with granulocytic hyperplasia and moderate dysplastic changes in erythroblastic and megakaryocytic lines, constitute, together with the granulocytic nuclear anomaly, the characteristic features of the studied cases. Cytogenetic analysis showed a clonal 12p anomaly in one of the three cases available for study. Survival was poor with a median of 15 months, bleeding and infections being responsible for the majority of deaths. All these findings point to abnormal chromatin clumping in leucocytes as the marker of a true entity with both myelodysplastic and myeloproliferative features. We propose that it take its place among myelodysplastic syndromes (MDS) beside chronic myelomonocytic leukaemia (CMML), with which it shares many similarities in clinical and biological behaviour.

Aged↗