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Biomedical subjects

R Gopal

Publications and source records attributed to R Gopal.

At least 127 records · Page 7Linked to original sources

Avascular necrosis of bone in acute lymphoblastic leukemia.

Avascular necrosis of bone (AVNB) is a known complication of systemic adrenocorticosteroid therapy and is thought to be dose related. However, despite the large amount of prednisolone that has been used in the standard treatment of acute lymphoblastic leukemia (ALL), AVNB has rarely been reported with this disease. We have described our experience with an adolescent girl with ALL who developed multifocal AVNB after aggressive chemotherapy, which included high cumulative doses of corticosteroids along with other cytotoxic drugs, some of which have been associated with AVNB. Five similar cases from literature are reviewed. The occurrence of AVNB may become more common in the future with the increasing use of aggressive chemotherapy. Awareness of this possibility will lead to a more rapid diagnosis and early treatment of AVNB.

Acute Disease↗

Terminal deoxynucleotidyl transferase in acute leukemias by direct immunofluorescence.

TdT (terminal deoxynucleotidyl transferase) can be detected by radio enzymatic assay, biochemical assay in cell extracts, serum or plasma, and intracellularly in the smear by indirect immunofluorescent methods. The IgG fraction of anti-TdT serum is conjugated with fluoresceinisothiocyanate and used directly on the cytospin smears of methanol fixed bone marrow/blood smears. The mice thymocytes and peripheral mononuclear cells of healthy donors were used as positive and negative controls, respectively, for TdT. 64% of our cases of ALL were found to be TdT+. The lymphoblasts of L1 morphology (FAB classification) were more frequently positive for TdT as compared to blasts with L2 morphology. 71% of our cALLa positive blasts in acute lymphoblastic leukemias were TdT+ve as compared to 58% of T-ALL blasts. 75% of PAS positive ALL cases were positive for TdT as well. Only 57% of the cases when acid phosphatase showed unipolar positivity (T type) were positive for TdT. 12% of cases with acute myeloid leukemia (6/47) were TdT+ve and 33% of CML in blastic crisis had TdT+ve blasts. Biochemical assay and IF assay for TdT were in good correlation in our study.

Bone Marrow↗

Adjuvant chemotherapy in Ewing's sarcoma.

Adjuvant chemotherapy using vincristine, cyclophosphamide, and adriamycin was used in 28 patients with localized Ewing's sarcoma. Life-table analysis revealed 55% disease-free survival at 3 years. In contrast, our historical control showed less than 10% long-term survival. Adjuvant chemotherapy appears to control both micrometastasis as well as local residual disease. The present study demonstrates the improved survival with adjuvant chemotherapy including adriamycin, vincristine, and cyclophosphamide, in patients with localized Ewing's sarcoma.

Adolescent↗