Biomedical subjects

R Weide

Publications and source records attributed to R Weide.

39 records · Page 3Linked to original sources

PubMed1990

The role of the MDR-1/P-170 mechanism in the development of multidrug resistance in chronic myeloid leukemia.

We studied blood and bone marrow cells from 42 patients with Ph-chromosome positive chronic myeloid leukemia (CML) and 20 normal subjects for amplification of the multidrug resistance gene (MDR-1) by Southern blotting and for overexpression of P-glycoprotein (P-170) by immunocytochemistry on intact cells with the monoclonal antibody C219. No P-170 could be detected in normal bone marrow or buffy coat. Overexpression of P-170 without amplification of MDR-1 was found in four of 11 patients with chronic phase CML at diagnosis, seven of 16 patients treated with busulfan or hydroxyurea in chronic phase and four of 15 patients in blast crisis. The P-170 overexpression involved only cells of the granulocyte lineage and varied from weak to strong in individual patients. It did not correlate with duration of or response to treatment during chronic phase. In transformation P-170 expression was seen in differentiated cells of the granulocyte lineage but not in blast cells, although three patients had been treated intensively with lipophilic and other cytotoxic drugs to which they had become resistant. We conclude that resistance to busulfan and hydroxyurea in chronic phase and resistance of blast cells to other cytotoxic drugs in transformation are not mediated primarily through the MDR-1/P-170 pathway.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

PubMedDate not supplied

Ultrasound evaluation of hepatic and splenic microabscesses in the immunocompromised patient: sonographic patterns, differential diagnosis, and follow-up.

High-dose chemotherapy, especially for bone marrow transplantation, causes a great degree of immunosuppression, and thus carries the risk for invasive fungal infections. Although hepatic and splenic involvement in disseminated candidiasis is frequent, involvement of these organs is rarely appreciated antemortem. During the last decade, focal hepatosplenic candidiasis has been recognized increasingly by ultrasound. We report the sonographic and clinical findings of 6 patients: 3 AML (acute myeloid leukemia), 2 NHL (non-Hodgkin's lymphoma), and 1 HD (Hodgkin's disease) who demonstrated multiple, small-nodule, hypoechoic lesions in spleen and/or liver after high-dose chemotherapy. All patients were in complete hematologic remission when the study was performed. Septic fever was unresponsive to antibiotic therapy. Granulocytopenia (< or = 1000/mm3) was seen for at least 10 days. However, the manifestation of hepatolienal microabscesses became apparent by ultrasound only after the neutrophil count returned to normal in all but 1 patient. Microabscesses decreased or disappeared on follow-up examination after antifungal treatment. Systemic candida infection was confirmed serologically. Sonographic-guided abscess biopsy (n = 3) revealed necrosis/abscess. Structural inhomogeneity of parenchymal organs was seen for several months after therapy.

Abscess↗

PubMedDate not supplied

Palliative treatment of advanced pancreatic carcinoma in community-based oncology group practices.

This study was aimed at evaluating the feasibility, effectiveness, and toxicity of palliative chemotherapy/supportive care in patients with advanced pancreatic cancer being treated on an outpatient basis. A retrospective analysis was performed on 127 consecutive, unselected patients with advanced pancreatic cancer in four community-based oncology group practices. Median age was 63 years and WHO performance status ranged from 0 to 3. Forty-three patients (34%) had locally advanced disease, and 84 patients (66%) had distant metastases; 94 patients (74%) received cytotoxic treatment during the course of their disease, and 33 (26%) received best supportive care only. First-line treatment consisted of gemcitabine (1,000 mg/m2 on days 1, 8, and 15 of a 28-day cycle) in 81 patients (86%), 5-fluorouracil (5-FU) in 8 patients (9%), radiochemotherapy in 4 patients (4%), and radiation therapy only in 1 patient (1%). A total of 1,501 gemcitabine treatments were given during the study period. Toxicity was moderate. Four patients (3%) required hospitalization for treatment-related side effects, and 111 patients (88%) died during the observation period. Symptom control, as measured by reduction of pain medication, was seen in 25% of patients receiving gemcitabine, whereas no reduction in pain medication was seen in the best supportive care group. The median survival of patients receiving cytotoxic treatment (mainly gemcitabine) was 42 weeks, and the median survival of patients receiving best supportive care was 21 weeks. The overall survival rate at 6, 12, 24, and 36 months was 65%, 32%, 14%, and 7%, respectively. Based on these outcomes, it appears that patients with locally advanced and metastatic pancreatic cancer benefit from adequate palliative treatment, including cytotoxic chemotherapy with gemcitabine, and this can be accomplished on an outpatient basis.

Adult↗