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Biomedical subjects

W Hunstein

Publications and source records attributed to W Hunstein.

At least 145 records · Page 8Linked to original sources

Treatment of acute myeloid leukemia developing after a myelodysplastic phase with low dose arabinosyl cytosine.

Patients with acute myeloid leukemia (AML) secondary to myelodysplastic phase respond poorly to standard chemotherapy designed for AML. As arabinosyl cytosine (Ara-C) at low-dose has been reported to achieve promising results in certain forms of AML, we have applied the low-dose (10 mg m-2/12 h subcutaneously for 14-24 days) regimen in 11 patients with AML secondary to myelodysplastic syndromes. Though a complete remission could be achieved in 2 patients and a short partial remission in 2 further patients, complications are severe and often life threatening. The amount of hematological supportive care required often exceeded that needed for patients treated by conventional TAD regimen. Moreover, survival of the responders did not seem to be longer than that of non-responders. A review of the literature showed that the results of this low-dose Ara-C regimen might be more promising in patients in the myelodysplastic phase and in those with de novo acute leukemia.

Aged↗

Terminal differentiation of cord blood lymphocytes induced by thymosin fraction 5 and thymosin alpha 1.

Cord blood lymphocytes (CBL) have been shown to be functionally immature compared with normal circulating adult lymphocytes (NAL). Differentiation of T cells is associated with changes in surface antigenic markers and in the pattern of purine degradative enzymes. Previous studies have demonstrated that thymosin fraction 5 (TMS-F5) and thymosin alpha 1 (TMS-alpha 1) can induce in vitro differentiation of murine T-cell precursors and human thymocytes. We have investigated the effects of TMS-F5 and TMS-alpha 1 on the pattern of the purine degradative enzymes adenosine deaminase, purine nucleoside phosphorylase, and ecto-5'-nucleotidase (5'NT) of CBL and on the phenotypic markers from the OKT series 3, 4, 8 and 11. Other than a significantly reduced level of 5'NT activity (P less than 0.001) and an elevated percentage of OKT4+ cells (P less than 0.01), CBL demonstrated the same immunological and biochemical patterns as NAL. Incubation of CBL with TMS-F5 (150 micrograms/ml) and TMS-alpha 1 (1 microgram/ml) for 40 h caused a significant rise in 5'NT level and decrease of cells positive for OKT4, resulting in a pattern characteristic of NAL. Thus TMS-F5 might induce the terminal differentiation of CBL, and TMS-alpha 1 seemed to be the active component.

5'-Nucleotidase↗

Enhanced prostanoid release from monocytes of patients with rheumatoid arthritis and active systemic lupus erythematosus.

In patients with rheumatoid arthritis high levels of prostaglandin E1 have been found in the joint fluid, and its increased production by adherent synovial cells and macrophages clearly supports the notion that this arachidonic acid metabolite is involved in the pathology of the disease. Besides its known inflammatory qualities and the suppressive effects on various lymphocyte functions prostaglandin E2 has proved to be an essential cofactor in the secretion of the lymphokine osteoclast activating factor. In this study we have discovered an enhanced release of prostaglandin E1 and thromboxane B2 from a subpopulation of blood monocytes from patients with rheumatoid arthritis and active systemic lupus erythematosus. No correlation between prostanoid release from monocytes and inflammatory activity of the disease was found. However, even monocytes from patients with early stage or mild inflammatory activity displayed a 'stimulated' arachidonic acid metabolism. In contrast only patients with active systemic lupus erythematosus showed in this respect comparable secretory activity or monocytes. Our findings may point to a possible pathogenic role of prostanoids in rheumatoid arthritis, which may also have some implication for the early diagnosis of this disease and for its differentiation from other chronic inflammatory rheumatic conditions.

Arthritis↗

Peripheral effects of thyroid hormones: alteration of intracellular Na-concentration, ouabain-sensitive Na-transport, and Na-Li countertransport in human red blood cells.

To investigate the effect of thyroid hormones on erythrocyte cation transport systems and intracellular electrolyte content we have measured the activity of Na-K ATPase, Na-Li countertransport, as well as red cell sodium and potassium contents in patients with hyperthyroidism and in euthyroid controls. Intracellular Na- and K-concentrations were determined in erythrocytes washed three times in isotonic MgCl2 solution. Ouabain-sensitive Na-transport was estimated as the increase of Na before and after addition of ouabain in an erythrocyte suspension in isotonic Na-free medium. Na-Li countertransport was measured according to the method described by Canessa et al. [2]. The patients with hyperthyroidism exhibited a significantly elevated intracellular sodium content as well as a highly increased Na-K ATPase activity. Intracellular potassium content was not altered in the hyperthyroid subjects, but Na-Li countertransport was markedly decreased as compared to the controls. The results indicate that different ion transport systems of the erythrocyte membrane are influenced by thyroid hormones. We suggest that the elevation of Na-K ATPase activity might be due to the increased intracellular sodium concentration which is caused by the diminished countertransport pathway. Furthermore, the activity of Na-K ATPase, Na-Li countertransport, and intracellular sodium content in erythrocytes might be a useful peripheral indicator of thyroid hormone excess.

Biological Transport, Active↗

Plasma and intracellular levels of lactate dehydrogenase, phosphohexose isomerase and lysozyme activity in acute leukemia.

Plasma and intracellular levels of lactate dehydrogenase (LDH), phosphohexose isomerase (PHI) and lysozyme activities were investigated in 20 patients with acute myelocytic leukemia (AML), 18 patients with acute lymphatic leukemia (ALL) and 10 patients with chronic myelocytic leukemia in blast transformation (CML/BT). Though the plasma levels of LDH and PHI in all patients with acute leukemia were elevated as compared to control persons there was no distinctive pattern which could be of use in the classification of acute leukemia. On the other hand the intracellular levels of these enzymes could be of value in classifying acute leukemia. The leukemic lymphoblasts were characterized by low levels of PHI and lysozyme as compared to leukemic myeloblasts or to normal lymphocytes (p less than 0.01). The LDH/PHI ratio is also significantly higher in leukemic lymphoblasts than in leukemic myeloblasts or in normal lymphocytes (p always less than 0.01). These characteristics might also be made use of in identifying the blasts of CML/BT als "lymphoid" or "myeloid" in corresponding cases.

Acute Disease↗

The influence of radiation therapy on T-lymphocyte subpopulations defined by monoclonal antibodies.

We studied the influence of radiation therapy on lymphocyte subpopulations in 17 patients undergoing adjuvant radiation therapy for primary breast cancer, and eight patients receiving brachytherapy and external beam irradiation for primary cancer of the uterus. Radiation therapy reduced B- and T-lymphocytes in proportion to the total lymphocyte population so that their percentages remained unchanged. Determination of helper and suppressor T-lymphocytes before, during and 6 months after completion of radiotherapy revealed that in both groups of patients suppressor T-lymphocytes were more resistant to and recovered faster after radiotherapy. This resulted in a decline of the "immunoregulatory balance" (helper/suppressor ratio). Although this ratio had been higher in both groups of patients than in healthy age- and sex-matched controls before therapy, it became normal and subnormal during and after radiotherapy. The clinical significance of the differential influence of radiotherapy on T-lymphocyte subpopulations remains to be determined.

Adult↗

Glucocorticoid receptor level, terminal deoxynucleotidyl transferase activity and initial responsiveness to prednisone and vincristine in leukemia.

We have investigated glucocorticoid receptor (GR) level, terminal deoxynucleotidyl transferase (TdT) activity and the initial responsiveness to prednisone and vincristine in 31 patients with acute lymphatic leukemia (ALL) and with chronic myelogenous leukemia in blast transformation (CML/BT). All 11 patients with low levels of GR (5,000 binding sites per cell) were resistant to this initial treatment whereas 13 of the 20 patients with high levels of GR responded readily. The correlations between clinical responsiveness and TdT activity were significant to the p less than 0.005 level but there was no linear correlation (r = 0.3427) between GR-level and TdT activity. High levels of both GR and TdT seemed to be associated with better prognosis in patients with these leukemias. Thus the determination of GR and TdT might help selection of patients likely to respond to prednisone and vincristine in ALL and CML/BT.

Adolescent↗

Effect of neuraminidase treatment on serum reactivity to autologous leukemic blast cells.

The sera of 35 patients with acute lymphoblastic leukemia (ALL) and acute non-lymphoblastic leukemia (ANLL) were tested for reactivity against cell surface antigens of autologous leukemic blast cells by protein A assay (PA), immune adherence assay (IA), and anti-C3 mixed hemadsorption assay (C3-MHA). Autologous serum reactivity was detectable by PA in four cases and by IA and C3-MHA in about half the patients. Autologous serum reactivity occurred more often in ALL than in ANLL. Absorption studies revealed that in one patient only the autologous reactivity was directed against a restricted antigen, which could be detected only on the individual T-ALL blast cells. All other autologous antibodies detected unspecific antigens. Neuraminidase treatment had two effects: first, it increased antibody attachment to antigens which are also present on untreated cells; secondly, after neuraminidase treatment an antigen was detectable on the cell surface which could also be demonstrated on neuraminidase-treated non-leukemic cells (e.g., erythrocytes). Neither of these two effects of neuraminidase treatment seems to be tumor-specific. Possible therapeutic effects of neuraminidase are probably caused by unspecific adjuvant effects of the enzyme.

Adolescent↗

Autologous transplantation of a bone marrow graft manipulated by chemoseparation to eliminate residual tumor cells.

An autologous bone marrow transplantation (ABMT) was performed in a 45-year-old male patient with AML in therapy-resistant first relapse including CNS-disease. The marrow graft was harvested 18 months before, at the beginning of first remission, and was subjected to an in-vitro incubation with 4-hydroperoxycyclophosphamide (4-HC) prior to cryopreservation to eliminate residual clonogenic tumor cells. After myeloablative therapy with high-dose Cyclo-phosphamide (CY), total body irradiation (TBI) and intrathecal application of Methotrexate (MTX), the manipulated marrow graft was reinfused. The myelopoietic reconstitution started already 6 days after ABMT and was completed 40 days thereafter. There is evidence for a complete remission in marrow and spinal fluid observed over a period of 4 months.

Bone Marrow↗

Characterization of blood mononuclear cells of rheumatoid arthritis patients. II. Depressed PPD presentation by monocytes to T lymphocytes.

Purified blood monocytes from patients with rheumatoid arthritis (RA) were significantly less capable of presenting purified protein derivative of tuberculin (PPD) to autologous lymphocytes than monocytes from patients with osteoarthritis, degenerative spine diseases, or healthy controls. Since lymphocytes from RA patients exhibited a normal response to soluble PPD or concanavalin A, the lowered T-cell reactivity had to be attributed to a diminished antigen-presenting capacity of monocytes. Several reasons may be responsible for this altered monocyte function in rheumatoid arthritis: a shift of monocytes to subpopulations expressing less Ia-like antigens, an inherent monocyte disorder, or a "preactivation" of monocytes associated with a reduced antigen-presenting capacity.

Adult↗

Effect of cytotoxic drugs on the function of the hypothalamo-pituitary-adrenal axis.

We measured the serum concentration of thyroid-stimulating hormone (TSH), its response to exogenic TSH-releasing hormone (TRH), as well as cortisol plasma levels before and after stimulation with adrenocorticotrophic hormone in 15 patients before, during and after a chemotherapeutic cycle. 3/6 patients receiving only cytotoxic drugs developed a marked suppression of the TSH response to TRH and 1 of these patients showed an impairment of the adrenal function under chemotherapy. This was also observed in 7/9 patients receiving both cytotoxic drugs and corticosteroids; however, the individual pattern of the impairment was quite variable. 5/9 patients in this group developed a suppression of the TSH response to TRH. Impairment of the hypothalamo-pituitary-adrenal axis function under cytotoxic drugs and/or corticosteroids occurs with great variability and the mechanisms involved in its etiology are not yet fully understood.

Adrenocorticotropic Hormone↗

Biochemical and immunological differentiation of human thymocytes induced by thymic hormones.

Changes in levels of purine degradative enzymes have been shown to occur during T-cell maturation in both rats and humans with a fall in adenosine deaminase (ADA) and a rise in purine nucleoside phosphorylase (PNP) and 5'-nucleotidase (5'NT) activities. We have investigated the effects of four thymic factors: thymosin fraction 5 (TMS-F5); thymosin alpha 1 (TMS-alpha 1); thymopoietin pentapeptide (TP-5); and thymic conditioned medium (CM) on TdT activity, purine enzyme levels and the phenotypic markers OKT3 (a marker for mature T cells) and NA1/34 (which reacts with immature cortical thymocytes) in human thymocytes and in the lymphoid leukaemic cell lines RPMI-8402 and JM1 (derived from Thy-ALL). All four thymic factors caused one or more maturation change in human thymocytes, e.g. TMS-F5 caused a significant increase in OKT3 expression, TMS-alpha 1 a fall in TdT and ADA activities and a rise in OKT3-positive cells, TP-5 an increase in PNP and CM a rise in 5'NT activity. TMS-F5 also caused a marked elevation of 5'NT in both the T lymphoblastic lines (P less than 0.001). On the other hand the non-physiological phorbol ester, 12-O-tetradecanoyl phorbol acetate (TPA), a tumour promotor with potency of inducing differentiation in some leukaemic cell lines, induced changes in both normal thymocytes and in the leukaemic line JM1 were inconsistent with maturation, e.g. a fall in the percentage of OKT3 cells. These observations suggest that maturation of normal thymocytes might proceed stepwise, each step requiring at least one of the thymic hormones. Although thymosin also induces differentiation changes in a malignant lymphoid line, the pattern of these differs from that induced in their normal counterparts.

Animals↗

Immunocytochemical method for the detection of terminal deoxynucleotidyl transferase in acute leukemia.

Terminal deoxynucleotidyl transferase (TdT) has become an important marker for the classification of acute leukemias. Originally detected by a biochemical assay, the presence of this enzyme in leukemia can now be detected by making use of a highly specific antibody and by applying the immunofluorescence method. In this study, an attempt was made to apply the unlabeled peroxidase-antiperoxidase (PAP) technique for the examination of TdT positive cells. We have optimized this method and have compared the different assays - biochemical, immunofluorescence, and immunocytochemical (PAP) - in ten patients with acute leukemia. The results obtained from all three methods are in accordance with one another, but the PAP method is a further simplification for the detection of TdT in the routine diagnostic of acute leukemias.

Acute Disease↗