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Biomedical subjects

Z Arlin

Publications and source records attributed to Z Arlin.

87 records · Page 5Linked to original sources

Treatment of acute nonlymphocytic leukemia in adults: response to 2,2-anhydro-1-B-D-arabinofuranosyl-5-fluorocytosine and thioguanine on the L-12 protocol.

Fifty-one adult patients with acute nonlymphocytic leukemia (excluding acute promyelocytic leukemia) were treated on the L-12 protocol. The L-12 differed from the preceding L-6 in that 2,2-anhydro-1-B-D-arabinofuranosyl-5-fluorocytosine (AAFC), replaced arabinosylcytosine (ara-C) together with 6-thioguanine (TG) for remission induction. Achievement of remission was followed by an extended 14-week multi-drug consolidation program. With this more intense regimen, an overall complete remission rate of 49% and a median remission duration of 23.7 months were achieved; these results were not significantly better than the 57% complete remission rate and 8.6 months median remission duration obtained with the L-6 regimen. Four year disease-free survival was 22% on the L-12 compared with 16% on the L-6 protocol. No relationship between prognosis and FAB classification was found on either the L-6 or the L-12 protocol.

Adolescent↗

The extracerebral dopamine antagonist domperidone block the suppressive effect of bromocriptine on prolactin and TSH secretion in man.

The effects of a single oral dose of 2.5 mg bromocriptine on serum level of TSH and prolactin were studied in a group of normal male subjects. Bromocriptine effectively inhibited basal TSH and prolactin concentration as well as the prolactin and TSH response to TRH given 4 hours later. The prior administration of the extracerebral dopamine antagonist domperidone reversed the endocrine effects of bromocriptine. The results suggest that dopamine receptors located at the pituitary may regulate TSH (and prolactin) release in man.

Adult↗

The significance of splenomegaly in 101 adults with acute lymphoblastic leukemia (ALL) at presentation and during remission.

One-hundred-one adult patients with ALL were analyzed to determine the prognostic implications of splenomegaly occurring at any time during the course of their illness. The clinical status of the spleen at presentation was not found to be of major prognostic significance. Complete response rates, remission durations, and survivals did not differ between patients with and without splenomegaly at presentation. An enlarged spleen accompanied relapse in four patients. In six additional patients, splenomegaly was present during complete remission, and splenectomies performed in five of these patients revealed no evidence of leukemia to account for the splenomegaly. Splenectomy does not appear to be detrimental, as all five patients are currently in complete remission from 20 to 63 mo after splenectomy. Evidence implicating the spleen as a source of an antibody directed against autologous leukemia cells in one patient is reviewed.

Adolescent↗

Induction of giant fat cells in human bone marrow culture by human serum factor.

Evidence is presented below that normal human sera contain a potent non-dialyzable factor inducing abundant giant fat cells in human bone marrow culture, normal as well as CML. Media with 20% heated (56 degrees C) human serum induce during 7-14 days almost complete monolayer of fat cells on the bottom of the plastic flasks or dishes. Fetal bovine sera do not exhibit this effect and shift cultures to the proliferation of fibroblasts. We are studying the functions of fat cells in hemopoiesis as well as the biochemical nature of fat cell-inducing factor in human sera.

Adipose Tissue↗

The eight-drug/radiation therapy program (MOPP/ABDV/RT) for advanced Hodgkin's disease: a follow-up report.

Eighty-four evaluable patients with advanced Hodgkin's disease (Stages IIB, IIIA age greater than 35 or mixed cellularity or lymphocyte depletion histology, IIIB, IVA, and IVB) were treated with alternating monthly MOPP and Adriamycin, bleomycin, dacarbazine, and vinblastine (ABDV). Radiation therapy (RT), 2000 rads in two weeks, was given to areas of initial bulky disease in untreated patients. Complete remission (CR) rates were 80% for previously untreated, 65% for prior RT or minimal chemotherapy treated, and 50% for heavily pretreated patients. Among 49 previously untreated patients there were no primary treatment failures. The estimated two-year relapse rate for the CR group was 9%. The therapeutic effectiveness of this program may have been due to either or both of the following elements: (1) two non-cross-resistant drug combinations, (2) low dose adjuvant RT to initial sites of bulky disease. These early results are among the best reported for the treatment of advanced Hodgkin's disease.

Adolescent↗

Heterogeneity of cell lineages in L3 leukemias.

Five cases of adult leukemia with L3 morphology in bone marrow were studied for the presence of immunologic, metabolic, and enzymatic markers. Among the five patients, there were four males and female. Median age was 66 with a range of 16-80 yr. Median survival was only 5 mo. Serum lactate dehydrogenase (LDH) levels, 3H-thymidine labeling indices, and DNA/RNA content of the L3 lymphoblasts were markedly elevated. B-cell markers were found in three cases, two exhibiting surface membrane IgM-lambda, and one IgG-K. Terminal deoxynucleotidyl transferase (TdT) enzymatic activity was consistently low in this group. In one case, the L3 lymphoblasts displayed only surface Fc receptors demonstrated by the binding of aggregated IgG. TdT activity was found to be significantly increased. In another instance, the lymphoblasts formed spontaneous rosettes with sheep erythrocytes and exhibited paranuclear staining with acid phosphatase. TdT activity was found to be low. Although most of the L3 leukemias are neoplasias of B lymphocytes, other lineages may also express this morphology.

Adult↗

Morphological classification, response to therapy, and survival in 263 adult patients with acute nonlymphoblastic leukemia.

Bone marrow smears of 263 protocol patients with acute nonlymphoblastic leukemia (ANLL) and related disorders treated between 1970 and 1978 at MSKCC were reviewed blindly by two pairs of hematomorphologists and classified according to the FAB system. It was found necessary to add one category (MO) for acute undifferentiated leukemia and to define more precise quantitative criteria for the categories M1-M6 based on bone marrow differential counts. Using this modified FAB classification, agreement between the two observer groups based on morphology alone was 69%. Cytochemical stains were essential in establishing the diagnosis in 9%, led to a change of diagnosis by one observer team in 14%, and helped to confirm the diagnosis in 32% of cases. Complete remission rates, remission duration, and survival were not significantly different among diagnostic categories. Myelodysplastic syndromes (MDS: M6, RAEB, CMML; CR rate 48%) and ANLL without differentiation (M0, M1, M5a; CR rate 50%) appeared to do less well than ANLL with partial differentiation (M2, M3, M4, M5b; CR rate 59%) on all three protocols studied. Auer rods were present in 53% of all cases with 63% in the myeloid categories (M1-M4). Auer rods were found to be the single most important prognostic parameter in this study, with a complete remission (CR) rate of 68% in the Auer-rod-positive and of 40% in the Auer-rod-negative group (p < 0.0001). Survival was significantly longer for patients exhibiting Auer rods (p < 0.0002). Median survival for the total group was 13.5 mo and median remission duration for responders was 11.5 mo in the Auer-rod-positive group compared to 6.2 mo median survival and 9.2 mo median remission duration for the Auer-rod-negative group.

Acute Disease↗

Massive lymphadenopathy mimicking lymphoma in leukemic reticuloendotheliosis.

Leukemic reticuloendotheliosis is increasingly noted to have a spectrum of laboratory findings suggestive of both lymphocytes and monocytes. However, previous reports have not noted a clinical presentation which may be confused with lymphoma. This report documents a case of leukemic reticuloendotheliosis in a 29 year old man with clinical findings of diffuse lymphadenopathy, organomegaly and cutaneous involvement. As cytotoxic agents may be dysfunctional in leukemic reticuloendotheliosis, the ability to distinguish between the disorder and a lymphomatous process may be critical to the patient's management. Both morphologic examination of the "hairy-cell" and cytochemistry may not give an unequivocal differentiation between these two diseases. However, functional studies of the neoplastic cell, such as cell-marker analysis, phagocytic function and ultrastructural morphology, can define by noninvasive methods the correct diagnosis in the atypical presentation of leukemic reticuloendotheliosis.

Adult↗

Macrophage-like cell transformation and CFU(c) fluctuations in normal and leukemic human marrow cultures treated by phorbol diester.

Bone marrow from normal and chronic myeloid leukemia donors was grown in liquid cultures without feeder layers and with and without 12-u-tetradecanoyl-phorbol-13-acetate (TPA). In 24-96 hours most of the cells (60-70%) cultured with 10(-7) M and 10(-8) M TPA stuck to the bottom of the flasks and had a peculiar shape resembling macrophages possessing strong phagocytizing activity and surface markers of monocyte-macrophage lineage of differentiation. 10(-7) M and 10(-8) M TPA fully inhibited CFU(c) in cultures of normal marrow as well as of chronic myeloid leukemia (CML) patients; 10(-9) M and 10(-10) M exhibited individually varied partial suppression. Cultivation of bone marrow with 10(-11) M to 10(-13) M TPA led in some cases to statistically significant increase of CFU(c) on day 4 and day 7.

Bone Marrow↗

Prophylactic heparin therapy in acute promyelocytic leukemia.

Twenty-four patients with acute promyelocytic leukemia were reviewed. Group I, treated between July 1970 and September 1973, received arabinosylcytosine and 6-thioguanine, and there was one complete remission, with 4/7 dying during induction with intracerebral hemorrhages, and 2/7 dying within one month. Group II, treated between May 1974 and March 1975, received daunomycin and arabinosylcytosine without heparin and 2/8 went into remission, with 6/8 dying during induction, 5 with intracerebral hemorrhages. Group III, treated between March 1975 and November 1976, received the identical chemotherapy as group II but with the addition of prophylactic heparin and there were 7/9 complete remissions, with 2/9 dying with intracerebral hemorrhages. In Group III there was an increased incidence of remission induction when compared to Group II (p less than .05) or when compared to Groups I and II combined (p less than .05). There was also a decreased incidence of fatal hemorrhage in Group III. This suggests that prophylactic heparin is useful during remission induction in acute promyelocytic leukemia.

Adolescent↗

Hypercalcemia associated with adenocarcinoma of the rectum. A case report and review of the literature.

Hypercalcemia is a well described complication of cancer both in solid tumor and hematologic malignancies. Metastatic adenocarcinoma of the rectum has not been reported to be associated with hypercalcemia. We report a case of a patient with metastatic adenocarcinoma of the rectum to the liver with hypercalcemia. Evaluation for other causes of hypercalcemia was negative. We suggest that adenocarcinoma of the rectum can lead to the development of hypercalcemia.

Adenocarcinoma↗

Phase II trial of vindesine in patients with acute leukemia.

Vindesine was administered to 18 patients with acute leukemia who had failed conventional chemotherapy. Each course of therapy consisted of an iv bolus infusion at a dose of 1-2 mg/m2 given daily x 5-10 days. Of 13 patients with acute lymphoblastic leukemia, two had partial remissions which lasted 2 and 3 months and five had minor responses. One of three patients with acute nonlymphoblastic leukemia and one of two patients with blastic crisis of chronic myelogenous leukemia each had a minor response. The data suggest that vindesine has activity in the treatment of acute leukemia.

Adolescent↗