RESUMEN
PURPOSE: We have observed a severe atypical neuropathy (SAN) in patients with small non-cleaved-cell (SNCL) and large-cell lymphoma (LCL) treated with intensive chemotherapy and hematopoietic colony-stimulating factors (CSFs). The present analysis was undertaken in an attempt to identify factors associated with the development of this syndrome. PATIENTS AND METHODS: Fifty-four adult and pediatric patients consecutively treated according to the same chemotherapy protocol were included in the analysis. Low-risk patients received three cycles of cyclophosphamide, vincristine, doxorubicin, and high-dose methotrexate (CODOX-M) while in high-risk patients this drug combination was alternated with high-dose cytarabine (ara-C), etoposide, and ifosfamide (IVAC) for a total of four cycles. Twenty-eight patients received a CSF (granulocyte [G]- or granulocyte-macrophage [GM]-CSF), and 26 patients received no CSF. A statistical analysis, which included a logistic regression model, was undertaken to examine the importance of potential contributing factors to the development of SAN. RESULTS: SAN, which consisted of excruciating foot pain, usually associated with marked motor weakness, was observed in 12 patients. There was a highly significant association between the occurrence of this syndrome and the administration of CSFs, and an independent association with the cumulative dose of vincristine given in the first cycle of chemotherapy. Furthermore, the analysis suggested a synergistic effect between administration of the CSFs and vincristine in the genesis of this neuropathy. CONCLUSION: Our results indicate that CSFs can precipitate SAN when given in conjunction with vincristine. The development of SAN was associated most strongly with the cumulative dose of vincristine -- the size of individual doses and the number of doses given in cycle 1 were important to the extent that they influenced the cumulative dose.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Enfermedades del Pie/inducido químicamente , Factor Estimulante de Colonias de Granulocitos y Macrófagos/efectos adversos , Linfoma de Células B Grandes Difuso/tratamiento farmacológico , Linfoma no Hodgkin/tratamiento farmacológico , Dolor/inducido químicamente , Enfermedades del Sistema Nervioso Periférico/inducido químicamente , Vincristina/efectos adversos , Adolescente , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Niño , Preescolar , Ciclofosfamida/administración & dosificación , Citarabina/administración & dosificación , Doxorrubicina/administración & dosificación , Etopósido/administración & dosificación , Femenino , Factor Estimulante de Colonias de Granulocitos y Macrófagos/uso terapéutico , Humanos , Ifosfamida/administración & dosificación , Lactante , Masculino , Metotrexato/administración & dosificación , Persona de Mediana Edad , Análisis Multivariante , Vincristina/administración & dosificaciónAsunto(s)
Coroides/patología , Infiltración Leucémica/diagnóstico , Órbita/patología , Leucemia-Linfoma Linfoblástico de Células Precursoras/diagnóstico , Médula Ósea/patología , Coroides/diagnóstico por imagen , Terapia Combinada , Exoftalmia/patología , Neoplasias del Ojo/diagnóstico , Fondo de Ojo , Humanos , Lactante , Infiltración Leucémica/terapia , Masculino , Órbita/diagnóstico por imagen , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia , Retinoblastoma/diagnóstico , Tomografía Computarizada por Rayos XRESUMEN
The biodistribution of 3F8, and IgG3 murine monoclonal antibody (MoAb) specific for the disialoganglioside GD2, was studied in nude mice xenografted with human neuroblastoma (NB). 3F8 conjugated to radioactive iodine and injected intravenously localized selectively to seven human NB when compared with Ewing's sarcoma and Hela cell xenograft controls. Uptake in NB was shown to be specific for MoAb 3F8 when contrasted with pooled mouse IgG or irrelevant IgG3 MoAb controls. Both small (50 mg) and large tumors greater than 2 g) showed radiolocalization. The percent injected dose uptake per gram tumor ranged from 8 to 50% and was inversely correlated with tumor size. Optimal tumor to normal tissue ratios were reached by 24-48 hr. There was no abnormal uptake in the reticuloendothelial system and the MoAb did not cross the blood-brain barrier. Based on the kinetics of the amount of radioactivity deposited in tissues, the relative radiation dose to normal organs was estimated to be 1% to 20% of the tumor dose. The MoAb 3F8 is useful for targeting radioactivity to human NB in vivo and the nude mice xenograft model may allow optimization of parameters that influence such biodistribution.
Asunto(s)
Anticuerpos Monoclonales/metabolismo , Gangliósidos/inmunología , Neuroblastoma/metabolismo , Animales , Antígenos de Neoplasias , Humanos , Ratones , Ratones Desnudos , Trasplante de Neoplasias , Neuroblastoma/inmunología , Distribución Tisular , Trasplante HeterólogoRESUMEN
Using a somatic cell hybridization technique, four murine monoclonal antibodies (three immunoglobulin M and one immunoglobulin G3) were produced against a human neuroblastoma cell surface glycolipid antigen. They reacted strongly with all human neuroblastoma tumor-containing specimens and six of eight human neuroblastoma cell lines. More than 98% of each neuroblastoma cell population possessed this surface antigen, and in the presence of complement, 100% of them were killed. While melanoma and osteogenic sarcoma carried this antigen, leukemia and most Ewing's and Wilms' tumors did not. There was no cross-reaction with 30 normal or remission bone marrow samples and none with normal human tissues other than neurons in vitro. This antigen was neuraminidase sensitive, separable on thin-layer chromatogram, and did not modulate after combining with the monoclonal antibodies. These antibodies could detect less than 0.1% tumor cells deliberately seeded in the bone marrow samples. Because of their unique properties, these monoclonal antibodies may have diagnostic and therapeutic potentials.
Asunto(s)
Anticuerpos Monoclonales/inmunología , Antígenos de Neoplasias/inmunología , Glucolípidos/inmunología , Neuroblastoma/inmunología , Animales , Línea Celular , Proteínas del Sistema Complemento/inmunología , Citotoxicidad Inmunológica , Epítopos , Humanos , Hibridomas , Ratones , Ratones Endogámicos BALB C , Ratones DesnudosRESUMEN
Four Ewing's sarcomas were examined for chromosomal characteristics, growth in cell culture, tumorigenicity in nude mice, and presence of beta-adrenergic receptors. Three tumors were from untreated patients (one obtained directly from the patient and two after growth in nude mice) and one was a metastatic lesion obtained after treatment. All four tumors were diploid or near-diploid, with one or more structural rearrangements. In the metastatic lesion, 21 abnormalities were seen. No specific chromosome aberration was found to be common to all four tumors, although a t(1,16) was observed in two and a t(11;22) in two. Abnormalities involving chromosomes #1, #3, #11, #13, #16, and #22 were each found in two of four tumors. All four tumors were tumorigenic in nude mice; two grew well in cell culture, one of which became an established line, and all four expressed high concentrations of beta-adrenergic receptors.
Asunto(s)
Sarcoma de Ewing/fisiopatología , Adolescente , Animales , División Celular , Bandeo Cromosómico , Femenino , Humanos , Masculino , Ratones , Ratones Desnudos , Trasplante de Neoplasias , Pronóstico , Receptores Adrenérgicos beta/metabolismo , Sarcoma de Ewing/genéticaRESUMEN
A computerized microspectrophotometer was developed to provide rapid and accurate sequential measurements on cells, including nuclear DNA content, by fluorescence staining, photometric grain counting from autoradiographs, and nuclear size estimated by measurement aperture area. To alleviate bulk and vibrations caused by additional stepper motors, the excitation light and filters as well as the emission filters and photomultipliers were detached from the main microscope frame. The light was directed to and from the microscope through fibre optic bundles. This configuration provided an excellent light gathering faculty and made optical alignment easier. The machine provided highly accurate sequential measurements on a relatively large numbers of cells by static photometry.
Asunto(s)
Tecnología de Fibra Óptica/instrumentación , Espectrofotometría/instrumentación , Células Cultivadas , Computadores , ADN/análisis , Estudios de Evaluación como Asunto , Humanos , Neuroblastoma/análisis , Neuroblastoma/patología , Neuroblastoma/ultraestructuraRESUMEN
Acute hematologic-oncologic problems fall into two groups, those that require immediate assessment, diagnosis, and therapy, and those that require attention but are not life threatening if treated appropriately. Both types are considered in this article, which discusses hemorrhagic disorders; anemias, with special emphasis on patients with sickle cell disease; an approach to fever and infection in the immunocompromised child; and oncologic disorders that may be life threatening.
Asunto(s)
Enfermedades Hematológicas , Anemia Hemolítica , Anemia de Células Falciformes , Infecciones Bacterianas , Transfusión Sanguínea , Niño , Preescolar , Coagulación Intravascular Diseminada , Urgencias Médicas , Fiebre , Enfermedades Hematológicas/terapia , Hemofilia A , Hemorragia/diagnóstico , Humanos , Tolerancia Inmunológica , Terapia de Inmunosupresión , Leucemia , Linfoma , Púrpura , Púrpura Trombocitopénica , Trombocitopenia , Enfermedades Vasculares , Vena Cava SuperiorRESUMEN
81 primary pediatric tumors and 4 tumor lines were heterotransplanted into nude mice with an overall success rate of 38.3%. There was variability in success between tumor types. Bone sarcomas were highly successful while brain, lymphoid, and benign tumors in general did poorly. With increasing passage lag times decreased but actual growth rates in general did not change. Results suggested that tumors obtained prior to therapy which grew in nude mice were more likely to recur in the patient. During the observation period 7 spontaneous mouse tumors developed, distinguished from human tumors by histology, cytogenetics, and isoenzyme studies.
Asunto(s)
Neoplasias/patología , Animales , Neoplasias Óseas/patología , Neoplasias Encefálicas/patología , Niño , Humanos , Isoenzimas , L-Lactato Deshidrogenasa/análisis , Leucemia/patología , Ratones , Ratones Desnudos , Trasplante de Neoplasias , Sarcoma/patologíaRESUMEN
To provide a constant level of tracer doses of tritiated thymidine to cultured cells during continuous infusion, miniature osmotic infusion pumps were used to provide replacement thymidine. By determining the loss of isotope from the media during nonreplacement, the rate of constant infusion replacement to maintain thymidine levels was calculated. The replacement rates were similar for the three cell lines examined and allowed a standard osmotic pump infusion.
Asunto(s)
Timidina/metabolismo , Línea Celular , Técnicas de Cultivo/instrumentación , Técnicas de Cultivo/métodos , Humanos , Cinética , Neuroblastoma , Técnica de Dilución de Radioisótopos , TritioRESUMEN
Chromosome analysis of a direct bone marrow preparation from a patient with acute, undifferentiated monoblastic leukemia showed a predominant clone of 51,XX,+6,+8,+4,+19,+21,11q+, along with a chromosomally normal clone. Studies with cytofluorometry confirmed the two populations of cells with different DNA content.
Asunto(s)
Aberraciones Cromosómicas , Leucemia Monocítica Aguda/genética , Médula Ósea/análisis , Células de la Médula Ósea , Bandeo Cromosómico , ADN de Neoplasias/análisis , Femenino , Citometría de Flujo , Historia del Siglo XV , Humanos , CariotipificaciónRESUMEN
Samplings of tumor cells from a patient with Stage IV neuroblastoma were analyzed for chromosome constitution. Chromosome preparations of the tumor cells from a bone marrow sample were compared to preparations of a solid metastatic tumor after growth in the nude mouse host or followed by culture. Six separate chromosome studies were done. The tumor karyotype demonstrated an overall stability, maintaining the consistent abnormalities of a 1p-, +17, and -22. Chromosomes 5 and 9 were also involved in structural abnormalities in sublines of the tumor cells. Double minutes were seen in all preparations.
Asunto(s)
Neuroblastoma/genética , Animales , Médula Ósea/patología , Preescolar , Humanos , Cariotipificación , Linfocitos/patología , Masculino , Ratones , Ratones Desnudos , Neoplasias Experimentales/genética , Neoplasias Experimentales/patología , Neuroblastoma/patología , Piel/patologíaRESUMEN
A graphic analysis of cellular deoxyribonucleic acid (DNA) histograms obtained by flow cytofluorometry is described. This technique utilizes probability paper that graphs data in cumulative percentile form. From this graphic representation, individual normal distributions contributing to the histogram may be isolated and statistically describe. G0G1 and G2M distributions are independently described and S phase is fit to 1--5 overlapping normal distributions as dictated by the analysis results. This technique offers several advantages, including relatively simple mathematical calculations and few assumptions or restraints placed on the analysis. It has proved to be useful in analyzing proliferating and nonproliferating populations as well as distributions with unusual findings such as debris or aberrant DNA contents.
Asunto(s)
Células de la Médula Ósea , ADN/análisis , Linfocitos/citología , Línea Celular , Técnicas Histológicas , Humanos , Neuroblastoma , ProbabilidadAsunto(s)
Neuroblastoma/enzimología , Receptores Adrenérgicos beta/metabolismo , Receptores Adrenérgicos/metabolismo , Adenilil Ciclasas/metabolismo , Animales , Unión Competitiva , Línea Celular , Dihidroalprenolol/metabolismo , Humanos , Ratones , Ratones Desnudos , Pindolol/análogos & derivados , Pindolol/metabolismoRESUMEN
5-Fluoro-2'-deoxyuridine (FdUrd) lowered the dTTP levels in rapidly frozen 12-day W rat embryos and in a human neuroblastoma grown in nude N:NIH(S) mice to about 20% of control values. This effect was associated with greatly increased dCTP levels and reduction of dGTP levels essentially to zero. Elimination of the dGTP pool correlated temporally with the cytotoxicity of FdUrd. Extremely rapid fixation of tissue was required to avoid artifactually high deoxyribonucleoside triphosphate values.
Asunto(s)
Desoxirribonucleótidos/metabolismo , Floxuridina/farmacología , Neuroblastoma/metabolismo , Animales , Técnicas de Cultivo/métodos , Embrión de Mamíferos/metabolismo , Femenino , Humanos , Intercambio Materno-Fetal , Ratones , Ratones Desnudos , Neoplasias Experimentales/metabolismo , Embarazo , RatasRESUMEN
A 2 1/2-year-old, previously healthy child developed progressive swelling of the left leg and a hematoma of the anterior chest wall associated with a falling hemoglobin concentration, as a result of a spontaneously acquired Factor IX inhibitor. Successful management of her condition required a four-volume exchange transfusion and immunosuppressive therapy consisting of cyclophosphamide for four days and prednisone for one month. A brief review of the literature regarding the occurrence and nature of acquired coagulation factor inhibitors and the role of immunosuppressive therapy is also presented.
Asunto(s)
Factor IX/antagonistas & inhibidores , Hemofilia B/etiología , Coagulación Sanguínea , Preescolar , Ciclofosfamida/uso terapéutico , Equimosis/etiología , Equimosis/terapia , Recambio Total de Sangre , Femenino , Hemofilia B/sangre , Hemofilia B/complicaciones , Humanos , Prednisona/uso terapéuticoRESUMEN
A female patient with severe idiopathic aplastic anaemia received a successful bone-marrow transplant from her HLA-identical, mixed-lymphocyte-culture-compatible, brother. 8 months after transplantation she had localised cutaneous measles. Chronic sclerodermatous changes developed which were indistinguishable from chronic graft-versus-host disease and were limited to the areas of the original exanthem. Interaction between viral infection and minor histocompatibility differences probably resulted in graft-versus-host disease in this patient.
Asunto(s)
Trasplante de Médula Ósea , Reacción Injerto-Huésped , Sarampión/inmunología , Complicaciones Posoperatorias/etiología , Esclerodermia Sistémica/etiología , Adolescente , Anemia Aplásica/terapia , Femenino , Humanos , Linfocitos/inmunología , Masculino , Virus del Sarampión/inmunología , Piel/inmunología , Trasplante IsogénicoAsunto(s)
Trasplante de Médula Ósea , Síndromes de Inmunodeficiencia/etiología , Enfermedad Injerto contra Huésped/sangre , Enfermedad Injerto contra Huésped/inmunología , Humanos , Síndromes de Inmunodeficiencia/inmunología , Terapia de Inmunosupresión , Lectinas/farmacología , Activación de Linfocitos , Metotrexato/farmacología , Trasplante HomólogoRESUMEN
Five commonly used developers (Acufine, Rodinal, Dektol, D19 and Microdol X) and two popular nuclear gel emulsions (Kodak NTB-2 and Ilford L4) were tested in combinations for adequacy of development characteristics and the distribution of silver particle (grain) size measured by means of a reflectance microphotometer. All developer-emulsion combinations had some range of development time during which maximum development was accomplished with no occurrence of background grains, with the exceptions of the combinations of NTB2-Acufine and NTB2-D19. Ilford L4 emulsion obtained the narrowest grain size distribution with Rodinal and Acufine, followed by Dektol, and D19. The narrowest size distribution for Kodak NTB2 emulsion was achieved with D19 followed by Acufine, Dektol and Rodinal. Microdol-X had undesirable effects on the integrity of the individual grains of both emulsions. The criteria are discussed for selecting the most advantageous emulsion-developer system for the particular mode of evaluation (visual, photometric, television camera) to be applied to the finished autoradiographic specimens.