Late effects in patients with Fanconi anemia following allogeneic hematopoietic stem cell transplantation from alternative donors.

Hematopoietic stem cell transplantation (HSCT) is curative for hematological manifestations of Fanconi anemia (FA). We performed a retrospective analysis of 22 patients with FA and aplastic anemia, myelodysplastic syndrome or acute myelogenous leukemia who underwent a HSCT at Memorial Sloan Kettering Cancer Center and survived at least 1 year post HSCT. Patients underwent either a TBI- (N=18) or busulfan- (N=4) based cytoreduction followed by T-cell-depleted transplants from alternative donors. Twenty patients were alive at time of the study with a 5- and 10-year overall survival of 100 and 84% and no evidence of chronic GvHD. Among the 18 patients receiving a TBI-based regimen, 11 (61%) had persistent hemochromatosis, 4 (22%) developed hypothyroidism, 7 (39%) had insulin resistance and 5 (27%) developed hypertriglyceridemia after transplant. Eleven of 16 evaluable patients (68%), receiving TBI, developed gonadal dysfunction. Two patients who received a TBI-based regimen died of squamous cell carcinoma. One patient developed hemochromatosis, hypothyroidism and gonadal dysfunction after busulfan-based cytoreduction. TBI appears to be a risk factor for malignant and endocrine late effects in the FA host. Multidisciplinary follow-up of patients with FA (including cancer screening) is essential for early detection and management of late complications, and improving long-term outcomes.

Separation of double-stranded DNA fragments in plastic capillary electrophoresis chips by using E99P69E99 as separation medium.

The separation of double-stranded DNA (dsDNA) fragments in polymethylmethacrylate (PMMA) capillary electrophoresis (CE) chips by using E99P69E99 as a separation medium has been demonstrated. The PMMA CE chips were simply manufactured by micromachining and adhesive tape sealing. To make the separation channel compatible with the separation medium, a dynamic nonionic surfactant coating procedure was developed, which made the plastic separation channel sufficiently hydrophilic to allow the separation medium to fill the channel by capillary action. Subsequent separation of DNA fragments was successful with a separation efficiency of the order of 10(4) theoretical plates over an effective separation distance of 1.5 cm. By using an applied electric field strength of 200 V/cm, the separation of low DNA mass ladder was completed within 5 min. The simple coating procedure, together with the self-assembled viscosity-adjustable separation medium, should be useful to meet some of the essential requirements for developing single-use disposable CE chips. Coating the channels with polymer blends of PMMA and the separation medium also showed promise.

Enhancement of enzyme-activated 1,2-dioxetane chemiluminescence in membrane-based assays.

Processes for enhancing the chemiluminescent signal generated by enzyme-activated 1,2-dioxetanes have been developed for membrane-based assays in which detection is done using a charge-coupled device (CCD) camera or X-ray film. The enhancement is demonstrated using slot-blots of biotinylated lambda DNA in conjunction with an avidin-alkaline phosphatase conjugate. For detection with a CCD camera, the nylon membrane is dried after processing and incubation in dioxetane substrate solution and heated to temperatures of 50 to 80 degrees C during detection. Up to a 100-fold signal increase is obtained using this enhancement process compared to the conventional detection procedure, in which the blot is kept saturated with substrate solution in a sealed plastic bag during detection. For detection with X-ray film, a fivefold increase in signal intensity is realized by drying the membrane before exposure to the film. These enhancement processes greatly reduce the time required for detection in membrane-based assays.

Immobilization of perfluoroalkylated enzymes in a biologically active state onto Perflex support.

Perflex has been introduced by E. I. du Pont de Nemours and Co., Inc., as a new fluorocarbon-based technology for protein immobilization. Due to the hydrophobic character of the support, however, significant loss of enzymatic activity may occur upon immobilization of certain enzymes, which appears to be due to a large conformational change of the protein ("inversion"). Pretreatment of the Perflex support with a neutral fluorosurfactant lessened the surface hydrophobicity, thus decreasing the hydrophobic interaction between the support and the protein. Modification of enzymes with a high number of fluorocarbon residues, which forms a hydrophobic "envelope" around the protein, also appears to prevent enzyme inactivation upon immobilization on Perflex support. Moreover, preactivation of the support with either perfluorooctylpropylisocyanate or reactive poly(fluoroalkyl) sugar reagents greatly improves the enzyme particle activity by increasing the amount of immobilized enzyme. Fluorosurfactant treatment of the support activated with perfluorooctylpropylisocyanate improves the retention of activity for sensitive enzymes such as alpha-chymotrypsin and increases the wetability and ease of handling of the Perflex particles.

Selectivity enhancement of an Escherichia coli bacterial electrode using enzyme and transport inhibitors.

The feasibility of using specific enzyme and transport inhibitors to minimize the glutamine response of a potentiometric microbial sensor is demonstrated. The glutamine response of a bacterial electrode prepared with Escherichia coli as the biocatalyst in conjunction with an ammonia gas-sensing electrode was greatly reduced by treating the electrode with the enzyme inhibitor 6-diazo-5-oxo-L-norleucine (DONL) and the transport inhibitor gamma-L-glutamylhydrazide. Each inhibitor effectively decreased glutamine response to a level sufficiently low to be considered negligible in clinical studies. Although the sensor ultimately recovered from the effects of a single exposure to an inhibitor, continuous exposure at an optimum concentration maintained a low response to glutamine. Furthermore, the treatment of the sensor with both inhibitors simultaneously resulted in a negligible response to glutamine of <1 mV, indicating that both inhibitors are necessary for optimum inhibition of glutamine response. This approach is promising as a means of enhancing the selectivity of microbial sensors.

Electrochemical determination of hemoglobin, hematocrit, and hemolysis.

Novel electrochemical methods have been developed for determination of total hemoglobin, hematocrit, and detection of hemolysis in whole blood. Hemoglobin is measured through its peroxidase activity, a fluoride ion-selective electrode being used to monitor the rate of fluoride ion production from the oxidation of an organofluorine compound. Results agree well with those obtained with the cyanmethemoglobin method (r = 0.970). Hematocrit is determined from the ratio of the sodium ion concentrations measured with an ion-selective electrode before and after lysis of the erythrocytes. Results by this and the microhematocrit method correlated well (r = 0.987). Hemolysis in a whole-blood sample is detected by using an oxygen electrode to measure the oxygen released when hemoglobin in plasma is oxidized.

Glutamine-selective membrane electrode that uses living bacterial cells.

A novel bioselective membrane electrode for L-glutamine has been constructed by coupling living bacteria of the strain Sarcina flava to a potentiometric ammonia gas sensor. Tests in aqueous standards and human serum show that the electrode combines excellent sensitivity and selectivity with rapid response and a useful lifetime of at least 2 weeks.