Antitheta immunization affects hemopoietic colony growth in a theta-incompatible mouse system.

Seeking a system with which to study the antitheta-sensitive regulatory cell (TSRC), other than the W/Wv anemic mouse, we tested a model which utilizes mouse strains differing almost exclusively in theta allotype. AKR/FuRd Thy 1.1 mice were immunized against CBA Thy 1.2 mouse thymocytes to produce antibody. The immunized mice were lethally irradiated and grafted with marrow cells from AKR/Cum Thy 1.2 mice. It was reasoned that in this situation antitheta-sensitive cells present in or produced by the graft will be destroyed, while theta-incompatible host cells may not be as capable of collaboration with the graft stem cells as are the graft's theta-compatible cells. Anti-Thy 1.2 immunization did not influence the number of spleen colonies formed by marrow from Thy 1.2 mice; but the colonies formed, especially the erythropoietic colonies, were reduced in size. Also, both the relative and absolute frequencies of erythropoietic colonies were decreased, while those of granulopoietic colonies were increased. Therefore, the destruction of antitheta-sensitive cells in this system resulted in decreased effectiveness of spleen colony growth and altered the differentiation pattern of colony-forming cells. These effects were not observed in control groups immunized with CBA tissues not bearing the Thy 1.2 antigen. This study further stresses the importance of the theta antigen in hemopoietic differentiation and may provide an alternative in vivo model for studying the TSRC.

Treatment with antitheta serum affects hemopoietic stem cell HSC proliferation in an in vivo culture system.

Marrow cells from normal WBB6F1 +/+ mice were treated in vitro with either anti-Thy 1.2 serum and complement (C') or normal mouse serum (NMS) and C' and then they were cultured in diffusion chambers implanted into peritoneal cavity of Balb/c mice. Following 1-19 days of culture, chamber contents were injected into W/Wv mice to test for either the capacity to form spleen colonies or to cure the W/Wv anemia. In contrast to NMS-treated marrow, anti-Thy 1.2 serum treated marrow hemopoietic stem cells almost completely failed to proliferate in this system. Number of cells per chamber upon termination of culture was less affected.

Hyperuricaemia as an index of the response to chemotherapy in solid tumors.

A transient increase in uric acid level following administration of high doses of Cyclophosphamide in the 1st course of cytostatic therapy applied for various solid tumors (mostly lung cancer) was observed in 10 patients with measurable disease simultaneously with complete or partial (above 50%) regression of the tumor. The same effect was noted in further 5 patients, who, however, had non-measurable disease. On the other hand, the clinical course of the disease and survival were similar in these 5 patients and in the former 10 patients. No corresponding increase in the uric acid level was observed in 87 patients with similar disease and treatment, but not responding to chemotherapy and with short survival. It is concluded, that hyperuricaemia may indicate responsiveness to chemotherapy in cancer patients with non-measurable disease.

Evaluation of the usefulness of nitroblue tetrazolium reduction test (NBT test) for detection of bacterial infection in cancer patients.

False positivity of the NBT test in neoplastic diseases described by some authose may be a limitation in the use of the test for infection screening in cancer patients. For explaining this problem studies were performed in a group of 30 patients with various untreated malignancies without infection and in 20 of these with bacteriologically confirmed infections. The obtained results were compared with those in groups of normal persons without and with infection. Slightly modified Park method for spontaneous and stimulated NBT test was used. No significant differences between patients of both groups without infection were found. The increase in positivity of the test in presence of infection was lower in cancer patients than in normal subjects, however, it was non-significant. We did not observe any false-positive results in our patients, though one case of false negativity in myeloma is described separately. It is concluded that neoplastic disease does not cause, as such positivity of the NBT test. Because of similar response of NBT test to presence of infection, the NBT test is recognized as very useful for infection screening in cancer patients similarly as in normal persons.

Modified megathrombocyte index in the diagnosis of thrombopoiesis injury produced by cancer chemotherapy.

The border-line separating the normal platelet from the megathrombocyte was lowered from 2.5 microns, classically used, to 2 microns. This modification allowed more precise definition of normal frequency of megathrombocytes among platelets (megathrombocyte index--MI) which was 10-35%. The modified MI determination demonstrated the same kinetics of changes following the intensive cancer chemotherapy as the classical one and, moreover, enabled individual diagnosis of thrombopoiesis perturbation induced by chemotherapy which was not possible with the classical MI.

Value of the NBT test in the diagnosis of bacterial infection in untreated cancer patients and in those on radio- and/or chemotherapy.

As the first step in the study, the results of the NBT test in 83 patients with various untreated neoplasms, including 20 lymphomas, without bacterial infections and in 35 neoplastic patients with this complications were compared with the results obtained in control groups. No significant differences in the results were found between the groups of neoplastic patients without or with bacterial infections and the controls. To evaluate the NBT test during radio- and/or chemotherapy, especially in neutropenia, 45 patients were NBT-monitored. During the study of 102 episodes of neutropenia 43 infections occurred and 30 were NBT-confirmed. In remaining 13 cases it was impossible to perform the test because of extremely low neutrophil count (below 500/mul). All 20 infections in patients with normal neutrophil count were NBT-positive. These results confirm the usefulness of the test for infection screening in untreated with malignancies, as well as in patients receiving radio- and/or chemotherapy. However, the test can be taken only in patients without severe neutropenia.

[Accidental contamination with cesium-137]. / Przypadek awaryjnego skazenia cezem--137.

The paper describes an accidental 137Cs internal and external contamination of a woman 28 years old by handling of two unsealed 137Cs sources of 2.5 Ci total activity. The only abnormality found by laboratory tests was leukopenia. The chromosomes of blood lymphocytes were also investigated. 137Cs content in urine between the 8th and 40th day after accident ranged from 34, 53 to 12.01 nCi/day. The mean feces: urine ratio was 0.25 +/- 0.06. The increase of 137Cs excretion in urine, after administration of diurectic "Lasix" and potassium was not observed. Mean biological half-life calculated from regression curve was 64 days. Body content found by whole body counting, performed on the 8th and 15th day after accident, was 6.5 muCi and 5.1 muCi respectively. The initial 137Cs body burden of 6.9 muCi was calculated for the value 5.1 muCi. The corresponding total radiation dose was 0.26 rads and quarterly dose was 0.16 rads.

[Problems with radiation protection for adjuvant radiotherapy of thyroid cancer]. / Problemy ochrony radiologicznej w izotopowym leczeniu uzupelniajacym raka tarczycy.

Ablative treatment of thyroid cancer with 131I is associated with the exposure to ionizing radiation of not only the target cells but also other cells and organs in the patient's body. Thermoluminescent dosimetry showed that the mean dose equivalent in ovaries equaled to several dozen mSv when the mean therapeutic dose was 2.8 GBq of 131I. In the treated young women the performed ovulation tests revealed no dysfunction of the ovaries. The highest dose equivalent in the clinic staff would not exceed 20 mSv per year. Accordingly, the dose equivalents to the public would not exceed the threshold limit of 1 mSv per year. In order to fulfill the requirements of regulations for disposal of radioactive waste and the necessity to store the waste for as long as 80 days it is obligatory to utilize setting tanks of very large capacity.

[Environmental radiation exposure of a thyroid cancer patient resulting from adjuvant iodine radiotherapy]. / Narazenie radiacyjne otoczenia chorego na raka tarczycy w wyniku uzupelniajacego leczenia jodem promieniotwórczym.

The aim of the study was to evaluate radiation risk in the environment of patients treated with 131I as an ablative therapy following radical surgery for the differentiated thyroid cancer. The activities of radioiodine used in this form of therapy approximate 2.8 GBq (76 mCi) and the in cases of the cancer metastases to other organs may be as high as 7.4 GBq (200 mCi). Dose equivalent rates were estimated in nine seated patients at the level of the thyroid close to the gland surface, and 0.5 and 1 m away from it. The measurements were performed at one, 24, 48, 72, 96, 120, 144, and 168 hours after the injection of 131I. The dose equivalent rates at various distances from the thyroid surface at different times were approximated with the exponential function by the least square method. Then, the dose equivalents were calculated from the moment of 131I application to the moment of the total removal of the isotope from the organism. From this relation, time intervals after which the annual threshold doses of 1, 5, and 50 mSv would be exceeded were computed as the function of the applied 131I activity. The results of the present study indicate that attendants of the patients treated with 131I will not be exposed to the doses of ionising radiation exceeding the acceptable annual thresholds provided with the limited time intervals. In addition, the present results may be useful in elaborating procedures of dealing with and handling the patients during their stay at hospital, at home, and at work.

[Evaluation of the relationship between chosen factors and results of whole body scintigraphy with 131I in patients with differentiated thyroid cancers]. / Ocena zaleznosci wybranych czynników i wyników badan scyntygraficznych calego ciala za pomoca 131I u chorych ze zróznicowanymi rakami tarczycy.

Treatment and diagnostics with 131I play an important role in patients with differentiated thyroid cancer (DTC) after thyreoidectomy. The aim of the study was to assess the influence of some factors on ablative therapy results. Fifty seven patients with DTC were investigated (44 females--mean age 46.6 yrs, 13 males--mean age 55.6 yrs.). Papillary thyroid cancer was diagnosed in forty five patients (79%) however, follicular thyroid cancer in the others (21%). We performed post-therapeutic whole-body scan (WBS) after high fixed doses of 131I (median = 75 mCi) and six months later diagnostic WBS (mean 4.3 mCi) in every patient. Postoperative radioiodine uptake, levels of TSH and thyroglobulin (Tg) serum concentrations were assessed after thyroid hormones withdrawal before imaging. The absence of radioiodine uptake in the thyroid bed (effective ablation) was observed in 64.9% of patients. In other cases scans showed significantly diminished uptake of the tracer in the remnants. Statistically significant difference in TSH levels before and after radioiodine therapy (75.6 vs. 106.7 microIU/ml, p < 0.001) was found in all patients. However, effectiveness of the ablative therapy did not depend on radioiodine uptake, TSH and Tg levels before radioiodine treatment.

Nitroblue tetrazolium (NBT) test: criteria for false positivity and its use in practice.

The criteria for false positivity of the NBT test were described including absence of classical clinical signs of bacterial infection, negative blood (and, if necessary, other) cultures, and lack of response of antibacterial treatment as the basis for appreciation of positive NBT test result as false-positive. A case of acute lymphoblastic leukaemia with all the criteria being fulfilled was described.

Patterns of changes in peripheral blood composition in the course of combination chemotherapy of cancer.

During MOPP (mechloretamine, vincristine, procarbasine and prednisone) chemotherapy in Hodgkin's disease a pattern of haematological injury develops gradually, and the period of maximal disturbances in peripheral blood parameters includes the last two or three months (the last 2 or 3 courses) of treatment with insufficient rebound between the courses. On the contrary, in the case of "synchronization" chemotherapy (vincristine and cyclophosphamide) in lung cancer a pattern of haematological injury develops rapidly, and the period of maximal disturbances in peripheral blood parameters takes only a few days, 7-12 days after each course, with sufficient or enhanced rebound between the courses. These differences are probably due to different scheduling of drugs in these methods of therapy.

Critical evaluation of the usefulness of different reticulocyte parameters in monitoring the erythropoiesis reaction to cancer chemotherapy.

Eighteen patients with various solid tumors were treated with combination of vincristine and 30-50 mg/kg of cyclophosphamide. Prior therapy and in 1-3 day intervals these patients had determined in peripheral bloods: frequency of reticulocytes (%R), absolute reticulocyte count (ARC), corrected reticulocyte count (CRC), reticulocyte production index (RPI) and hematocrit (Ht). These studies have shown that the impairment of reticulocyte production is earlier diagnosed by RPI than ARC and CRC, and finally by %R. On the other hand, %R was the parameter which allowed for the earliest detection of the beginning of recovery post chemotherapy. It is concluded that the RPI is the parameter of choice for detecting the impairment of erythropoiesis during evaluation of new drugs and protocols of cancer chemotherapy.

Lung scanning using microspheres labeled with radioactive isotopes in the diagnosis and evaluation of therapeutic results in pulmonary malignant neoplasms.

In 25 patients with malignant pulmonary neoplasms 38 scintiscanning investigations were carried out using the method of albumin microspheres labeled with 131I, technetium -99 m, or indium -113 m and macrocolloids of ferric hydroxide labeled with 113mIn. In 10 patients with infiltration of the main or lobar bronchi scintiscanning demonstrated in 9 cases complete absence of perfusion of one lung. In these cases routine radiological investigations demonstrated normal perfusion and aeration of lung parenchyma in the involved lung. Among 13 cases of carcinoma situated in segmental or subsegmental bronchi the areas with absent perfusion were in 7 cases larger than changes observed during radiological examination. Scintiscanning investigations were used also for evaluation of therapeutic results of synchronized chemotherapy in malignant neoplasms of this organ. Scintiscanning is a method well tolerated by the patients and it may be performed repeatedly in the same case for evaluation changes in perfusion disturbances caused by malignant lung neoplasms. It may be helpful in choice of a proper method of treatment.