ABSTRACT
In a retrospective study of laboratory tests for paroxysmal nocturnal hemoglobinuria (PNH), the red blood cells of several patients gave conflicting results when different testing procedures were used. To resolve these discrepancies, an examination of the various procedures was undertaken, using sulfhydryl reagent-treated red blood cells as model PNH cells. Rabbit antiserum to human red blood cells was used to sensitize erythrocytes for specific antibody-dependent complement lysis sensitivity tests. Acidified serum and inulin were used in fluid-phase complement activation tests. For the general laboratory, a modification of the sucrose lysis test is described, which can give the relative complement sensitivity and size of an abnormal subpopulation of red blood cells. Considering the results of our patients and the reports in the literature of the association of PNH with a variety of lymphoproliferative and myeloproliferative disorders, it is stressed that testing procedures for PNH be controlled more carefully for a better understanding of the nature of the membrane defect.
Subject(s)
Erythrocytes , Hemoglobinuria, Paroxysmal/diagnosis , Complement System Proteins , Diagnostic Errors , Hematologic Tests , Hemolysis/drug effects , Humans , Hydrogen-Ion Concentration , Inulin/pharmacology , Retrospective Studies , Sucrose/pharmacology , Sulfhydryl Reagents/pharmacologySubject(s)
Spleen/abnormalities , Thrombocytopenia/etiology , Adult , Humans , Recurrence , SplenectomyABSTRACT
Previous studies demonstrated a protective effect of hypoxia on subsequent death breathing oxygen. Four groups of rats were exposed to air for 120 hours plus 99% O2 for 52 hours (A + O2); 120 hours of hypoxia plus 52 hours 99% O2 (H + O2); 172 hours of only air (A); and 120 hours of only hypoxia (H). Rats were sacrificed and lung lavage protein (gm/ 100 ml) was 0.57 +/-0.18 in A + O2 and 0.26 +/- 0.12 in H + O2. Hematocrits were increased at sacrifice. Rats with induced hematocrits of 61% did not have a protective effect breathing oxygen. Mean total phospholipid in lung lavage was: A + O2 O.94; H + O2 1.10; A 1.08; and H 1.76 (micronM/ml). Phosphatidyl choline (lecithin) was: A + O2 0.49; H + O2 0.61; A 0.59; and H 1.15 micronM/ml. Differences among the groups were significant for total phospholipids and phosphatidyl choline except between air (A) and hypoxia + O2 (H + O2). Palmitic acid was decreased in A + O2 compared to the other groups. Oxygen breathing results in decreased total phospholipids and phosphatidyl choline in lung lavage. Pretreatment with hypoxia and subsequent oxygen breathing results in amounts similar to rats breathing air only.
Subject(s)
Hypoxia/physiopathology , Oxygen/toxicity , Animals , Blood Protein Electrophoresis , Blood Proteins/metabolism , Fatty Acids/metabolism , Hematocrit , Hypoxia/blood , Hypoxia/metabolism , Leukocyte Count , Lung/metabolism , Male , Phosphatidylcholines/metabolism , Phospholipids/metabolism , Polycythemia/physiopathology , Rats , TemperatureSubject(s)
Hodgkin Disease/pathology , Adolescent , Adult , Child , Evaluation Studies as Topic , Female , Hodgkin Disease/surgery , Hodgkin Disease/therapy , Humans , Male , Middle Aged , MinnesotaABSTRACT
27 adult patients with acute lymphocytic leukemia have been analyzed. Complete remission was induced in 9 of 113 patients treated with prednisone +6-MP, 4 of 6 patients treated with prednisone + vincristine, and the one patient treated with a combination of prednisone, vincristine, 6-MP, and methotrexate. The median survival for these 20 patients was 11 months and the median duration of complete remission was 71/2 months. Two of these patients remain in complete remission at 8+ years. Our most recent regimen for remission induction, prednisone + vincristine + daunomycin, has produced complete remission in 7 of 7 patients, with a median duration of complete remission of 15 months. Three patients remain in their original complete remission from 16+ to 24+ months, and 5 of these 7 patients remain alive from 16+ to 24+ months.
