ABSTRACT
Scintigraphy of the reticuloendothelial system (RES) was performed in 19 patients with polycythemia vera (PCV) and in 18 with secondary or relative polycythemia (PS). Bone marrow extension was found in all patients with PCV and in 11 of 18 patients with PS. The patients with PCV had a higher degree of extension than those with PS. Increased pelvic bone marrow activity was found in 16 of 19 PCV patients, but in none with PS. Splenomegaly was found in 9 patients with PCV, and in none with PS. It is concluded that RES scintigraphy in the majority of patients may differentiate between PCV and PS using the parameters pelvic bone marrow activity, bone marrow extension and splenic size.
Subject(s)
Mononuclear Phagocyte System/diagnostic imaging , Polycythemia Vera/diagnostic imaging , Polycythemia/diagnostic imaging , Adult , Aged , Aged, 80 and over , Bone Marrow/diagnostic imaging , Diagnosis, Differential , Female , Humans , Male , Middle Aged , Polycythemia/etiology , Radionuclide Imaging , Technetium Tc 99m Aggregated Albumin , Time FactorsABSTRACT
Serum was analyzed for zinc in 51 patients of varying age and with varying degrees of alveolar bone loss as recorded on roentgenograms. There was a reversed correlation between marginal alveolar bone loss and serum zinc levels. The observations are discussed in relation to the physiological functions of zinc.
Subject(s)
Bone Resorption/blood , Periodontal Diseases/blood , Zinc/blood , Adult , Alveolar Process/diagnostic imaging , Female , Humans , Male , Middle Aged , Periodontal Diseases/diagnostic imaging , RadiographyABSTRACT
Forty-four adult patients under 60 years of age with acute nonlymphoblastic leukemia were randomized for induction treatment with one of the following three regimens: R 1 = courses of daunorubicin on day 1 + ARA-C on days 1--5; R 2 = courses of daunorubicin on days 1 and 2 + ARA-C on days 4--8; R 3 = courses of daunorubicin-DNA complex on days 1--2 + ARA-C on days 4--8. Out of 14 patients, 9 went into remission on R 1, 6 out of 14 on R 2, and 8 out of 16 on R 3. The preliminary results suggest that daunorubicin-DNA complex has the same efficacy for inducing remission as daunorubicin alone, if the same time intervals and dosages are used.
Subject(s)
DNA/therapeutic use , Daunorubicin/therapeutic use , Leukemia/drug therapy , Acute Disease , DNA/adverse effects , Daunorubicin/adverse effects , Evaluation Studies as Topic , Humans , Middle Aged , Time FactorsABSTRACT
In order to study the effect of oxymetholone therapy in advanced myelofibrosis, 11 patients (4 females, 7 males) were given, 3--5 mg per kg body weight, long-term oxymetholone treatment in a prospective multicenter study. Five cases had previously had a diagnosis of polycythemia vera. All patients had anemia initially, 4 leukocytopenia and 10 thrombocytopenia in addition. Hepato-splenomegaly was present in all cases but in varying degree. Five patients required regular blood transfusions before treatment. In 9 of the 15 courses given, there was normalization of the peripheral blood or substantial improvement (better than 3 g hemoglobin/dl or 50 X 10(9) platelets/1) after androgens. Significant effects were noted both on hemoglobin values and platelet counts. The need for blood transfusions ceased completely in all 5 cases. When oxymetholone treatment was reduced or interrupted 4 patients relapsed; 2 of them responded to a renewed course. The red cell counts returned to previous polycythemic values in one patient and another died from acute leukemia. The results of this study suggest that androgens might be of value in advanced cases of myelofibrosis with transfusion-requiring anemia or severe thrombocytopenia.
Subject(s)
Oxymetholone/therapeutic use , Primary Myelofibrosis/drug therapy , Aged , Anemia/etiology , Female , Hepatomegaly/etiology , Humans , Leukopenia/etiology , Male , Middle Aged , Oxymetholone/administration & dosage , Primary Myelofibrosis/complications , Prospective Studies , Splenomegaly/etiology , Thrombocytopenia/etiologyABSTRACT
This is a prospective multi-center study in which patients with aregenerative anaemia were treated with a standardized high dosage regime of an anabolic steroid (oxymetholone, Anasteron). 53 patients were included and divided into two groups according to bone marrow cellularity. Furthermore the hypocellular group was subdivided in order to make comparison with earlier studies possible. In the hypocellular group, the frequency of remission was 56% and the 2-year-survival from the onset of symptoms was 75%. This is longer than in some earlier studies, perhaps because of possible differences in etiology and/or because of the effect of systematic high dosage, long term androgen therapy. Patient selection was minimized and was not considered to be of major importance. Patients with hypercellular marrows, on the other hand, responded poorly to androgens. In this group 63% died of acute leukaemia, which confirms earlier suggestions that this form of aregenerative anaemia, frequently is of a preleukaemic nature.
Subject(s)
Anemia, Aplastic/drug therapy , Oxymetholone/therapeutic use , Adolescent , Adult , Aged , Anemia, Aplastic/complications , Anemia, Aplastic/mortality , Chemical and Drug Induced Liver Injury , Child , Female , Humans , Leukemia/etiology , Leukemia/mortality , Liver/drug effects , Male , Middle Aged , Oxymetholone/adverse effects , Prognosis , Prospective Studies , Remission, Spontaneous , Sweden , Time FactorsABSTRACT
One hundred and fourteen patients with acute leukemia, 57 children (10 AML and 47 ALL) and 57 adults (37 AML and 20 ALL) were treated with L-asparaginase (Asnase) 200 or 1000 IU/kg daily for 30 days unless withdrawn on account of side effects. Combinations with other cytotoxic drugs were used in all but eight patients. Hypersensitive reactions, decrease in Asnase activity in plasma, and bivalent antibodies to Asnase appeared more frequently in adults (28%, 46%, and 79%, respectively) than in children (16%, 17%, and 25% respectively). There was a clear association between these three parameters. Thus hypersensitive reactions generally developed at the time of or after the decrease in plasma Asnase activity. Antibodies were detected only where Asnase activity had disappeared from the plasma. This time sequence, and in vitro experiments, suggest the formation of antigen-antibody complexes which might be responsible for inactivation of Asnase and for the development of hypersensitive reactions. However in many cases antibodies were found without concomitant enzyme inactivation or hypersensitive reactions. Antibodies to Asnase of IgE type (reagins) were found in only 10 children and 6 adults. There was no correlation between hypersensitive reactions, decrease in Asnase activity, and IgE antibodies. The frequency of remission among patients developing bivalent antibodies to Asnase was 68% (13/19) in contrast to 27% (3/11) among patients whose sera contained no detectable antibodies to Asnase, but the difference was not statistically significant.
Subject(s)
Antibody Formation , Asparaginase/therapeutic use , Hypersensitivity, Delayed , Leukemia, Lymphoid/drug therapy , Leukemia, Myeloid, Acute/drug therapy , Adult , Antineoplastic Agents/therapeutic use , Asparaginase/blood , Asparaginase/immunology , Child , Drug Therapy, Combination , Humans , Immunoglobulin E/analysis , Leukemia, Lymphoid/immunology , Leukemia, Myeloid, Acute/immunology , Time FactorsABSTRACT
77 unselected adult patients with acute myeloblastic leukaemia (AML), including practically all AML patients from an area with 1.9 million inhabitants, were randomized for either (1) 5 days pretreatment with 1-asparaginase and prednisolone followed by a combination of rubidomycin and cytosine arabinoside (ARAP), or (2) treatment with a combination of rubidomycin, cytosine arabinoside and prednisolone without 1-asparaginase pretreatment (RAP). Complete remission was induced with ARAP in 12 patients (31%) and with RAP in 13 patients (34%). Thus pretreatment with 1-asparaginase did not improve the therapeutic response. The overall remission frequency was significantly higher below the age of 60; 50% compared to 13% above this age. Side-effects such as liver dysfunction, nausea and vomiting were more common in patients pretreated with 1-asparaginase. Sterilization of the gut did not improve the remission frequency with either regime.
