Intermittent high-dose vitamin D prophylaxis during infancy: effect on vitamin D metabolites, calcium, and phosphorus.

In infants receiving intermittent high dose vitamin D prophylaxis (600,000 IU ergocalciferol per dose orally) every 3-5 mo, the serum concentrations of vitamin D metabolites, calcium (Ca), and phosphorus (P) were determined before and 2 wk after each dose. The 25-hydroxyvitamin D (OHD) concentrations increased to well above normal but the values returned to the normal range before each subsequent dose. The 24,25- and 25,26-dihydroxyvitamin D ([OH]2D) levels followed a pattern similar to that of 25-OHD, and both were closely related to the latter (r = 0.85, p less than 0.005, and r = 0.84, p less than 0.005, respectively). The 1,25-(OH)2D concentrations did not vary in a consistent pattern and remained largely within the normal range. All infants had normal Ca levels before the first dose but 14 infants (34%) later had one or both Ca values above the upper normal limit of 2.80 mmol/L (2.81-3.32 mmol/L), indicating that the vitamin D doses were excessive despite the lack of accumulative increases in serum vitamin D concentrations.

[Cryopreservation of bone marrow for the autologous transplantation in children]. / Kryokonservierung von Knochenmark zur autologen Transplantation bei Kindern.

In preparing the autologous transplantation of children a method for cryoconservation of bone-marrow was developed by means of investigating the donor's bone-marrow. This method is adapted to our conditions, can easily be practised and is cell-preserving. Quantity and quality of the stored bone-marrow cells were evaluated concerning their proliferation capability by means of CFU-c assays. The highest recovery in CFU-c (78%) and cells (98%) was observed if isolated mononuclear cells with cryoprotective addition of 5% DMSO, 20% of human albumin, and 20% of serum were slowly frozen at a controllable rate, stored in liquid oxygen and thawed very quickly. According to the elaborated method the remission marrow was taken from 15 children affected with malignant diseases for autologous reinfusion. The data gained here confirm the experimental experiences.

[Use of human albumin as an additional cryoprotective agent in freeze preservation of hematopoietic stem cells]. / Verwendung von Humanalbumin als zusätzliches Kryoprotektivum bei der Tieftemperaturkonservierung hämatopoetischer Vorlüferzellen.

14 bone-marrow samples of healthy donors were cryopreserved with 5% of DMSO in combination with different volume percentages of 20% human albumin, with the protective impact of the respective freezing mixture on the proliferating capacity of early hemotopoietic precursor cells being determined by means of CFU-c-technique. A combination of 5% of DMSO with 20% of human albumin with an addition of 20% of autologous serum proved to be the most favourable freezing protection. CFU-c-recovery which was achieved in this way amounted to 78 +/- 7%. A protective impact of human albumin for CFU-c during incubation with the freezing medium at room temperature was statistically not significant. Thus, the method presented is suitable for cryopreservation of bone marrow for autologous transplantation. The advantages over the traditional procedure results from the slight degree of toxicity by reducing the DMSO percentage from the common 10% to 5% as well as from the fact that the thawed cell suspension may be directly infused with the substance for freezing protection, thus avoiding an additional loss of proliferative material. The procedure may be used especially for autologous transplantation in childhood.

Results of acute lymphoblastic leukemia therapy in childhood with a modified BFM protocol in a multicenter study in the German Democratic Republic.

Between 1 September 1981 and 31 December 1985, 382 previously untreated children with ALL were entered into study VII/81, a multicentric and randomized study with a modified BFM protocol. Patients were divided into three risk groups according to the initial lymphoblast count and liver and spleen enlargement: standard- (SR), medium- (MR), and high-risk (HR) groups. Of all patients, 94% attained complete remission. The actuarial probability of event-free survival is 0.62 +/- 0.04 (SR group, 0.66 +/- 0.06; HR group, 0.29 +/- 0.12). Sixty-one patients relapsed, 10 had isolated CNS relapses, and 11 CNS relapses were combined with bone marrow relapses. Concerning the duration of maintenance therapy, patients were randomized into two groups of 18 and 24 months respectively. Up to now, there has been a slight advantage for the 18-month group. Two different methods of CNS preventive therapy for SR patients (irradiation plus intrathecal methotrexate and intermediate-dose methotrexate (IDMTX) plus intrathecal methotrexate) were used and revealed a higher rate of CNS relapses but a lower rate of bone marrow relapses in the intermediate-dose MTX group.

Improved treatment results in childhood acute nonlymphoblastic leukemia with the BFM-AML protocol 78 in a multicenter study in the GDR.

Eighty-seven children with acute nonlymphoblastic leukemia were treated with the AML protocol BFM 78 between June 1979 and February 1986 in a multicenter study in the GDR. Seventeen children (20%) died from early complications, eight did not respond to therapy. Fifty-eight patients (70%) achieved a complete remission. Twenty-three patients relapsed. The life table analysis revealed after 5 years a probability for event-free survival of 36% (SD = 6%) and an event-free interval of 51% (SD = 8%). Six patients were transplanted in first remission. Two of them died; one (M 1) on day + 19 from encephalopathy and one (M 4) on day + 60 from acute GVHD. The overall results are in good correlation with the original BFM study, but there are differences in the subtypes. Results are superior to other AML protocols in our group.

Influence of phytogenic substances with thyreostatic effects in combination with iodine on the thyroid hormones and somatomedin level in pigs.

Growing pigs were given 8% rape seed meal (RSM), which was offered without or with different iodine-supplements and further trace elements. RSM without I-supplementation reduced food intake and weight gains by more than 50%, thyroid weight increased by the factor 6, T4 declined below the detectable limit, T3 by two thirds and somatomedin activity by 50% compared to the control group (soy bean meal). In spite of supplementation with iodine and further trace elements the T3-level reached the level of the control group in no variant due to nutrient deficiency (reduced food intake) and the conversion-impeding effect of goitrogenic substances. The same is true for Sm-activity and weight gains, whereas the T4-level increased even above the level of control animals due to I-supplementation. There are significant correlations (correlation coefficients 0.77 and 0.64 resp.; p less than 0.001) between food intake and T3-concentration resp. and Sm-activity. This study demonstrate that the reduced growth in case of the intake of phytogenic substances with thyreostatic effects is directed by the diminished food consumption and the peripheral hypothyroid situation via decreased Sm-synthesis. The high content of thyreostatic substances in tissues of rape seed fed animals is a potential danger for the human consumer.

[NK and K cell activity in children with leukemias and aplastic anemias before and after allogeneic bone marrow transplantation]. / NK- und K-Zell-Aktivität bei Kindern mit Leukämien und aplastischen Anämien vor und nach allogener Knochenmarktransplantation.

Mononuclear leukocytes from the peripheral blood and bone-marrow of children affected with aplastic anemia and leukemia were investigated for K-cell activity (antibody-dependent cellular cytotoxicity) and NK-cell activity before and after allogenous bone-marrow transplantation. 51Cr liberation test against murine Graffi erythroblast leukemic cells covered with xenoantibodies and K-562 cells were used for identification. Strongly lowered NK- and K-cell activities could be found in aplastic anemia prior to bone-marrow transplantation. However, NK-cell activity was only lowered significantly in leukemic patients with indication of bone-marrow transplantation. K-cell and NK-cell activities normalised after bone-marrow transplantation. K-cell and NK-cell activities could be observed to be reconstituted very early after bone-marrow transplantation.

Zinc, copper, manganese and gold content of the hair of infants.

In the hair of 41 normal newborn children the amounts of the trace elements zinc, copper, manganese and gold were followed up longitudinally by neutron activation analysis, the samples being taken on the 1st day of life, between the 63th and 109th days, the 200th and 240 th as well as between the 368th and 478th days of life. In the newborn children no correlations among their hair trace elements themselves and with the duration of normal pregnancy, birth weight, weight percentiles according to Lubchenko et al. [21] and birth length were found. The zinc content of 212 +/- 63 ppm, the copper content of 8.1 +/- 2.3 ppm and the manganese content of 0.211 +/- 0.366 ppm agreed well with values in the literature from different parts of the world. The hair gold content was found to be 0.086 +/- 0.006 ppm. In early childhood the trace element contents do not exhibit any dependence on sex. The investigation of trace elements in the hair of babies resulted in the remarkable observation that in the first three months of life zinc, copper and gold contents shows a considerable increase to multiple levels of the birth values, followed by a decrease. This is important for the interpretation of hair trace element analyses in infants. There are significant positive correlations among zinc, copper and gold contents in hair. It must be emphasized that gold, although classified as a non-essential element, behaves in the hair of infants just like the physiologically important essential trace elements zinc and copper.(ABSTRACT TRUNCATED AT 250 WORDS)

Diagnostics and therapy of non-Hodgkin lymphomas in childhood.

Many changes have taken place in the diagnosis and treatment of non-Hodgkin-lymphomas in childhood during the last years. From 1979 to 1982, the Working Group for Paediatric Haematology, Oncology and Immunology of the GDR treated 50 children with NHL according to the LSA2L2-protocol in a multicentric study. The Kiel-classification was applied for histological diagnosis. Main localizations were the mediastinum and abdomen. The treatment resulted in a complete continuous remission of 65% (Stages I and II: 87%, Stages III and IV: 53%) for all patients, independently of the stage. Patients with extranodal tumours and wide-spread abdominal disease had a very bad prognosis with this protocol.

[Nonspecific killer cells in premature and mature neonates and infants]. / Unspezifische Killerzellen bei unreifen und reifen Neugeborenen und Säuglingen.

K (killer) and natural killer (NK) cells were investigated in peripheral blood of 76 children, preterm small for date babies (n = 8), preterm babies (n = 15), fullterm small for date babies (n = 6) fullterm babies (n = 7) and infants up to 12 months age (n = 40). The K and NK cell activity of human leukocytes was analysed as compared with those cells of the K 562 cell line and murine cells covered by xenologous antibodies in Graffi erythroblast leukemia by means of the 51Cr release test. K cell activities were significantly lower in preterm small for date babies to infants with 1-12 months of age. In our results it is shown that NK capacity of preterm or term newborns and infants up to 6 months age does not differ significantly from each other. Children who are 6-12 months old will have significantly higher NK cell activities. It can be concluded that K cell activities are fully developed during pregnancy and NK cell activities later when the children are between 6 and 12 months of age.