摘要:

AbstractIn order to identify individuals in whom marrow abnormalities might be contributing to or responsible for neutropenia, we quantitatively examined the number and distribution of cells comprising neutrophil marrow in patients with blood neutrophils less than 2,000/μl. Neutrophil marrow cellularity was determined from ferrokinetic estimation of normoblast numbers and neutrophil‐normoblast ratios obtained from marrow biopsy sections. Only two of 30 patients exhibited the change in cellularity expected of a normal marrow responding to removal of circulating neutrophils: reduced numbers of segmented cells, an expanded mitotic pool, and a normal ratio of metamyelocytes and band forms to promyelocytes and myelocytes. Twenty‐three patients had basal mitotic pool size or increased numbers of segmented marrow cells despite neutropenia, a hypoplastic mitotic pool, or a reduction in the number of metas and bands relative to promyelocytes and myelocytes. The results in individual patients were consistent with hypoplasia, subnormal proliferative or release responses, loss of cells during ontogeny, or combinations thereof. In five cases the results could not be so classified. Clinical observations seldom predicted marrow cellularity. Diverse disorders of marrow function appear to be common among neutropenic patients. Neutropenia constitutes a rich field for study of neutrophil marrow physio

ISSN:0361-8609    

DOI:10.1002/ajh.2830120402

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1982

数据来源: WILEY

摘要:

AbstractHelper and suppressor T cells play a physiological role in immunoregulation and possibly in other biological systems. Previous studies have suggested that unfractionated T cells influence human blood cell formation in vitro. Subpopulations of such cells (TMand TGcells) were prepared by immune ox erythrocyte resetting techniques. Co‐cultures were established in semi‐solid agar with autologous null lymphocytes as a source of granulocyte—macrophage progenitor cells (CFU‐GM). TM(helper) cells produced an increase and TG(suppressor) cells a decrease in the expression of CFU‐GM as reflected in the number of GM colonies generated by comparison with cultures of null lymphocytes alone. These data point to a contribution from T lymphocyte subpopulations to the physiological regulation of human granu

ISSN:0361-8609    

DOI:10.1002/ajh.2830120403

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1982

数据来源: WILEY

摘要:

AbstractIn the autologous mixed lymphocyte reaction (AMLR), T lymphocytes are stimulated to proliferate by autologous non‐T mononuclear cells. In five untreated patients with Hodgkin disease, the AMLR was diminished. In addition, in the same five patients, T cell response to PHA was inhibited by a cell in the non‐T cell fraction, the response of non‐T cells to PWM was diminished, and there was a diminished ability of the non‐T cell population to stimulate in allogeneic MLR. However, the response of T cells from patients with Hodgkin disease to allogeneic antigen was normal. The AMLR and allogeneic MLR were then studied in an additional five untreated patients before and after monocyte depletion of the stimulating non‐T mononuclear cell population. In this second group of Hodgkin disease patients, the AMLR was again diminished when T cells were incubated either with non‐T cells or non‐T cells depleted of monocytes. In the Hodgkin patients, monocyte depletion did not alter the T cell response in the AMLR. In the controls, monocyte depletion greatly diminished the proliferative response. The diminished AMLR in untreated Hodgkin disease patients may be the result of a failure of adequate monocyte stimulation of autol

ISSN:0361-8609    

DOI:10.1002/ajh.2830120404

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1982

数据来源: WILEY

摘要:

AbstractMost cases of immune hemolytic anemia are associated with a positive direct antiglobulin test. However, in some cases, the antiglobulin test is not sensitive enough to detect low levels of red‐cell bound antibodies. This report describes a method using radiolabelled purified staphylococcal protein A which is capable of detecting IgG sensitization of red cells beyond the threshold of serologic techniques. It is less cumbersome than previously described methods and does not require antibody purification procedures. Its effectiveness was demonstrated for the detection of red‐cell alloantibodies and in evaluation of patients with acquired hemolytic anemias associated with a negative direct antiglobulin t

ISSN:0361-8609    

DOI:10.1002/ajh.2830120405

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1982

数据来源: WILEY

摘要:

AbstractIn an attempt to determine the indications for platelet transfusion in thrombocytopenic patients, we randomized 56 children with acute leukemia to one of two regimens of platelet transfusion. The prophylactic group received platelets when the platelet count fell below 20,000 per mm3irrespective of clinical events. The therapeutic group was transfused only when significant bleeding occurred and not for thrombocytopenia alone. The time to first bleeding episode was significantly longer and the number of bleeding episodes were significantly reduced in the prophylactic group. The survival curves of the two groups could not be distinguished from each other. Prior to the last month of life, the total number of days on which bleeding was present was significantly reduced by prophylactic therapy. However, in the terminal phase (last month of life), the duration of bleeding episodes was significantly longer in the prophylactic group. This may have been due to a higher incidence of immunologic refractoriness to platelet transfusion. Because of this terminal bleeding, comparison of the two groups for total number of days on which bleeding was present did not show a significant difference over the entire study period.

ISSN:0361-8609    

DOI:10.1002/ajh.2830120406

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1982

数据来源: WILEY

摘要:

AbstractTen patients with sickle cell anemia surviving beyond the age of 40 were compared to 11 subjects with sickle cell anemia who died before that age. Hematologic and biochemical data as well as clinical and physical parameters of the two groups were compared. There was no statistically significant difference between the two groups with respect to the degree of anemia, severity of hemolysis, or hemoglobin A2levels. A statistically significant difference was found between the two groups with respect to fetal hemoglobin, red cell zinc, and secondary sexual characteristics. Although the long survivors had fewer crises per year than the short survivors, the long‐term complications such as leg ulcer, congestive heart failure, and aseptic necrosis of the hip were more common in the older patients. Cerebrovascular accidents were the cause of death in 9/11 short survivors and are absent in the long survivors. The α/β chain synthesis ratio was normal in the long‐survivor group and α gene mapping in five subjects in that group revealed the genotype αα/αα in four and — α/αα in one. The older patients as a group had higher red cell zinc values. The secondary sexual characteristics were also better developed in the older subjects. The overall significance of zinc status and of a higher HbF on longevity of sickle cell anemia patients

ISSN:0361-8609    

DOI:10.1002/ajh.2830120407

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1982

数据来源: WILEY

摘要:

AbstractThe fetal hemoblobin (Hb F) of a few hundred nonblack patients with a heterozygosity or homozygosity for β‐thalassemia (β‐thal), δβ‐thalassemia (δβ‐thal), and some forms of the hereditary persistence of Hb F (HPFH) was isolated by DEAE‐cellulose chromatography and further characterized by high‐pressure liquid chromatography. Quantitative data for the three types of γ chain (AγT,AγI, andG‐γ) were compared with those obtained for the Hb F from black patients with similar conditions.TheGγ chain levels in nonblack β‐thal heterozygotes varied greatly and did not fall into two distinct groups with high or low levels, as has been observed in blacks. The level of theAγTchain inAγTheterozygotes did not differ significantly when this anomaly was in cis or in trans to the β‐thal determinant. Beta‐thalassemia homozygotes from Turkey and Yugoslavia, hadGγ values varying between 40% and 80%. Only 13 of 34 patients carried theAγTgene. Nine wereAγTheterozygotes with anAγT/totalAγ level averaging 39% and four wereAγThomozygotes.TheGγ chain levels in nonblack δβ‐thal heterozygotes varied between 28% and 46%. An additionalAγTchain heterozygosity in cis to the δβ‐thal determinant demonstrated that over 90% of the γ chains is produced by genes in cis to this anomaly. Analyses of members of two relatively large families with β‐thal, δβ‐thal, and theAγTchain heterozygosities and homozygosities occurring in different combinations allowed a more or less quantitative evaluation of the production of γ‐chain genes in cis or in trans to either of the two types of thalassemia determinants. Such calculations were possible both in simple he

ISSN:0361-8609    

DOI:10.1002/ajh.2830120408

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1982

数据来源: WILEY

摘要:

AbstractBecause of osmotic effects erythrocytes suspended in their native plasma do not have the same volume as the same erythrocytes suspended in Isoton. The discrepancy varies depending upon the osmolality and composition of the native plasma and the length of time the cells have been suspended in Isoton. Consequently, the MCV recorded in an electronic particle counter (Coulter in this case) may differ markedly from the true in vivo MCV. A similar error affects the Coulter hematocrit, which is calculated from the MCV and the erythrocyte count. This matrix effect should be taken into account in any laboratory quality assurance program.

ISSN:0361-8609    

DOI:10.1002/ajh.2830120409

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1982

数据来源: WILEY

摘要:

AbstractA technique for dual staining of cells using terminal deoxynucleotidyl transferase (TdT) and myeloperoxidase (MPO) is described. The technique has been applied to cells of two patients. One patient had chronic myelomonocytic leukemia evolving into acute myelomonocytic leukemia. The other patient had chronic myelogenous leukemia in blast crisis. Our findings indicate that TdT and MPO are exclusive markers except for a rare precursor cell with dual staining in one patient. This study supports the concept of acute mixed leukemia.

ISSN:0361-8609    

DOI:10.1002/ajh.2830120410

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1982

数据来源: WILEY

摘要:

AbstractSurface immunoglobulins (SIg) were determined on peripheral blood samples from 55 patients with hairy cell leukemia (HCL) and on hairy cells from spleen preparations of 14 of these 55 patients. The patterns of SIg for HCL was compared to the patterns on peripheral blood leukemic cells from 39 patients with chronic lymphocytic leukemia (CLL) and 15 patients with poorly differentiated lymphocytic (PDL) lymphoma. Of the 55 HCL patients, 42 could be scored for individual heavy and light chains; 16 had only IgG, 14 had two or three heavy chains, 7 had only IgD, and 5 cases had no SIg and were E‐rosette negative. This pattern was different from the B‐cell pattern in CLL and PDL where there were few cases of IgG alone (5%) and many cases of IgM alone (50%). Surface marker profile did not correlate with survival in any of the sub‐groups tested. HCL appears to be a B‐cell lymphoproliferative disease in greater than 90% of cases; many combinations of heavy chains with only a single light chain can be demon

ISSN:0361-8609    

DOI:10.1002/ajh.2830120411

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1982

数据来源: WILEY