摘要:

AbstractA modified protein‐bound cobalamin absorption test was used to study dietary cobalamin absorption in healthy adults of different age groups and patients with isolated low serum concentrations of cobalamin. Dietary cobalamin absorption was significantly reduced in healthy adults aged 55‐75 years compared with young adults, with a further reduction in those older than 75 years. No difference was detected between dietary cobalamin absorption in patients with isolated low serum cobalamin and controls of a similar age group. Cobalamin malabsorption was associated with elevated serum gastrin. The diagnostic value of this protein‐bound cobalamin absorption test in the elderly was limited by the frequent finding of reduced absorption in healthy elderly people with normal serum cobalamin concentrations. The performance of such tests should be evaluated in different age groups before application in diag

ISSN:0361-8609    

DOI:10.1002/ajh.2830390202

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

年代:1992

数据来源: WILEY

摘要:

AbstractThe expression of both natural‐killer (NK)‐associated and activation antigens was studied by flow cytometry in the peripheral blood of 47 untreated multiple myeloma (MM) patients. A significant increase in both absolute and relative numbers of CD57 positive cells as well as in the proportion of CD16 and CD11b cells was observed in patients with MM, specially in those in early stages of the disease (clinical stages I and II), suggesting a possible surveillance mechanism in response to an emerging malignant clone. Additional double stainings showed that strong CD16+ NK cells coexpress the CD56, CD11b, and CD2 antigens, while they lacked CD3, CD5, and WT31 antigens. Moreover, the previously reported increase in CD8 cells present in MM would be mainly due to a subset of CD8 cells that coexpress the CD57 Ags. The expression of activation antigens, especially CD38, was increased in peripheral blood lymphocytes of MM patients, the differences reaching statistical significance both in absolute and relative numbers in those cases with high numbers of CD16 NK cells and thus suggesting that these cells are functionally activated. These results reveal the existence of an increase in NK and activated cells in the peripheral blood of myeloma patients that may reflect a host's immunological mechanism in an attempt to modulate tumor cell gro

ISSN:0361-8609    

DOI:10.1002/ajh.2830390203

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

年代:1992

数据来源: WILEY

摘要:

AbstractBleeding times, von Willebrand activities, and platelet retentions were examined before and following d‐DAVP in 13 uremic patients. Shortening of the bleeding time from 16.6 ± 2.2 (SEM) to 6.8 ± 0.7 min was seen in six patients. However, bleeding times remained ± 20 min in the remaining seven individuals. The only baseline parameter that correlated with response to d‐DAVP was the amount of blood loss (mg/min) during the bleeding time test. Responders had normal blood loss values averaging 6.2 ± 1.5 mg/min. By contrast, these values were elevated in 6/7 of the non‐responders and averaged 28.4 ± 5.9 mg/min (P= 0.01). Von Willebrand activities increased following d‐DAVP in the responders but not in the non‐responders. Platelet retention was uniformly low in all patients and improved from 21.0 ± 7.0% to 75.0 ± 7.9% (P=<0.001) following d‐DAVP in responders but not non‐responders. To further define the retention abnormality in uremia, the two‐stage platelet retention assay was performed prior to d‐DAVP. Most of the patients (9/12) had both first‐ and second‐phase abnormalities. Therefore, the retention defect in uremia appears to be more complex than that seen in von Willebrand's disease (2nd phase abnormality only). Nevertheless, d‐DAVP seems to improve platelet rheology in uremic individuals whose von Willebrand a

ISSN:0361-8609    

DOI:10.1002/ajh.2830390204

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

年代:1992

数据来源: WILEY

摘要:

AbstractAs part of an epidemiological survey of myelodysplastic syndromes (MDS) in southern Tasmania, 62 MDS patients identified over a 2 year period were tested for the presence of CD34, the human progenitor cell antigen (HPCA), in their peripheral blood. The results were correlated with transformation to acute myeloid leukemia (AML) and patient survival, and CD34+ status was compared as a prognostic indicator with Bournemouth score, cytogenetics, and CFU‐GM colony growth which were also assessed. Circulating CD34+ cells were found in 23 of the 62 MDS patients; 9 of the 23 patients with circulating CD34+ cells transformed to AML, as compared with none of the 39 CD34 negative patients (P<0.0001); and 11 of the 23 patients with circulating CD34+ cells were dead at the end of the 2 year period, as opposed to 6 of the 39 with no CD34+ cells (P<0.03). The Bournemouth score was also significantly associated with transformation to AML (P<0.0001) and poor survival (P<0.04). These were the only significant associations of the possible prognostic factors studied with either transformation or survival. In summary, the presence of circulating CD34+ cells was significantly associated with both progression to AML and poor survival and was found to be a better prognostic indicator than cytogenetics or CFU‐GM colony gro

ISSN:0361-8609    

DOI:10.1002/ajh.2830390205

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

年代:1992

数据来源: WILEY

摘要:

AbstractThe purpose of this paper is to evaluate the possible clinical association of autoimmune thyroid disease and acute leukemia. This study is a retrospective review of all adult patients with acute leukemia treated at our institutions from 1978‐1989. Those with both leukemia and thyroid disease were evaluated and are presented. Twenty‐seven of eight hundred seventy patients with acute leukemia had evidence of thyroid disease. This is a 3‐fold increase in overall incidence. Twenty‐one patients had acute myeloid leukemia, five had acute lymphoid leukemia, and one had accelerated chronic myeloid leukemia. Thyroid diseaseentities included toxic multinodular goiter (four patients), idiopathic hypothyroidism (eight patients), Graves' disease (eight patients), and Hashimoto's thyroiditis (seven patients). Whereas the association may have had a negative effect on elderly patients, those with Graves' disease and Hashimoto's disease appeared to have an improved outcome of the leukemia. There is an increased association of autoimmune thyroid disease and acute leukemia. Since thyroid hormones are important regulators of hematopoiesis and utilize receptors similar to those of differentiating factors such as retinoids, the association may be important for further study of mechanisms of growth regulations in l

ISSN:0361-8609    

DOI:10.1002/ajh.2830390206

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

年代:1992

数据来源: WILEY

摘要:

AbstractA transient hyporegenerative neutropenia has been reported in neonates, but not in older children or adults, undergoing treatment with recombinant erythropoietin (epo). Monocytopenia has not been reported. We postulated that epo might selectively reduce the responsiveness of neonatal progenitors to Granulocyte Colony‐Stimulating Factor (G‐CSF), while not similarly affecting their responsiveness to Macrophage Colony‐Stimulating Factor (M‐CSF). To test this hypothesis two types of experiments were performed. First, progenitors of adult or fetal origin were pre‐incubated with epo (or control), then washed, and their responsiveness to G‐CSF and M‐CSF evaluated in clonogenic culture assays. Second, clonogenic maturation was initiated using either G‐CSF or M‐CSF, after which the effect of a late addition of epo to the developing clones was evaluated. Indeed, pre‐incubation with epo resulted in production of fewer neutrophils from fetal progenitors grown in G‐CSF (P<0.001), but it did not reduce the number of macrophages generated from progenitors grown in M‐CSF. Adding epo to the already‐developing G‐CSF‐responsive and M‐CSF‐responsive adult and fetal clones did not alter colony development. Thus, epo appears to have an action on G‐CSF‐responsive, but not‐M‐CSF‐responsive fetal progenitors, resulting in reduced production of neutrophils. This effect is no longer apparent, however, when progeni

ISSN:0361-8609    

DOI:10.1002/ajh.2830390207

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

年代:1992

数据来源: WILEY

ISSN:0361-8609    

DOI:10.1002/ajh.2830390208

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

年代:1992

数据来源: WILEY

ISSN:0361-8609    

DOI:10.1002/ajh.2830390209

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

年代:1992

数据来源: WILEY

ISSN:0361-8609    

DOI:10.1002/ajh.2830390210

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

年代:1992

数据来源: WILEY

摘要:

AbstractErythromelalgia is caused by platelet‐mediated acral inflammation and arteriolar thrombosis in thrombocythemia in its primary form or associated with polycythemia vera. The prompt and lasting relief of burning pain by low‐dose aspirin is a prerequisite for the diagnosis of thrombocythemic erythromelalgia.Here we extend observations on the occurrence of erythtromelalgia in thrombocythemia associated with primary myelofibrosis, Philadelphia‐chromosome positive micromegakaryocytic myelofibrosis, and myelodysplastic syndrome type II. It is concluded that erythromelalgia may occur in thrombocythemia of all variants of chronic myeloproliferative disease as well as myelodysplastic syndrome if platelet counts are sufficiently

ISSN:0361-8609    

DOI:10.1002/ajh.2830390211

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

年代:1992

数据来源: WILEY