摘要:

ABSTRACTChronic neutropenia is a term used to describe a group of disorders characterized by a persistent neutrophil count of less than 1500 cells/μl. We studied seven children and three sets of parents. We separated patients into a group with good prognosis and a group at higher risk of infection by using a combination of tests, including bone marrow aspiration and biopsy, steroid stimulation of bone marrow reserve, andin vitroCFU-GM and CSA assays. Children with a normal number of myeloid elements in their bone marrow and a normal bone marrow response to steroid stimulation had a benign course. CFU-GM and CSA assays helped to classify these children's neutropenia when their bone marrow had decreased numbers of myeloid elements. Family studies in three children were consistent with an inherited neutropenia, even when their parents were hematologically normal.

ISSN:0192-8562    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

ABSTRACTA study of reproductive function was carried out in 31 patients following long-term treatment of acute lymphoblastic leukemia (mean: 4 1/12 years); 17 prepubertal; nine pubertal, and five adults.Spontaneous clinical pubertal development was observed in 4 of 17 prepubertal patients. Serum testosterone response to hCG was normal or increased in the nine prepubertal patients studied. Intratesticular testosterone concentration was normal in 11 out of 12 patients. Only two of 14 prepubertal patients had a reduced number of germ cells. Normal progress of spermatogenesis was seen in six out of seven pubertal patients and only moderate hypospermatogenesis with focal hyalinosis was found in the five adults. Two of them had normal sperm count and one fathered two children. In six out of 14 prepubertal patients unexpected early signs of pubertal stimulation were found. Serum gonadotrophins response to LH-RH was normal in most patients. Testicular infiltration of blastic cells was found in four of 26 biopsies, but only one of 23 patients was without clinical signs of testicular relapse. Computerized axial tomography was normal in 10 out of 13 patients. Bone age was significantly below chronological age in four out of 15 patients. This study suggests that the gonad is moderately injured by long-term antileukemic therapy. In addition, microscopic testicular infiltration is not frequent in subjects without testicular enlargement.

ISSN:0192-8562    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

ABSTRACTThrombocytopenia in the fetus must be anticipated when the mother has or has had idiopathic thrombocytopenic purpura (ITP). Although maternal morbidity and mortality is extremely low, the overall fetal mortality is high and ranges from 13–25%. The mortality in almost all cases is due to intracranial hemorrhage and appears to be related to the events surrounding labor and delivery. At the present time, the only guide to possible fetal involvement is the activity of the ITP process in the mother. In this review the current state of the art is examined. A scheme for the management of these cases at the time of expected date of confinement is proposed and is based upon the maternal and fetal platelet counts, maternal response to corticosteroids, and obstetrical considerations. It is recommended that cesarean section be given strong consideration when significant fetal involvement is anticipated or demonstrated by fetal scalp blood platelet level.

ISSN:0192-8562    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

ABSTRACTOvarian function was evaluated in eight adolescent women 1–90 months after completion of treatment for non-Hodgkin's lymphoma, which included a cyclophosphamide-containing combination chemotherapy protocol and radiation therapy. Two women received whole abdomen irradiation and both had ovarian failure. In contrast, none of six women who received combination chemotherapy and radiation therapy which did not include the abdomen had evidence of ovarian failure. These findings suggest that both the prepubertal and postpubertal ovary are relatively unaffected by this combination chemotherapy program which included cyclophosphamide and methotrexate.

ISSN:0192-8562    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

ABSTRACTAs physicians become increasingly capable of managing the physical aspects of cancer, the psychological responses of patients and their families take on growing importance. The present study sought to assess the psychological experience of parents whose leukemic children are finishing chemotherapy. Nineteen mothers and one father of children whose chemotherapy had been discontinued were interviewed. The results suggested that negative reactions including anxiety and fears relating to relapse may be a normal emotional response. This paper discusses aspects of the experience of caring for a leukemic child that contribute to this fear and anxiety and possible ways of easing parents' discomfort.

ISSN:0192-8562    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

ABSTRACTTo evaluate the possible additive leukocyte count-enhancing properties of lithium and oxymetholone, patients (1–21 years old) were randomized to receive lithium or lithium plus oxymetholone after chemotherapy. Seventy-one trials with lithium, 63 with both drugs, and 79 in the control group, were compared. White blood cell count and neutrophil nadirs were better in both treatment groups than in the controls (p= 0.001) but an additive effect of oxymetholone above and over lithium alone was seen only in patients under 15 years old (p= 0.05). The median duration of severe neutropenia (absolute neutrophil count <1000/mm3) was 6.2 days/patient in the control group but only 4.5 days/patient and 3.8 days/patient in the lithium and lithium plus oxymetholone groups, respectively (p= 0.0001). Both the lithium and lithium plus oxymetholone treatments had a modest platelet-sparing effect (p= 0.03). No difference in the hemoglobin nadirs was observed in the three groups. While the majority of the patients lost weight in the control and lithium-treated group, the patients on oxymetholone gained weight (median 1.25 kg)p= 0.00001. Lithium reduces the period of neutropenia after chemotherapy during which the patients may acquire infection. The addition of oxymetholone does not substantially lessen myelosuppression in most patients but improves the patients' appetite and weight.

ISSN:0192-8562    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

ABSTRACTThe three-dimensional shape of erythrocytes is assessed by light microscopy using a simple technique to view glutaraldehyde-fixed erythrocytes. The technique and its standardization is described. Using this method the erythrocytes of adults have been compared to those of full-term and premature infants. In adults, the majority of erythrocytes are bowl-shaped at 37°C and disc-shaped at room temperature. Newborn infants have significantly more bowl-shaped cells as well as significantly more irregularly shaped cells. Erythrocyte differential counts have been performed on a large series of patients to determine the normal range for each cell shape in adults, full-term, and premature infants. It is suggested that the study of erythrocyte morphology in haematologic disease in newborn infants requires three-dimensional assessment and quantitative data of normal values.

ISSN:0192-8562    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

ABSTRACTThe effect of dental evaluation and treatment prior to bone marrow transplantation in 11 pediatric patients was assessed. Oral complications associated with marrow ablative therapy and the immediate posttransplant period (Days 0–35) were also studied. Oral complications during marrow ablative therapy included: xerostomia (2/11 patients) and parotitis (1/11 patients). Oral complications in the immediate posttransplant period (Days 0–35) included: mucositis (11/11 patients); moniliasis (9/11 patients); and stomatitis associated with acute G.V.H.D. (3/9 patients receiving allogeneic marrow transplants). The onset of the mucositis in the posttransplant period usually occurred at the nadir of the white blood cell count and resolved when the absolute neutrophil count was approximately 500/m3. The onset of moniliasis in the posttransplant period was usually 1–2 days after the onset of the mucositis. Resolution of the moniliasis usually paralleled resolution of the mucositis. No patient developed an infectious and/or hemorrhagic complication of odontogenic origin.

ISSN:0192-8562    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

ABSTRACTA white female neonate with clinical manifestations of Down's syndrome was found to have a peripheral white count of 74,000/mm3with 65% blast forms. Bone marrow aspirate revealed 36% blasts. On chromosomal analysis of bone marrow and peripheral blood, two cell lines were found, one with trisomy 21 and another with pentasomy 21. Colony cultures on the patient's bone marrow cells revealed an adequate growth pattern of CFU/GM. Cells were reactive with myeloblast alloantisera. At the age of 3 weeks, peripheral counts were within normal limits as was morphology of the repeat bone marrow aspirate. Chromosome analysis at that time showed complete absence of pentasomy 21 cell line, and repeat cell colony studies revealed normal growth, differentiation, and maturation of CFU/GM. Maternal serum totally inhibited colony growth of the patient's remission marrow and allogeneic blast cells. This serum inhibitor actually disappeared 1 month postpartum. The patient has had no recurrence of blast cells up to the present age of 3 years.

ISSN:0192-8562    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

ABSTRACTA follow-up study was made of the prevalence of the use of unproven treatment methods by families of children being treated for cancer at UT M. D. Anderson Hospital. Information was also obtained about parental attitudes toward conventional and alternative treatments and their understanding of them, as well as the physicians' awareness of the use of alternative treatments. Cross-cultural comparisons were made to assess the differences between Hispanics and Anglos in their perceptions of treatment. Sixty-six parents responded to questionnaires (34 Anglo, 30 Hispanic, and two others), and the results in terms of prevalence of use were comparable to those obtained in an earlier study (<10%) at the same institution, as well as to those recently reported by investigators at another institution in northwestern U.S. No parents reported the use of Laetrile. Significant differences were found between the Anglos and Hispanics in their perceptions of the treatment administered at the hospital. A significant number of parents expressed a desire for more information from their physicians about all types of treatment. This study serves as a pilot project for a nationwide, multihospital study to be conducted in 1982.

ISSN:0192-8562    

出版商:OVID    

年代:1983

数据来源: OVID