The use of unrelated bone marrow donors in the treatment of patients with chronic myelogenous leukemia: experience of four marrow transplant centers

Thirty-seven patients with chronic myelogenous leukemia who lacked an HLA-identical sibling were transplanted with bone marrow from an HLA-A,B,DR-matched, one locus-mismatched, or two locus-mismatched unrelated volunteer donor. Twenty-two were in chronic phase and 15 had advanced to either accelerated phase or blast crisis. The projected 1000-day survival is 55% for chronic phase patients and 22% for accelerated or blast phase patients. For patients transplanted during chronic phase, results appeared to be comparable whether the donor was fully HLA-matched or HLA one locus-mismatched. These results indicate that marrow grafting from either HLA-identical or HLA one locus-mismatched volunteer donors may be effective therapy for patients with chronic myelogenous leukemia who lack an acceptable related donor.     

Simultaneous bilateral cataract extraction in the UK.

AIMS/BACKGROUND--Simultaneous bilateral extracapsular cataract extraction (SBCE) is not routinely performed in the developed world. This study investigated the safety and efficacy of this procedure as performed in the UK. METHODS--A review of 319 consecutive patients (638 eyes) who underwent SBCE with posterior chamber intraocular lens implantation is presented. RESULTS--The incidence of intraoperative complications was 7.7%. These included posterior capsule rupture (0.8%) and vitreous loss (0.3%). Postoperative complications were seen in 8.7% of operated eyes and included iris prolapse (0.3%) and raised intraocular pressure (3.0%). Endophthalmitis occurred in one eye (0.15%). There were no major bilateral complications, and, in particular, no cases of bilateral endophthalmitis. Final visual acuities compared favourably with reports for unilateral surgery. Eighty two per cent achieved a final visual acuity of 6/12 or better, and 41% tested 6/6 or better. CONCLUSION--This study illustrates that SBCE is not associated with an increased incidence of complications and that the visual results are good. Where indicated, and under strict surgical protocol, this procedure is safe.     

Therapeutic irradiation of the central nervous system using intrathecal 90Y--DTA.

The erdication of established neuroleukaemia is often difficult, and with subsequent relapses even harder. The use of an intrathecally-injected beta emitting isotope has the advantage of preserving the bone-marrow of the vertebral column and cranium whislt irradiating the meninges. The value of intrathecal 90Y-DTPA(diethylene-triamine penta-acetic acid) has been investigated in nine patients with neuroleukaemia or CNS involvement in malignant lymphoma. Measurements of retention of the isotope in the whole body, spinal, and intracranial subarachnoid spaces have been made, together with blood levels, and are reported. The clinical results are presented. In three out of five evaluable patients 90Y-DTPA failed to maintain a chemotherapy-induced CNS remission and in two out of two evaluable patients malignant cells were not dispersed from the CNS with a single intrathecal injection of 90Y-DTA. It is concluded, therefore, that with this agent and the doses used no useful clinical result is gained.     

Scotopic visual pigment composition in the retinas and vitamins A in the pigment epithelium of the goldfish

Recently, the retinas of goldfish from Grassyfork Fisheries (Martinsville, Indiana 46151, U.S.A.) were reported to possess a rhodopsin with an absorbance maximum at 499 nm, in addition to the known porphyropsin. Rhodopsin and porphyropsin are visual pigments respectively derived from the conjugation of vitamin A₁ aldehyde (retinal) and vitamin A₂ aldehyde (3-dehydroretinal) to a species-specific opsin. In this study, goldfish from a different supplier (Ozark Fisheries, Stoutland, Missouri 65567, U.S.A.) were also confirmed to possess a rhodopsin with an absorbance maximum at 499 nm. In addition, this paper describes how external factors (photoperiod, light intensity, temperature and exogenous thyroxine) affected the composition of these visual pigments in the goldfish retinas and the vitamins A (retinol/3-dehydroretinol) in their pigment epithelium.After 50 days of acclimation, constant illumination (at 30°C with a 7·5 W incandescent light bulb) and constant darkness (at 30°C) both favored high proportions of porphyropsin (more than 85%) whereas fish held under a 16L/8D cycle (at 30°C with a 7·5 W light bulb) had predominately rhodopsin (less than 10% porphyropsin). Testing at 16L/8D and 30°C, light intensities higher and lower than the equivalent of a 7·5 W bulb (i.e. 6×10¹³ photons/cm²-sec, 400–750 nm, measured at water surface) both favored significantly higher proportions of porphyropsin. Lower water temperature (10°C and 20°C) or the introduction of thyroxine to the tank water (at a concentration of 100 μg l-thyroxine per liter tank water) also resulted in significantly higher proportions of porphyropsin.Despite the influence of these external factors on the visual pigment composition in the goldfish retinas, the vitamins A (retinol and 3-dehydroretinol) in their pigment epithelium remained predominately 3-dehydroretinol. Although the rhodopsin dominated retinas were always associated with pigment epithelium of slightly lowered 3-dehydroretinol proportions, these results do not agree with previous reports on other species where the proportions of retinol and 3-dehydroretinol mirrored the ratios of rhodopsin to porphyropsin.