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151.
Bone marrow transplantation for patients with Philadelphia chromosome- positive acute lymphoblastic leukemia 总被引:1,自引:2,他引:1
Forman SJ; O'Donnell MR; Nademanee AP; Snyder DS; Bierman PJ; Schmidt GM; Fahey JL; Stein AS; Parker PM; Blume KG 《Blood》1987,70(2):587-588
We report the treatment outcome of allogeneic bone marrow transplantation in ten patients with Philadelphia chromosome-positive acute lymphoblastic leukemia. Six patients are alive and well for 6 to 30 months (median 19 months) after transplantation. Four patients died with transplant related complications. In view of the poor prognosis associated with this disease, marrow ablation followed by allogeneic or syngeneic marrow grafting may be the preferred treatment modality if a suitable marrow donor is available. 相似文献
152.
Matthews DC; Appelbaum FR; Eary JF; Fisher DR; Durack LD; Bush SA; Hui TE; Martin PJ; Mitchell D; Press OW 《Blood》1995,85(4):1122-1131
In an attempt to decrease the relapse rate after bone marrow transplantation (BMT) for advanced acute leukemia, we initiated studies using 131I-labeled anti-CD45 antibody (BC8) to deliver radiation specifically to hematopoietic tissues, followed by a standard transplant preparative regimen. Biodistribution studies were performed in 23 patients using 0.5 mg/kg trace 131I-labeled BC8 antibody. The BC8 antibody was cleared rapidly from plasma with an initial disappearance half-time of 1.5 +/- 0.2 hours, presumably reflecting rapid antigen- specific binding. The mean radiation absorbed doses (cGy/mCi131I administered) were as follows: marrow, 7.1 +/- 0.8; spleen, 10.8 +/- 1.4; liver, 2.7 +/- 0.2; lungs, 2.1 +/- 0.1; kidneys, 0.7 +/- 0.1; and total body, 0.4 +/- 0.03. Patients with acute myelogenous leukemia (AML) in relapse had a higher marrow dose (11.4 cGy/mCi) than those in remission (5.2 cGy/mCi; P = .001) because of higher uptake and longer retention of radionuclide in marrow. Twenty patients were treated with a dose of 131I estimated to deliver 3.5 Gy (level 1) to 7 Gy (level 3) to liver, with marrow doses of 4 to 30 Gy and spleen doses of 7 to 60 Gy, followed by 120 mg/kg cyclophosphamide (CY) and 12 Gy total body irradiation (TBI). Nine of 13 patients with AML or refractory anemia with excess blasts (RAEB) and two of seven with acute lymphocytic leukemia (ALL) are alive disease-free at 8 to 41 months (median, 17 months) after BMT. Toxicity has not been measurably greater than that of CY/TBI alone, and the maximum tolerated dose has not been reached. This study demonstrates that with the use of 131I-BC8 substantially greater doses of radiation can be delivered to hematopoietic tissues as compared with liver, lung, or kidney, which may improve the efficacy of marrow transplantation. 相似文献
153.
Lymphadenopathy-associated virus antibodies and T cells in hemophiliacs treated with cryoprecipitate or concentrate 总被引:1,自引:0,他引:1
Gjerset GF; McGrady G; Counts RB; Martin PJ; Jason J; Kennedy S; Evatt B; Hansen JA 《Blood》1985,66(3):718-720
Evidence for exposure to lymphadenopathy-associated virus (LAV) was investigated in 48 patients with hemophilia, 15 of whom had been treated exclusively with single-donor cryoprecipitate. The prevalence of antibodies to LAV in all patients was 53% in 1983 and 63% in 1984, while in patients treated only with cryoprecipitate, the prevalence was 31% in 1983 and 40% in 1984. Patients treated with any concentrate had a seroprevalence of 65% in 1983 and 77% in 1984. Seropositive patients were more likely to have a significant reduction in the ratio of helper to suppressor T cells, absolute numbers of helper T cells, and T cell function in vitro. Seven of 18 patients who were seronegative in 1983 had seroconverted by 1984. The relative risk of seroconversion for patients using any concentrate since 1981 compared with those using cryoprecipitate only was 3.9 (P = .04). Nevertheless, the rate of conversion in the latter group was 18% per year. 相似文献
154.
Biliary stricture dilatation: multicenter review of clinical management in 73 patients 总被引:7,自引:0,他引:7
Mueller PR; vanSonnenberg E; Ferrucci JT Jr; Weyman PJ; Butch RJ; Malt RA; Burhenne HJ 《Radiology》1986,160(1):17-22
Eighty-nine biliary strictures in 73 patients who had undergone percutaneous balloon dilatation were reviewed to determine long-term patency rates and clinical management problems. The majority of dilatations were performed in patients with anastomotic strictures (n = 44), iatrogenic strictures (n = 28), and strictures associated with sclerosing cholangitis (n = 17). Patency rates after 36 months or more were 67%, 76%, and 42%, respectively. Complications, mostly minor, occurred in less than 7% of patients. Of patients with significant biliary obstruction, 15% had little or no intrahepatic biliary duct dilatation demonstrated by cross-sectional imaging and/or direct cholangiography. No definite conclusions could be drawn about the utility of long-term internal/external stenting. 相似文献
155.
Cerebral blood flow relationships associated with a difficult tone recognition task in trained normal volunteers 总被引:2,自引:2,他引:0
Holcomb HH; Medoff DR; Caudill PJ; Zhao Z; Lahti AC; Dannals RF; Tamminga CA 《Cerebral cortex (New York, N.Y. : 1991)》1998,8(6):534-542
Tone recognition is partially subserved by neural activity in the right
frontal and primary auditory cortices. First we determined the brain areas
associated with tone perception and recognition. This study then examined
how regional cerebral blood flow (rCBF) in these and other brain regions
correlates with the behavioral characteristics of a difficult tone
recognition task. rCBF changes were assessed using H2(15)O positron
emission tomography. Subtraction procedures were used to localize
significant change regions and correlational analyses were applied to
determine how response times (RT) predicted rCBF patterns. Twelve trained
normal volunteers were studied in three conditions: REST, sensory motor
control (SMC) and decision (DEC). The SMC-REST contrast revealed bilateral
activation of primary auditory cortices, cerebellum and bilateral inferior
frontal gyri. DEC-SMC produced significant clusters in the right middle and
inferior frontal gyri, insula and claustrum; the anterior cingulate gyrus
and supplementary motor area; the left insula/claustrum; and the left
cerebellum. Correlational analyses, RT versus rCBF from DEC scans, showed a
positive correlation in right inferior and middle frontal cortex; rCBF in
bilateral auditory cortices and cerebellum exhibited significant negative
correlations with RT These changes suggest that neural activity in the
right frontal, superior temporal and cerebellar regions shifts back and
forth in magnitude depending on whether tone recognition RT is relatively
fast or slow, during a difficult, accurate assessment.
相似文献
156.
157.
158.
DB Grant ND Barnes M Dumic M Ginalska-Malinowska PJ Milla W von Petrykowski RJ Rowlatt R Steendijk JH Wales E Werder 《Archives of disease in childhood》1993,68(6):779-782
Review of 20 patients with glucocorticoid deficiency (three cases also with salt loss) associated with absent tear secretion (19 cases) and achalasia of the cardia (15 cases) revealed neurological abnormalities in 17 including hyper-reflexia, muscle weakness, dysarthria, and ataxia together with impaired intelligence and abnormal autonomic function, particularly postural hypotension. These findings indicate that significant neurological problems are common in this multisystem disorder. 相似文献
159.
160.
PJ Blanchet B. Gomez-Mancilla T. Di Paolo PJ Bédard 《Fundamental & clinical pharmacology》1995,9(5):434-442
Summary— Abnormal involuntary movements (dyskinesias) of variable intensity eventually emerge in the majority of Parkinson's disease patients chronically treated with standard oral levodopa. They create social and physical embarrassment and narrow the therapeutic options normally proposed to improve Parkinsonian symptoms. Thus far, indirect clinical and experimental evidence has implicated the potential role of dopamine D1 receptor activation in the generation of dopa dyskinesia. In recent years, our group has tested several dopaminergic agonists of variable half-life and selectivity in monkeys rendered Parkinsonian following toxic exposure to 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). These monkeys readily develop dyskinesia when treated with levodopa and provide the best animal model to study this complication. Our results in "drug-naive" and "dyskinesia-primed" MPTP animals suggest that pathological sensitisation of D2 receptor-mediated striatal outflow is necessary and sufficient for the induction of dopa dyskinesia, with perhaps a synergistic contribution from D1 receptors, and that repeated short-lived stimulation is important in the sensitisation process. This model supports the hypothesis that more continuous forms of dopaminomimetic therapy represent the best therapeutic approach for Parkinson's disease and calls for the development of novel D1 agonists for further clinical testing. 相似文献