bluuebunny/crossref_metadata_2025 huggingface dataset:
Bone marrow delta-aminolaevulinate synthase deficiency in a female with congenital sideroblastic anemia
Authors: Buchanan GR , Bottomley SS , Nitschke R
Published: October 2019

Heme biosynthesis was examined in erythroid tissue of a 4-yr-old girl with severe sideroblastic anemia since infancy, as documented by the presence of intramitochondrial deposits of iron in erythroblasts. Free red cell protoporphyrin, urinary porphyrins, and activities of erythrocyte porphobilinogen synthase, uroporphyrinogen 1 synthase, aspartate aminotransferase, and pyridoxine kinase were normal or increased. Bone marrow ferrochelatase activity was normal. Activity of bone marrow delta-aminolaevulinate (ALA) synthase was markedly reduced to 7 pmole ALA/10(6) erythroblasts/30 min (normal 127 +/- 29) but was enhanced fivefold by pyridoxal phosphate (normal 0%--25% increase). Therapy with oral pyridoxine and parenteral pyridoxal-5′-phosphate did not increase effective red cell production. The sideroblastic anemia in this patient appears to be related to a congenital defect in the initial step of heme biosynthesis.
Granulocyte transfusions: current status
Authors: Higby DJ , Burnett D
Published: October 2019

Since granulocyte transfusions first became widely used in clinical medicine, there have been advances in the treatment of acute leukemia and improvement in prevention and management of infection in neutropenic patients. Improved understanding now exists concerning prognosis of infections in such patients, and advances have been made in procurement of granulocytes. Granulocyte transfusions should be given for specific indications, and used adjunctively to other established antiinfective therapy. Once initiated, transfusions should be given in adequate doses at daily intervals (at least) with ongoing evaluation and periodic reassessment of the whole antiinfective program. Serious complications of granulocyte transfusion therapy are relatively rare, but the physician should be prepared to manage them intelligently. Research continues in discerning exactly how granulocyte transfusion work, in preservation of granulocytes, and in delineation of immunologic phenomena affecting the efficiacy of such therapy. Granulocyte transfusions will continue to be important in the management of acute leukemia, and other reversible bone marrow failure states, and in marrow transplantation and autotransplantation.
Plasma concentrations of platelet-specific proteins correlated with platelet survival
Authors: Doyle DJ , Chesterman CN , Cade JF , McGready JR , Rennie GC , Morgan FJ
Published: October 2019

Relationships between 51Cr platelet survival and plasma concentrations of beta-thromboglobulin (betaTG) and platelet factor 4 (PF4) were analyzed in 91 studies of patients with coronary artery disease. betaTG was significantly correlated with platelet life-span, turnover, and the number of hits in the multiple hit model. PF4 was significantly correlated with life-span and turnover. The most significant relationship involving platelet-specific protein concentrations and life-span estimates was between betaTG and life-span estimated using the multiple hit model (r = -0.39, p less than 0.001). There was a high correlation between betaTG and PF4 (r = 0.62, p less than 0.001), and no improvement could be obtained by combining the measurements of the two proteins in any regression with life-span or turnover. The results indicate that the patients with the shortest platelet survival time in this group tended to have the highest plasma concentration of betaTG and PF4 and thus probably increased in vivo release of betaTG and PF4. They strengthen the claim that these platelet-specific proteins may be indicators of platelet involvement in disease.
Individual cell-by-cell quantitation of lymphocyte surface membrane Ig in normal and CLL lymphocyte and during ontogeny of mouse B lymphocytes by immunoperoxidase assay
Authors: Dighiero G , Bodega E , Mayzner R , Binet JL
Published: October 2019

A new quantitative immunoperoxidase method is presented for determining absolute amounts of peroxidase and, consequently, surface antigen densities of individual cells in B lymphocytes from normal individuals, from subjects with CLL and prolymphocytic leukemia, and during ontogeny of B lympocytes in the mouse. The following results were observed: (1) The density of B antigenic sites were lower on CLL than on normal B lymphocytes. (2) The B antigens density of leukemic lymphocytes varied less from cell to cell, forming a homogeneous peak on histograms. (3) In a very rare case of CLL, the antigen density was measured at the time of initial diagnosis (22,500 sites or 647 U) and during the development of a blastic crisis (135,000 sites or 2576 U). The cell by cell distribution changed from a homogeneous peak with a low number of antigenic sites per cell to a heterogeneous peak with a high number of antigenic sites per cell. (4) In prolymphocytic leukemia, the density of B antigenic sites was greater than on normal B lymphocytes and much more heterogeneous than on CLL lymphocytes. (5) During ontogeny of B lymphocytes in the mouse, maturation is associated with the appearance of a population of cells of intermediate to high Smig density. The finding of a decrease in, and altered distribution of, surface markers in CLL is compared with these ontologic findings in the mouse, and the concept that a monoclonal B lymphocyte in CLL may be arrested at a particular stage in its differentiation is discussed.
Increased in vitro B-cell IgG secretion during acute graft-versus-host disease and infection. Observations in 50 human marrow transplant recipients
Authors: Ringden O , Witherspoon RP , Storb R , Ekelund E , Thomas ED
Published: October 2019

B-cell antibody secretion by lymphocytes from 50 bone marrow transplant recipients and 42 healthy controls was studied in vitro using an indirect hemolysis-in-gel assay to determine Ig-class-specific plaque- forming cells (PFC). The numbers of PFC were determined in medium alone and after stimulation of lymphocytes with killed Staphylococcus aureus bacteria. The PFC responses for IgG, IgA, and IgM after stimulation with S. aureus were significantly lower in patients studied during the first 101 days after grafting compared to normals. Statistically significant increased IgG-PFC were found in patients who had acute graft-vesus-host disease (GVHD), grafts from HLA-nonidentical donors, or infections. Healthy patients studied more than 1 yr following transplantation had normal B-cell responses, but patients with chronic GVHD had deficient IgM production. The data suggest that antibody secretion by B cells varies in different marrow transplant patient subgroups and present a basis for further investigation of the interaction between lymphocyte subpopulations leading to antibody production.
"Microgranular" acute promyelocytic leukemia: a distinct clinical, ultrastructural, and cytogenetic entity
Authors: Golomb HM , Rowley JD , Vardiman JW , Testa JR , Butler A
Published: October 2019

Three patients with acute leukemia, disseminated intravascular coagulation, and a specific acquired chromosome abnormality [t (15;17)] were found by transmission electron microscopy to have the typical distribution of granules seen in promyelocytes. However, the average granule sizes were 120, 170, and 180 nm, respectively, for the three patients, significantly less than the 250-nm resolution of light microscopy. We regard the leukemia in these three patients as comprising a distinct clinical, ultrastructural, and cytogenetic entity that we have chosen to call “microgranular” acute promyelocytic leukemia.
Polybrene-induced platelet agglutination and reduction in electrophoretic mobility: enhancement by von Willebrand factor and inhibition by vancomycin
Authors: Coller BS
Published: October 2019

It has recently been reported that the polycation Polybrene (hexadimethrine bromide), like ristocetin, agglutinates platelets more extensively in the presence of normal plasma than von Willebrand plasma. Since we have previously proposed that ristocetin may initiate agglutination by reducing platelet surface charge, I investigated the correlation between Polybrene's ability to induce agglutination and alter platelet electrophoretic mobility. In the absence of plasma, low concentrations of Polybrene produced small platelet aggregates and reduced the electrophoretic mobility. Higher concentrations were needed to produce small platelet aggregates in the presence of von Willebrand plasma; these same concentrations produced more rapid agglutination and much larger aggregates in the presence of normal plasma. The reductions in electrophoretic mobility were also greater in the presence of normal than von Willebrand plasma. Both agglutination and the reduction in mobility could be partially reversed with citrate. Vancomycin, an antibiotic that inhibits ristocetin-induced agglutination with some specificity, inhibited both Polybrene-induced agglutination and the reductions in platelet mobility. These data are consistent with our electrostatic model and support the view that reductions of platelet surface charge may be necessary (but perhaps not sufficient) to initiate the interaction between platelets and von Willebrand factor.
Detection of platelet-directed immunoglobin G in sera using the peroxidase-anti-peroxidase (PAP) slide technique
Authors: Schmidt GM , Bross KJ , Blume KG , Enders N , Santos S , Novitski M , Chillar RK
Published: October 2019

An immunohistochemical procedure for the detection of immunoglobulin G adherent to platelets is described. The peroxidase anti-peroxidase method is used to detect antibody activity directed against platelets from normal donors in the sera from 305 individuals. These subjects were divided into three groups: group 1, patients referred for tissue typing; group 2, healthy normal females; group 3, healthy normal males. In group 1, 28% of the sera were found to be positive; in most of these a history of prior transfusions was obtained. In group 2, 7.4% were found to be positive, most having previous pregnancies. Only 1% were found to be positive in group 3, and no reason for presensitization was found. Results from the indirect immunofluorescence technique served as a control and as a means to compare the sensitivity. Under the conditions chosen, the peroxidase anti-peroxidase test was two to eight times more sensitive than the immunofluorescence technique. Specificity of the peroxidase anti-peroxidase technique was demonstrated using a monospecific anti-PLA1 antiserum. It is concluded that the peroxidase anti-peroxidase slide technique may be a useful tool in the study of platelet-related immunophenomena.
Comparison of two direct assays for platelet-associated IgG (PAIgG) in assessement of immune and nonimmune thrombocytopenia
Authors: Kelton JG , Giles AR , Neame PB , Powers P , Hageman N , Hirsch J
Published: October 2019

A number of methods have been developed to measure platelet-associated IgG (PAIgG). The antiglobulin consumption assay directly quantitates IgG on the platelet and is sensitive and specific. A fluorescent anti- IgG assay has recently been described and has the advantage of simplicity. We compared the results of these two PAIgG assays in immune and nonimmune thrombocytopenia and nonthrombocytopenic controls. The antiglobulin consumption assay was negative in 61 of 62 and the fluorescent negative in 54 of 62 assays in nonthrombocytopenic controls, and they were negative in 11 of 13 and 8 of 13 assays, respectively, in nonimmune thrombocytopenic patients. The antiglobulin consumption assay was positive in 54 of 58 and the fluorescent positive in 24 of 58 assays of patients with immune thrombocytopenia (ITP and SLE). The overall sensitivity and specificity of the antiglobulin consumption assay was 94% and 95% and of the fluorescent assay was 44% and 82%.
Functional and metabolic studies of polymorphonuclear leukocytes in the congenital Pelger-Huet anomaly
Authors: Johnson CA , Bass DA , Trillo AA , Snyder MS , DeChatelet LR
Published: October 2019

Polymorphonuclear leukocytes (PMNL) from two individuals with congenital Pelger-Huet anomaly (PHA) were examined to determine whether functional or metabolic defects accompanied the known morphological abnormality. No abnormalities of the PHA cells, as compared to normal control cells, were found when tested for quantitative leukocyte enzyme activities, nitroblue tetrazolium reduction, hexose monophosphate shunt activity, superoxide production, generation of chemiluminescence, or iodination. The PHA cells, as compared to normal PMNL, demonstrated normal chemotaxis and random migration, as well as bactericidal activity.
Aggregation of hemoglobin S and hemoglobin CHarlem with nonsickle hemoglobin in concentrated phosphate buffer
Authors: Adachi K , Asakura T , Schwartz E
Published: October 2019

The effect of HbA and HbF on both the aggregation and deaggregation of deoxy HbS and deoxy HbCHarlem in concentrated phosphate buffers was studied by a turbidimetric method. Although pure deoxy HbA is fully soluble in 2.4 M potassium phosphate buffer, the same concentration of deoxy HbAS was insoluble in the same buffer. Since there was little dissolved hemoglobin in the solute of a mixture of HbA and HbS, and since the intensity of turbidity was approximately twice that which would be expected from deoxy HbS alone, deoxy HbA must have coaggregated with deoxy HbS. Similar studies with mixtures of HbS and HbF showed different results. The rates of aggregation of deoxygenated mixtures of HbS and HbF were much slower than those of similar mixtures of HbS and HbA. Measurements of the absorption spectrum of the solute after centrifugation and the electrophoresis of both the aggregates and the solutes showed that a portion of the HbF was coaggregated with HbS, while some of the HbS was still in solution. The solubility of HbS and mixtures of sickle and nonsickle hemoglobins in 2.2 M phosphate buffer increased in the order of HbS, HbACHarlem, HbAS, HbCHarlem, HbSF, and HbFCHarlem.
Elimination of acute myelogenous leukemic cells from marrow and tumor suspensions in the rat with 4-hydroperoxycyclophosphamide
Authors: Sharkis SJ , Santos GW , Colvin M
Published: October 2019

Cell suspensions of normal rat marrow mixed with rat acute myelogenous leukemic cells were prepared and incubated in vitro with graded doses of 4-hydroperoxycyclophosphamide (4HC). The cell suspensions were injected into rats prepared with a lethal dose of total body irradiation. Animals injected with these cells survived fatal irradiation induced aplasia. In a dose related manner 4HC was able to “purge” tumor cells from the cell mixtures. Thus, animals given cell suspensions incubated with the lower doses of 4HC showed prolonged survival before death from leukemia and animals given cell suspensions incubated with higher doses of 4HC survival lethal irradiation without the subsequent appearance of leukemia. These studies clearly establish that tumor cells may be eliminated from normal marrow suspensions without completely destroying the pluripotent stem cells.
Dysmyelopoietic syndrome: sequential clinical and cytogenetic studies
Authors: Streuli RA , Testa JR , Vardiman JW , Mintz U , Golomb HM , Rowley JD
Published: October 2019

Clinical and cytogenetic studies were done on 8 patients with dysmyelopoietic syndrome: 6 of these patients had refractory anemia with an excess of blasts (RAEB), and 2 patients had chronic myelomonocytic leukemia (CMML) according to the French-American-British classification. The ages of these 8 patients (3 female and 5 male) ranged from 45 to 70 yr (median, 61.5 yr). Seven of the 8 patients died 3–86 mo (median, 11 mo) after the onset of symptoms of hemorrhage or infections. Cytogenetic studies of bone marrow cells with the Q-banding technique showed clonal karyotypic abnormalities in 7 of the 8 patients (87.5%). Five of the 7 chromosomally abnormal patients had very complex karyotypes; all 7 patients, however, had at least 1 of 4 specific changes: -5 (or 5Q-), -7, +8, and +21. Three of the 7 patients with abnormal karyotypes had had some exposure to potential mutagenic/carcinogenic agents. Five of the 7 patients had serial cytogenetic analyses, 4 of which showed evolution of the karyotype to further complexity; in 2 cases, this coincided with the evolution of the disease into acute leukemia. The median survival time of patients whose initial cytogenetic samples showed both normal and abnormal metaphases was more than twice that of patients who had only abnormal metaphases initially (12 mo versus 4.5 mo).
Inhibition of platelet function by organic nitrate vasodilators
Authors: Schafer AI , Alexander RW , Handin RI
Published: October 2019

There is evidence that platelet activation in the coronary circulation may be important in the pathogenesis of myocardial ischemia. Since organic nitrate vasodilators are commonly used in coronary artery disease, we have studied the in vitro effects of these drugs on platelet function. Nitroglycerin, isosorbide dinitrate, and their biotransformation product, inorganic nitrite, inhibited platelet aggregation with collagen, epinephrine, arachidonate, and ionophore, and blocked both primary and secondary aggregation in response to ADP. Nitroglycerin was studied in more detail. Its inhibitory effect was reversible and not dependent on external calcium concentration. It inhibited arachidonic acid oxygenation as measured by the arachidonate- induced oxygen burst and malonaldehyde production. These effects were not due to an increase in intracellular cyclic AMP. This unusual generalized inhibition of platelet function by nitroglycerin possibly contributes to its beneficial effect in myocardial ischemia in part by attenuating platelet reactivity in the coronary circulation.
Continuous human bone marrow culture: Ia antigen characterization of probable pluripotential stem cells
Authors: Moore MA , Broxmeyer HE , Sheridan AP , Meyers PA , Jacobsen N , Winchester RJ
Published: October 2019

The presence of Ia-like antigens on human CFU-C and BFU-e is confirmed and a cell type that lacked immediate capacity for granulocytic colony formation but generated CFU-c after brief incubation in simple suspension culture is identified. This pre-CFU-c, and its immediate progeny, was extremely sensitive to killing by anti-Ia serum with complement. In contrast, anti-Ia serum plus complement treatment of human bone marrow, while eliminating 93%-97% of all CFU-c and BFU-e, did not prevent the rapid regeneration of these progenitor cells and their production for some weeks under the conditions of continuous marrow culture. These studies suggest that the human equivalent of the pluripotential stem cell can replicate for some weeks in culture and generate committed progenitors, such as CFU-c and BFU-e. Furthermore, it would appear that Ia-like antigen is absent on the pluripotential stem cell, is rapidly gained as commitment to the various progenitor cell types occur, and is subsequently lost as these latter undergo differentiation within the marrow.
Localization of factor-VIII-related antigen in human vascular subendothelium
Authors: Rand JH , Sussman II , Gordon RE , Chu SV , Solomon V
Published: October 2019

Factor-VIII-related antigen has previously been shown to be synthesized by vascular endothelial cells. Using both an immunofluorescent staining technique and electron microscopy, we have demonstrated the presence of factor-VIII-related antigen in human vascular subendothelium. This finding may have implications in the mechanism of platelet adhesion to deendothelialized blood vessel surfaces.
The effect of hemodialysis and C5a des arg on neutrophil subpopulations
Authors: Klempner MS , Gallin JI , Balow JE , Van Kammen DP
Published: October 2019

Alterations in neutrophil subpopulations during human hemodialysis or following injection of C5a des arg into rabbits were studied. Whereas baseline peripheral blood neutrophils contained approximately 80% of cells that formed rosettes with IgG-sensitized erythrocytes, neutrophils harvested at the granulocyte nadir (20 min after initiating hemodialysis or the injection of C5a des arg) were markedly depleted of this population. This was seen in a change in ratio of rosette-forming neutrophils (RFN) to non-rosette-forming neutrophils (non-RFN) from 4:1 at 0 time to 1:2 at 20 min. Since non-RFN are less active in assays of adherence and chemotaxis, these alterations in circulating neutrophil populations were reflected in abnormal functional capacity of neutrophils harvested at 20 min. To study the mechanism of RFN depletion, we investigated the ability of C5a des arg to aggregate various human neutrophil suspensions. Unfractionated neutrophils and RFN demonstrated prompt in vitro aggregation in response to C5a des arg, whereas this activated complement fragment induced little aggregation in a population enriched for non-RFN. These results may explain the alterations in neutrophil adherence, chemotaxis, phagocytosis, and bactericidal activity, which have been reported to accompany clinical disorders characterized by in vivo complement activation (i.e., hemodialysis or gram-negative sepsis).
Influence of red cell water content on the morphology of sickling
Authors: Clark MR , Guatelli JC , Mohandas N , Shohet SB
Published: October 2019

The response of sickle cells with varying water content to alterations in oxygen tension has been studied. Cells that were severely dehydrated while sickled retained the characteristic sickled morphology even after prolonged reoxygenation. When the cell water content was increased by reduction of the suspending medium osmolality, the cells unsickled. Cells that were dehydrated before deoxygenation were unable to assume the spiculated morphology typical of sicked cells. This was true both for high mean cell hemoglobin concentration (MCHC) discoid sickle cells and for irreversibly sickled cells. When such cells were resuspended in hypotonic medium before deoxygenation, they sickled with the characteristic morphology of sickle cells with normal MCHC. The morphological behavior of Ca-loaded sickled cells as well as irreversibly sickled cells showed a major influence of increased hemoglobin concentration and extremely high internal viscosity. Constraint on cell morphology by putative membrane rigidity was not observed.
Factor VIII-related protein circulates in normal human plasma as high molecular weight multimers
Authors: Hoyer LW , Shainoff JR
Published: October 2019

The size of human factor VIII-related protein in plasma has been determined by sodium dodecyl sulfate (SDS) glyoxyl agarose electrophoresis. The protein was immobilized after the electrophoresis by coupling it to the modified agarose, and it was identified by autoradiography using purified rabbit anti-factor VIII-related antigen (VIIR:Ag). A series of multimeric forms was identified with Mr of 0.85- 12 x 10(6). The distribution of VIIR:Ag multimers was the same in heparin and citrate anticoagulated plasmas and in serum, and the pattern was the same after freezing as in plasma kept at 37 degrees C from the time of venipuncture until the electrophoresis was complete. These observations indicate that VIIR:Ag circulates in normal plasma as a population of very large multimers and that the size distribution is not an artifact induced by purification methods, freezing, or calcium chelation.
The detection and use of hemoglobin mutants in the direct analysis of human globin genes
Authors: Little PF , Whitelaw E , Annison G , Williamson R , Kooter JM , Flavell RA , Goossens M , Sergeant GR , Montgomery D
Published: October 2019

Many human globin-chain mutants contain amino acid replacements that result from single base changes in the corresponding globin gene. Using recombinants, the coding sequences of each of the alpha-, beta-, Ggamma- , and Agamma-globin genes have now been determined. Those sequences of DNA that are cleaved by a number of specific restriction endonucleases have been identified and accurately positioned. Mutations at these sequences abolish the restriction site, and therefore, the pattern of DNA fragments containing hybridizing globin-gene sequences is altered compared to DNA from normal persons. This allows the identification of one of a pair of cross-hybridizing human globin-gene sequences, as is shown here for the two alpha-globin, the two gamma-globin, and the delta- and beta-globin genes.
Ia antigen is a differentiation marker on human eosinophils
Authors: Koeffler HP , Billing R , Levine AM , Golde DW
Published: October 2019

Evidence suggests that the “la-like” or antigen is a differentiation marker that is expressed on early human hematopoietic precursor cells, but is absent on their mature progeny. The eosinophil precursor cell (CFU-EO) is distinct from the granulocyte-monocyte colon-forming cell (CFU-C). We provide data that indicate that the ia antigen is expressed on the human eosinophil colony-forming cells and is absent on mature eosinophils. All CFU-EO were inhibited in the presence of rabbit la antiserum at a titer of 1:30. Cytotoxicity was complement-dependent. The metamyelocytic eosinophil and more mature eosinophil forms did not express the la antigen.
Regulation of iron absorption and storage iron turnover
Authors: Rosenmund A , Gerber S , Huebers H , Finch C
Published: October 2019

The regulation of iron supply to plasma was studied in male rate. Repeated exchange transfusions were first carried out with plasma from iron-deficient or iron-loaded animals. There was no recognizable effect on the amount of iron entering the plasma as evidenced by plasma iron concentration or iron absorption by recipient animals. In other studies, iron compounds having different tissue distribution were injected. Subsequent iron release was greater from reticuloendothelial cells than from other iron-loaded tissues. When requirements for transferrin iron were increased by exchange transfusion with high reticulocyte blood, within minutes there was a doubling of the rate of tissue iron donation. It was concluded from these studies that (1) iron turnover in the plasma is primarily determined by the number of tissue receptors for iron, particularly those of the erythron, (2) that the amount of iron supplied by each donor tissue is dependent on the output of other donor tissues, and (3) that a humoral mechanism regulating iron exchange is unlikely in view of the speed of response and magnitude of changes in plasma iron turnover. It is proposed that there is some direct mechanism that determines the movement of iron from donor tissues to unsaturated transferrin binding sites.
Hemopathologic consequences of protracted gamma irradiation: alterations in granulocyte reserves and granutocyte mobilization
Authors: Seed TM , Cullen SM , Kaspar LV , Tolle DV , Fritz TE
Published: October 2019

Aplastic anemia and myelogenous leukemia are prominent pathologic effects in beagles exposed to continuous, daily, low-dose gamma irradiation. In the present work, granulocyte reserves and related mobilization functions have been sequentially assessed by the endotoxin stress assay during the preclinical and clinical phases of these hemopoietic disorders. Characteristic patterns of granulocyte reserve mobilization are described that reflect given stages of pathologic progression. For radiation-induced leukemia, a five stage pattern has been proposed. In contrast, a simple pattern of progressive, time- dependent contraction of granulocyte reserves and mobilization capacity was noted in the development of terminal aplastic anemia. Early preclinical phases of radiation-induced leukemia appear to involve an extensive depletion of the granulocyte reserves ((phase I) during the first approximately 200 days of exposure followed by a partial renewal of the reserves and associated mobilization functions approximately 200 and 400 days (phase II). Sustained, subnormal granulocyte mobilizations (phase III) following endotoxin stress typify the responses of dogs during the intermediate phase, whereas late preclinical, preleukemic stages (phase IV) are characterized by a further expansion of the reserves and in the mobilization capacities, particularly of the less mature granulocytes. Such late alterations in the pattern of granulocyte mobilization, together with other noted cellular aberrancies in the peripheral blood and marrow, appear to indicate leukemia (phase V) onset.
A staphylococcal slide test for detection of antineutrophil antibodies
Authors: Harmon DC , Weitzman SA , Stossel TP
Published: October 2019

We describe a simple test for direct or indrect detection of antineutrophil antibodies. Sensitized leukocytes adherent to glass slides and fixed with paraformaldehyde can be stored in buffer for at least 3 wk. Killed Cowan I staphylococci, containing protein A, bind to sensitized but not control cells, and binding is ascertainable by light microscopy. Indirect tests were positive for 39/41 patients suspected of having immune neutropenia and found to have antineutrophil antibodies by an indirect radiochemical opsonic method. Fifty-four control sera from healthy persons, patients with bone marrow failure, or with immune complex diseases without neutropenia, gave negative indirect tests. Direct tests for cell-bound antibody could be done even during severe neutropenia by reacting fixed autologous cells with staphylococci in the absence of added serum. In some patients only the direct test was positive.
The familial occurrence of polycythemia vera: report of a father and son, with consideration of the possible etiologic role of exposure to organic solvents, including tetrachloroethylene
Authors: Ratnoff WD , Gress RE
Published: October 2019

The occurrence of polycythemia vera in a father and son, both of whom had intermittent exposure to organic solvents, including tetrachloroethylene and Stoddard solvent, is reported. Only three other well substantiated familial occurrences of polycythemia vera, none encompassing successive generations, were found among many reported instances.
Mitogen stimulation of chronic lymphocytic leukemic lymphocytes: defective phytohemagglutinin stimulation independent of immunologic cell surface markers
Authors: Davis S , Rambotti P
Published: October 2019

Peripheral blood lymphocytes (PBL) from 107 untreated patients with chronic lymphocytic leukemia (CLL) were analyzed for the presence of surface immunoglobulin (Ig) and the ability to form rosettes with sheep erythrocytes (SRBC). Four groups were identified based on the cell surface markers: (1) 81 patients' PBL expressed primarily IgM kappa or IgM lambda, 4 further patients' PBL expressed IgM with equal percentages of kappa and lambda surface markers; (2) 13 patients had equal percentages of PBL expressing lg and SRBC receptors; (3) 6 patients' PBL primarily formed rosettes with SRBCs, and (4) in 3 patients and the majority of cells had no detectable markers (null cells). Lymphocytes from all patients within each group were tested for their ability to respond to phytohemagglutinin (PHA) and pokeweed mitogen (PWM). The maximum response in PHA-stimulated normal cell cultures appeared at 2--3 days; for PWM-stimulated cultures, maximal response was at 3--5 days. CLL cultures from all patients in each of the four groups required 5--7 days to develop a maximal PHA response. The response of CLL lymphocytes in all groups to PWM stimulation was similar to normal lymphocytes. Thus, the abnormal PHA response of CLL lymphocytes was independent of the presence or pattern of cell surface markers.
The effects of acute thrombocytopenia on megakaryocyte-CFC and granulocyte-macrophage-CFC in mice: studies of bone marrow and spleen
Authors: Levin J , Levin FC , Metcalf D
Published: October 2019

The effects of acute thrombocytopenia, produced by platelet antiserum (PAS), on both megakaryocyte colony-forming cells (Meg-CFC) and granulocyte-macrophage colony-forming cells (GM-CFC) were studied. During the 1-hr to 14-day period following acute thrombocytopenia (platelet counts < 5% of normal), bone marrow and splenic cells of C57BL/6J mice were obtained and cultured for 7 days in 0.3% agar. Numbers of GM and Meg colonies were determined. At no times were alterations in frequency of GM-CFC and Meg-CFC detected in femoral bone marrow. In contrast, GM-CFC in spleen were increased from 3 to 7 days after PAS and from 4 to 7 days after normal serum (NS). Increase in Meg- CFC in the spleen occurred from 3 to 5 days after PAS with a lesser, not significant increase after NS. Alterations in white blood cells and hematocrit values were not detected. Similar responses were observed in germ-free mice and after rechallenge of animals that had received PAS or NS 14 days previously. The delayed increase in Meg-CFC indicates that they are unlikely to be responsible for the altered megakaryopoiesis previously reported in bone marrow after acute thrombocytopenia and was not due to inhibition by PAS. The increase in GM-CFC may reflect stimulation of the reticuloendothelial system by heterologous proteins.
Thrombotic thrombocytopenic purpura: a ten-year experience
Authors: Cuttner J
Published: October 2019

Splenectomy, corticosteroids, and antiplatelet agents have improved survival in thrombotic thrombocytopenic purpura (TTP). In 1974 we reported the successful treatment in 5 of 6 patients using splenectomy, corticosteroids, and average molecular weight dextran. This report describes a 10-yr experience with TTP at Mount Sinai Hospital (MSH). Twenty patients with TTP were seen. Possible inciting factors included pregnancy, oral contraceptives, and surgery. Splenectomy was performed in 18 patients and typical findings of TTP were found in 14 (78%). Fifteen patients were treated with splenectomy, corticosteroids, and average molecular weight dextran. Two of the 15 patients received, in addition, ASA and dipyridamole and a third received only dipyridamole. Thirteen of the 15 (87%) have survived and remain disease-free.
Prediction of response to chemotherapy in acute myelocytic leukemia
Authors: Preisler HD
Published: October 2019

Marrow specimens obtained from 23 patients with acute myelocytic leukemia were exposed to cytosine arabinoside and/or daunorubicin in vitro, and the effects of these agents on colony formation in vitro was determined. Thymidine suicide indices were determined as well, which permitted a distinction to be made between kinetic and metabolic resistance to cytosine arabinoside. The sensitivity of the colony- forming cells to the two chemotherapeutic agents did not correlate with each other, indicating that sensitivity to each was independently determined. The relationship between in vitro sensitivity to daunorubicin and cytosine arabinoside and response to 25 courses of in vivo therapy with these two agents administered to 21 patients was determined. These studies indicated a clear-cut relationship between in vitro drug sensitivity and in vivo response with patients whose leukemic cells were sensitive to both agents entering complete remission, whereas patients whose leukemic cells were insensitive to one or both drugs in vitro failed to enter remission.
Phorbol myristate acetate stimulates macrophage differentiation and replication and alters granulopoiesis and leukemogenesis in long-term bone marrow cultures
Authors: Greenberger JS , Newburger PE , Sakakeeny M
Published: October 2019

The effects of the tumor-promoter phorbol myristate acetate (PMA) on normal hemopoiesis and Friend leukemia virus (FLV) granulocytic leukemogenesis in long-term bone marrow cultures were examined. FLV- anemia-inducing strain (FLV-A) infected, Rauscher R-MuLV clone M52R infected, or uninfected control NIH Swiss mouse marrow cultures were treated weekly with PMA or 4-O-methyl-PMA at 2.0 ng/ml or 200.0 ng/ml. Addition of PMA to control uninfected or R-MuLV-infected cultures decreased production of nonadherent granulocytic cells and granulocyte- macrophage progenitor cells (GM-CFU-c), and increased the numbers of adherent macrophages. Addition of PMA to FLV-A-infected cultures did not inhibit generation of granulocytic leukemia cell lines even though the numbers of adherent adipocytes were decreased and adherent macrophages were increased. PMA treatment of freshly explanted whole bone marrow but not purified nonadherent GM-progenitor cells from long- term bone marrow cultures stimulated GM-CFU-c and cluster formation in the absence of added colony-stimulating factor (CSF). The sensitivity of purified GM-progenitor cells to L929 or WEHI-3 CSF was not altered by PMA; however, PMA treatment of bone marrow macrophages or peritoneal exudate macrophages stimulated detectable GM-CFU-c and cluster formation by purified GM-progenitor cells under conditions where equal numbers of untreated macrophages failed to be stimulatory. Thus, several PMA effects on hempoietic stem cells in vitro are mediated through indirect action on adherent stromal cells including macrophages.
Enhancement of human erythroid progenitor cell growth by media conditioned by a human t-lymphocyte line
Authors: Hamburger AW
Published: October 2019

Recent studies have shown that soluble factors elaborated by human T lymphocytes enhance erythroid burst formation by human peripheral blood null cells. This study demonstrates that media conditioned by a long- term T lymphocyte line augmented the growth of erythroid colonies in vitro in the presence of erythropoietin (Ep). ATCC.CCl 119 (CCRF-CEM) was derived from a patient with ALL of T-lymphoblast origin. Cells from the stocks used in these experiments maintained T-cell characteristics as determined by histochemical and rosetting techniques. Increased numbers of 16 day BFU-E were seen when Ficoll-Hypaque separated peripheral blood leukocytes were cultured in the presence of a 10% (v/v) concentration of CCL 119 conditioned medium (CM). CM increased the number of BFU-E even when Ep or fetal calf serum were not growth limiting. CM also increased the number of late BFU-E observed in cultures of nonadherent bone marrow cells. When peripheral blood mononuclear cells were depleted of E-rosetting cells, only small numbers of BFU-E grew. Addition of 119 CM increased the numbers of BFU- E in E-rosette-depleted cultures. CM from B-cell, macrophage, or other T-cell lines tested did not stimulate BFU-E growth as consistently. These studies indicate that CM obtained from ATCC.CCL 119 cells contained burst-promoting activity, one of the factors required for proliferation of early erythroid progenitors.
Switching of the nonallelic forms of fetal hemoglobin during late gestation
Authors: Vedvick TS , Wheeler SA , Koenig HM
Published: October 2019

The gamma chains of human fetal hemoglobin occur in two nonallelic forms, designated G gamma and A gamma, which differ from one another in having either glycine or alanine as their 136th residue respectively. In newborns, G gamma comprises about 75% of the total gamma chains, while in adults, G gamma comprises about 40% of the total gamma chains. The timing of the switching events that lead to the alteration of the rates of production of G gamma and A gamma are still unknown. Umbilical cord red blood cells from term infants were separated by density gradient fractionation into four age-dependent fractions. Red blood cell size and reticulocyte content decreased and the percent fetal hemoglobin increased with increasing gradient densities, confirming age- dependent density separation. The percent G gamma was determined by two methods on fractionated cord red blood cells to determine if the switch in the production ratio of the nonallelic forms of gamma chains began during late gestation. The G gamma content of fetal hemoglobin was found to decrease with decreasing red blood cell age, demonstrating that the switch from predominately glycine-containing gamma chains to predominately alanine-containing gamma chains begins during late gestation.
Distribution of complement receptors on human normal and malignant mononuclear cells
Authors: Slease RB , Gadek JE , Frank MM , Scher I
Published: October 2019

Mononuclear cells from normal human subjects and patients with chronic lymphocytic leukemia (CLL), chronic lymphosarcoma cell leukemia (LCL), and hairy cell leukemia (HCL) were labeled with fluoresceinated, purified human C3b (FI-C3b) and analyzed using the fluorescence- activated cell sorter (FACS). FI-C3b labeled 17.6% +/- 6.0% of peripheral blood mononuclear cells (PBM) from 20 normal subjects, which, when separated by the FACS, consisted of B lymphocytes and approximately 5% monocytes. Analyses in which either monocytes or B lymphcoytes were excluded from consideration demonstrated that both these cell types were labeled by the FI-C3b with a heterogeneous distribution of fluorescence intensity, indicating either heterogeneity of CR density or variable avidity of individual CR for the FI-C3b. FACS profiles of PBM ( < 5% monocytes) from 14 of 15 patients with CLL showed a homogeneous distribution of very low fluorescence intensity, with > 60% of the cells being slightly more fluorescent than unlabeled controls. This low, homogeneous distribution of fluorescence is strikingly similar to profiles of CLL cells labeled with anti-Ig reagents and suggests homogeneity of low CR density and/or avidity. Similarly, CR+ mononuclear cells from five patients with HCL and three patients with LCL displayed more homogeneous FI-C3b labeling than normal CR+ PBM. Homogeneity of FI-C3b binding to CLL, LCL, and HCL cells further supports the concept for a clonal origin for these disorders.
Characterization of B-cell leukemias: a tentative immunomorphological scheme
Authors: Koziner B , Kempin S , Passe S , Gee T , Good RA , Clarkson BD
Published: October 2019

Analysis of the morphological and immunologic [surface (Sm Ig) and cytoplasmic (Cy Ig) immunoglobulin, faintness (f.imfl) or brightness (b.imfl) of surface immunofluorescence, rosette formation with mouse erythrocytes (MR), or sheep red cells coated with C3 (EAC)] characteristics of the neoplastic lymphocytes involved in 137 cases of B-cell leukemias allowed the differentiation of the following cytologic categories: B1 small lymphocytes (71); SM Ig+, f.imfl., Cy Ig-, MR+, EAC+; B2 prolymphocyte (4): SM Ig+, b.imfl., Cy Ig-, MR+, EAC+. B3 plasmacytoid lymphocyte (2): Sm Ig+, b.imfl., Cy Ig+/-, MR+!-, EAC+/- B4 small cleaved lymphocyte (23): Sm Ig+, b.imfl., Cy Ig-, MR-, EAC+. B5a large cleaved and B5b noncleaved lymphocytes (14): Sm Ig+, b.imfl., Cy Ig-, MR-, EAC-. B6 small noncleaved “Burkitt-like” lymphocyte (5): Sm Ig+, b.imfl., Cy Ig-, MR-, EAC-. B7 plasma cell (2): Sm Ig+, MR-, EAC-. B8 hairy cell (16): Sm Ig+, b.imfl., Cy Ig-, MR-, EAC-, also exhibiting ingestion or attachment of particulate material, not seen in other types. Improved delineation of the heterogeneous group of B-cell leukemias might be of developmental significance in lymphocyte differentiation and improve current prognostic and therapeutic criteria.
A statistical analysis of murine stem cell suicide techniques
Authors: Quesenberry PJ , Stanley K
Published: October 2019

The clinical application of soft agar cloning techniques for granulocyte-macrophage stem cells (CFU-C) has resulted in a number of contradictory reports that may in part be due to an inadequate data base. Growth of murine CFU-C is more reproducible and less variable than that of human CFU-C. We utilized in vivo hydroxyurea suicide of murine marrow CFU-C to address the question of how many experiments are needed to detect a specific difference with a p of less than 0.05. In 66 experiments the mean marrow CFU-C hydroxyurea kill was 23.3%; 6–9 separate experiments were necessary to detaect differences of 25%-30%. In order to be sure that a 25%-30% difference is not present, 15–21 experiments were required. Using a Dec-20 computer, 1000 samples of sample size 3, 4, or 10 were drawn from the 66 experiments; it was found that with 3 experiments and a true value of 23%, the actually observed value was below 10%, 17% of the time, and was over 40% in 10% of the samplings. In a smaller number of experiments similar results were obtained analyzing 3HTdR suicide of pluripotent stem cells and CFU- C. These data could provide a base from which to judge the validity of studies utilizing the CFU-C technique.
Crotalocytin: recognition and purification of a timber rattlesnake platelet aggregating protein
Authors: Schmaier AH , Claypool W , Colman RW
Published: October 2019

After being envenomated by the timber rattlesnake, a patient was found to have a platelet count of 5000 per microliter, prothrombin time and activated partial thromboplastin time both greater than 150 sec, plasma fibrinogen 0 mg/dl, and fibrinogen split products 2560 microgram/ml. However, this patient did not appear to have acute disseminated intravascular coagulation since coagulation factors II-XII were normal. We postulated that this venom contained, in addition to a fibrinogen clotting enzyme, a platelet activating protein, Crotalocytin. Crotalocytin was purified from crude timber rattlesnake venom by Sephadex G-100 gel-filtration, low ionic strength precipitation, and DEAE-A50 Sephadex chromatography. By sodium dodecyl sulfate gel electrophoresis and gel-filtration Crotalocytin was a single chain polypeptide, molecular weight 55,000. Thrombocytopenia after timber rattlesnake bite appeared to be due to a protein that directly activated platelets. Timber rattlesnake bite mimicked the clinical presentation of disseminated intravascular coagulation.
Splenic granulocytopoiesis and production of colony-stimulating activity in lymphoma and leukemia
Authors: Greenberg PL , Steed SM
Published: October 2019

Spleen cell production of granulocyte-macrophage colony stimulating activity (CSA) and colony forming capacity (CFU-GM) from 59 patients with Hodgkin's and non-Hodgkin's lymphoma, acute (AML) and chronic myeloid leukemia (CML), and control subjects was quantified to evaluate local cellular potential for modulating splenic granulocytopoiesis. Mononuclear spleen cell conditioned media stimulated myeloid CFU-GM by human nonadherent marrow target cells. In contrast to conditioned media produced by marrow and peripheral blood cells, the vast majority of spleen CSA was generated by nonadherent lymphoid cells rather than adherent monocytic cells. The nonadherent cells producing CSA were non- T cells (assessed by sheep erythrocyte rosetting), with 98% +/- 2% CSA produced by the nonrosetted fraction (B lymphocytes and null cells), and had a peak density heavier than that of the adherent spleen CSA- producing cells. Dose response curves demonstrated significantly increased cellular CSA production from patients with lymphomas and AML in remission. In a high proportion of patients, foci of immature granulocytic cells were found by specific cytochemical staining of histologic sections of spleens. A limited degree of splenic granulocytopoiesis was demonstrated morphologically and by CFU-GM incidence. CSA was not detectable in conditioned medium prepared from nonadherent spleen cells from 5 patients with CML, due to a nondialyzable substances(s) produced by the nonadherent cells which inhibited normal CFU-GM response to CSA. The high CFU-GM incidence and extensive leukemic granulocytopoiesis present in the CML spleens suggests diminished effect of this inhibitor on leukemic as opposed to normal granulocytic precursor cell proliferation.
Isotypic discordance of paraproteins and lymphocyte surface immunoglobulins in myeloma
Authors: Nicholls M , Vincent PC , Repka E , Saunders J , Gunz FW
Published: October 2019

B lymphocyte surface immunoglobulins (Smlg) were studied in 24 patients with multiple myeloma by means of anti-isotypic antisera, and their heavy and light chain isotypes were compared in each patient with those of the paraprotein. In 21 patients, lymphocyte Smlg consisted of only one light chain type, and in 16 of only 1 heavy chain type. However, the Smlg and paraprotein heavy and light chain types were identical in only 5 patients while in 6 they differed in heavy and light chain types, in 7 in light chain type, and in 4 in heavy chain type. In 2 patients with light chain myeloma, Smlg light chains were isotypically the same as the paraprotein. Isotypic discordance between paraprotein and Smlg may signify the proliferation of a second malignant clone with failure to differentiate into secreting plasma cells. Alternatively, it is conceivable that the lymphocyte Smlg could have the same idiotypic specificity as the paraprotein despite the isotypic differences, but this will require further studies using anti-idiotypic antisera.