Arthur Sawitsky

Chromosomal Breakage and Acute Leukemia in Congenital Telangiectatic Erythema and Stunted Growth

Excerpt Investigation of unusual and unexplainable aspects of leukemia may lead toward further understanding of malignant neoplasia. This is a report of three individuals with a rare and only recen...

A comparative study of a bcnu containing 4-drug program versus mopp versus 3-drug combinations in advanced Hodgkin's disease. A cooperative study by the cancer and leukemia group B

A prospective randomized trial by CALGB examined the relative value of four chemotherapy regimens in 537 patients with stage III B and IV Hodgkins disease. A new combination BOPP, derived by substitution of BCNU for nitrogen mustard in the MOPP regimen, was compared to MOPP and to two 3‐drug regimens, derived by removing the procarbazine in BOPP (BOP) or removing the alkylating agent (OPP). The 4‐drug programs gave significantly higher frequency of complete remissions (BOPP 67%, MOPP 63%) than the 3‐drug regimens (BOP 40%, OPP 42%), and significantly longer duration of remission and survival. BOPP had a therapeutic activity equal to MOPP, and was accompanied by less toxicity. After 6 cycles of induction chemotherapy, responding patients, both CR and PR, were continued on maintenance chemotherapy for 3 years. No significant difference in relapse rate was demonstrated following maintenance treatment with either vinblastine, chlorambucil, or chlorambucil plus monthly vincristine + prednisone doses. Nor could a reinforcement phase late in the maintenance program be shown to influence the relapse rate. The median survival for all patients entered on the 4‐drug programs was 5 years, while the median has not yet been reached at 6 years for those patients, who obtained CR.

Hepatocellular carcinoma in a long-term survivor of acute lymphocytic leukemia

Hepatocellular carcinoma (HCC) occurred in a 28‐year‐old woman treated for acute lymphocytic leukemia (ALL) with methotrexate (MTX) and 6‐mercaptopurine (6‐MP), off all therapy for 15 years, who was also heterozygous for alpha‐1 antitrypsin (α‐1 AT) deficiency. MTX is responsible for the development of HCC in this patient. The literature concerning the incidence of HCC in patients treated with MTX and 6‐MP and in α‐1 antitrypsin deficiencies is reviewed.

The effect of pH on the distribution ofbilirubin in peripheral blood, cerebrospinal fluid, and fat tissues

Bilirubin was found in sigificant concentration in the spinalfluid and tissue fat of young rabbits previously rendered acidotic by the administration of sulfisoxazole, acetazolamide, or ammonium chloride, and then given indirect-reacting sodium bilirubiate intravenously. The production of respiratory acidosis followed by the administration of bilirubin did not result in the accumulation of significant amounts of bilirubin in the spinal fluid, although tissue fat became very icteric. Hyperchloremic metabolic acidosis did not increase or alter the concentration of cerebrospinal fluid protein. Metabolic and respiratory alkalosis followed by administration of bilirubin did not result in accumulation of pigment in spinal fluid or tissue fat. These studies suggest that the acidotic state, by depressing the dissociation of bilirubin, favors the transport of the lipid soluble undissociated molecule across membranes and into the cerebrospinal fluid and fat tissue. The converse is observed in the alkalotic animal.

Mediastinal irradiation for chronic lymphocytic leukemia

Thirty-one patients with chronic lymphocytic leukemia were treated with mediastinal radiation. In none of the patients was complete remission achieved; either partial remission or clinical improvement was achieved in 52 per cent, but the duration of response was short. The response rate was 77 per cent for the patients receiving a total radiation dose greater than 3,000 rads and 45 per cent for those receiving less than 3,000 rads. Severe life-threatening toxicity was noted in 11 patients and seven of these patients died; two patients died with progressive disease. Severe toxicity was manifested by one or more of the following: bone marrow aplasia, pancytopenia, gram-negative sepsis, generalized herpes zoster and severe esophagitis. Neither the total dose of radiation nor the dose per week correlated withe the severity of reaction or death.

The demonstration of antibody in acute hemolytic anemia complicating infectious mononucleosis

Abstract A case of acute hemolytic anemia and infectious mononucleosis in a seventeen year old negress is presented. By the use of the Coombs reagent autosensitization of the patients red cells was demonstrable during the hemolytic phase of the disease.

Gaucher's Disease and Coagulation Factors

Excerpt To the editor: The concurrence of two unusual disorders in one patient has led us to investigate the relationship between them. Patient H.G. is a 52-year-old man with Gauchers disease; the...

Drug Fever Produced by Six-mercaptopurine

Excerpt The adenine analog 6-mercaptopurine is an inhibitor of growth in various microbiological systems (1), of mouse sarcoma 180 (2), and of cell growth in several types of acute leukemia in mice...

Biochemical and Morphological Observations on Lymphocytes in Continuous Cell Culture from a Patient with Chronic Lymphocytic Leukemia

A continuous cell culture was established from unstimulated peripheral blood lymphocytes of a patient with chronic lymphocytic leukemia. The cells grew singly and in free-floating aggregates, and the

CLINICAL EVALUATION OF 6‐MERCAPTOPURINE

The adenine analog, 6-mercaptopurine (6-MP), has been shown to be an inhibitor of growth in various microbiological systems,l an in sivo inhibitor of growth of mouse sarcoma 180: and an inhibitor of leukemic cell growth of several types of acute lymphocytic leukemia of mice.3 Burchenal and his colleagues4 reported on clinical studies of the antagonist and found it to be ineffective in chronic lymphatic leukemia, but to provide temporary remission, either partial or complete, in a relatively high percentage of patients having acute leukemia and chronic myeloid leukemia.