Lars Engstedt

Polymorphonuclear (PMN) function after small intestinal shunt operation for morbid obesity.

The possible influence on blood polymorphonuclear (PMN) granulocyte functions of the small intestinal shunt operation for obesity was studied in 10 massively overweight patients. They were investigated prior to operation and for 9 months afterwards, when they had lost on average 32 kg body weight. Preoperatively they showed reduced PMN bactericidal capacity and increased PMN adherence compared with controls of normal weight. During the first 2–4 months postoperatively all patients displayed a gradually increasing bactericidal capacity, which then reached levels similar to the controls and remained so for the rest of the follow‐up period. This enhancement was more easily assessed by a new in vitro assay in which each PMN was provided with 30–40 bacteria, than by a standard assay using 2–4 bacteria per granulocyte. PMN adherence decreased during the first postoperative months and then returned to preoperative levels. The changes in PMN functions were not statistically related either to each other or to the continuous loss of body weight. Thus, impairment of PMN killing function occurring in extremely obese patients became normalized after small bowel shunt operation, while the high adherence remained unchanged.

Comparison of daunorubicin and daunorubicin-DNA complex in the treatment of acute nonlymphoblastic leukemia

SummarySixty consecutive patients, 15–60 years old, with ANLL were divided randomly into three groups for induction treatment with one of the following regimens: R1, daunorubicin (DNR) 1.5 mg/kg on day 1+ARA-C 2 mg/kg body weight on days 1–5; R2, DNR 1.5 mg/kg on days 1 and 2+ARA-C 2 mg/kg on days 4–8; R3, DNR-DNA complex 1.5 mg/kg on days 1 and 2+ARA-C 2 mg/kg on days 4–8. Maintenance treatment consisted of monthly courses of DNA 1.5 mg/kg (R1, R2) or DNR-DNA 1.5 mg/kg (R3) combined with ARA-C 1 mg/kg on days 1–5, alternating with thioguanine 2 mg/kg PO on days 1–5 combined with ARA-C 1 mg/kg IV on days 1–5. Fourteen patients of 20 went into complete remission with R1, 13 of 18 with R2, and 15 of 22 with R3. The overall remission frequency was 70% and there was no significant difference between the different groups. The median time in first remission and the median survival time were 300 and 510 days, respectively, with R1; 335 and 495 days with R2; and 295 and 677 days with R3. There was no statistically significant difference between the groups treated according to the different regimens concerning the time in first remission. Survival was slightly better with R3 than with R1. Treatment with the DNR-DNA complex caused less pronounced thrombocytopenia and fewer ‘minor’ cardiac abnormalities than treatment with free DNR in the same dosage schedule.

Treatment of acute nonlymphoblastic leukemia in adults with daunorubicin-DNA complex: A preliminary report

SummaryForty-four adult patients under 60 years of age with acute nonlymphoblastic leukemia were randomized for induction treatment with one of the following three regimens: R 1 = courses of daunorubicin on day 1+ARA-C on days 1–5; R 2 = courses of daunorubicin on days 1 and 2+ARA-C on days 4–8; R 3 = courses of daunorubicin-DNA complex on days 1–2+ ARA-C on days 4–8.Out of 14 patients, 9 went into remission on R 1, 6 out of 14 on R 2, and 8 out of 16 on R 3. The preliminary results suggest that daunorubicin-DNA complex has the same efficacy for inducing remission as daunorubicin alone, if the same time intervals and dosages are used.

Oxymetholone Treatment in Hypoproliferative Anaemia1

45 patients with hypoproliferative or aregenerative anaemia were treated with oxymetholone, steroid an anabolic, androgenic steroid. Minimum treatment time accepted for entrance into the study was 3 months. Therapeutic effect was assessed by effect on bone marrow cellularity, haemoglobin concentration and granulocyte and platelet counts. Patients with a hypocellular marrow responded best. Of 18 cases, a partial remission was seen in 8 and a complete remission in 5. A complete remission was only seen in patients who did not have pancytopenia. Of the 7 patients with myelofibrosis, 4 had thrombocytopenia at the outset. Improvement after treatment was seen in all 4. The only serious side-effect that necessitated withdrawal of treatment was jaundice.

Prednimustine and vincristine compared with cytosine arabinoside and thioguanine for treatment of elderly patients with acute nonlymphoblastic leukemia

SummarySixty-seven patients with acute nonlymphoblastic leukemia (ANLL) and above the age of 60 years were randomly allocated to treatment with either prednimustine+vincristine or cycles with cytosine arabinoside and thioguanine. Of the 67 patients, 13 (19%) entered a complete remission and four a partial remission. Of 33 patients randomized to prednimustine and vincristine (15 adequately treated), three entered a complete remission and one a partial remission. Four further patients went into complete remission after a switch to other treatment modalities. Of 34 patients randomized to cycles of ARA-C and thioguanine (22 adequately treated), four entered a complete remission and three a partial remission with the correct program. One patient entered a remission with intermittent cytosine arabinoside+thioguanine (wrong program) and one further patient entered a complete remission after a switch to prednimustine and vincristine. Prednimustine+vincristine did not appear to be superior to treatment with cytosine arabinoside thioguanine cycles for elderly patients with ANLL.