William S. Adams

Purine and pyrimidine excretion in normal and leukemic subjects

Abstract The excretion of various purine and pyrimidine compounds in the urine of one normal and four leukemic subjects is reported. Additional data obtained from ten normal subjects and forty patients with leukemia have not been reported since much of the information accumulated is duplicated. The methods which have been utilized are described in some detail. Possibly such methods may be applicable to other biologic systems, such as blood serum and cell extracts.

Paper chromatography data for purines, pyrimidines and derivatives in a variety of solvents

Abstract Paper chromatographic data for 215 purines,pyrimidines and derivatives in nine solvent systems have been reported. The data ae useful as an aid in identification of compounds, and for selection of solvents to perform various separations.

A method of human plasmapheresis.

Summary A simple method for human plasmapheresis is described. In a single patient with multiple myeloma it has been shown that the removal of 30 g of plasma protein daily can be continued without ill effect and without substantial decrease in the concentration of plasma protein for at least five weeks. Nitrogen equilibrium was maintained when the diet contained 85 g of protein per day and 2500 calories.

Urinary purines and pyrimidines in normal and leukemic subjects

Abstract Methods of separation, identification, and quantitation of urinary pyrimidines and purines have been described. The presence in human urine of cytidine, 2′-O-methylcytidine, 3-methylcytosine, adenosine, 1-methyladenine, N 6 -methyladenine, 1-methyladenosine, N 6 -methyladenosine, 1-methylguanosine, 1-methylinosine and 5-aminoimidazole-4-carboxamide ribonucleoside are reported for the first time. The possible significance of the methylated compounds is discussed with particular emphasis on the 1-methyl and N 6 -methyl derivatives of adenosine.

Serum ribonuclease in multiple myeloma

Abstract Evidence is presented to show that most patients with multiple myeloma have an increased level of serum RNase, assayed with the synthetic polymer, polycytidylate. In addition, the results suggest that the enzyme level may be a useful indicator of response to chemotherapy with the alkylating agents cyclophosphamide and melphalan in multiple myeloma. Preliminary results of enzyme levels in the urine suggest that high serum levels are due to excessive entry of RNase into the serum rather than to a decreased capacity for urinary excretion of the enzyme.

The Dermal Loss of Iron.

Summary “Cell poor” and “cell rich” sweat samples from 25 normal subjects have been analyzed (total of 118 determinations). The iron content of “cell poor” sweat was negligible. On the other hand “cell rich” sweat contained a high concentration of iron. This iron loss is not an essential function of the process of sweating, but is associated primarily with desquamation.

The management of multiple myeloma.

Abstract The management of multiple myeloma has been discussed. Conservative measures which may be helpful in the care of the patient with this disease have been outlined. So-called specific drug therapy in this disease leaves a great deal to be desired and still provides wide opportunity for continued search for more effective agents.

Metabolic balance study of a patient with multiple myeloma treated with dexamethasone: Dexamethasone-induced fatal necrotizing polyarteritis of coronary vessels and kidneys

Abstract A middle aged woman with multiple myeloma was observed for approximately eight months. During this time metabolic balance studies totaling seventy days were undertaken to evaluate the effects of an increase in dietary nitrogen, phosphorus and calcium and later to document the clinical aspects and the exchanges of nitrogen, phosphorus, calcium, sodium, chloride and potassium before and during corticosteroid (dexamethasone) therapy. After the administration of moderate doses of dexamethasone for ten days, severe renal and later cardiac failure developed, rapidly leading to the death of the patient. Postmortem findings were compatible with multiple myeloma, but in addition demonstrated an acute necrotizing polyarteritis of coronary vessels and kidneys. The results of the metabolic balance data and the relationship of the fatal necrotizing polyarteritis to corticosteroid therapy are discussed.

Clinical and metabolic investigations of eight cases of multiple myeloma during prolonged cyclophosphamide administration

Abstract Eight unselected patients with multiple myeloma were studied at varying intervals utilizing metabolic balance technics to determine the effects of long-term continuous oral cyclophosphamide therapy on the metabolic exchanges of calcium, phosphorus and nitrogen, and upon other measurable clinical and laboratory features of their disease. The mean duration of cyclophosphamide therapy was sixteen months. Two patients showed striking subjective and objective evidences of improvement, including reversal of markedly negative calcium balances. Two patients showed no significant progression of their disease after cyclophosphamide therapy was initiated. In both there was improvement in one or more of the parameters of response measured. In two patients who did not remain on prolonged continuous cyclophosphamide therapy, negative calcium balances became less negative during the treatment period. Two patients demonstrated no beneficial effects of cyclophosphamide therapy. It is concluded that prolonged continuous cyclophosphamide therapy can provide significantly beneficial results in some patients with multiple myeloma.