A patient with Burkitt's lymphoma in complete remission received myeloablative consolidation treatment with superfractionated total body irradation (1,320 rad) and cyclophosphamide (200 mg/kg) followed by autologous transplantation of previously harvested and cryopreserved blood-derived hemopoietic stem cells. Seven successive leukaphereses were performed to yield a total of 55.2 X 10(9) mononuclear cells (MNC) comprising 15.1 X 10(6) CFU-GM or 4.34 X 10(6) CFU-GEMM. Following autologous blood stem cell transplantation (ABSCT), reconstitution of all cell lines occurred very rapidly, ie, 1,000 leucocytes per microL were reached after nine days, 500 granulocytes and 50,000 platelets per microL after ten days. B cells reached normal values around day 35 post- transplantation. CFU-GM first appeared in the circulating blood exhibiting an enormous overshoot. Some days later CFU-GM also appeared in the marrow. The kinetics and pattern of hemopoietic reconstitution after myeloablative treatment and ABSCT provide clear evidence that blood-derived hemopoietic stem cells are capable of completely restoring hemopoietic function in man. A possible reconstitutive advantage of blood over marrow-derived stem cells is discussed.
Former East German uranium miners who are known to have been exposed to radon are estimated to be at high risk for lung carcinogenesis. Among these miners over 200 occupationally caused lung cancer cases are expected to occur each year, resulting in a total of 7,000-24,000 excess lung cancer cases in the coming years. It is still unknown whether there is a correlation between biomarkers and the exposure of the uranium miners to ionizing radiation that might enable us to trace those miners with high lung cancer risk. The primary aim of this pilot study was to test the possibility of performing a biomarker study in this unique cohort of former uranium miners in spite of several limitations that had to be taken into consideration when comparing them with healthy controls, such as old age, age-dependent diseases and potential confounding artefacts from dissimilar smoking patterns. The second aim was to test a range of biomarkers for DNA damage and inflammation in leukocytes and bronchoalveolar fluid for their ability to detect biological effects. In this cohort of miners we found an increased frequency of chromosomal aberrations in blood lymphocytes and an increased prevalence of both fibronectin and tumour necrosis factor alpha in the bronchoalveolar fluid.
The aim of this study was to determine chronic respiratory disease morbidity in construction workers, and to assess the prognostic value of various morbidity measures on permanent disability and on all-cause mortality.Subjects in this analysis were male employees in the German construction industry, aged 40-64 yrs, who were examined by the occupational health service between August 1986 and December 1988. Prevalence of respiratory disorders as characterized by: 1) pathological findings on lung auscultation; 2) reduced forced expiratory volume in one second (FEV1); and 3) a medical diagnosis of chronic respiratory disease (International Classification of Diseases 9th revision (ICD-9) 490-496) was assessed among occupational groups of construction workers, and compared with prevalence among white-collar employees. Active follow-up was conducted between October 1992 and July 1994 to ascertain working and life status (completeness: 92 and 96%, respectively). The prognostic value of the morbidity measures on permanent disability and on allcause mortality was assessed using the Cox proportional hazards model.In the entire cohort, crude prevalence was 7.6% for pathological findings on lung auscultation, 8.8% for a reduced FEV1 (<70% of predicted value), and 6.1% for a recorded diagnosis of chronic respiratory disease. There was strong variation of prevalence with age, smoking status and, less clearly, occupation. The relative risk for permanent disability varied between 1.9 and 3.2, and for mortality between 2.0 and 2.9, respectively, when men with the various measures of bronchopulmonary disorders were compared with other men.The morbidity measures utilized allow the identification of employees at higher risk of disability and death, and this may facilitate targeting of specific prevention and rehabilitation measures.
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