Factor-VIII enriched cryoprecipitate was prepared by exercising donors on a bicycle ergometer. The mean increase in the activity of factor VIII was about 40%. The effect in vivo of post-exercise cryoprccipitate was studied in patients with haemophilia A. The increment of factor VIII was only perceptible during the first hours after transfusion. This was due to a more rapid disappearance of factor VIII from the circulation, as was apparent by a shortened half-survival time of the first phase of the biphasic disappearance curve.
In a prospective study, immune status was measured in 23 previously untreated patients with Hodgkin's disease Stage I-IIIA. Assessments of immunologic capacity were performed at diagnosis and repeated after staging laparotomy and after radiotherapy. The immune status was measured using delayed-type hypersensitivity tests to common recall antigens, the number of T-and B-lymphocytes in the peripheral blood, in vitro lymphocyte responsiveness to mitogens, antigens, and allogeneic lymphocytes, and serum levels of immunoglobulins. Skin reactivity was not significantly affected by either the staging laparotomy with splenectomy or the radiotherapy. Absolute T-lymphocyte count increased after splenectomy (P < 0.025) and decreased after radiotherapy (P < 0.005 compared to postsplenectomy values). In vitro lymphocyte responsiveness after splenectomy was comparable to the initial presenting level and diminished after radiotherapy (P < 0.005). Serum levels of IgM were lowered after radiotherapy (P < 0.05) while the fall was not significant after splenectomy. Three months after radiotherapy, lowest mean T-cells percentages were noted, but the responses to mitogens were significantly higher than those obtained immediately after treatment (P < 0.01). While the reduction in the proportion of the T-lymphocytes persisted for 18 months, the mean lymphocyte responsiveness to mitogens, antigens, and allogeneic lymphocytes increased on follow-up. Apart from a severe impairment of the immune status following radiotherapy, this study also shows the existence of significant repair mechanisms during the follow-up period.Cancer 53:62-69. 1984.NTREATED Hodgkin's disease is commonly accom-
Absrracr. 35 patients with Hodgkin's disease, 13 patients with other lymphomas and 26 control subjects have been typed for 8 HL-A antigens.The frequency of HL-A8 and HL-A7 was higher among the patients with Hodgkin's disease and other lymphomas than among control subjects. In contrast to findings reported by others we did not find any difference in HL-A5 frequency between patients with Hodgkin's disease and control subjects.
Immune status was measured in 47 previously untreated patients with Hodgkin's disease. For all patients, a 5-year follow-up was established. Immunologic capacity was measured by delayed-type hypersensitivity tests to common recall-antigens; enumeration of T- and B-lymphocytes in the peripheral blood; in vitro lymphocyte responsiveness to mitogens, antigens, and allogeneic lymphocytes; and serum levels of immunoglobulins. Compared with healthy controls, skin reactivity was decreased in the patients (P less than 0.05), but was not a prognostic marker with regard to survival. Total lymphocyte counts and the numbers of T- and B-cells did not differ between surviving and deceased patients. Decreased in vitro lymphocyte responsiveness to phytohemagglutinin and impaired responding capacity of patients lymphocytes in the mixed lymphocyte culture (MLC), used as markers, were a poor prognostic sign (P less than 0.001). The relevant clinical parameters with regard to 5-year survival were age, stage, and B symptomatology (P less than 0.005). The prognostic information supplied by age plus responding capacity in the MLC exceeded the predictive value of any combination of clinical parameters. Lymphocyte stimulation to pokeweed mitogen and antigens, stimulatory capacity of patients' lymphocytes in mixed lymphocyte cultures, the spontaneous DNA-synthesis, and immunoglobulin levels, did not provide prognostic information. The use of mixed lymphocyte cultures in staging patients with Hodgkin's disease may refine the prognostic information supplied by age, stage, and symptomatology.
Alpha-1-antitrypsin levels in controls, autistic children, and children with untreated and with treated cceliac disease. protecting tissues against enzymatic attack, and its serum level does rise as part of an inflammatory response.4 It is possible that a low level of alpha-1-antitryp sin may predispose to the small-intestinal damage which occurs in cceliac disease. It is more difficult to speculate concerning the significance of a reduction in serum alpha-1-antitrypsin in 8 autistic children, none of whom had evidence of coeliac disease. Studies of the level of serum alpha-1-antitrypsin in larger groups of children and their families with these disorders will be of interest.
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