3 results on '"H. J. H. Williams"'
Search Results
2. Interferon is effective in hairy-cell leukaemia
- Author
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Miles V. Joyner, P. C. Bevan, C. P. Worman, J. C. Cawley, J. M. Bottomley, P. J. Green, H. J. H. Williams, Daniel Catovsky, E. C. Gordon-Smith, and L. Camba
- Subjects
Adult ,Male ,T-Lymphocytes ,medicine.medical_treatment ,Splenectomy ,Spleen ,Interferon ,medicine ,Humans ,Platelet ,Somnolence Syndrome ,Aged ,Leukemia, Hairy Cell ,business.industry ,Hairy cell leukaemia ,Hematology ,Middle Aged ,medicine.disease ,Combined Modality Therapy ,medicine.anatomical_structure ,Interferon Type I ,Immunology ,Hairy Cell ,Female ,business ,Infiltration (medical) ,medicine.drug - Abstract
Seventeen patients with hairy-cell leukaemia (HCL) and peripheral cytopenias were given human lymphoblastoid interferon (Wellferon), 3 megaunits daily or 6 megaunits on alternate days intramuscularly, for 4-24 weeks. Twelve of the patients had undergone splenectomy, three had no palpable spleen and had therefore not been offered surgery, and two patients with substantial splenomegaly were given interferon (IFN) as treatment of first choice. Toxic effects were minor except in one patient who experienced a severe form of somnolence syndrome. In all patients hairy cells (HCs) were cleared from the blood and platelet and Hb levels improved in 2-14 weeks. Neutrophils were improved in 14/17 of the patients. In the two patients with splenomegaly, the spleen became impalpable after 5-8 weeks therapy, and haematological improvement occurred at 12-14 weeks. HC infiltration of the marrow was reduced in all patients, but was complete (less than 5%) in only two, both of whom had impalpable spleens. Immunological surface-marker studies confirmed that light-chain-restricted B cells disappeared from the blood in parallel with the clearance of morphological HCs. There was no evidence of HC maturation and no increase in phenotypic NK cells. T cells were moderately reduced and the relatively greater reduction of Leu 2a+ suppressor cells resulted in increased Leu 3a+/2a+ helper/suppressor ratios in 11/17 of the patients. Early experience in the six patients who have stopped IFN suggests that, after an initial further increase in Hb and neutrophil levels, HCs gradually return with slow deterioration of haematological parameters. Interferon is now the treatment of choice for patients becoming cytopenic post-splenectomy or for patients without splenomegaly. IFN is effective first-line therapy in patients with splenomegaly, but further work is needed to establish whether the agent should replace splenectomy in such patients. Some form of maintenance or re-treatment therapy will probably be necessary.
- Published
- 1985
3. Membrane phenotype and response to deoxycoformycin in mature T cell malignancies
- Author
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Daniel Catovsky, H. J. H. Williams, N. Traub, M. Brozovic, M. Mills, C. E. Dearden, David C. Linch, E. Matutes, A. V. Hoffbrand, and K. Ganeshaguru
- Subjects
Adult ,Male ,Vincristine ,Lymphoma ,T cell ,T-Lymphocytes ,Antineoplastic Agents ,hemic and lymphatic diseases ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Pentostatin ,T-cell lymphoma ,Humans ,Sezary Syndrome ,Cyclophosphamide ,General Environmental Science ,Aged ,Aged, 80 and over ,Deltaretrovirus Infections ,Leukemia ,business.industry ,Coformycin ,Cell Membrane ,General Engineering ,Combination chemotherapy ,General Medicine ,Middle Aged ,medicine.disease ,Prognosis ,Leukemia, Lymphoid ,medicine.anatomical_structure ,Phenotype ,Doxorubicin ,Immunology ,Deoxycoformycin ,General Earth and Planetary Sciences ,Neoplastic cell ,Prednisone ,Female ,Ribonucleosides ,business ,medicine.drug ,Follow-Up Studies ,Research Article - Abstract
The adenosine deaminase inhibitor deoxycoformycin was used in low doses to treat 19 patients with clinically aggressive T cell malignancy with a mature membrane phenotype. The patients comprised eight with prolymphocytic leukaemia, two with chronic lymphocytic leukaemia, four with adult T cell leukaemia-lymphoma, three with Sezary syndrome, and two with T cell lymphoma. Two thirds of the patients had been resistant or minimally responsive to combination chemotherapy. Complete remission was obtained in five patients (two with prolymphocytic leukaemia and one each with chronic lymphocytic leukaemia, adult T cell leukaemia-lymphoma, and Sezary syndrome) and partial remission in two others. Unmaintained complete remission lasting more than one year was seen in three patients. Responses were obtained only in patients with CD4+,CD8-membrane markers (seven out of 10), and no responses were recorded in any of the nine patients with a different phenotype. In this series remission appeared to correlate with the membrane phenotype of the neoplastic cell and not with the cytopathological diagnosis. Future studies should establish the biochemical basis for the greater sensitivity of CD4+ lymphoid cells to deoxycoformycin.
- Published
- 1987
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